bluuebunny/crossref_metadata_2025 huggingface dataset:
Saikosaponin a Enhances Transient Inactivating Potassium Current in Rat Hippocampal CA1 Neurons
Authors: Xie Wei , Yu Yun Hong , Du Yong Ping , Zhao Yun Yan , Li Chang Zheng , Yu Lin , Duan Jian Hong , Xing Jun Ling
Published: February 2013

Saikosaponin a (SSa), a main constituent of the Chinese herbBupleurum chinenseDC., has been demonstrated to have antiepileptic activity. Recent studies have shown that SSa could inhibit NMDA receptor current and persistent sodium current. However, the effects of SSa on potassium (K+) currents remain unclear. In this study, we tested the effect of SSa on 4AP-induced epileptiform discharges and K+currents in CA1 neurons of rat hippocampal slices. We found that SSa significantly inhibited epileptiform discharges frequency and duration in hippocampal CA1 neurons in the 4AP seizure model in a dose-dependent manner with anIC50of 0.7 μM. SSa effectively increased the amplitude ofITotalandIA, significantly negative-shifted the activation curve, and positive-shifted steady-state curve ofIA. However, SSa induced no significant changes in the amplitude and activation curve ofIK. In addition, SSa significantly increased the amplitude of 4AP-sensitive K+current, while there was no significant change in the amplitude of TEA-sensitive K+current. Together, our data indicate that SSa inhibits epileptiform discharges induced by 4AP in a dose-dependent manner and that SSa exerts selectively enhancing effects onIA. These increases inIAmay contribute to the anticonvulsant mechanisms of SSa.
Nonunion with Breakage of Gamma Nail and Subsequent Fracture in the Ipsilateral Femur
Authors: Niikura Takahiro , Lee Sang Yang , Sakai Yoshitada , Nishida Kotaro , Kuroda Ryosuke , Kurosaka Masahiro
Published: February 2013

We describe a rare case with breakage of gamma nail accompanied by nonunion of the original fracture and a subsequent new fracture in the ipsilateral femur. A 73-year-old woman suffered a subtrochanteric fracture of the femur, and the fracture was fixed with gamma nail at a previous hospital. However, fracture reduction was not adequately achieved and a large gap remained between the fracture fragments. The fracture demonstrated atrophic nonunion 10 months after surgery, and autologous bone grafting was performed at the same hospital. Two months after the second surgery, a breakage of the nail at the distal screw hole was observed. Twenty-six months after the second surgery, the patient fell and a fracture occurred at the level of the nail breakage. The atrophic nonunion site and fresh fracture site were very close thus demonstrating a segmental fracture. We exchanged the original gamma nail with a long gamma nail and performed autologous bone grafting at the nonunion site. Both the fresh fracture site and the nonunion site obtained bony union. This tragic chain of events was caused by inappropriate initial treatment and replacing the nail to a longer nail and autologous bone grafting were effective as salvage surgery.
Is Yangxue Qingnao Granule Combined with Antihypertensive Drugs, a New Integrative Medicine Therapy, More Effective Than Antihypertensive Therapy Alone in Treating Essential Hypertension?
Authors: Wang Jie , Yang Xiaochen , Feng Bo , Qian Weidong , Fang Zhuyuan , Liu Wei , Li Haixia , Li Xiaoke , Chu Fuyong , Xiong Xingjiang
Published: February 2013

Background. Yangxue Qingnao granule (YQG) combined with antihypertensive drugs, a new integrative medicine therapy, has been widely used for essential hypertension (EH) in China. This study aims to assess the current clinical evidence of YQG combined with antihypertensive drugs for EH.Methods. Randomized controlled trials(RCTs) published between 1996 and 2012 on YQG combined with antihypertensive drugs versus antihypertensive drugs in treating EH were retrieved from six major electronic databases, including The Cochrane Library, PubMed, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, Chinese Biomedical Literature Database, and Wanfang Data. Meta-analysis was performed on the overall effects on blood pressure.Results. Twelve randomized trials were included. Methodological quality of the trials was evaluated as generally low. Meta-analysis showed that YQG combined with antihypertensive drugs demonstrated potential effect for lowing either SBP (MD: −7.31 [−11.75, −2.87];P=0.001) or DBP (MD: −5.21 [−8.19, −2.24];P=0.0006) compared to antihypertensive drugs alone.Conclusions. It indicated that YQG combined with antihypertensive drugs is more effective than antihypertensive drugs alone in treating EH. However, more RCTs of larger scale, multicentre/country, longer follow-up periods, and higher quality are required to verify the efficacy of integrative medicine therapy over all antihypertensive therapies.
Latent Fingerprint Enhancement Using Tripolyphosphate-Chitosan Microparticles
Authors: Il Dueik Issa M. A. , Morris Gordon A.
Published: February 2013

Chitosan has been widely used in the preparation of microparticles for drug delivery; however, it has not been considered in forensic applications. Tripolyphosphate- (TPP-) chitosan microparticles were formed using ionotropic gelation in the presence of a coloured dye and deposited onto latent fingerprints enabling fingerprint identification.
A Simple Generation Technique of Complex Geotechnical Computational Model
Authors: Lin Hang , Liu Taoying , Li Jiangteng , Cao Ping
Published: February 2013

Given that FLAC3D (a geotechnical calculation software) is difficult to use for building large, complex, and three-dimensional mining models, the current study proposes a fast and a convenient modeling technique that combines the unique advantages of FLAC3D in numerical calculation and those of SURPAC (a mine design software) in three-dimensional modeling, and the interface program was compiled. First, the relationship between the FLAC3D and the SURPAC unit data was examined, and the transformation technique between the data was given. Then, the interface program that transforms the mine design model to calculate the model was compiled using FORTRAN, and the specific steps of the program implementation were described using a large iron and copper mine modeling example. The results show that the proposed transformation technique and its corresponding interface program transformed the SURPAC model into the FLAC3D model, which expedited FLAC3D modeling, verified the validity and feasibility of the transformation technique, and expanded the application spaces of FLAC3D and SURPAC.
Constraints on a Fourth Generation of Fermions from Higgs Boson Searches
Authors: Lenz Alexander
Published: February 2013

We review the past and current status of the extension of the standard model (SM) by a fourth generation of fermions. In particular the new results for Higgs boson searches at the LHC and at Tevatron exclude the possibility of having simply a perturbative fourth generation of fermions with one Higgs doublet (SM4). We also briefly mention more complicated extensions of the SM4, which are not yet excluded, like adding in addition another Higgs doublet to the SM4.
The Use of an Intra-Articular Depth Guide in the Measurement of Partial Thickness Rotator Cuff Tears
Authors: Carroll Michael J. , More Kristie D. , Sohmer Stephen , Nelson Atiba A. , Sciore Paul , Boorman Richard , Hollinshead Robert , Lo Ian K. Y.
Published: February 2013

Purpose. The purpose of this study was to compare the accuracy of the conventional method for determining the percentage of partial thickness rotator cuff tears to a method using an intra-articular depth guide. The clinical utility of the intra-articular depth guide was also examined.Methods.Partial rotator cuff tears were created in cadaveric shoulders. Exposed footprint, total tendon thickness, and percentage of tendon thickness torn were determined using both techniques. The results from the conventional and intra-articular depth guide methods were correlated with the true anatomic measurements. Thirty-two patients were evaluated in the clinical study.Results. Estimates of total tendon thickness (r= 0.41,P= 0.31) or percentage of thickness tears (r= 0.67,P= 0.07) using the conventional method did not correlate well with true tendon thickness. Using the intra-articular depth guide, estimates of exposed footprint (r= 0.92,P= 0.001), total tendon thickness (r= 0.96,P= 0.0001), and percentage of tendon thickness torn (r= 0.88,P= 0.004) correlated with true anatomic measurements. Seven of 32 patients had their treatment plan altered based on the measurements made by the intra-articular depth guide.Conclusions. The intra-articular depth guide appeared to better correlate with true anatomic measurements. It may be useful during the evaluation and development of treatment plans for partial thickness articular surface rotator cuff tears.
[18F]-FLT Positron Emission Tomography Can Be Used to Image the Response of Sensitive Tumors to PI3-Kinase Inhibition with the Novel Agent GDC-0941
Authors: Cawthorne Christopher , Burrows Natalie , Gieling Roben G. , Morrow Christopher J. , Forster Duncan , Gregory Jamil , Radigois Marc , Smigova Alison , Babur Muhammad , Simpson Kathryn , Hodgkinson Cassandra , Brown Gavin , McMahon Adam , Dive Caroline , Hiscock Duncan , Wilson Ian , Williams Kaye J.
Published: February 2013

The phosphoinositide 3-kinase (PI3K) pathway is deregulated in a range of cancers, and several targeted inhibitors are entering the clinic. This study aimed to investigate whether the positron emission tomography tracer 3′-deoxy-3′-[18F]fluorothymidine ([18F]-FLT) is suitable to mark the effect of the novel PI3K inhibitor GDC-0941, which has entered phase II clinical trial. CBA nude mice bearing U87 glioma and HCT116 colorectal xenografts were imaged at baseline with [18F]-FLT and at acute (18 hours) and chronic (186 hours) time points after twice-daily administration of GDC-0941 (50 mg/kg) or vehicle. Tumor uptake normalized to blood pool was calculated, and tissue was analyzed at sacrifice for PI3K pathway inhibition and thymidine kinase (TK1) expression. Uptake of [18F]-FLT was also assessed in tumors inducibly overexpressing a dominant-negative form of the PI3K p85 subunit p85α, as well as HCT116 liver metastases after GDC-0941 therapy. GDC-0941 treatment induced tumor stasis in U87 xenografts, whereas inhibition of HCT116 tumors was more variable. Tumor uptake of [18F]-FLT was significantly reduced following GDC-0941 dosing in responsive tumors at the acute time point and correlated with pharmacodynamic markers of PI3K signaling inhibition and significant reduction in TK1 expression in U87, but not HCT116, tumors. Reduction of PI3K signaling via expression of Δp85α significantly reduced tumor growth and [18F]-FLT uptake, as did treatment of HCT116 liver metastases with GDC-0941. These results indicate that [18F]-FLT is a strong candidate for the noninvasive measurement of GDC-0941 action. Mol Cancer Ther; 12(5); 819–28. ©2013 AACR.
Are Agonistic Autoantibodies against G-Protein Coupled Receptors Involved in the Development of Long-Term Side Effects of Tumor Chemotherapy?
Authors: Haberland Annekathrin , Santos Robson A.S. , Schimke Ingolf , Wallukat Gerd
Published: February 2013

Metabolic syndrome and cardiomyopathies are long-term consequences of chemo- and radiotherapy and develop long after completing the initial tumor treatment. The slow progression of such late effects might be an indication of the involvement of autoimmune processes in the development of such follow-up consequences. Functionally active autoantibodies, which permanently stimulate relevant cell receptors, might be a crucial component. Here, we report the detection of functionally active agonistic autoantibodies such as the autoantibody against the adrenergic alpha1-receptor, the muscarinic M2-receptor, and the newly discovered autoantibody against the Mas-receptor in the plasma of a cancer survivor following chemotherapy treatment.
That “Fatty Lump”
Authors: Choo Jessey J.C.
Published: February 2013

The fetus and fetal development were discussed in early imperial Chinese texts of
various genres, which often approached these matters in one or more of the
following terms: (1) the cosmic (human life begins and matures in the same way
as the rest of the universe, following the interplay of yin and
yang); (2) the correlative (the fetus grows according to
the Five Phases, all things corresponding to them going through a cycle of
changes that give rise to and diminish one another); and (3) the Indic-Buddhist
(the fetus comes into being and suffers as a result of karma). These texts do
not always present the perspective of the expectant parents on pregnancy; the
perspective of the fetus on gestation in particular is prominent in the texts
bearing Indic-Buddhist influences. This paper argues that over time the
confluence of concepts and metaphors presented in these texts added up to an
extremely negative attitude widely held toward the fetus and childbirth. This
negativity in turn reinforced, and was reinforced by, the concepts and practices
of filial piety that emerged in the centuries following the collapse of the Han
dynasty, which were different from those that came before. It also profoundly
transformed and enhanced the mother-child bond at the expense of that of the
father and child. In particular, the salvational dimension of the mother-child
relationship, introduced by Buddhism, made possible a women-centered
interpretation of filial piety.
Disruptive Voices
Authors: Yang Binbin
Published: February 2013

While historical records in China abound in accounts of “exemplary
women,” little is known of what was lying beneath the unflinching moral
stance with which these women tackled all the vicissitudes of life to bring
glories to their families and lineages. This study is an attempt to approach the
lives of these women from the angle of their own life-writings—in
particular, their bieji (personal collections). The three cases
examined in this study expose a stunning “outspokenness” of the
women. It was this degree of their outspokenness, I argue, that often called
into question the Confucian patriarchal values that were integral to their very
existence as moral exemplars.
Ecological divergence between two evolutionary lineages of Hyla savignyi (Audouin, 1827) in Turkey: effects of the Anatolian Diagonal
Authors: Gül Serkan
Published: February 2013

Most of Turkey’s land area is covered by one of three biodiversity hotspots (Caucasus, Irano-Anatolian, and Mediterranean). Anatolia is one of the main corridors for postglacial colonization of Europe. Uncovering how populations of a species differ genetically and ecologically is important for understanding evolutionary processes. Here, I examined ecological information to define ecological divergence between two lineages of Hyla savignyi. Using ecological niche modeling, I determined whether the two genetically divergent lineages of H. savignyi are geographically isolated and addressed the effect of the geographical distribution in the Anatolian Diagonal on the lineages. Separate analysis of the lineages showed no overlap of their predicted ranges based on climatic data of their respective habitats. This suggests that the lineages were formed as a result of range fragmentation during the Ice Age, and were consequently adapted to different climatic conditions.
From Casablanca to Casanegra: Neoliberal Globalization and Disaffected Youth in Moroccan Urban Cinema
Authors: Bahmad Jamal
Published: February 2013

This article deals with the two major actors in North Africa’s 2011 uprisings—namely, youth and the city—through a critical exploration of the cinematic realism that has defined Moroccan filmmakers’ response to the country’s socioeconomic transformation under neoliberal globalization since the 1980s. Taking Noureddine Lakhmari’s Casanegra (2008) as a case study, I argue that this aesthetic frame discloses the critical potential of everyday life and the ordinary affects of anger and the will to revolt among Casablanca’s youth today. This acclaimed film further allows us to approach Moroccan cinema’s affective realism within an urban landscape in a country that has witnessed the rise of a new historical consciousness of postcolonial youth on and off the screen. The first part of this article looks at the neoliberal Casablanca that emerged in the aftermath of Morocco’s market reforms in the 1980s and how that transformation engendered a new wave of urban cinema a decade later. The second part looks at Casanegra’s affective economy of anger and revolt and the articulation of Moroccan youth’s postcolonial subjectivity.
Water soluble nanocomposite films based on poly(vinyl alcohol) and chemically modified montmorillonites
Authors: Pique Teresa M , Pérez Claudio J , Alvarez Vera A , Vázquez Analía
Published: February 2013

Different montmorillonites were added to poly(vinyl alcohol) in order to improve their properties. The used montmorillonite’s were: Cloisite Na+ (Na), Nanofil (NF), and Cloisite 30B (30B). Poly(vinyl alcohol) + montmorillonite films, obtained by casting, were characterized by means of Fourier transform infrared spectroscopy, differential scanning calorimetry, thermogravimetric analysis, X-ray diffraction pattern, transmission electron microscopy, water absorption, contact angle, and mechanical properties. Sodium and organically modified montmorillonites were used. The montmorillonite basal peak shifted to a lower angle for composites, with sodium montmorillonites, and the films were exfoliated–intercalated nanocomposites. Composites with organically modified montmorillonites presented a micro-morphology and the lowest water absorption. The best mechanical properties were obtained for the composite with sodium montmorillonites.
Conformity to Christ
Authors: Hooker Morna D.
Published: February 2013

Following Paul’s experience on the Damascus Road, his life was drastically changed. Although he continued to maintain his loyalty to Israel’s God and the Scriptures, he now believed himself to be commissioned to preach the gospel to the Gentiles. At the heart of his theology lay his relationship with Christ – summed up in the phrase ‘in Christ’ – a relationship shared by all Christians, who must be ‘shaped’ by the gospel – conformed to the pattern of self-giving, death and resurrection seen in Christ – not simply in baptism but in their daily lives. Paul’s hope for the future envisages its final fulfilment.
The effects of the phosphodiesterase type 5 inhibitor vardenafil on cognitive performance in healthy adults: a behavioral- electroencephalography study
Authors: Reneerkens OAH , Sambeth A , Ramaekers JG , Steinbusch HWM , Blokland A , Prickaerts J
Published: February 2013

Phosphodiesterase type 5 inhibitors (PDE5-Is) improve cognitive performance of rodents, but the few human studies investigating their effects did not systematically investigate cognitive effects and the results have been quite contradictory. Therefore, we examined whether the PDE5-I vardenafil improves memory and executive functioning and affect electroencephalography (EEG) in healthy young adults. Participants were selected out of a group of volunteers, based on their performance on a memory screening and they were orally treated with vardenafil (10–20 mg or placebo). Memory and executive functioning were tested while EEG activity was recorded. Additionally, a simple reaction time task and questionnaires addressing various complaints were presented. No prominent effects of vardenafil on cognition were found: participants only made more mistakes on a reaction time task after 20 mg vardenafil. During encoding of words, the P300 was generally smaller after vardenafil treatment. Furthermore, the N400 was larger after vardenafil 10 mg than placebo treatment in a spatial memory task at Fz. Finally, headache and feeling weak were reported more after vardenafil treatment. Vardenafil did not affect cognitive performance of healthy adults and showed only some incidental effects on ERPs. These findings in humans do not corroborate the cognition-enhancing effects of PDE5-Is in healthy animals.
Where is food ‘good to think’? Rationalities of food and place in Sweden and France
Authors: Bildtgård Torbjörn
Published: February 2013

Where is food ‘good to think’? This comparative study describes the mental foodscapes of Swedish and French people by asking them to say where, in time and space, they would go to in order to eat well. Both the Swedish and French respondents say they would avoid the US and fast-food establishments in order to eat well, but while the French in general point inward, toward the countryside of their region a couple of decades ago, the Swedes, in their choices, want to go far away, to the Mediterranean region, South-east Asia or an abstract wilderness. The article argues that the reason for these differences is that consumers in these two countries use different dominant rationalities to judge the food of different places – a nutritional rationality in Sweden and a rationality of origin in France – and it proceeds to identify the politico-historical roots of these rationalities. Finally, it argues that while each rationality makes a certain set of food and place qualities cognizable and judgeable, others, such as exotic foods in France and conviviality in Sweden, are left non-cognizable and difficult to judge.
Can Children With Hyperlipidemia Receive Ketogenic Diet for Medication-Resistant Epilepsy?
Authors: Liu Yeou-Mei Christiana , Lowe Helen , Zak Maria M. , Kobayashi Jeff , Chan Valerie W. , Donner Elizabeth J.
Published: February 2013

The very-high-fat ketogenic diet can worsen lipid levels in children with pre-existing hyperlipidemia by increasing serum lipoproteins and reducing antiatherogenic high-density lipoproteins. A retrospective chart review of 160 children treated with the ketogenic diet from September 2000 to May 2011 was performed. Twelve children with pre-existing hyperlipidemia were identified. Lipid levels including total cholesterol, low-density lipoprotein, triglycerides, high-density lipoprotein, and total cholesterol/high-density lipoprotein were measured pre-diet and at 3, 6, and 12 months of treatment. During treatment, there was a significant reduction in mean total cholesterol, low-density lipoprotein, and total cholesterol/high-density lipoprotein. Total cholesterol and low-density lipoprotein were normalized in 8 and 7 children at 6 months; and 9 and 9 children at 12 months respectively. At 6 and 12 months, tot cholesterol/HDL ratio was normalized in 5 and 7 children respectively. Diet modifications were made to achieve healthy lipid levels. By extrapolating the data, it suggests lipid levels can be controlled in children and adults with ketogenic diet treatment.
Variable Compensation
Authors: Greene Robert J.
Published: February 2013

Organizations with fixed cost workforces are handicapped when trying to operate in a variable revenue world. Downsizing has become common as a cost reduction strategy but has generally failed to produce the desired results. When all direct compensation is all in the form of base pay and benefits, costs keep rising, and the cost/revenue gap keeps widening. By adopting direct compensation strategies that include a broader use of variable compensation, workforce costs can be better aligned with the resources available. Selecting the right incentive programs can provide greater motivation while helping to control workforce costs.
Influence of silaned nano-SiO2 on impact properties of carbon fibre-reinforced polyethylene composites
Authors: Luo Caisong , Cai Xuefeng , Bi Xianshun
Published: February 2013

Silaned nano-silicon dioxide (SiO2) was used to improve the adhesion properties of carbon fibre/polyethylene (CF/PE) composites. The nano-SiO2 were treated by silane under different discharge time. And the changes on the surface properties of the treated and untreated composites were studied by impact, three-point bending tests and scanning electron microscopic analysis. The measurement showed that CF increases fracture toughness with the increase in CF content. Too much high content of CF did not further cause the increase in the toughness of CF/PE composite. The impact strength of silaned specimens is still higher than those of the unsilaned ones. The modified composite with the good matrix/fibre adhesion possessed 20% higher interlaminar shear strengths than the composite having weak interface.
Enhanced thermal properties of poly(ethylene tetrasulfide) via expanded graphite incorporation by in situ polymerization method
Authors: Allahbakhsh Ahmad , Sheydaei Milad , Mazinani Saeedeh , Kalaee Mohammadreza
Published: February 2013

In this study, a novel poly(ethylene tetrasulfide) (PETS)/expanded graphite (EG) nanocomposite with 40°C improvement in melting point is prepared via in situ polymerization technique. The morphology, chemical characteristics and the structural behavior of nanocomposites are characterized using scanning electron microscopy, Fourier transform infrared spectroscopy and x-ray diffraction (XRD) techniques, respectively. XRD observations show about 0.1 nm increase in d-spacing of PETS crystals in the presence of 2 wt% EG in nanocomposite. This behavior could be related to the intercalation of polysulfide macromolecules in the interlayer structure of EG sheets. Furthermore, the thermal properties of nanocomposites are investigated using differential scanning calorimetry and thermogravimetric analysis techniques. The thermal degradation temperature of nanocomposite containing 2 wt% graphite shows an improvement of about 10°C compared to unfilled polysulfide. Moreover, the chemical resistance of nanocomposites in different common solvents increases in the presence of EG, which could be accounted as a clear proof of interconnections for EG and macromolecular structure of the polymer.
Practical and statistical issues in missing data for longitudinal patient-reported outcomes
Authors: Bell Melanie L , Fairclough Diane L
Published: February 2013

Patient-reported outcomes are increasingly used in health research, including randomized controlled trials and observational studies. However, the validity of results in longitudinal studies can crucially hinge on the handling of missing data. This paper considers the issues of missing data at each stage of research. Practical strategies for minimizing missingness through careful study design and conduct are given. Statistical approaches that are commonly used, but should be avoided, are discussed, including how these methods can yield biased and misleading results. Methods that are valid for data which are missing at random are outlined, including maximum likelihood methods, multiple imputation and extensions to generalized estimating equations: weighted generalized estimating equations, generalized estimating equations with multiple imputation, and doubly robust generalized estimating equations. Finally, we discuss the importance of sensitivity analyses, including the role of missing not at random models, such as pattern mixture, selection, and shared parameter models. We demonstrate many of these concepts with data from a randomized controlled clinical trial on renal cancer patients, and show that the results are dependent on missingness assumptions and the statistical approach.
Estimating effect sizes for health-related quality of life outcomes
Authors: Julious Steven A , Walters Stephen J
Published: February 2013

Summary

To enable an assessment of the costs and benefits of a new health technology one should use a range of outcome measures, including medical, psychosocial and economic. Therefore, unless a patient-reported outcome as well as clinical outcome is assessed in a study, the effect of a health technology on the patient will remain unknown as two therapies may have similar clinical consequences but different impacts upon the quality of the life of the patients. An important issue when designing a study with a new patient-reported outcome is the quantification of an effect size. Through a case study we highlight how simple calculations can enable the estimation of the effect sizes if there is information on established outcomes. This is done by mapping changes on the new scale to clinically relevant and important changes on established scales. We recommend the approaches described in this paper be considered for the quantification of important treatment effects when designing a clinical trial with a new patient-reported outcome measure.
Improving maternal perinatal mental health: integrated care for all women versus screening for depression
Authors: Laios Lia , Rio Ines , Judd Fiona
Published: February 2013

Objective:

The objective of this article is to highlight the debate about universal routine screening and psychosocial assessment in the perinatal period, and suggest an alternative/additional approach to improving maternal perinatal mental illness.

Conclusions:

Universal routine screening and psychosocial assessment in the perinatal period has been introduced in Australia despite a lack of evidence that this affects perinatal maternal morbidity. Furthermore, this approach is not designed to detect maternal illnesses such as schizophrenia, bipolar disorder, borderline personality disorder, although it is these women and their infants who have the highest rates of morbidity and mortality. We propose that any approach to improving maternal perinatal mental health should be tailored to particular situations and populations, with mental health care (inclusive of all mental illness, not just depression) integrated into, and thus a routine aspect of, maternity care provided to all women throughout the perinatal period.
Have Primary Mental Health Teams lived up to their expectations?
Authors: Rodrigo Asiri , Foo Lea , Majoor Jennifer
Published: February 2013

Objective:

Primary Mental Health Teams (PMHTs) were established in Victoria in 2002 to integrate psychiatric services into primary care. This study aimed to evaluate the characteristics of patients referred to Eastern Health PMHT, the effectiveness of management plans and referrer satisfaction.

Method:

Retrospective case note review of referrals (116) made to the PMHT from January to August 2010 and analysis of returned satisfaction surveys (105) from referrers between January 2006 and August 2010.

Results:

The mean age of patients was 40 years with 55% being female. The commonest primary diagnosis was depression (41%). The majority of patients (59%) had multiple psychiatric diagnoses. The response time for telephonic consultation was 1.4 days and 13.2 days for an initial patient consultation. Psychotherapy was the most frequently recommended treatment (85%). Average treatment period was 6.8 weeks and the majority of patients (93%) were discharged back to the primary referrer. Referrers were satisfied with PMHT services and average improvement of patients on the Health of the Nation Outcome Scales was 2.3.

Conclusion:

Our study suggests that PMHTs have embedded psychiatric services within primary care settings, with high levels of referrer satisfaction and patient improvement.
Vulnerability and mental health in Afghanistan: Looking beyond war exposure
Authors: Trani Jean-François , Bakhshi Parul
Published: February 2013

This study examined the prevalence of mental distress among groups in Afghanistan considered to be at risk. Data were drawn from a representative cross-sectional disability survey carried out in Afghanistan including 5,130 households in 171 clusters throughout the 34 provinces of the country. The sample included 838 nondisabled control participants aged above 14, and 675 disabled participants. Results showed that various vulnerable groups (disabled people, the unemployed, the elderly, minority ethnic groups, as well as widowed, divorced or separated women) were at higher risk of experiencing mild to severe mental health problems. The adjusted odds ratio for war-related disability compared to nondisabled was 4.09 (95% confidence interval 2.09 to 7.99) for mild mental distress disorders, and 7.10 (3.45–14.5) and 14.14 (3.38–59.00) for moderate or severe mental distress disorders, respectively. Women with disabilities (whatever the cause of impairment) when compared with nondisabled men, as well as poorer segments of society compared to the richest, had a higher prevalence of mental health problems. Women with non-war-related disabilities compared with nondisabled men were respectively 3.35 (1.27–8.81) and 8.57 (3.03–24.1) times more likely to experience mild or moderate mental distress disorders. People who experience multiple vulnerabilities are more at risk of deteriorating mental health in conflict zones. The study shows that mental health, in times of war, is influenced by a combination of demographic and socioeconomic characteristics linked to social exclusion mechanisms that were in place before the conflict began and that are redefined in relation to the changing social, cultural, and economic contexts. Mental health policies and programmes must prioritise the most vulnerable segments of Afghan society.
The source, the resource and the collaborator: The role of citizen journalism in local UK newspapers
Authors: Canter Lily
Published: February 2013

The rise of citizen journalism and widespread use of multimedia technology via Web 2.0 is a growing field of research. Yet the impact on local newspapers in the UK has received limited attention from scholars. At the time of this study, Northcliffe Media’s flagship newspaper the Leicester Mercury was piloting a project with community reporter network Citizens’ Eye to incorporate reader content into the newspaper and its website. This article explores the nature of this experimental relationship and the economic motivations behind it. It identifies that citizen journalists have a variety of fluid roles which flow between source, resource and collaborator. However, the key to the success of the project is the creation of distinctive boundaries between low level reporting carried out by community reporters and investigative journalism carried out by employed, trained staff. The research was conducted via a case study incorporating interviews and observation.
Simulation of virtual natural lighting solutions with a simplified view
Authors: Mangkuto RA , Aries MBC , Loenen EJ van , Hensen JLM
Published: February 2013

Daylight is limited in time and space. In situations where daylight is insufficiently available, virtual natural lighting solutions (VNLS), which are systems that artificially provide lighting and view comparable to those of real windows and skylights, can be promising. VNLS can turn currently unused floor space into space with daylight qualities. The space-gaining potential of VNLS in buildings can be predicted using computational building performance simulation. This paper describes the approach of modelling VNLS with a simplified view, using the Radiance tool to evaluate the lighting performance in a reference office. The VNLS are modelled as arrays of small light sources resembling the sky, the horizon and the ground. The simulation results show that VNLS with wide beam angles generally offer a better uniformity and a larger percentage of sufficiently lit workplane area compared to those obtained with real windows under overcast sky conditions, while the discomfort glare remains comparable to that received from real windows.
Factors Influencing the Incidence of Endovenous Heat-Induced Thrombosis (EHIT)
Authors: Rhee Soo J. , Cantelmo Nancy L. , Conrad Mark F. , Stoughton Julianne
Published: February 2013

Introduction:

Extension of thrombus from the great saphenous vein into the common femoral vein can be an early postprocedural complication of endothermal ablation (ETA).

Methods:

A retrospective review was performed over a 3-year period. Intraprocedural ultrasound images demonstrating the distance of the catheter tip to the saphenofemoral junction (SFJ) were available for 519 procedures, and this distance was measured.

Results:

Twenty-one (4.0%) cases of endovenous heat-induced thrombus (EHIT) were diagnosed. In all, 15 (6.4%) EHITs occurred following endovenous laser ablation and 6 (2.1%) after radiofrequency ( P = .02). Distance from catheter tip to SFJ, vein diameter, concomitant treatments, and perioperative anticoagulation were not significant risk factors for EHIT. Of the clinical factors assessed, gender ( P = .002), Clinical, Etiologic, Anatomic and Pathophysiologic classification 3 to 6 ( P = .003), history of prior thrombosis ( P = .04), and Caprini thrombosis risk factor assessment score ( P = .004) were significant. On multivariate analysis, Caprini score ( P = .0002) and male gender ( P = .0003) remained significant.

Conclusions:

Male gender and increased Caprini score are predictive factors for EHIT following ETA.
Obesogenic Cultural Drift and Nutritional Transition
Authors: Companion Michèle
Published: February 2013

Social ecology models applied to eating behaviors and health outcomes in low-income urban areas have focused on food deserts and other structural constraints to healthier eating. This study expands that work by identifying culturally specific constraints on food behaviors among low-income urban Native Americans. Exposure to commodities packages supplied by the Food Distribution Program on Indian Reservations has created a new conception of what is meant by “traditional food,” creating a barrier to change. However, this study identifies opportunities to expand the institutional role of urban Indian Centers, allowing for culturally sensitive interventions to mitigate the negative impacts of obesogenic cultural drift.
Failed back (surgery) syndrome: time for a paradigm shift
Authors: Vleggeert-Lankamp Carmen LAM , Arts Mark P , Jacobs Wilco CH , Peul Wilco C
Published: February 2013

Summary points

1. The group of patients with so-called ‘failed back surgery syndrome’ (FBSS) is very diverse. Published studies evaluating the outcome of surgical treatment vary widely in terms of surgical interventions that were performed. Results from these papers cannot be generally applied to all people who have persisting complaints after low back surgery.

2. The literature search that was performed demonstrated that the articles that scored as acceptable on assessment bias demonstrated a low to moderate patient-perceived recovery percentage. The only randomized controlled trial on this topic did not demonstrate a difference between instrumented fusion and cognitive intervention and exercise.

3. Current research does not show repeat surgery to be successful in ‘FBSS patients’, but clinical practice indicates that, in a small, carefully selected group, repeat surgery can yield rewarding results. However, parameters that make a patient prone to recover from a subsequent surgical intervention cannot be found in the literature.

4. The term ‘failed back surgery syndrome’ implies a causative role of surgery in a problem situation; failed back surgery syndrome is frequently regarded as failed back surgery. The literature does not, however, provide evidence for this.

5. It is important to inform the patient adequately to shape realistic expectations. Preoperative evaluation of parameters evaluating the psychological condition could help to better predict the outcome of surgery.

6. The term ‘failed back surgery syndrome’ has been demonstrated to be an ill-defined term, serving as a container for all kinds of back and leg problems, and wrongly implying a definite role for the surgical intervention in the aetiology. We suggest shifting the paradigm to ‘failed back syndrome’. With this term we suggest defining those patients with back and radicular leg pain without a structural deficit, or with a structural deficit that has a low a priori chance of benefiting from a surgical intervention.
Validation of ICD-9-CM codes for identification of acetaminophen-related emergency department visits in a large pediatric hospital
Authors: de Achaval Sofia , Feudtner Chris , Palla Shana , Suarez-Almazor Maria E
Published: February 2013

Background

Acetaminophen overdose is a major concern among the pediatric population. Our objective was to assess the validity of International Classification of Disease (ICD-9-CM) codes for identification of pediatric emergency department (ED) visits resulting from acetaminophen exposure or overdose.

Methods

We conducted a retrospective medical record review of ED visits at Texas Children’s Hospital in Houston, Texas, between January 1, 2005, and December 31, 2010. Visits coded with 1 or more ICD-9 codes for poisoning (965, 977, and their subcodes and supplemental E-codes E850, E858, E935, E947, and E950 and their subcodes) were identified from an administrative database, and further review of the medical records was conducted to identify true cases of acetaminophen exposure or overdose. We then examined the sensitivity, positive predictive value, and percentage of false positives identified by various codes and code combinations to establish which codes most accurately identified acetaminophen exposure or overdose.

Results

Of 1,215 ED visits documented with 1 or more of the selected codes, 316 (26.0%) were a result of acetaminophen exposure or overdose. Sensitivity was highest (87.0%) for the combination of codes 965.4 (poisoning by aromatic analgesics, not elsewhere classified) and E950.0 (suicide and self-inflicted poisoning by analgesics, antipyretics, and antirheumatics), with a positive predictive value of 86.2%. Code 965.4 alone yielded a sensitivity of 85.1%, with a positive predictive value of 92.8%. Code performance varied among age groups and depending on the type of exposure (intentional or unintentional).

Conclusion

ICD-9 codes are useful for ascertaining which ED visits are a result of acetaminophen exposure or overdose within the pediatric population. However, because ICD-9 coding differs by age group and depending on the type of exposure, hypothesis-driven strategies must be utilized for each pediatric age group to avoid misclassification.
The effect of alkaline phosphatase and intrahepatic metastases in large hepatocellular carcinoma
Authors: Kim Jong Man , Kwon Choon Hyuck David , Joh Jae-Won , Park Jae Berm , Ko Justin Sangwook , Lee Joon Hyeok , Kim Sung Joo , Park Cheol-Keun
Published: February 2013

Background

Hepatectomy is the standard treatment for HCC. However, large HCC poses a difficult challenge because of the technical complexity of surgical resection and the fear of postoperative hepatic decompensation. We analyzed the outcome and prognostic factors in patients with large hepatocellular carcinoma (HCC ≥10 cm) after surgery.

Methods

We retrospectively investigated the medical records of 91 patients who had undergone hepatectomy between January 2006 and June 2010. A survival analysis was performed utilizing the Kaplan-Meier method and prognostic factors were evaluated using Cox regression analysis.

Results

Of the 91 patients evaluated, most tumors were associated with hepatitis B virus (HBV). The median tumor size was 12.3 cm (range, 10 to 21 cm), with microvascular invasion present in most patients. The postoperative mortality rate was 2.2%. The median disease-free survival and overall survival were six months and 41 months. The one-year, two-year, and three-year disease-free survival rates were 33.5%, 29.3%, and 18.8%, respectively. The one-year, two-year, and three-year overall survival rates were 73.9%, 63.7%, and 54.8%, respectively. Of the 89 surviving patients, 69 patients (77.5%) developed HCC recurrence during the mean follow-up period of 23.4 ± 15.9 months. On multivariate analysis, the statistically significant factors that predicted HCC recurrence were ALP ≥ 80 IU/mL (P = 0.009) and intrahepatic metastases (P = 0.013).

Conclusions

Our study suggests that preoperative ALP levels (≥ 80 IU/L) and intrahepatic metastases could be utilized to monitor and predict recurrence in HCC patients.
Should trainee doctors use the developing world to gain clinical experience? The annual Varsity Medical Debate – London, Friday 20th January, 2012
Authors: Gilbert Barnabas J , Miller Calum , Corrick Fenella , Watson Robert A
Published: February 2013

The 2012 Varsity Medical Debate between Oxford University and Cambridge University provided a stage for representatives from these famous institutions to debate the motion “This house believes that trainee doctors should be able to use the developing world to gain clinical experience.” This article brings together many of the arguments put forward during the debate, centring around three major points of contention: the potential intrinsic wrong of ‘using’ patients in developing countries; the effects on the elective participant; and the effects on the host community. The article goes on to critically appraise overseas elective programmes, offering a number of solutions that would help optimise their effectiveness in the developing world.
Rapid and Quantitative Detection Method for Acteoside during Chromatographic Purification of Adhesive Rehmannia Leaf Extract Using near Infrared Spectroscopy and Chemometrics
Authors: Jin Ye , Liu Xuesong , Luan Lianjun , Qing Guangming , Zhong Ying , Wu Yongjiang
Published: February 2013

The feasibility of rapid and non-destructive analysis of acteoside, the main active component of adhesive rehmannia leaf, in the macroporous resin adsorption and elution process by Fourier transform near infrared spectroscopy together with different chemometrics methods was investigated in this study. The usable spectral region (5500–6200 cm−1) was identified, spectral preprocessing, including Savitzky–Golay smoothing derivative was employed, and spectral dimension was also reduced through principal component analysis for artificial neural networks (ANN) and least square support vector machines (LS-SVM) methods. The multivariate calibration models based on principal component regression, partial least-squares regression, ANN, and particle swarm optimisation-based LS-SVM were developed to correlate the pretreated spectral data and the corresponding acteoside concentrations determined by high performance liquid chromatography. For all regression models, the coefficients of determination for all data sets (calibration, validation and prediction set) were higher than 0.988, indicating that the four methods were effective for building acteoside calibration models using samples taken from either the adsorption or the elution process. However, according to the relative standard error of prediction values for the prediction set samples, the LS-SVM model was slightly more accurate than the models obtained using the other regression techniques.
Implementation Science in the Real World: A Case Study of HIV Rapid Testing
Authors: Mssw H Knapp , Anaya HD
Published: February 2013

Implementation science theories offer technical principles for carrying out activities designed to create or improve systems; however, such theories tend not to provide pragmatic or streamlined guidance when it comes to executing the actual implementation. We assembled a streamlined and comprehensive six-step theory-based implementation science model (ADAPTS - Assessment, Deliverables, Activate, Pretraining, Training, Sustainability) derived from the methods we have used to successfully execute multiple self-sustaining implementation efforts within the Veteran's Affairs Healthcare System. This paper provides a case study of our ADAPTS implementation science model, using a complex multisite HIV rapid testing implementation project as an exemplar.