bluuebunny/crossref_metadata_2025 huggingface dataset:
The Westgate Service and Related Referral, Assessment, and Treatment Processes
Authors: Bennett Alice L.
Published: June 2014

The formerly named “Dangerous and Severe Personality Disorder” (DSPD) units are no longer standalone services within the criminal justice system in England and Wales. These sites now provide personality disorder treatment services in the high-security prison estate as part of the new national Offender Personality Disorder (OPD) Pathway Strategy. The OPD Pathway intends to take responsibility for the assessment, treatment, and management of offenders who are likely to have a personality disorder and who present a high risk of re-offending (men and women) and serious harm to others (men). Further PD treatment and progression services are being commissioned in lower security prisons and in the community as part of the new PD Strategy. While the suitability criteria for the two male high-security PD treatment sites are the same, the individual units have their own assessment and treatment methods. This article aims to communicate the referral, assessment, and treatment methods employed within the prison-based Westgate Personality Disorder Treatment Service, HMP Frankland.
Examining the Direct and Indirect Effects of Fear and Anger on Criminal Decision Making Among Known Offenders
Authors: Bouffard Jeff A.
Published: June 2014

Deterrence represents the central theoretical core of the American criminal justice system, yet relatively little attention has been paid to how emotions like fear and anger may relate to deterrence. Psychological research has debated whether negative emotions each have similar impacts on decision making (valence approaches) or if distinct emotions have unique impacts (appraisal tendency approaches). This study explores the direct and indirect influences of fear and anger on hypothetical drunk driving likelihood, including their impact on cost perceptions. Surveys were administered to 1,013 male and female incarcerated felony offenders in the Southwestern United States. Using a multivariate path model and controlling for a number of other individual factors, current fear related to increased cost perceptions and anger to decreased costs. Anger also maintained a direct influence on drunk driving, whereas fear did not. Despite their shared negative valence, fear and anger appear to have dissimilar influences on cost perceptions and criminal decision making. A better understanding of these processes may lead to improved crime prevention approaches.
Headache in sleep apnea syndrome: Epidemiology and pathophysiology
Authors: Russell Michael B , Kristiansen Håvard A , Kværner Kari J
Published: June 2014

This review investigates the relation between obstructive sleep apnea and sleep apnea headache, migraine and tension-type headache. Focus is made on studies from the general population with interviews conducted by a physician and obstructive sleep apnea confirmed by polysomnography.

Obstructive sleep apnea syndrome is observed in 3% of the middle-aged population. The prevalence of sleep apnea headache in this population is 12%–18%, while morning headache with similar symptomatology as sleep apnea headache occur in 5%–8% of the general population. People with sleep apnea headache did have significantly more minutes below 90% oxygen saturation (23.1 min vs. 1.9 min, p = 0.002), higher level of average oxygen desaturation (5.9% vs. 4.5%, p < 0.001) and lower average of the lowest oxygen saturation (80.9% vs. 88.5%, p < 0.001) than people with morning headache. A comparison of those with obstructive sleep apnea with or without sleep apnea headache showed no significant differences. Thus, oxygen desaturation alone cannot explain the pathophysiology of sleep apnea headache.

Obstructive sleep apnea and migraine, and obstructive sleep apnea and tension-type headache are not related in the general population.

The cause of sleep apnea headache remains to be elucidated.
The Influence of Cervical Muscle Characteristics on Head Impact Biomechanics in Football
Authors: Schmidt Julianne D. , Guskiewicz Kevin M. , Blackburn J. Troy , Mihalik Jason P. , Siegmund Gunter P. , Marshall Stephen W.
Published: June 2014

Background:

An athlete is thought to reduce head acceleration after impact by contracting the cervical musculature, which increases the effective mass of the head.

Purpose:

To compare the odds of sustaining higher magnitude in-season head impacts between athletes with higher and lower preseason performance on cervical muscle characteristics.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Forty-nine high school and collegiate American football players completed a preseason cervical testing protocol that included measures of cervical isometric strength, muscle size, and response to cervical perturbation. Head impact biomechanics were captured for each player using the Head Impact Telemetry System. A median split was used to categorize players as either high or low performers for each of the following outcome measures: isometric strength (peak torque, rate of torque development), muscle size (cross-sectional area), and response to cervical perturbation (stiffness, angular displacement, muscle onset latency). The odds of sustaining moderate and severe head impacts were computed against the reference odds of sustaining mild head impacts across cervical characteristic categorizations.

Results:

Linemen with stronger lateral flexors and composite cervical strength had about 1.75 times’ increased odds of sustaining moderate linear head impacts rather than mild impacts compared with weaker linemen. Players who developed extensor torque more quickly had 2 times the increased odds of sustaining severe linear head impacts (odds ratio [OR], 2.10; 95% CI, 1.08-4.05) rather than mild head impacts. However, players with greater cervical stiffness had reduced odds of sustaining both moderate (OR, 0.77; 95% CI, 0.61-0.96) and severe (OR, 0.64; 95% CI, 0.46-0.89) head impacts compared with players with less cervical stiffness.

Conclusion:

The study findings showed that greater cervical stiffness and less angular displacement after perturbation reduced the odds of sustaining higher magnitude head impacts; however, the findings did not show that players with stronger and larger neck muscles mitigate head impact severity.
Connecting People and Place Prosperity
Authors: Schrock Greg
Published: June 2014

In recent years, the field of workforce development has emerged as a distinct area of policy and practice. While planning scholars have begun to engage with the workforce development field, its relevance and points of connection to planning scholarship remain underexplored. This article attempts to define the workforce development field by articulating its core concerns as well as its domains of practice and scholarship outside the planning field. The article locates workforce development within three stands of planning scholarship, concluding that workforce development represents an important bridge for planners between “place” and “people” prosperity within communities.
School Bullying, Low Self-Control, and Opportunity
Authors: Moon Byongook , Alarid Leanne Fiftal
Published: June 2014

The theory of low self-control has been shown to be a valid predictor of a wide variety of criminal and deviant behaviors. However, a limited number of studies were conducted to understand the relationship between low self-control and bullying and the effects of opportunity factors (i.e., parental supervision, association with other bullies, negative school environment, and disciplinary measures used by teachers) on bullying in the context of low self-control theory. The present study, using a sample of nearly 300 youths, examined the effects of low self-control and opportunity factors on various types of bullying behaviors. Results indicated that youths with low self-control were likely to physically and psychologically bully, consistent with the theory’s prediction. When opportunity measures were introduced, they were stronger explanations of bullying than low self-control, especially association with other bullies and youth who experienced disciplinary measures by their teacher. Negative school environment was a significant predictor of psychological bullying but not for physical bullying. Theoretical and policy implications are discussed.
Design and implementation of a real-time power management strategy for a parallel hybrid electric bus
Authors: Ye Xiao , Jin Zhenhua , Hu Xiaosong , Lu Qingchun
Published: June 2014

A real-time energy management strategy derived from an equivalent consumption minimization strategy for a parallel hybrid electric bus is introduced. Although an equivalent consumption minimization strategy is a near-optimal control strategy for the power management problems of hybrid electric vehicles, the computation cost and the driveability requirements are still barriers for it to be directly implemented on real-time controllers. This paper analyses the controller characteristics of the equivalent consumption minimization strategy based on the Willans line model for an internal-combustion engine and an electric motor. A two-step method is proposed to simplify and approximate the standard equivalent consumption minimization strategy controller. The strategy for the proposed controller, which is called the Willans line–equivalent consumption minimization strategy, can reduce the computation cost of optimization and can guarantee near-optimum fuel economy, while improving the vehicle driveability. The proposed controller is then validated by offline simulation and an onboard bench test. A backward simulation is conducted to test the fuel economy performance of the controller simplified from the two steps, together with dynamic programming and an equivalent consumption minimization strategy based on look-up tables. Then the controller is tuned by a high-fidelity forward simulation to explore the trade-off between the fuel economy and the driveability. Finally, a bench test with real powertrain components is presented to illustrate the effectiveness of the proposed methodology.
Can Classic Moral Stories Promote Honesty in Children?
Authors: Lee Kang , Talwar Victoria , McCarthy Anjanie , Ross Ilana , Evans Angela , Arruda Cindy
Published: June 2014

The classic moral stories have been used extensively to teach children about the consequences of lying and the virtue of honesty. Despite their widespread use, there is no evidence whether these stories actually promote honesty in children. This study compared the effectiveness of four classic moral stories in promoting honesty in 3- to 7-year-olds. Surprisingly, the stories of “Pinocchio” and “The Boy Who Cried Wolf” failed to reduce lying in children. In contrast, the apocryphal story of “George Washington and the Cherry Tree” significantly increased truth telling. Further results suggest that the reason for the difference in honesty-promoting effectiveness between the “George Washington” story and the other stories was that the former emphasizes the positive consequences of honesty, whereas the latter focus on the negative consequences of dishonesty. When the “George Washington” story was altered to focus on the negative consequences of dishonesty, it too failed to promote honesty in children.
The effect of injector size on compressor performance in a transonic axial compressor with discrete tip injection
Authors: Wang Wei , Chu Wuli , Zhang Haoguang
Published: June 2014

The present study investigates the effects of injector size, which covers both circumferential extent and radial extent on compressor stability and radial work redistribution using time-accurate three-dimensional numerical simulations for multi-passages in a transonic compressor with discrete tip injection. Injector width ranges from 1% to 14.5% of casing perimeter and injector throat height varies from 2 to 6 times the height of rotor tip clearance. Six identical injectors are uniformly mounted around the annulus. Results indicate that, with sufficient covering of injection, tip injection can significantly improve compressor stability. Stability margin is improved by 3.5% employing 0.65% of the annulus mass flow. With injector width increased, stability improves sharply when the width is less than 4.5% of casing perimeter, but increases flatly for the rest coverage. Expanding injector throat height to an intermediate level can further enhance compressor stability, but excessive throat height is detrimental on account of the deterioration of the aerodynamic characteristic of Coanda injector. The average decrement of the blockage in injection region, which is defined as injection efficiency, is a key factor that takes primary responsibility for the capacity of tip injection in stability improvement. Injection efficiency derived from the same operating condition for all the configurations with tip injection is well-qualified to estimate the trend of stability improvement. The unsteady influence on radial work redistribution is much more significant than the time-averaged one.
Tacrolimus is an effective treatment for lupus nephritis in pregnancy
Authors: Webster P , Wardle A , Bramham K , Webster L , Nelson-Piercy C , Lightstone L
Published: June 2014

Lupus nephritis during pregnancy increases morbidity and mortality for mother and baby. Flares are difficult to treat as many therapeutic options are teratogenic or fetotoxic. Steroids alone may be unable to control disease activity and are associated with higher rates of preterm delivery, sepsis and gestational diabetes. Reports of using tacrolimus to treat lupus nephritis in pregnancy are limited. We describe the pregnancies of nine women in whom tacrolimus was successfully used to treat lupus nephritis flare (six patients) or maintain stable disease (three patients). Introduction or dose escalation of oral steroids was avoided in five of the patients who developed active disease and steroid dose was rapidly reduced in the sixth patient. All women with disease flare attained partial or complete remission after starting tacrolimus. None of the women on maintenance treatment developed active disease. We propose tacrolimus as an effective adjuvant or alternative therapy to steroids for treating lupus nephritis flare or maintaining stable disease during pregnancy.
Cylindrical ferroelectric heat pump
Authors: Mohammadi Saber , Khodayari Akram , Mohammadi Pouria
Published: June 2014

In this article, the feasibility of using ferroelectric materials as a heat pump based on electrocaloric effect has been studied. Alternative switching of the electrocaloric elements generate directed heat flux. The dynamics of temperature variations at the inner boundary of a layered cylindrical structure to an applied periodic electric field have been studied in two different cases. These two different cases are the outer boundary convection condition and the outer boundary constant temperature condition. The inner boundary is insulated in two cases. Results show that different boundary conditions affect the heat pump performance.
The Integrative Team Knowledge Building Training Strategy in Distributed Problem-Solving Teams
Authors: Rentsch Joan R. , Delise Lisa A. , Mello Abby L. , Staniewicz Melissa J.
Published: June 2014

Team knowledge building requires teams to discuss all available pertinent task information. However, teams tend to extract information ineffectively due to impediments including the sampling advantage of common information and differential schema structures among team members. In addition, distributed teams have difficulty building knowledge due to constraints associated with low-bandwidth computer-mediated communication. Therefore, we tested a team training strategy aimed at facilitating team knowledge building in distributed teams. Data were collected from 40 teams of three distributed members. Teams were assigned to a training or control condition, and they completed a realistic problem-solving task. Training condition teams were trained to build knowledge by creating a knowledge object integrated with schema-enriched communication behaviors in text chat. Control condition teams communicated using chat only and received no training. Results indicated trained teams, relative to untrained teams, shared more unique information, transferred more knowledge, developed higher cognitive congruence, and produced higher quality solutions.
Students, Severe Illness, and Palliative Care
Authors: Beccaro M. , Gollo G. , Ceccon S. , Giordano M. , Salvini E. , Vignali S. , Costantini M. , Di Leo Silvia
Published: June 2014

This study was aimed at piloting a school-based intervention on severe illness, within a project focused on spreading knowledge of palliative care among high school students (phases 0-2 Medical Research Council Framework). The intervention entailed the screening of a topic-related movie, 2 classroom meetings, and the development of a class-based multimedia production. Five classes from 5 high schools participated in this study, and a before–after evaluation was used to assess intervention feasibility and impact. Valid questionnaires were filled in by 84% (before) and 79% (after) of the 89 students. Concerning students’ knowledge on palliative care, the after evaluation showed a significantly higher paired proportions of students reporting on “improving patient quality of life” and “life-threatening illness.” Intervention components were deemed helpful by students, and positive feedback on the experience was given.
Utilizing Middle School Common Planning Time to Support Inclusive Environments
Authors: Hunter William , Jasper Andrea D. , Williamson Robert L.
Published: June 2014

In common planning time (CPT), middle school educators have an opportunity to share their experience and expertise during a designated period. Common planning time is especially beneficial in the collaborative process in which special and general educators can address the needs of students with exceptionalities. This column provides an outline on the possible implementation and the virtual experience of CPT and also offers information on how special education topics can be incorporated within CPT.
Cynics and Skeptics
Authors: Carr D. Jasun , Barnidge Matthew , Lee Byung Gu , Tsang Stephanie Jean
Published: June 2014

With the increase in citizen-generated news, the need to understand how individual predispositions interact with news sources to influence perceptions of news credibility becomes increasingly important. Using a web-based experiment, this study examines the influences individual predispositions toward the media and politics have on perceived credibility of mainstream and citizen journalism. Analyzing data drawn from a representative sample of the U.S. adult population, results indicate that media skepticism and political cynicism interact, such that cynics and skeptics perceive citizen journalism as more credible, while non-cynics and non-skeptics think mainstream journalism is more credible.
Unpacking Masculinities in the Context of Social Change
Authors: Boratav Hale Bolak , Fişek Güler Okman , Ziya Hande Eslen
Published: June 2014

Through analysis of fifty in-depth interviews with married men from different socioeconomic backgrounds and ages in seven provinces in Turkey, this article examines the internal dilemmas and contradictions in the construction of masculine identities in the context of social change in the country. The focus is on men’s experiences of most salient relational contexts with their parents, their children, and their spouses, and the possible implications of these relational experiences as well as prevailing social discourses for how these men negotiate masculinity. Overall, the men’s narratives indicate that both the relationship with the children and with the wife are relationships in transition, reflected in the dilemmas and contradictions at the discursive level, as well as between discourse and lived reality, resulting from the juxtaposition of relatively traditional backgrounds and the prevailing discourse of traditionalism with the emerging modernist discourse of egalitarianism. Findings are discussed in the context of the relevant literature and the socio-cultural context.
‘Except that Joss Whedon is god’: fannish attitudes to statements of author/ity
Authors: Fathallah Judith
Published: June 2014

Early internet and fan studies theorists believed the New Media context and work of the active fan would bring theories like the Death of the Author to fruition. Contemporary fan studies scholars are more reserved, acknowledging diversity in fan attitudes. Through analysis of a LiveJournal article with comments on authors’ views concerning fanfiction, this article demonstrates the paradoxical investment in various forms of authorial authority espoused across fan communities, as well as defiance and repudiation of them. I argue that while the authors quoted are denied legitimate authority through various tactics, the concept of an originating, proprietary authorship, with attendant capitalist powers and rights, retains much influence. The concept of the author holds more power than the individual figures attempting to wield it, and fans attribute or deny the power of authorship to particular figures according to their public personas and cultural politics. In this sense, fans may withhold or bestow legitimation through the operation of Foucault’s author-function, interpreting text and statements of authority through the public persona of the author.
Measuring Aggregate Social Capital Using Census Response Rates
Authors: Martin David C. , Newman Benjamin J.
Published: June 2014

Despite the importance of social capital to political science research, conventional means of measuring it are subject to a range of problems, including nonresponse bias, declining validity over time, and/or a lack of conceptual coherence. We argue that, in the case of the United States, rates of response to the decennial census represent a powerful yet overlooked measure for aggregate social capital. In this research note, we elaborate a theoretical rationale for the measure and empirically validate it, showing across multiple data sets and levels of geographic aggregation that census response rates (CRR) strongly predict various dimensions of social capital. Our findings highlight an important opportunity for social capital scholars to use existing governmental data to better measure geospatial variation in a key social science construct.
Cognitive Impairment Among Elderly Individuals in Shanghai Suburb, China
Authors: Chen Jin-Mei , Cui Guo-Hong , Jiang Guo-Xin , Xu Rui-Fang , Tang Hui-Dong , Wang Gang , Chen Sheng-Di , Cheng Qi
Published: June 2014

Objectives:

To investigate the association between serum C-reactive protein (CRP) concentration and cognitive impairment as well as interactions between CRP and other relevant factors.

Methods:

Patients with cognitive impairment and 1 to 2 age- and sex-matched controls nested from a population-based study among residents aged 60 years and older in Shanghai suburb. The associations of serum CRP concentration and other relevant factors were examined with logistic regression analysis.

Results:

The mean CRP in patients with cognitive impairment was higher than that in controls ( P < .001). The highest quartile of CRP (>4.77 mg/L), abdomen obesity, hypertriglyceridemia, and hyperglycemia was associated with cognitive impairment. Significant interactions were found between increased CRP and hypertriglyceridemia as well as between increased CRP and hyperglycemia on cognitive impairment; and the attributable proportion due to interaction was 82% ( P < .0001) and 37% ( P = .007), respectively.

Conclusions:

Increased CRP was associated with cognitive impairment, and additive effects of increased CRP with hypertriglyceridemia and hyperglycemia on cognitive impairment were observed among elderly individuals.
Developing CIRCA-BC and Exploring the Role of the Computer as a Third Participant in Conversation
Authors: Purves Barbara A. , Phinney Alison , Hulko Wendy , Puurveen Gloria , Astell Arlene J.
Published: June 2014

The Computer Interactive Reminiscence Conversation Aid (CIRCA) is a software program using touch screen technology and digital materials from public archives to support conversation between people with dementia and their carers. In this 2-phase study, we first worked with seniors’ focus groups to identify and select relevant content for a regional adaptation of CIRCA (British Columbia version of CIRCA [CIRCA-BC]). We then pilot tested CIRCA-BC with 3 participants having dementia and a conversation partner, analyzing their interactions to explore how they drew on program content and format to shape their conversations together. Findings provide insight into, first, how participants’ shared and distinct social histories influence reminiscence-based conversations and, second, how the computer can be viewed as a third “participant” in the interaction. These findings offer guidelines for ongoing adaptation and application of the CIRCA program in addition to contributing further evidence regarding the role of technology in facilitating meaningful interaction between people with dementia and their carers.
The Value and Underutilization of Simple Reading Glasses in Geropsychiatry Inpatient Settings
Authors: Barnes Shawn S. , Sewell Daniel D.
Published: June 2014

For almost everyone, the need for reading glasses is an inevitable part of the second half of life. Forgetting one’s reading glasses at a restaurant can be a disturbing reminder of one’s dependence on them. For geriatric inpatients, however, the value of reading glasses in improving quality of life and preventing delirium may be overlooked. Subsequently, the authors present a brief review of visual impairment, the relationship of visual impairment and cognition and the cost of reading glass, and the results of a survey that was conducted to determine the proportion of inpatient geriatric psychiatry inpatient units in the United States, which provide reading glasses to inpatients as well as to assess the knowledge of medical directors of these units regarding the cost and perceived value of providing reading glasses to hospitalized patients.
Ciz1 is a novel predictor of survival in human colon cancer
Authors: Wang Dong-qing , Wang Kun , Yan Dong-wang , Liu Ju , Wang Bin , Li Ming-xue , Wang Xiao-wei , Liu Jing , Peng Zhi-hai , Li Guang-xin , Yu Zhen-hai
Published: June 2014

Cip1-interacting zinc-finger protein1 (Ciz1) is a nuclear matrix protein associated DNA replication factor which has been implicated in breast and lung cancer progression. However, the clinical significance of Ciz1 expression in colon cancer has not been determined. This study aimed to examine Ciz1 expression pattern and its potential as a biomarker of prognosis in colon cancer. Using quantitative PCR, tissue microarray (TMA), and ELISA, we evaluated Ciz1 mRNA and protein levels in tumor tissues from patients with colon cancer and in paired adjacent normal tissues. Ciz1 mRNA expression was significantly upregulated in 22 of 39 paired samples ( P < 0.001). Immunohistochemistry on TMA-containing samples from 203 colon cancer patients indicated that Ciz1 protein expression was significantly higher in tumor tissues than in adjacent normal tissues (Stuart-Maxwell test, P < 0.001). Elevated expression of Ciz1 protein was significantly correlated with T stage ( P < 0.001), N stage ( P = 0.005), M stage ( P = 0.021), and AJCC stage ( P = 0.002). Multivariate Cox proportion hazard model analysis revealed that Ciz1 expression is an independent prognostic factor for overall time (OS; hazard ratio (HR): 1.76; 95% confidence interval (CI): 1.04–2.98; P = 0.034) and disease-free survival (DFS; HR: 2.02; 95% CI: 1.14–3.58; P = 0.017) of patients with colon cancer after colectomy. Our data suggested that Ciz1 may be involved in colon cancer progression and could serve as a novel predictor of survival for colon cancer patients.
Steroids inhibit vascular endothelial growth factor expression via TLR4/Akt/NF-κB pathway in chronic rhinosinusitis with nasal polyp
Authors: Cho Jung-Sun , Kang Ju-Hyung , Park Il-Ho , Lee Heung-Man
Published: June 2014

Vascular endothelial growth factor (VEGF) is elevated in chronic rhinosinusitis with nasal polyps. Steroids have anti-inflammatory properties and are ideal candidates for treating chronic inflammatory airways. The aims of this study were to identify the inhibitory effects and mechanisms of steroids on lipopolysaccharide (LPS)-induced VEGF expression in nasal polyps. Nasal polyp-derived fibroblasts (NPDFs) were stimulated with LPS alone or with both LPS and steroids were used to determine the expression levels of toll-like receptor (TLR)-4, myeloid differentiation primary response gene 88 ( MyD88), and VEGF by using reverse transcription-polymerase chain reaction (RT-PCR). VEGF protein level was analyzed by immunocytochemical staining and enzyme-linked immunosorbent assay (ELISA). Small interfering RNA (siRNA) for TLR4 was transfected to down-regulate TLR4 expression. Activation of Akt and nuclear factor κB (NF-κB) pathway on VEGF expression was determined by Western blot analysis, immunocytochemical staining, and ELISA. Nasal polyp organ cultures were stimulated with LPS alone or in conjunction with steroids or LPS-RS (TLR4 inhibitor) and accessed the expression of VEGF. Steroids decreased the expressions of TLR4, MyD88, and VEGF mRNA and VEGF protein in LPS-stimulated NPDFs. Steroids inhibited LPS-induced VEGF expression levels in dose-dependent manner. The suppression of TLR4 transcription by siRNA treatment reduced LPS-induced expression of both TLR4 and VEGF in NPDFs. Furthermore, steroids inhibited the production of VEGF by blocking Akt and NF-κB activation and preventing with NF-κB translocation. Also, steroid and TLR4 inhibitor decreased VEGF expression in nasal polyp organ cultures. These results indicate that steroids inhibit LPS-induced VEGF expression through the TLR4/Akt/NF-κB signaling pathway in chronic rhinosinusitis with nasal polyp.
Effects of magnesium deficiency – More than skin deep
Authors: Chandrasekaran Navin Chandrakanth , Weir Christopher , Alfraji Sumaya , Grice Jeff , Roberts Michael S , Barnard Ross T
Published: June 2014

Dead Sea and magnesium salt therapy are two of the oldest forms of treatment for skin disease and several other disorders, supported by a body of largely anecdotal evidence. In this paper we review possible pathways for penetration of magnesium ions through the epidermis to reach the circulation, in turn replenishing cellular magnesium levels. We also discuss mechanisms for intercellular movement of magnesium ions and possible mechanisms for the interaction between magnesium ions and inflammatory mediators. Upon addition of magnesium ions in vitro, the expression of inflammatory mediators such as tumour necrosis factor α (TNFα) and nuclear factor κβ (NFκβ) is down regulated. Dysregulation of these and other inflammatory mediators has been linked to several inflammatory disorders, including asthma, arthritis, atherosclerosis and neuroinflammation.
Persistent Sexual, Emotional, and Cognitive Impairment Post-Finasteride
Authors: Ganzer Christine Anne , Jacobs Alan Roy , Iqbal Farin
Published: June 2014

Finasteride is a synthetic 5-α reductase inhibitor, which prevents the conversion of testosterone to dihydrotestosterone and has been used for more than 20 years in the treatment of male pattern hair loss. Randomized, controlled trials have associated finasteride with both reversible and persistent adverse effects. In this pilot study, we sought to characterize sexual and nonsexual adverse effects that men reported experiencing at least 3 months after stopping the medication. Based on previous research on persistent side effects of finasteride, we constructed an Internet survey targeting six domains: physical symptoms, sexual libido, ejaculatory disorders, disorders of the penis and testes, cognitive symptoms, and psychological symptoms and was e-mailed to patients who reported experiencing symptoms of side effects of finasteride. Responses from 131 generally healthy men (mean age, 24 years) who had taken finasteride for male pattern hair loss was included in the analysis. The most notable finding was that adverse effects persisted in each of the domains, indicating the possible presence of a “post-finasteride syndrome.”
High Estrogen in Men After Injectable Testosterone Therapy
Authors: Tan Robert S. , Cook Kelly R. , Reilly William G.
Published: June 2014

Testosterone replacement improves quality of life and is aromatized in men in adipose tissues to estrogen. Hyperestrogenism is believed to be harmful to male sexuality. This is a description of our experience of screening 34,016 men in the Low T Centers, of which approximately 50% were converted to treatment. Men were treated with injectable testosterone, and we have available data from 2009 to 2014. The data were extracted from our electronic health record (AdvancedMD) of 35 Low T Centers across the United States. In all, 7,215 (20.2%) out of the 34,016 patients had high estradiol levels defined as ≥42.6 pg/ml. Estradiol was measured using electro-chemiluminescence immunoassay. Of the patients who had high estradiol levels, the age distribution was as follows: 132/989 (13.3%) were older than 65 years, 3,753/16,955 (22.1%) were between 45 and 65 years; 2,968/15,857 (18.7%) were between 25 and 44 years, 7/215 (3.3%) were younger than 25 years. The difference between extreme age groups (<25 and ≥65) was statistically significant using a chi-square test ( p = .013). The correlation coefficient of serum estradiol to age was .53, SD = 8.21. It was observed that practitioners used aromatase inhibitor and selective estrogen receptor modulator to treat symptoms of hyperestrogenism, irrespective of blood estradiol levels. Gynecomastia was rarely documented as a reason for the prescription. Our finding was that high estradiol levels were not associated with higher rates of low libido but established higher rates of documented low libido with those with normal or lower estradiol levels. The difference was statistically significant ( p < .05).
Headaches in children
Authors: Ahmed Mas , Naz Sabina , Akinnawo Elizabeth
Published: June 2014

Headaches are common in children; however, assessment can be a challenge in this age group. The description of an attack may not be clear, attacks may be infrequent and so a pattern of attacks may be difficult to ascertain, examination can be difficult, especially in a very young or uncooperative child, and presentation is often accompanied by significant parental anxiety. This article aims to provide a strategy for GPs to differentiate primary from secondary headaches and common primary headache types such as migraine and tension-type headache. It also outlines the primary care management of these conditions.
Asenapine augmentation and treatment-resistant schizophrenia in the high-secure hospital setting
Authors: Smith E. Naomi , Durge Vijay , Sengupta Samrat , Das Mrigendra
Published: June 2014

Introduction:

Asenapine is a novel, recently introduced antipsychotic drug. It has a unique receptor profile and it is licensed in the UK for the treatment of bipolar-affective disorder. However, there is some evidence for its effectiveness in schizophrenia and it is licensed for schizophrenia treatment in a number of countries. Significant numbers of patients within the high-secure hospital setting suffer from treatment-resistant schizophrenia. Many patients fail to respond to adequate antipsychotic trials, and require trials of augmentation with other medications.

Methods:

We report on our experience of using asenapine for augmentation of other antipsychotic medications in two male patients with treatment-resistant schizophrenia and histories of interpersonal violence. The patients provided informed consent to participate in this case series. Data were collected from the patients’ clinical records, incident reports and hospital medical centre records. These records were used to derive primary and secondary outcome measures. These included time spent in seclusion, verbal and physical aggression, numbers of incidents and metabolic parameters. Symptoms were rated pre- and postaugmentation using the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression rating scales.

Results:

Both patients showed an improvement after the addition of asenapine. These improvements were characterized by a reduction in global PANSS scores, in the PANSS excitability component, a reduction in scores of violence, overall incidents and reduction in seclusion hours.

Conclusions:

We found asenapine to be an effective augmentation agent with other antipsychotics in both patients. Clinical improvement was noted within weeks. The case-series nature and small sample size limited our ability to draw firm conclusions from our data. However, retrospective analysis has allowed us to take a naturalistic approach that this augmentation strategy may be advantageous on an individual patient basis in a high-secure hospital setting.
Caval variations in neurologically diseased patients
Authors: Akinola Rachael A , Idowu Olufemi E , Nelson-Paseda Adedolapo O
Published: June 2014

Background

The import of the cavum variation and its prevalence rate in healthy individuals is still not clear, likewise in neurologically diseased patients.

Purpose

To evaluate the frequency and pattern of caval variations in neurologically diseased patients.

Material and Methods

The presence or absence of the cavum septum pellucidum (CSP), cavum vergae (CV), or cavum velum interpositum (CVI) was reviewed from successive cranial computerized tomography (CT) images of patients who were aged 6 months and above. Two hundred and seventeen cranial CT images were reviewed.

Results

At least a cavum variation was noted in 130 (59.9%) of the CT scan images reviewed. The CV, CVI, and CSP were noted in 86 (39.6%), 53 (24.4%), and 50 images (23%), respectively. Caval multiplicity was noted in 102 patients (47%). There was no significant difference in the rate of occurrence of cavum variations in patients with congenital brain diseases and acquired brain conditions ( P = 0.484), neither was there a significant difference in the frequency of cavum variation in children aged older than 6 months compared to adults ( P = 0.101).

Conclusion

Cava variations are relatively common in neurological brain diseases. Patients with congenital brain diseases did not have a higher frequency of cava variation when compared with those that had acquired lesions. The most common type of cavum variation noted in this study was the vergae variety, while the CSP is the rarest.
Economically affordable anatomical kidney phantom with calyxes for puncture and drainage training in interventional urology and radiology
Authors: Ristolainen Asko , Ross Peeter , Gavšin Juri , Semjonov Eero , Kruusmaa Maarja
Published: June 2014

Background

Trends in interventional radiology and urology training are orientated towards reducing costs and increasing efficiency. In order to comply with the trends, we propose training on inexpensive patient-specific kidney phantoms.

Purpose

To develop a new kidney phantom for puncture and drainage training in interventional urology and radiology, and to evaluate their anatomical correctness and suitability for training compared to the traditional way of training on home-made phantoms.

Material and Methods

A case study for validation of kidney phantoms was conducted with nine radiology students divided into two groups: one trained on standard home-made training phantom ( n = 4) and the other on our kidney phantoms ( n = 5). Another test phantom was used to evaluate the effectiveness of the training of the two groups. The tests were video recorded and analyzed. Duration of the procedure was used as the primary indicator of procedure’s quality. Comparison tests were also conducted with professional radiologists. Anatomical correctness of the kidney phantom was evaluated by comparing the post mortem kidney scans with reconstructed models from CT scans. Subjective feedback was also collected from the participants. Wider use of kidney phantoms was analyzed.

Results

The average volumetric difference between post mortem kidney scans and reconstructed CT kidney models was 4.70 ± 3.25%. All five students practicing on the kidney phantom improved their performance and the results were almost equal to the results of the professional radiologist while in the other group two students out of four trained on standard home-made training phantoms failed to improve their performance. However, the small number of test subjects prevents us from drawing general conclusions about the efficiency of the new practice. The kidney phantoms were found usable also for nephrostomy catheter placement training under fluoroscopy.

Conclusion

The feedback from radiologists showed that the anatomically correct features of the phantom is an added value for the training and has a potential to increase the quality of minimally invasive procedures in general.
Differences in Patient Ratings of Medical Home Domains Among Adults With Diabetes
Authors: Hall Allyson G. , Webb Fern J. , Scuderi Christopher B. , Tamayo-Friedel Claudia , Harman Jeffrey S.
Published: June 2014

Background: There is growing and sustained recognition that Patient-Centered Medical Homes (PCMHs) represent a viable approach to dealing with the fragmentation of care faced by many individuals, including those living with diabetes. The National Committee for Quality Assurance (NCQA) has spearheaded a program that recognizes medical practices that adopt key elements of the PCMH. Even though practices can achieve the same level of recognition, it is unclear whether all PCMHs deliver care in the same manner and how these differences can be associated with patient ratings of their experience with care. Methods: This study uses a mixed-methods approach to explore differences in care delivery across 4 NCQA level 3 recognized PCMHs located in a southern state. Furthermore, the study examines the association between each clinic and patient ratings of key PCMH domains. The qualitative component of the study included in-depth interviews with medical directors at each site in order to determine how the PCMH at each clinic was operationalized. In addition, 1300 adult patients with diabetes were surveyed about their experiences with their PCMH. Bivariate and ordinal logistical analyses were conducted to determine how PCMH experiences varied across the 4 clinics. Results: The in-depth interviews revealed that one clinic (clinic 1) had a stronger primary care orientation relative to the other locations. Furthermore, patients at these clinics were more likely to provide higher ratings of care across all PCMH domains. Conclusions: This study demonstrates that not all PCMH clinics are alike and that these differences can possibly affect patient perceptions of their care.
Race, Space, and Being Policed
Authors: Bonner Kideste Mariam Wilder
Published: June 2014

Research on race and policing has consistently documented the link between race, space, and policing with racial disparities in perceptions and experiences often explained by nature of policing within low-income, distressed communities of color. This study adds a new dimension to past research by examining the relationship between race, racial composition of place, and residents’ experiences with southern police across public and semipublic spaces within a middle-class, low-crime, tourism-driven resort area. Using grounded theory methods, this study combines survey data with in-depth group interviews and structured observations to reveal variability in participants’ experiences with southern patrols. Specifically, African American participants expressed concern for excessive police distribution, differential enforcement, and social exclusion, offering the least supportive attitudes regarding officer demeanor. These findings highlight the importance of using comprehensive measures to access residents’ experiences with police and contribute to the understanding of how various geographic contexts might produce racial disparities, highlighting the salience of race in the policing of ethnically diverse public spaces.
Studies on the stretching behaviour of medium gauge high impact polystyrene sheets during positive thermoforming
Authors: Kommoji Satish , Banerjee Ritima , Bhatnagar Naresh , Ghosh Anup K
Published: June 2014

High impact polystyrene sheets (HIPS) of 1.5 mm and 2.5 mm thicknesses were thermoformed on moulds of different parameters at sheet heating temperatures of 130℃ and 140℃. Formability studies indicated no difference in wall thickness distribution at different sheet temperatures. Due to non-uniform stretching of the sheet, wall thickness distribution along the slant length was found to have three regions. In the regions near the mould corner and clamp point, wall thickness was found to decrease with increase in distance from the corner, in these zones. The decrease near the corner was much greater and sharper than that near the clamp point. The decrease in both regions was found to increase at higher depths of draw and decrease at higher draft angles. In the intermediate portion of the slant length, no significant variation in wall thickness was observed.
FOLFOX as second-line chemotherapy in patients with pretreated metastatic pancreatic cancer from the FIRGEM study
Authors: Zaanan Aziz , Trouilloud Isabelle , Markoutsaki Theofano , Gauthier Mélanie , Dupont-Gossart Anne-Claire , Lecomte Thierry , Aparicio Thomas , Artru Pascal , Thirot-Bidault Anne , Joubert Fanny , Fanica Daniella , Taieb Julien
Published: June 2014

Background

FOLFOX second-line treatment seems to be a validated option for patients with pancreatic cancer (PC) progressing after gemcitabine chemotherapy. However, other therapeutics strategy has developed in first-line therapy, as the FIRGEM phase II study that evaluated gemcitabine alone versus FOLFIRI.3 alternating with gemcitabine every two months. The present study assessed the efficacy and safety of FOLFOX after failure of the first-line therapy used in the FIRGEM study.

Methods

In this prospective observational cohort study, we analysed all consecutive patients who received second-line chemotherapy with FOLFOX among 98 patients with metastatic PC included in the FIRGEM study. Progression-free survival (PFS) and overall survival (OS) were estimated from the start of second-line chemotherapy using the Kaplan-Meier method.

Results

Among 46 patients who received second-line chemotherapy, 27 patients (male, 55%; median age, 61 years; performance status (PS) 0–1, 44%) were treated with FOLFOX after progression to first-line gemcitabine alone (n = 20) or FOLFIRI.3 alternating with gemcitabine (n = 7). Grade 3 toxicity was observed in 33% of patients (no grade 4 toxicity). At the end of follow-up, all patients had progressed and 25 had died. No objective response was observed, and disease control rate was 36%. Median PFS and OS were 1.7 and 4.3 months, respectively. In multivariate analysis, PS was the only independent prognostic factor. For patients PS 0–1 versus 2–3, median PFS was 3.0 versus 1.2 months (log rank, p = 0.002), and median OS was 5.9 versus 2.6 months (log rank, p = 0.001).

Conclusions

This study suggests that FOLFOX second-line therapy offered interesting efficacy results with an acceptable toxicity profile in metastatic PC patients with a good PS.