bluuebunny/crossref_metadata_2025 huggingface dataset:
A link between gut community metabolism and pathogenesis: molecular hydrogen-stimulated glucarate catabolism aids
Salmonella
virulence
Authors: Lamichhane-Khadka Reena , Benoit Stéphane L. , Maier Susan E. , Maier Robert J.
Published: December 2013

Glucarate, an oxidized product of glucose, is a major serum organic acid in humans. Still, its role as a carbon source for a pathogen colonizing hosts has not been studied. We detected high-level expression of a potential glucarate permease encoding gene
gudT
when
Salmonella enterica
serovar Typhimurium are exposed to hydrogen gas (H
2
), a gaseous by-product of gut commensal metabolism. A
gudT
strain of
Salmonella
is deficient in glucarate-dependent growth, however, it can still use other monosaccharides, such as glucose or galactose. Complementation of the
gudT
mutant with a plasmid harbouring
gudT
restored glucarate-dependent growth to wild-type (WT) levels. The
gudT
mutant exhibits attenuated virulence: the mean time of death for mice inoculated with WT strain was 2 days earlier than for mice inoculated with the
gudT
strain. At 4 days postinoculation, liver and spleen homogenates from mice inoculated with a
gudT
strain contained significantly fewer viable
Salmonella
than homogenates from animals inoculated with the parent. The parent strain grew well H
2
-dependently in a minimal medium with amino acids and glucarate provided as the sole carbon sources, whereas the
gudT
strain achieved approximately 30% of the parent strain's yield. Glucarate-mediated growth of a mutant strain unable to produce H
2
was stimulated by H
2
addition, presumably owing to the positive transcriptional response to H
2
. Gut microbiota-produced molecular hydrogen apparently signals
Salmonella
to catabolize an alternative carbon source available in the host. Our results link a gut microbiome-produced diffusible metabolite to augmenting bacterial pathogenesis.
Long-term potentiation in hippocampal oriens interneurons: postsynaptic induction, presynaptic expression and evaluation of candidate retrograde factors
Authors: Nicholson Elizabeth , Kullmann Dimitri M.
Published: December 2013

Several types of hippocampal interneurons exhibit a form of long-term potentiation (LTP) that depends on Ca
2+
-permeable AMPA receptors and group I metabotropic glutamate receptors. Several sources of evidence point to a presynaptic locus of LTP maintenance. The retrograde factor that triggers the expression of LTP remains unidentified. Here, we show that trains of action potentials in putative oriens-lacunosum-moleculare interneurons of the mouse CA1 region can induce long-lasting potentiation of stimulus-evoked excitatory postsynaptic currents that mimics LTP elicited by high-frequency afferent stimulation. We further report that blockers of nitric oxide production or TRPV1 receptors failed to prevent LTP induction. The present results add to the evidence that retrograde signalling underlies
N
-methyl-
d
-aspartate (NMDA) receptor-independent LTP in oriens interneurons, mediated by an unidentified factor.
Inception of a false memory by optogenetic manipulation of a hippocampal memory engram
Authors: Liu Xu , Ramirez Steve , Tonegawa Susumu
Published: December 2013

Memories can be easily distorted, and a lack of relevant animal models has largely hindered our understanding of false-memory formation. Here, we first identified a population of cells in the dentate gyrus (DG) of the hippocampus that bear the engrams for a specific context; these cells were naturally activated during the encoding phase of fear conditioning and their artificial reactivation using optogenetics in an unrelated context was sufficient for inducing the fear memory specific to the conditioned context. In a further study, DG or CA1 neurons activated by exposure to a particular context were labelled with channelrhodopsin-2 (ChR2). These neurons were later optically reactivated during fear conditioning in a different context. The DG experimental group showed increased freezing in the original context in which a foot shock was never delivered. The recall of this false memory was context specific, activated similar downstream regions engaged during natural fear-memory recall, and was also capable of driving an active fear response. Together, our data demonstrate that by substituting a natural conditioned stimulus with optogenetically reactivated DG cells that bear contextual memory engrams, it is possible to incept an internally and behaviourally represented false fear memory.
Systematic study of genes influencing cellular chain length in Streptococcus sanguinis
Authors: Evans Karra , Stone Victoria , Chen Lei , Ge Xiuchun , Xu Ping
Published: December 2013

Streptococcus sanguinis is a Gram-positive bacterium that is indigenous to the oral cavity. S. sanguinis, a primary colonizer of the oral cavity, serves as a tether for the attachment of other oral pathogens. The colonization of microbes on the tooth surface forms dental plaque, which can lead to the onset of periodontal disease. We examined a comprehensive mutant library to identify genes related to cellular chain length and morphology using phase-contrast microscopy. A number of hypothetical genes related to the cellular chain length were identified in this study. Genes related to the cellular chain length were analysed along with clusters of orthologous groups (COG) for gene functions. It was discovered that the highest proportion of COG functions related to cellular chain length was ‘cell division and chromosome separation’. However, different COG functions were also found to be related with altered cellular chain length. This suggested that different genes related with multiple mechanisms contribute to the cellular chain length in S. sanguinis SK36.
Optimization of projective transformation matrix in image stitching based on chaotic genetic algorithm
Authors: Fan Yanming , Li Ming
Published: December 2013

Purpose

– The purpose of this paper is to present weighted Euclidean distance for measuring whether the fitting of projective transformation matrix is more reliable in feature-based image stitching.

Design/methodology/approach

– The hybrid model of weighted Euclidean distance criterion and intelligent chaotic genetic algorithm (CGA) is established to achieve a more accurate matrix in image stitching. Feature-based image stitching is used in this paper for it can handle non-affine situations. Scale invariant feature transform is applied to extract the key points, and the false points are excluded using random sampling consistency (RANSAC) algorithm.

Findings

– This work improved GA by combination with chaos's ergodicity, so that it can be applied to search a better solution on the basis of the matrix solved by Levenberg-Marquardt. The addition of an external loop in RANSAC can help obtain more accurate matrix with large probability. Series of experimental results are presented to demonstrate the feasibility and effectiveness of the proposed approaches.

Practical implications

– The modified feature-based method proposed in this paper can be easily applied to practice and can obtain a better image stitching performance with a good robustness.

Originality/value

– A hybrid model of weighted Euclidean distance criterion and CGA is proposed for optimization of projective transformation matrix in image stitching. The authors introduce chaos theory into GA to modify its search strategy.
The perceptions of health professionals of the implementation of Recovery-oriented health services: a case study analysis
Authors: Hungerford Catherine , Kench Patricia
Published: December 2013

Purpose

– Recovery approaches to healthcare are now an important feature of the mental health policies and plans of many western countries. However, there are continuing challenges to the operationalisation of these approaches. The purpose of this paper is to consider how to overcome these challenges, using insights gained from health managers and practitioners who have been involved in the process of implementation.

Design/methodology/approach

– The analysis is undertaken through a descriptive single-case embedded study of the implementation of Recovery into a public mental health service in Australia. The unit of analysis that features in this paper is the perceptions of the implementation of Recovery-oriented services, of health managers and practitioners.

Findings

– The analysis suggests that although health service managers followed many of the recommendations that can be found in the research literature to support achievement of Recovery-oriented services, there was a need to go further. For example, practitioners in the case study context were educated about the principles of Recovery and provided with new processes of clinical documentation to support their work, however these practitioners felt they were ill-equipped to address complex issues of practice, including the management of clinical risk and professional accountability issues. This raises questions about the content of the education and training provided, and also about the ongoing support provided to practitioners who work within a Recovery-oriented framework.

Originality/value

– The descriptive single-case embedded study of the implementation of Recovery is the first of its kind in Australia. Findings of the study provide insight for other health service organisations committed to effectively implementing Recovery-oriented services.
A practice placement design facilitating occupational therapy students’ learning
Authors: Bonsaksen Tore , Emil Granå Kjell , Celo Cecilia , Ellingham Brian , Myraunet Ingunn
Published: December 2013

Purpose

– The purpose of this paper is to describe an addition to the practice placement design for occupational therapy students in Oslo, and to report on the learning experiences related to this modified practice placement design among the participants.

Design/methodology/approach

– Occupational therapy students and practice educators were interviewed in focus groups after having participated in an exploration of the utility of the Assessment of Communication and Interaction Skills during mental health placement. Thematic analysis was applied to the data material.

Findings

– Four themes emerged relating to the students’ learning experiences during practice placement. They were theory-practice integration; the role of supervision; self-awareness of communication; and socialization to the therapist role.

Practical implications

– The practice placement design addition presented in this paper was well received by students and practice educators. It contributed to students’ focussed experience and to their active participation within a community of practice. The program appears to be one way of organizing placement with a potential for making a substantial contribution to occupational therapy students’ learning.

Originality/value

– The study adds to the existing literature in providing an example of a successful addition to the practice placement design, and in the detailed account of the learning experiences among the participants.
Standards in mental health facilities – an in depth case study in Greece using the WHO QualityRights tool
Authors: Nomidou Aikaterini
Published: December 2013

Purpose

– The purpose of this paper is to assess the quality of healthcare offered by a Greek Public Psychiatric Clinic. Special attention is paid to the degree to which the Clinic promotes human rights, social inclusion, and autonomy.

Design/methodology/approach

– The paper opted for an exploratory study using the open-ended approach of grounded theory, including 21 depth interviews with patients, staff members and patients’ relatives, documentation review and observation by an independent assessment team consisting of the author, a sociologist with mental disabilities, and a psychologist using the World Health Organization QualityRights tool kit which uses the Convention on the Rights of Persons with Disabilities (CRPD) as its frame. The data complemented by a group discussion with employees in another Clinic of the same hospital.

Findings

– The paper provides empirical insights about how the steps taken by the Psychiatric Clinic to address several of the themes drawn from the CRPD require either improvement or initiation to comply fully with the convention's themes, and how this compares unfavorably with the Urology Clinic.

Research limitations/implications

– Sample size and restriction of the data to only one mental health facility limit the generalizibility of the results. Staff who reported professional burnout and cuts in wages may have been be susceptible to recall bias due to current negative mood. Respondent patients may also have failed to disclose their true experiences due to fear of punishment.

Originality/value

– The paper uses a new methodology and instrument to assess current practice in mental health facilities in relation to international human rights standards emanating from the CRPD as well as the degree of parity between mental health and general health services.
Idea avoidance: reflections on a conference and its language
Authors: Richards Larry
Published: December 2013

Purpose

– This paper aims to offer a personal reflection on the 2012 joint conference of the American Society for Cybernetics and the Bateson Idea Group, “An Ecology of Ideas”. The intent is to raise awareness, through examples, of ideas – and their associated ways of thinking – that the author tends to take for granted in the work as systems theorists as well as in everyday life, yet ideas that confound the very social issues the conferees were trying to address.

Design/methodology/approach

– The thoughts expressed arose after five days of listening to presentations and discussions, both formal and informal. The approach is conversational, with a desire to stimulate further conversation.

Findings

– Certain versions of systems theory – whole systems, purposeful systems, systems theory as ideology – rely on ideas that although written about extensively in philosophical and socio-political works go unchallenged in everyday life. Three of these ideas – hierarchy, purpose, belief – are embedded in the way of talking about, and the language used to formulate, solutions to social problems. The suggestion is to avoid or suspend these ideas so that alternatives can be considered.

Originality/value

– Idea avoidance offers those who study social change and/or those who participate in making it happen a way to escape the stuckness of ideas so ingrained in the everyday ways of thinking that they go unnoticed.
The ethical implications of automated computation in design
Authors: dos Santos Cabral Filho Jose
Published: December 2013

Purpose

– The paper aims to present a framework for discussing ethics and computational design.

Design/methodology/approach

– The main propositions of computational design are presented, discussed according to different authors and contrasted with cybernetic principles.

Findings

– The paper finds that with algorithmic and parametric procedures, architects are using computation to reach a hitherto unknown ease of modelling multiple iterations of a design, so they can expand their possible design scenarios and cope with the uncertainties of ill-defined tasks. However, this strategy faces an ethical limitation because they fail to extend this openness to the final segment of the design chain, the user in the act of dwelling.

Originality/value

– The paper brings a cybernetic perspective for discussing the often-overlooked ethical implications of computational strategies in design.
Falls and fractures: a literature review and Welsh perspective
Authors: Morgan Gareth
Published: December 2013

Purpose

– This paper has three main elements to it. The first is to present some of the epidemiological considerations of this situation. The second is to describe some of the risk factors and by extension, the interventions that might be helpful. Third, a case study on the Welsh situation will be described.

Design/methodology/approach

– This paper draws from the published literature and combines this with the professional experience of the author in Wales. Epidemiological calculations are presented using readily available data and summarised diagrammatically.

Findings

– Falls and fractures constitute a significant public health challenge due to the number of individuals affected and the seriousness of impacts. Risk factors, such as vitamin D deficiency, are open to modification and interventions such as exercise are also helpful. In Wales, policy could be geared to improving the response to this, such as an expansion of cost saving fracture liaison services.

Originality/value

– This paper draws together a diverse literature to help develop policy in Wales.
Deafblind UK expands operations in Northern Ireland to further reduce isolation and enhance the lives of older deafblind people
Authors: Lamont Becky
Published: December 2013

Purpose

– The purpose of this paper is to highlight the need for services catering for older deafblind people in Northern Ireland (NI) and how Deafblind UK is responding, supported by funding from the Big Lottery Fund.

Design/methodology/approach

– This paper is designed to provide an overview of deafblindness in NI. Supported by research and case studies, it explains the current situation, highlights the issues of this disability, the unique response required and how Deafblind UK's Connections NI project is meeting these needs.

Findings

– Older deafblind people are a highly vulnerable group yet there was a severe lack of services in the region catering for their specific needs. Based on work elsewhere in the UK and initial feedback, Deafblind UK's Connections NI project has been designed to support older deafblind people in the region to give them control over their life choices and retain independence as far as possible.

Research limitations/implications

– The project was only launched in April 2013 so although results have been achieved by Deafblind UK elsewhere in the country, it could take some time for similar results to be seen in NI, particularly when considering the nature of the work.

Practical implications

– Deafblind UK will work alongside agencies and in the community to raise awareness of deafblindness, helping to create clearer classification of the disability and associated issues, and deliver more targeted services that reach a higher proportion of older deafblind people in the region.

Originality/value

– This paper highlights the lack of services for older deafblind people in NI and how Deafblind UK is uniquely meeting these needs.
The rewards of cooperation: The effects of membership in European regulatory networks
Authors: Maggetti Martino
Published: December 2013

Networks famously epitomize the shift from ‘government’ to ‘governance’ as governing structures for exercising control and coordination besides hierarchies and markets. Their distinctive features are their horizontality, the interdependence among member actors and an interactive decision‐making style. Networks are expected to increase the problem‐solving capacity of political systems in a context of growing social complexity, where political authority is increasingly fragmented across territorial and functional levels. However, very little attention has been given so far to another crucial implication of network governance – that is, the effects of networks on their members. To explore this important question, this article examines the effects of membership in European regulatory networks on two crucial attributes of member agencies, which are in charge of regulating finance, energy, telecommunications and competition: organisational growth and their regulatory powers. Panel analysis applied to data on 118 agencies during a ten‐year period and semi‐structured interviews provide mixed support regarding the expectation of organisational growth while strongly confirming the positive effect of networks on the increase of the regulatory powers attributed to member agencies.
Combined treatment of rapamycin and dietary restriction has a larger effect on the transcriptome and metabolome of liver
Authors: Fok Wilson C. , Bokov Alex , Gelfond Jonathan , Yu Zhen , Zhang Yiqiang , Doderer Mark , Chen Yidong , Javors Martin , Wood William H. , Zhang Yongqing , Becker Kevin G. , Richardson Arlan , Pérez Viviana I.
Published: December 2013

Rapamycin (Rapa) and dietary restriction (DR) have consistently been shown to increase lifespan. To investigate whether Rapa and DR affect similar pathways in mice, we compared the effects of feeding mice ad libitum (AL), Rapa, DR, or a combination of Rapa and DR (Rapa + DR) on the transcriptome and metabolome of the liver. The principal component analysis shows that Rapa and DR are distinct groups. Over 2500 genes are significantly changed with either Rapa or DR when compared with mice fed AL; more than 80% are unique to DR or Rapa. A similar observation was made when genes were grouped into pathways; two‐thirds of the pathways were uniquely changed by DR or Rapa. The metabolome shows an even greater difference between Rapa and DR; no metabolites in Rapa‐treated mice were changed significantly from AL mice, whereas 173 metabolites were changed in the DR mice. Interestingly, the number of genes significantly changed by Rapa + DR when compared with AL is twice as large as the number of genes significantly altered by either DR or Rapa alone. In summary, the global effects of DR or Rapa on the liver are quite different and a combination of Rapa and DR results in alterations in a large number of genes and metabolites that are not significantly changed by either manipulation alone, suggesting that a combination of DR and Rapa would be more effective in extending longevity than either treatment alone.
Do patients with paranoid and disorganized schizophrenia respond differently to antipsychotic drugs?
Authors: Corves C. , Engel R. R. , Davis J. , Leucht S.
Published: December 2013

Objective

The aim of this study was to compare the differential response to amisulpride in patients with paranoid versus disorganized schizophrenia.

Method

We reanalyzed the original data from five different randomized drug trials comparing Brief Psychiatric Rating Scale (BPRS) scores in a database containing 427 paranoid and 296 disorganized patients with schizophrenia.

Results

Both the disorganized and the paranoid group showed a substantial improvement of the BPRS total score within the first 4 weeks. In the paranoid group, mean (±SD) BPRS reduction was 16.9 (±14.6) (t = 24.06, df = 426, P < 0.001) and in the disorganized group 17.0 (±15.9) (t = 18.49, df = 295, P < 0.001). An analysis of covariance (ancova) controlling for BPRS at baseline and the influence of different trial protocols showed significant differences between diagnostic groups (F = 13.47, df = 1, P < 0.001), Cohen's D 0.31 (CI = 0.16–0.46). Paranoid patients improved by 4.8 BPRS points more than disorganized patients (adjusted means 18.90 (CI = 17.33–20.37) for the paranoid and 14.1 (CI = 12.04 – 16.11) for the disorganized group.

Conclusion

We conclude that amisulpride is effective in disorganized as well as in paranoid schizophrenia, but that symptom reduction in the disorganized subtype is less pronounced.
Regulatory mutations in the A2M gene are involved in the mastitis susceptibility in dairy cows
Authors: Wang X. G. , Huang J. M. , Feng M. Y. , Ju Z. H. , Wang C. F. , Yang G. W. , Yuan J. D. , Zhong J. F.
Published: December 2013

Mutations, such as single nucleotide polymorphisms (SNPs), in the 5′‐flanking and microRNA (miRNA) regulatory regions may result in altered gene expression levels and cause diseases. Alpha‐2‐macroglobulin (A2M) has the function of binding host or foreign peptides and particles, and thereby serves as a defense barrier against pathogens in the plasma and tissues of animals. To investigate the functional markers of the A2M gene associated with mastitis, the promoter was characterized and SNPs that affect promoter activity or binding affinity with the target miRNA were identified using the luciferase reporter assay and real‐time quantitative PCR method. Results showed that the core promoter of A2M was found between the bases g.‐2641 and g.‐2479. Four novel SNPs (g.‐724A>G, g.‐665G>A, g.‐535C>G and g.‐520_‐519insA) in the promoter region were completely linked. The activity of the mutant haplotype (GAGA) increased by 177% compared with that of the wild haplotype (AGC‐). Bta‐miR‐2898 was upregulated by 6.25‐fold in the mammary gland tissues of mastitis‐infected cows compared with that of the healthy cows. One SNP (c.4659_4661delC) located in the 3′‐untranslated region of the A2M gene may affect the binding affinity with the target bta‐miR‐2898. Five SNPs exhibited tight linkage. Association analysis showed that the milk somatic cell score for cows with the mutant haplotype (GAGA‐) was lower than that for cows with the wild haplotype. Thus, the mutant type can be used as a potential functional marker for a mastitis resistance breeding program in dairy cows. Our findings provided the molecular basis for A2M transcriptional and post‐transcriptional regulations. A close relationship between regulatory mutations and mastitis susceptibility of cows also was established.
Reduction of gastric cancer mortality by endoscopic and radiographic screening in an isolated island: A retrospective cohort study
Authors: Matsumoto Satohiro , Ishikawa Shizukiyo , Yoshida Yukio
Published: December 2013

Objective

To evaluate the efficacy of endoscopic and radiographic screening for gastric cancer.

Design

A retrospective cohort study.

Setting

Community in an isolated island.

Participants

The study involved 186 patients (131 men, 55 women) diagnosed with gastric cancer between 2000 and 2005.

Interventions

Endoscopic and radiographic screening.

Main outcome measurements

The odds ratio of death from gastric cancer in participants versus non‐participants of screening, the cumulative survival rate of the gastric cancer patients.

Results

The odds ratio of death from gastric cancer in the participants versus non‐participants of screening was 0.091 (95% confidence interval (CI) 0.027–0.308; P < 0.0001). The cumulative survival rate of the gastric cancer patients in the screening group was higher than that in the non‐screening group (P < 0.0001). In the endoscopic screening district, the odds ratio of death from gastric cancer among the participants versus non‐participants of endoscopic screening was 0.117 (95% CI 0.013–1.056; P = 0.0525), while in the radiographic screening district, it was 0.086 (95% CI 0.020–0.376; P < 0.0001). The cumulative survival rates were higher in both the screening groups as compared with the non‐screening group (endoscopy, P = 0.0302; radiography, P = 0.0012).

Conclusion

The results suggest that both radiographic and endoscopic screening may prevent gastric cancer deaths.
Outreach surgical consulting services in North East Victoria
Authors: Chittleborough Timothy John , Lourensz Kaleb , Elliott Matthew , Thomas Peter , Franzi Stephen
Published: December 2013

Objective

There is a paucity of data regarding the provision of consultative outreach specialist surgical services to rural areas. This paper aims to describe a model of outreach consultative practice to deliver specialist surgical services to rural communities.

Design

Analysis of prospectively collected data for consultations in a three month period for two surgeons based in Wangaratta.

Setting

Two surgeons in regional Victoria based in Wangaratta, North East Victoria, conducting outreach consultations to Beechworth, Benalla, Bright and Mansfield.

Participants

All patients seen in consultations over a 3‐month period.

Main outcome measures

Patient workload, casemix of presenting complaint, consultation outcome including plan for surgical procedure.

Results

Outreach surgical consulting was associated with a higher proportion of new consultations, and there was trend towards being more likely to result in a surgical procedure than consultations in the base rural centre.

Conclusions

Outreach surgical consulting provides surgeons with a larger referral base and provides communities with better access to local specialists. Outreach practice should be encouraged for surgeons in regional centres.
Pre‐operative co‐morbidity and postoperative survival in the elderly: beyond one lunar orbit
Authors: Carlisle J. B.
Published: December 2013

Mortality is a good measure of killing, but it is a poor measure of cure, palliation or the maintenance of function. Nevertheless, it has remained the primary metric of hospital care for 200 years. This article discusses the factors that contribute to mortality risk and survival trajectories, as well as the increasing recognition that surgery kills for months after the last suture is tied. This article discusses how disparate factors can usefully combine to generate an ‘elderly’ group with a monthly mortality in excess of 1% and a median life expectancy less than 3.5 years. A downloadable spreadsheet is provided that combines risk factors to generate mortality risks and their associated survival curves, emphasising the importance of looking beyond one postoperative month.
Anti‐thyroid antibodies as a predictor of thyroid cancer
Authors: Wong Sze Ling , Grodski Simon , Yeung Meei J. , Serpell Jonathan W.
Published: December 2013

Background

Recent literature has suggested an association between autoimmune thyroiditis and papillary thyroid cancer. The aims of this study were to evaluate if positive thyroid antibodies are associated with thyroid carcinoma and to examine the role of thyroid antibodies in the management of thyroid nodules.

Methods

This is a database study of all patients undergoing thyroidectomy with recorded preoperative thyroid antibodies (autoantibodies to thyroglobulin and/or thyroid peroxidase) levels from 2010 to 2012. We analysed preoperative thyroid antibody levels, fine needle aspiration cytology (FNAC) results, type of thyroid surgery and final histopathology.

Results

There were 960 patients who underwent thyroidectomy with recorded preoperative thyroid antibodies. Of 960 patients, 784 had preoperative FNAC of thyroid nodules. Final histopathology showed 758 benign and 202 malignant cases. As expected, there was a strong association between raised thyroid antibodies and lymphocytic thyroiditis on histology (P = 0.0001) (two‐sided probability). Overall, positive thyroid antibodies were not found to be a predictor of thyroid carcinoma (P = 0.161) (two‐sided probability). However, in patients with benign FNAC, positive thyroid antibodies increased the risk of thyroid malignancy (odds ratio 2.16; 95% confidence interval 1.11 to 4.21, P = 0.027) (two‐sided probability).

Conclusion

Patients with positive thyroid antibodies have a greater risk of malignancy in those with benign FNAC. We recommend routine thyroid antibody assessment in addition to FNAC as part of the assessment of thyroid nodules.
Improving operating theatre communication between the orthopaedics surgeon and radiographer
Authors: Yeo Cheng Hong , Gordon Robert , Nusem Iulian
Published: December 2013

Objectives

This study was designed to assess the importance of communication between surgeons and radiographers in the operation of image intensifiers during orthopaedic surgery.

Methods

This study was designed and conducted as single‐centre, observational study. Fifteen medical officers and 15 radiographers were involved in this study. Each of the 15 radiographers was assigned to a medical officer. The 15 pairs were then each given a task to simulate achieving ‘perfect circles’ on fluoroscopy for distal locking of an intramedullary nail. The time taken for the surgeon to verbally instruct the radiographer how to position the image intensifier in order to achieve ‘perfect circles’ was recorded. The overall time taken to perform the task, and total number of images taken was recorded before and after a terminology system to manoeuvre image intensifier was introduced to the pairs.

Results

The mean time taken for the pairs to achieve perfect circles after the introduction of the manoeuvre terminology showed statistically significant reduction from 212 to 97 s (t = 4.212, df = 88, P < 0.05) after the introduction of the terminology. The mean number of fluoroscopy exposures taken also showed a statistically significant reduction from 12 to 6 (t = 6.791, df = 88, P < 0.05).

Conclusion

The implementation of a clear and unambiguous set of commands to control the image intensifier, which are common to both surgeon and radiographer, can reduce the time to acquire the desired images, and requires less radiation exposure in the process.
Disrupted Futures: Unpacking Metaphors of Marginalization in Eviction and Resettlement Narratives
Authors: Ramakrishnan Kavita
Published: December 2013

In this paper, I examine how linguistic tropes that emerged during ethnographic fieldwork in a Delhi resettlement colony both capture and reaffirm the experiences of forced eviction and marginalization on the urban periphery. By analyzing the urban subjectivities embedded in recurrent metaphors, I explore how people “make sense” of dispossession and ultimately, articulate their “place” in the city. Drawing on Lakoff and Johnson (1980,Metaphors We Live By; 1999,Philosophy in the Flesh: The Embodied Mind and its Challenge to Western Thought), I argue that the utilization of metaphors in everyday language influences how people structure their relationships—with the state, with other residents of the resettlement colony, and with the city itself—and captures the pervasive uncertainty of resettlement. Unpacking such metaphors as “guides” to thought and practice can contribute to theories on spaces of insecurity and performativity of the marginalized in the city.
The effects of ageing on the onset and disappearance of unexplained abdominal pain: a population‐based study
Authors: Choung R. S. , Locke G. R. , Schleck C. D. , Zinsmeister A. R. , Talley N. J.
Published: December 2013

Background

The population ≥65 years is rapidly increasing, but remarkably little is known about the natural history of abdominal pain with ageing.

Aim

To prospectively evaluate the natural history of abdominal pain (severity and frequency) in a US population, and evaluate potential risk factors (including somatisation) for the onset and disappearance of abdominal pain with increasing age.

Methods

Between 1988 and 2004, valid self‐report questionnaires that recorded gastrointestinal symptoms including severity and frequency of abdominal pain were mailed to randomly selected cohorts of community residents followed over time. This study identified all respondents who answered abdominal pain questions at an initial and follow‐up survey.

Results

One thousand nine hundred and thirteen subjects were included (mean age in years at first survey: 48 ± 12 (SD), mean age at second survey: 59 ± 13 (SD); 53% female). The onset and disappearance rate of abdominal pain over the follow‐up were 18% (95% CI, 16, 20) and 47% (43, 50) respectively. The rates of increasing vs. decreasing abdominal pain score were 18% (16, 20) vs. 21% (20, 23) respectively. While younger age at initial survey was associated with the onset of abdominal pain {vs. subjects without abdominal pain, [OR 0.9 (0.7, 1.0)]}, older age at initial survey and times between surveys were associated with the disappearance of abdominal pain {vs. subjects with abdominal pain, [OR 1.2 (1.0, 1.5)]}. Female gender (OR 1.4 [1.0, 2.1]), higher somatisation scores (OR 5.3 [3.2, 8.7]) and larger changes in somatisation score (OR 2.1 [1.4, 3.2]) were positively associated with the onset of abdominal pain.

Conclusion

Increasing age is associated with the disappearance of abdominal pain in the community.
Estimating marginal properties of quantitative real‐time PCR data using nonlinear mixed models
Authors: Gerhard Daniel , Bremer Melanie , Ritz Christian
Published: December 2013

A unified modeling framework based on a set of nonlinear mixed models is proposed for flexible modeling of gene expression in real‐time PCR experiments. Focus is on estimating the marginal or population‐based derived parameters: cycle thresholds and , but retaining the conditional mixed model structure to adequately reflect the experimental design. Additionally, the calculation of model‐average estimates allows incorporation of the model selection uncertainty. The methodology is applied for estimating the differential expression of a phosphate transporter gene OsPT6 in rice in comparison to a reference gene at several states after phosphate resupply. In a small simulation study the performance of the proposed method is evaluated and compared to a standard method.
Current status of magnetic resonance imaging (MRI) and ultrasonography fusion software platforms for guidance of prostate biopsies
Authors: Logan Jennifer K. , Rais‐Bahrami Soroush , Turkbey Baris , Gomella Andrew , Amalou Hayet , Choyke Peter L. , Wood Bradford J. , Pinto Peter A.
Published: December 2013

Prostate MRI is currently the best diagnostic imaging method for detecting PCa. Magnetic resonance imaging (MRI)/ultrasonography (US) fusion allows the sensitivity and specificity of MRI to be combined with the real‐time capabilities of transrectal ultrasonography (TRUS). Multiple approaches and techniques exist for MRI/US fusion and include direct ‘in bore’ MRI biopsies, cognitive fusion, and MRI/US fusion via software‐based image coregistration platforms.
Is Narco‐Violence in Mexico Terrorism?
Authors: CAMPBELL HOWARD , HANSEN TOBIN
Published: December 2013

Mexico's drug ‘war’ produced 100,000 deaths between 2006 and 2012. The extreme violence has raised the notion that Mexico has become a failed state wracked by terrorism. We categorise the forms of narco‐violence in Mexico in light of the literature on terrorism and contemporary Mexican politics. Our study suggests three overlapping dimensions of narco‐violence that should be considered terrorism: (a) narco‐terror as a struggle for regional political control; (b) narco‐terror as a practice ordered by cartel leaders rather than spontaneous violence of foot soldiers; and (c) narco‐terror as an expansion strategy from solely drug trafficking to other kinds of organised crime.
Perceived Discrimination and Ethnic Affirmation: Anglo Culture Orientation as a Moderator Among Mexican‐Origin Adolescent Mothers
Authors: Derlan Chelsea L. , Umaña‐Taylor Adriana J. , Toomey Russell B. , Updegraff Kimberly A. , Jahromi Laudan B. , Flores Lluliana I.
Published: December 2013

This study examined whether Anglo culture orientation modified the association between adolescents' perceived ethnic discrimination and ethnic identity affirmation over time in a sample of Mexican‐origin adolescent mothers (N = 205, Mage = 16.24 years). Results indicated that perceived ethnic discrimination was significantly associated with decreases in ethnic identity affirmation over time for adolescents reporting high Anglo culture orientation, but no relation existed for adolescents reporting low Anglo culture orientation. Findings suggest that a person–environment mismatch (i.e., between adolescents' perceptions of their connection to Anglo culture and the messages they receive from others regarding that connection in terms of perceived ethnic discrimination) may be detrimental to adolescents' development of positive feelings about their ethnicity.
Endolaparoscopic removal of colonic polyps
Authors: Goh C. , Burke J. P. , McNamara D. A. , Cahill R. A. , Deasy J.
Published: December 2013

Aim

A proportion of colonic polyps is not amenable to exclusively colonoscopic removal due to their location, size or tortuosity of the colon. A combined laparoscopic/colonoscopic polypectomy or endolaparoscopic polypectomy (ELP) is an alternative to formal segmental resection. We present our experience of ELP.

Method

This is a retrospective review of a consecutive series of patients who underwent ELP for preoperatively diagnosed benign polyps between 2010 and 2013. Data are presented as median (interquartile range, IQR).

Results

Thirty patients commenced ELP. Eighteen were male and the median (IQR) age was 65.4 (61.6–73.5) years. Of 30 attempted cases, 22 (73%) underwent successful ELP surgery. Patients in whom combined ELP surgery was unsuccessful were converted to laparoscopic colectomy (one) or colonic mobilization and colotomy (seven). The median operation time for successful ELP was 105 (75–125) min. The complication rate was 13.3% and the median length of stay was 2.0 (1.0–3.0) days for successful ELP compared with 5.5 (3.5–6.8) days for converted patients (P = 0.014). The median polyp size was 14 (10–22) mm; eight (26.7%) had high‐grade dysplasia with two cases of invasive cancer identified.

Conclusion

A combined endoscopic–laparoscopic approach provides an alternative to segmental resection for treating challenging colonic polyps. This approach appears to be safe and effective and should be offered to selected patients with benign colonic polyps.
Serum 25‐hydroxyvitamin D concentration does not independently predict incident diabetes in older women
Authors: Schafer A. L. , Napoli N. , Lui L. , Schwartz A. V. , Black D. M. ,   the Study of Osteoporotic Fractures
Published: December 2013

Aims

To investigate whether 25‐hydroxyvitamin D concentration was associated with incident diabetes in a large cohort of older women.

Methods

Data were analysed from women included in the Study of Osteoporotic Fractures, a cohort of community‐dwelling women aged ≥65 years at enrolment. Serum 25‐hydroxyvitamin D concentration was assessed at the year 6 visit, as were BMI and other factors associated with vitamin D and/or diabetes. Diabetes status was determined at each subsequent visit by self‐report and medication use. Only those without prevalent diabetes at the year 6 visit were included in the present analysis (N = 5463, mean age 76.5 years).

Results

During a mean ±sd follow‐up of 8.6 ± 4.4 years, incident diabetes was reported in 320 participants. The mean BMI was higher in those with a 25‐hydroxyvitamin D concentration <20 ng/ml (<50 nmol/l) than in those with concentrations 20–30 or ≥30 ng/ml [50–74 or ≥75 nmol/l (P < 0.0001)]. A higher 25‐hydroxyvitamin D concentration was associated with a 13% lower risk of incident diabetes after adjustment for age and clinic site [hazard ratio 0.87, 95% CI 0.76–0.99, per sd increase in 25‐hydroxyvitamin D]; however, the addition of BMI to the model attenuated the estimated effect (hazard ratio 0.97, 95% CI 0.86–1.11). Adjustment for additional potential confounders yielded similar results.

Conclusions

Serum 25‐hydroxyvitamin D does not independently predict incident diabetes in older women. Although those with higher 25‐hydroxyvitamin D concentrations are less likely to develop diabetes, this is mainly explained by their lower BMI.
HNF4A mutation: switch from hyperinsulinaemic hypoglycaemia to maturity‐onset diabetes of the young, and incretin response
Authors: Arya V. B. , Rahman S. , Senniappan S. , Flanagan S. E. , Ellard S. , Hussain K.
Published: December 2013

Background

Hepatocyte nuclear factor 4α (HNF4A) is a member of the nuclear receptor family of ligand‐activated transcription factors. HNF4A mutations cause hyperinsulinaemic hypoglycaemia in early life and maturity‐onset diabetes of the young. Regular screening of HNF4A mutation carriers using the oral glucose tolerance test has been recommended to diagnose diabetes mellitus at an early stage. Glucagon‐like peptide‐1 and glucose‐dependent insulinotropic polypeptide are incretin hormones, responsible for up to 70% of the secreted insulin after a meal in healthy individuals. We describe, for the first time, gradual alteration of glucose homeostasis in a patient with HNF4A mutation after resolution of hyperinsulinaemic hypoglycaemia, on serial oral glucose tolerance testing. We also measured the incretin response to a mixed meal in our patient.

Case report

Our patient was born with macrosomia and developed hyperinsulinaemic hypoglycaemia in the neonatal period. Molecular genetic analysis confirmed HNF4A mutation (p.M116I, c.317G>A) as an underlying cause of hyperinsulinaemic hypoglycaemia. Serial oral glucose tolerance testing, after the resolution of hyperinsulinaemic hypoglycaemia, confirmed the diagnosis of maturity‐onset diabetes of the young at the age of 10 years. Interestingly, the intravenous glucose tolerance test revealed normal glucose disappearance rate and first‐phase insulin secretion. Incretin hormones showed a suboptimal rise in response to the mixed meal, potentially explaining the discrepancy between the oral glucose tolerance test and the intravenous glucose tolerance test.

Conclusions

Maturity‐onset diabetes of the young can develop as early as the first decade of life in persons with an HNF4A mutation. Impaired incretin response might be contributory in the early stages of HNF4A maturity‐onset diabetes of the young.
Comparison of insulin lispro protamine suspension versus insulin glargine once daily added to oral antihyperglycaemic medications and exenatide in type 2 diabetes: a prospective randomized open‐label trial
Authors: Arakaki R. F. , Blevins T. C. , Wise J. K. , Liljenquist D. R. , Jiang H. H. , Jacobson J. G. , Martin S. A. , Jackson J. A.
Published: December 2013

Aims

To compare efficacy and safety of two, once‐daily basal insulin formulations [insulin lispro protamine suspension (ILPS) vs. insulin glargine (glargine)] added to oral antihyperglycaemic medications (OAMs) and exenatide BID in suboptimally controlled type 2 diabetes (T2D) patients.

Methods

This 24‐week, open‐label, multicentre trial randomized patients to bedtime ILPS (n = 171) or glargine (n = 168). Non‐inferiority of ILPS versus glargine was assessed by comparing the upper limit of 95% confidence intervals (CIs) for change in haemoglobin A1c (HbA1c) from baseline to week 24 (adjusted for baseline HbA1c) with non‐inferiority margin 0.4%.

Results

Non‐inferiority of ILPS versus glargine was demonstrated: least‐squares mean between‐treatment difference (ILPS minus glargine) (95% CI) was 0.22% (0.06, 0.38). Mean HbA1c reduction was less for ILPS‐ versus glargine‐treated patients (−1.16 ± 0.84 vs. −1.40 ± 0.97%, p = 0.008). Endpoint HbA1c < 7.0% was achieved by 53.7% (ILPS) and 61.7% (glargine) (p = NS). Overall hypoglycaemia rates (p = NS) and severe hypoglycaemia incidence (p = NS) were similar. Nocturnal hypoglycaemia rate was higher in patients treated with ILPS versus glargine (p = 0.004). Weight gain was similar between groups (ILPS: 0.27 ± 3.38 kg; glargine: 0.66 ± 3.93 kg, p = NS). Endpoint total insulin doses were lower in patients treated with ILPS versus glargine (0.30 ± 0.17 vs. 0.37 ± 0.17 IU/kg/day, p < 0.001).

Conclusions

ILPS was non‐inferior to glargine for HbA1c change over 24 weeks, but was associated with less HbA1c reduction and more nocturnal hypoglycaemia. Treat‐to‐target basal insulin therapy improves glycaemic control and is associated with minimal weight gain when added to OAMs and exenatide BID for suboptimally controlled T2D.