bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Randomization to Intensive Glucose Control on Adverse Events, Cardiovascular Disease, and Mortality in Older Versus Younger Adults in the ACCORD Trial
Authors: Miller Michael E. , Williamson Jeff D. , Gerstein Hertzel C. , Byington Robert P. , Cushman William C. , Ginsberg Henry N. , Ambrosius Walter T. , Lovato Laura , Applegate William B. ,   for the ACCORD Investigators
Published: October 2013

OBJECTIVE

We explore the effect of randomized treatment, comparing intensive to standard glucose-lowering strategies on major cardiovascular outcomes, death, and severe adverse events in older versus younger participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial.

RESEARCH DESIGN AND METHODS

Participants with type 2 diabetes (n = 10,251) with a mean age of 62 years, a median duration of diabetes of 10 years, and a median A1C of 8.1% (65 mmol/mol) were randomized to treatment strategies targeting either A1C <6.0% (42 mmol/mol) or 7.0–7.9% (53–63 mmol/mol) and followed for a mean of 3.7 years. Outcomes were analyzed within subgroups defined by baseline age (<65 vs. ≥65 years).

RESULTS

Older and younger ACCORD participants achieved similar intensive-arm A1C levels and between-arm A1C differences. Within the older subgroup, similar hazards of the cardiovascular primary outcome and total mortality were observed in the two arms. While there was no intervention effect on cardiovascular mortality in the older subgroup, there was an increased risk in the intensive arm for the younger subgroup (older hazard ratio [HR] = 0.97; younger HR = 1.71; P = 0.03). Regardless of intervention arm, the older subgroup experienced higher annualized rates of severe hypoglycemia (4.45% intensive and 1.36% standard) than the younger subgroup (2.45% intensive and 0.80% standard).

CONCLUSIONS

Intensive glucose lowering increased the risk of cardiovascular disease and total mortality in younger participants, whereas it had a neutral effect in older participants. The intensive to standard relative risk of severe hypoglycemia was similar in both age subgroups, with higher absolute rates in older participants within both treatment arms.
Effect of Glycemic Treatment and Microvascular Complications on Menopause in Women With Type 1 Diabetes in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Cohort
Authors: Kim Catherine , Cleary Patricia A. , Cowie Catherine C. , Braffett Barbara H. , Dunn Rodney L. , Larkin Mary E. , Gatcomb Patricia M. , Wessells Hunter B. , Nathan David M. , Sarma Aruna V. ,   for the DCCT/EDIC Research Group
Published: October 2013

OBJECTIVE

We examined the impact of intensive versus conventional diabetes treatment upon menopause among women with type 1 diabetes in the Diabetes Control and Complications Trial (DCCT), a randomized controlled trial of intensive diabetes treatment, and its observational follow-up, the Epidemiology of Diabetes Interventions and Complications (EDIC) study.

RESEARCH DESIGN AND METHODS

In a secondary analysis of women in the DCCT/EDIC (n = 657), outcomes were the cumulative incidences of natural menopause and surgical menopause. Cox regression analyses were used to examine associations with treatment group, time-varying estimates of hemoglobin A1c (HbA1c), insulin dosage, BMI, and microvascular complications (retinopathy, nephropathy, and neuropathy).

RESULTS

By EDIC year 18, after an average of 28 years of follow-up, 240 (38%) women had experienced natural menopause and 115 (18%) women had experienced surgical menopause. Age at natural menopause was similar in the intensive versus conventional groups (49.9 vs. 49.0 years; P = 0.28), and age at surgical menopause was similar in the intensive versus conventional groups (40.8 vs. 42.0 years; P = 0.31). In multivariable models, treatment group, HbA1c, and microvascular complications were not associated with risk of natural or surgical menopause. Each 10 unit/day increase in insulin dosage decreased risk of natural menopause (hazard ratio [HR] 0.91, 95% CI 0.75–0.98) and each kg/m2 increase in BMI increased risk of surgical menopause (HR 1.08, 95% CI 1.00–1.16).

CONCLUSIONS

In the DCCT/EDIC, intensive versus conventional treatment group and HbA1c level were not associated with menopause risk. Greater insulin dose was associated with lower menopause risk.
Long-term outcome of sudden acquired retinal degeneration syndrome in dogs
Authors: Stuckey Jane A. , Pearce Jacqueline W. , Giuliano Elizabeth A. , Cohn Leah A. , Bentley Ellison , Rankin Amy J. , Gilmour Margi A. , Lim Christine C. , Allbaugh Rachel A. , Moore Cecil P. , Madsen Richard W.
Published: October 2013

Objective—To investigate long-term outcomes and owner-perceived quality of life associated with sudden acquired retinal degeneration syndrome (SARDS) in dogs.

Design—Survey study.

Animals—100 dogs with SARDS examined at 5 academic veterinary institutions from 2005 to 2010.

Procedures—The diagnosis was based on documented acute vision loss, normal results of ophthalmic examinations, and evaluation of extinguished bright-flash electroretinograms. Primary owners of affected dogs completed a questionnaire addressing outcome measures including vision, systemic signs, and perceived quality of life for their dogs.

Results—Age at diagnosis was significantly correlated with positive outcome measures; dogs in which SARDS was diagnosed at a younger age were more likely to have alleged partial vision and higher owner-perceived quality of life. Polyphagia was the only associated systemic sign found to increase in severity over time. Medical treatment was attempted in 22% of dogs; visual improvement was not detected in any. Thirty-seven percent of respondents reported an improved relationship with their dog after diagnosis, and 95% indicated they would discourage euthanasia of dogs with SARDS.

Conclusions and Clinical Relevance—Blindness and concurrent systemic signs associated with SARDS appeared to persist indefinitely, but only polyphagia increased in severity over time. Most owners believed their pets had good quality of life and would discourage euthanasia of dogs with SARDS.
Use of recombinant human thyroid-stimulating hormone for thyrotropin stimulation testing in euthyroid ferrets
Authors: Mayer Jörg , Wagner Robert , Mitchell Mark A. , Fecteau Kellie
Published: October 2013

Objective—To evaluate the effects of IM administration of recombinant human thyroid-stimulating hormone (rhTSH) on plasma total thyroxine (T4) concentrations in euthyroid ferrets.

Design—Evaluation study.

Animals—25 healthy neutered ferrets (14 female and 11 male) of various ages from 2 populations (laboratory ferrets from Georgia and pet ferrets from Pennsylvania).

Procedures—Each ferret underwent a physical examination and standard hematologic testing to ensure it was healthy and had clinically normal thyroid function. Once determined to be euthyroid, ferrets received a single IM injection of 100 μg of rhTSH. Blood samples were collected into plasma-separator tubes immediately before the rhTSH injection (time 0) and 4 hours after injection to measure T4 concentrations.

Results—Males did not differ from females in regard to prestimulation or poststimulation plasma T4 concentrations; however, prestimulation and poststimulation T4 concentrations were significantly different between the 2 groups of ferrets. A significant difference was also identified between prestimulation T4 concentration (mean ± SD, 21.3 ± 6.1 nmol/L) and poststimulation T4 concentration (29.9 ± 8.2 nmol/L). All 25 ferrets had high poststimulation T4 concentrations (median difference, 7. 5 nmol/L; 10% to 90% interval, 3.26 to 17.70 nmol/L [0.25 to 1.38 μg/dL]; range, 2.50 to 20.70 nmol/L [0.19 to 1.61 μg/dL]); this represented a median increase in T4 concentration of 35% (10% to 90% interval, 18% to 81%; range, 8% to 126%).

Conclusions and Clinical Relevance—Results suggested that rhTSH can be used for thyrotropin stimulation testing in ferrets when administered IM. According to the findings, a euthyroid ferret should have an increase of approximately 30% in plasma T4 concentration 4 hours after rhTSH injection.
Effects of urinary bladder retroflexion and surgical technique on postoperative complication rates and long-term outcome in dogs with perineal hernia: 41 cases (2002–2009)
Authors: Grand Jean-Guillaume , Bureau Stéphane , Monnet Eric
Published: October 2013

Objective—To evaluate the effects of urinary bladder retroflexion (UBR) and surgical technique on postoperative complication rates and long-term outcome in dogs with perineal hernia.

Design—Retrospective case series.

Animals—41 client-owned dogs with perineal hernia that underwent surgery between November 2002 and November 2009.

Procedures—Medical records were reviewed for information on dog signalment, history, physical examination findings, ultrasonographic findings, surgical techniques, intraoperative complications, duration of hospital stay, postoperative complications, and long-term outcome.

Results—31 dogs had no UBR, and 10 dogs had UBR. Internal obturator muscle transposition (IOMT) was performed in 20 dogs, and a cystopexy or colopexy was performed before the IOMT (LapIOMT) in 21. Postoperative complications included tenesmus (n = 8) and urinary incontinence (1). Rates of postoperative complications were not significantly different between the no-UBR and UBR groups or between the IOMT and LapIOMT groups. Thirty-two dogs were free of clinical signs at the time of the study. The median disease-free interval did not differ significantly between dogs in the no-UBR and UBR groups, but it was significantly lower in the LapIOMT group than in the IOMT group. None of the 7 dogs with UBR that were treated without cystopexy developed recurrence of UBR.

Conclusions and Clinical Relevance—UBR was not associated with an increased rate of postoperative complications relative to no UBR and had no effect on the long-term outcome in dogs with perineal hernia. The use of IOMT alone may be recommended for clinical use because LapIOMT offered no clear advantage.
Clinical features, treatment options, and outcome in dogs with thymoma: 116 cases (1999–2010)
Authors: Robat Cecilia S. , Cesario Lori , Gaeta Rachael , Miller Mairin , Schrempp Diane , Chun Ruthanne
Published: October 2013

Objective—To describe clinical signs, diagnostic findings, treatment, and outcome and determine factors associated with survival time for dogs with thymoma.

Design—Multi-institutional retrospective case series.

Animals—116 dogs with thymoma.

Procedures—Medical records were searched for information regarding signalment, physical examination findings, results of laboratory testing and diagnostic imaging, medical and surgical treatment, and survival data.

Results—Of the 116 dogs with thymoma, 44 (38%) were Labrador Retrievers and Golden Retrievers. Twenty of 116 (17%) dogs had signs of myasthenia gravis (diagnosis was confirmed for 13 dogs). At the time of thymoma diagnosis, 40 (34%) dogs had hypercalcemia, 8 (7%) dogs had a concurrent immune-mediated disease, and 31 (27%) dogs had another tumor; 16 (14%) dogs developed a second nonthymic tumor at a later date. Tumor excision was performed for 84 dogs, after which 14 (17%) had tumor recurrence; prognosis was good for dogs undergoing a second surgery. Median survival time with and without surgical treatment was 635 and 76 days, respectively. Presence of another tumor at the time of thymoma diagnosis, lack of surgical excision, and higher pathological stage were significantly associated with shorter survival time. Hypercalcemia and presence of myasthenia gravis or megaesophagus at the time of thymoma diagnosis, histopathologic subtype of thymoma, or tumor development at a later date was not associated with survival time.

Conclusions and Clinical Relevance—Dogs with thymoma, even those with a large tumor burden or a paraneoplastic syndrome, had a good prognosis following surgery. Surgical treatment, tumor stage, and the presence of a second tumor at diagnosis influenced survival time.
Quadriceps and Hamstrings Morphology Is Related to Walking Mechanics and Knee Cartilage MRI Relaxation Times in Young Adults
Authors: Kumar Deepak , Subburaj Karupppasamy , Lin Wilson , Karampinos Dimitrios C. , McCulloch Charles E. , Li Xiaojuan , Link Thomas M. , Souza Richard B. , Majumdar Sharmila
Published: October 2013

Study Design

Controlled laboratory study using a cross-sectional design.

Objectives

To analyze the relationship of quadriceps-hamstrings and medial-lateral quadriceps anatomical cross-sectional area (ACSA) ratios with knee loads during walking and articular and meniscal cartilage composition in young, healthy subjects.

Background

Muscle forces affect knee loading during walking, but it is not known if muscle morphology is associated with walking mechanics and cartilage composition in young subjects.

Methods

Forty-two knees from 27 young, healthy, active volunteers (age, 20–35 years; body mass index, <28 kg/m2) underwent 3-T magnetic resonance imaging (MRI) and 3-D motion capture. Standard MRI sequences were used for articular and meniscal cartilage T1rho and T2 relaxation times and for quadriceps and hamstrings muscle ACSA. Frontal plane kinetics during the stance phase of walking was calculated. Generalized estimating equation models were used to identify muscle variables that predicted MRI and gait parameters.

Results

Quadriceps-hamstrings and medial-lateral quadriceps ACSA ratios were positively related to frontal plane loading (β = .21–.54, P≤.006), global articular cartilage relaxation times (β = .22–.28, P≤.041), and the medial-lateral ratio of meniscus T1rho relaxation time (β = .26–.36, P≤.049). The medial-lateral quadriceps ACSA ratio was positively related to global meniscus T1rho relaxation times (β = .30, P = .046).

Conclusion

Higher quadriceps-hamstrings and medial-lateral quadriceps ACSA ratios were associated with higher frontal plane loading during walking and with articular and meniscal cartilage T1rho and T2 relaxation times. These findings highlight the relationships between different knee tissues and knee mechanics in young, healthy individuals. J Orthop Sports Phys Ther 2013;43(12):881–890. Epub 30 October 2013. doi:10.2519/jospt.2013.4486
Uncertainty in Clinical Prediction Rules: The Value of Credible Intervals
Authors: Haskins Robin , Osmotherly Peter G. , Tuyl Frank , Rivett Darren A.
Published: October 2013

Synopsis

Decision making in physical therapy is increasingly informed by evidence in the form of probabilities. Prior beliefs concerning diagnoses, prognoses, and treatment effects are quantitatively revised by the integration of new information derived from the history, physical examination, and other investigations in a well-recognized application of Bayes' theorem. Clinical prediction rule development studies commonly employ such methodology to produce quantified estimates of the likelihood of patients having certain diagnoses or achieving given outcomes. To date, the physical therapy literature has been limited to the discussion and calculation of the point estimate of such probabilities. The degree of precision associated with the construction of posterior probabilities, which requires consideration of both uncertainty associated with pretest probability and uncertainty associated with test accuracy, remains largely unrecognized and unreported. This paper provides an introduction to the calculation of the uncertainty interval, known as a credible interval, around posterior probability estimates. The method for calculating the credible interval is detailed and illustrated with example data from 2 clinical prediction rule development studies. Two relatively quick and simple methods for approximating the credible interval are also outlined. It is anticipated that knowledge of the credible interval will have practical implications for the incorporation of probabilistic evidence in clinical practice. Consistent with reporting standards for interventional and diagnostic studies, it is equally appropriate that studies reporting posterior probabilities calculate and report the level of precision associated with these point estimates. J Orthop Sports Phys Ther 2014;44(2):85–91. Epub 30 October 2013. doi:10.2519/jospt.2014.4877
Minimal Clinically Important Difference of the Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH) and Its Shortened Version (QuickDASH)
Authors: Franchignoni Franco , Vercelli Stefano , Giordano Andrea , Sartorio Francesco , Bravini Elisabetta , Ferriero Giorgio
Published: October 2013

Study Design

Prospective, single-group observational design.

Objectives

To determine the minimal clinically important difference (MCID) for the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure and its shortened version (QuickDASH) in patients with upper-limb musculoskeletal disorders, using a triangulation of distribution- and anchor-based approaches.

Background

Meaningful threshold change values of outcome tools are crucial for the clinical decision-making process.

Methods

The DASH and QuickDASH were administered to 255 patients (mean ± SD age, 49 ± 15 years; 156 women) before and after a physical therapy program. The external anchor administered after the program was a 7-point global rating of change scale.

Results

The test-retest reliability of the DASH and QuickDASH was high (intraclass correlation coefficient model 2,1 = 0.93 and 0.91, respectively; n = 30). The minimum detectable change at the 90% confidence level was 10.81 points for the DASH and 12.85 points for the QuickDASH. After triangulation of these results with those of the mean-change approach and receiver-operating-characteristic-curve analysis, the following MCID values were selected: 10.83 points for the DASH (sensitivity, 82%; specificity, 74%) and 15.91 points for the QuickDASH (sensitivity, 79%; specificity, 75%). After treatment, the MCID threshold was reached/surpassed by 61% of subjects using the DASH and 57% using the QuickDASH.

Conclusion

The MCID values from this study for the DASH (10.83 points) and the QuickDASH (15.91 points) could represent the lower boundary for a range of MCID values (reasonably useful for different populations and contextual characteristics). The upper boundary may be represented by the 15 points for the DASH and 20 points for the QuickDASH proposed by the DASH website. J Orthop Sports Phys Ther 2014;44(1):30–39. Epub 30 October 2013. doi:10.2519/jospt.2014.4893
Clinical Rehabilitation Guidelines for Matrix-Induced Autologous Chondrocyte Implantation on the Tibiofemoral Joint
Authors: Edwards Peter K. , Ackland Timothy , Ebert Jay R.
Published: October 2013

Synopsis

Autologous chondrocyte implantation (ACI) has become an established technique for the repair of full-thickness chondral defects in the knee. Matrix-induced ACI (MACI) is the third and current generation of this surgical technique, and, while postoperative rehabilitation following MACI aims to restore normal function in each patient as quickly as possible by facilitating a healing response without overloading the repair site, current published guidelines appear conservative, varied, potentially outdated, and often based on earlier ACI surgical techniques. This article reviews the existing evidence-based literature pertaining to cell loading and postoperative rehabilitation following generations of ACI. Based on this information, in combination with the technical benefits provided by third-generation MACI in comparison to its surgical predecessors, we present a rehabilitation protocol for patients undergoing MACI in the tibiofemoral joint that has now been implemented for several years by our institution in patients with MACI, with good clinical outcomes.

Level of Evidence

Therapy, level 5. J Orthop Sports Phys Ther 2014;44(2):102–119. Epub 30 October 2013. doi:10.2519/jospt.2014.5055
The Gains From Vertical Scaling
Authors: Briggs Derek C. , Domingue Ben
Published: October 2013

It is often assumed that a vertical scale is necessary when value-added models depend upon the gain scores of students across two or more points in time. This article examines the conditions under which the scale transformations associated with the vertical scaling process would be expected to have a significant impact on normative interpretations using gain scores. It is shown that this will depend upon the extent to which adopting a particular vertical scaling approach leads to a large degree of scale shrinkage (decreases in score variability over time). Empirical data are used to compare school-level gain scores computed as a function of different vertical scales transformed to represent increasing, decreasing, and constant trends in score variability across grades. A pragmatic approach is also presented to assess the departure of a given vertical scale from a scale with ideal equal-interval properties. Finally, longitudinal data are used to illustrate a case when the availability of a vertical scale will be most important: when questions are being posed about the magnitudes of student-level growth trajectories.
Excelling in the Role of Advocate: A Qualitative Study Exploring Advocacy as an Essential Physiotherapy Competency
Authors: Kelland Kerri , Hoe Erica , McGuire Michaela J. , Yu Jane , Andreoli Angie , Nixon Stephanie A.
Published: October 2013

Purpose: To explore the perspectives of leading advocates regarding the attributes required for excelling in the advocate role as described within the Essential Competency Profile for Physiotherapists in Canada (2009). Methods: We used a descriptive qualitative design involving in-depth, semi-structured interviews conducted with leading Canadian advocates within the physiotherapy profession. Transcribed interviews were coded and analyzed using thematic analysis. Results: The 17 participants identified eight attributes necessary for excelling in the role of advocate: collaboration, communication, scholarly practice, management, professionalism, passion, perseverance, and humility. The first five attributes correspond to roles within the Essential Competency Profile for Physiotherapists in Canada. Participants identified the attributes of collaboration, communication, and scholarly practice as the most important for successful advocacy. Participants also noted that the eight identified attributes must be used together and tailored to meet the needs of the advocacy setting. Conclusions: Identifying these eight attributes is an important first step in understanding how competence in the advocate role can be developed among physiotherapy students and practitioners. Most importantly, this study contributes to the knowledge base that helps physiotherapists to excel in advocating for their clients and the profession.
Phenotypic detection of Extended Spectrum Beta-Lactamases and Amp C Beta- Lactamases among nosocomial isolates in a tertiary care hospital
Authors: Vijayvergia V , Sahni AK , Lall M , Vijay K , Khan ID
Published: October 2013

Background & objectives: Extended-Spectrum Beta-Lactamases (ESBLs) is an important resistance mechanism in Enterobacteriaceae infections. Lack of standard guidelines from Clinical Laboratory Standards Institute (CLSI) for Amp C beta-lactamase detection poses a problem. This study was undertaken to detect ESBLs by phenotypic tests and Amp C beta-lactamase by inhibitor based method. Material and Methods: 200 consecutive non-repetitive isolates of E.coli, Klebsiella and Proteus from clinical samples were screened for ESBLs as per CLSI guidelines and confirmed by PCDT, DDST and E-tests (AB Biodisk, Biomerieux). Amp C beta lactamases were screened by cefoxitin resistance and confirmed by inhibitor (Cloxacillin) based method. Simultaneous occurrence of Amp C and ESBLs was detected by combined disk test (Neo-Sensitabs and Diatabs). Descriptive and Kappa statistics were used. Results: Out of 200 isolates studied, 131 were initially screened as ESBL producers and later 114 (57%) were confirmed by phenotypic methods. E-Test was found most sensitive phenotypic test as compared to PCDT and DDST. 13 strains resistant to cefoxitin (30?g) were found to be pure Amp C producers. Combined disk test detected 36 to be ESBL and Amp C co-producers. Surprisingly, six isolates found sensitive to cefoxitin disk were confirmed as Amp C producers by cloxacillin disk inhibition test. Conclusion: 57% ESBLs and 27.5% Amp C producers were isolated from nosocomial pathogens showing significant resistance to 3rd generation cephalosporins. Phenotypic confirmation by E-test, PCDT & DDST were useful for ESBL identification and for detection of Amp C, cloxacillin was found to be an effective inhibitor. DOI: http://dx.doi.org/10.3329/bjms.v12i4.13309 Bangladesh Journal of Medical Science Vol. 12 No. 04 October 13 Page 378-384
Issues and dilemmas in career planning of medical students in Surat, India
Authors: Jariwala RA , Kanpurwala DB , Desai KT , Bansal RK
Published: October 2013

Background: In recent time issues of career choices in medical student has been gaining mounting attention. Aim: The current study was planned with an aim to understand issues and dilemmas in career planning of medical students in Surat city, India Methods: This is a cross-sectional study comprising of personal interviews using a self -designed structured questionnaire among 400 simple randomly selected medical students, interns and junior residents of Surat Municipal Institute of Medical Education and Research covering issues associated with their career concerns and future life. Data analysis was done with help of Epi Info 7. The study sample comprised of students 46.5%, intern doctors 36%, junior resident doctors 17.5%. Results:Females were more content with either a graduate or a post graduate degree, whereas males were more inclined towards pursuing super specialty degrees (P<0.001). Majority 62% of the respondent stated that given another chance, they would again like to choose for medical studies only. The percentages of females interested in a non clinical career abroad as compared to clinical career in India were lower. Majority 89% of respondents agree that there is more struggle for the students who enter M.B.B.S. from a non medical background. Percentages of males in favor of increasing the postgraduate/super specialty seats far exceeded females (P<0.0001). The vast majority of the respondents wanted the specialty and super specialty seats to increase as they wanted an equal ratio of Undergraduate: Postgraduate seats (70%). Those who did not favor the increase in the seats perceived that the quality of treatment may actually worsen rather than improve if the number of seats increased (60%). Conclusion: Freshly graduating doctors do face a severe dilemma regarding their future career after graduation, which is a very perplexing situation for them and their parents, as there is absence of any career guidance cell; absence of the culture and avenues of campus placement; and there is human need to be materialistically comparable to their counterparts who are already in a job as an engineer. DOI: http://dx.doi.org/10.3329/bjms.v12i4.13336 Bangladesh Journal of Medical Science Vol. 12 No. 04 October 13 Page 385-391
Investigation of the morphology of longus colli among patients with neck pain using ultrasonography  a preliminary study
Authors: Hussain RI , Henry LJ , Ramli A , Othman SN , Mohan V , Mohamad HF
Published: October 2013

Objective: Longus colli provides stability to cervical spine during movements. In clinical practice, the clinicians teach exercises to longus colli to manage neck pain. The aim of this study was to investigate differences in thickness or anterior-posterior dimension (APD), shape ratio and contraction ratio of longus colli between subjects with neck pain and healthy controls. Materials and methods: A total of 12 subjects (6 with neck pain and 6 healthy controls) were recruited by predefined selection criteria. Ultrasound imaging of bilateral longus colli was conducted at the level C5-C6. Anterior-posterior dimension (APD) and lateral dimension (LD) were measured using Ultrasonography. Shape ratio (LD/APD) and contraction ratio (APD during contraction/APD during rest) were calculated. Mann-Whitney U test was used to compare the thickness of longus colli between healthy and neck pain subjects. Results and discussion: The results showed that the subjects with neck pain had smaller APD (Mean Rank=4.83, n=6) than healthy subjects (Mean Rank=8.17, n=6), U=16.00, z=-1.601 (corrected for ties), p=0.109, two tailed. Also, shape ratio showed higher values in neck pain subjects (Mean Rank=7.17, n=6) than normal subjects (Mean Rank=5.83, n=6), U=14.00, z=-0.641(corrected for ties) p=0.522, two tailed. In addition, contraction ratio was smaller in neck pain subjects (Mean Rank=4.83, n=6) than those healthy subjects (Mean Rank=8.17, n=6), U=8.00, z=- 1.601(corrected for ties) p=0.109, two tailed. Conclusion: There is a trend of reduced size of longus colli with the median of APD and smaller contraction ratio among patients with neck pain when compared to healthy controls. DOI: http://dx.doi.org/10.3329/bjms.v12i4.13692 Bangladesh Journal of Medical Science Vol. 12 No. 04 October 13 Page 419-426
Antrochoanal polyp mimicking juvenile nasoangiofibroma
Authors: Muhammed NA , Mohamad I , Abdullah B
Published: October 2013

Antrochoanal polyp is a benign lesion, usually arising from the maxillary sinus extending posteriorly into the nasopharynx. Typically it presents as a unilateral nasal obstruction with mucopus rhinorrhea, sleep disturbance, postnasal drip, and mouth breathers. Epistaxis is an extremely rare complaint. Unilateral nasal mass presenting in a teenage boy will increase the suspicion of juvenile nasoangiofibroma. We report a teenage with extensive unilateral nasal mass with such presentation, which later turned out to be antrochoanal polyp. DOI: http://dx.doi.org/10.3329/bjms.v12i4.16664 Bangladesh Journal of Medical Science Vol. 12 No. 04 October 13 Page 432-434
A White Board Needle in the Trachea
Authors: Rahim SBA , Maruthamuthu T , Chooi LL , Singh A , Yunus MRBM
Published: October 2013

Foreign body aspiration often occurs amongst extreme age. Most of aspirated object are; nuts, nails, pins, coins, metal piece and dental appliances. Foreign body aspiration can be life threatening. Patients with foreign body aspiration may present with choking, coughing, wheezing, haemoptysis, asphyxia and even death. The symptoms and severity depend on the site of obstruction. This is a case of 9 year old boy provided the history of aspiration of white board needle. He had persistent cough but examination revealed normal vital signs. Radiological examination confirmed needle like radio opaque material in his trachea. This case report depicts the management and bronchoscope as diagnostic procedure of this case and role of X-ray and CT scan in dealing with foreign body in the tracheobronchial tree. DOI: http://dx.doi.org/10.3329/bjms.v12i4.16668 Bangladesh Journal of Medical Science Vol. 12 No. 04 October 13 Page 449-452
Economic Prospects for a One-State Solution in Palestine-Israel
Authors: Farsakh Leila
Published: October 2013

This paper explores the economic underpinnings of a one-state solution in Israel/Palestine, a dimension that has rarely been addressed in the growing literature on this subject. It seeks to demonstrate that economic developments since 1993 prove the demise of the two-state solution but without shifting the power imbalances in favor of a one-state alternative. This is largely because Israel has been able to dispense with the Palestinians, both economically and politically. The international community has inadvertently contributed to this situation but also holds the key to its reversal.
Palestine's Pre-Islamic History and Cultural Heritage: A Proposal for Palestinian High-School Curriculum Revision
Authors: Thompson Thomas L.
Published: October 2013

This article is presented in the hope of engaging debate on Palestine's cultural heritage in view of recommending a revision of the Palestinian high-school curriculum for the pre-Islamic history of Palestine. After a brief clarification of intent and an introduction to the current status of research on Palestine's history, brief summaries of the proposed curriculum are offered in chronological order: 1) the Stone Age; 2) the Bronze Age; 3) regional histories from Iron I to Alexander and 4) the Hellenistic Period. The presentation closes with a conclusion, followed by 3 appendices on early legendary figures in Palestinian history; on Palestinian place names and on the importance of structuring Palestine's history regionally.
Effect of Different Feed Structures and Bedding on the Horizontal Spread of Campylobacter jejuni within Broiler Flocks
Authors: Skånseng Beate , Svihus Birger , Rudi Knut , Trosvik Pål , Moen Birgitte
Published: October 2013

In this study, we investigated the effects of different feed structures and beddings on the spread of C. jejuni in broiler flocks, and the effect on the cecal microbiota. Broiler chickens raised in 24 eight-bird group cages on either rubber mat or wood shavings were fed either a wheat-based control diet (Control), a diet where 50% of the ground wheat was replaced by whole wheat prior to pelleting (Wheat), or a wheat-based diet, such as the control diet diluted with 12% oat hulls (Oat). Samples from the cloacal mucosa of all birds were taken daily for C. jejuni quantification and cecum samples were collected at the end of the experiment for C. jejuni quantification and microbiota analyses. We have shown a statistically significant effect of increased feed structure on the reduced spread of C. jejuni in chicken flocks, but no significant differences were detected between types of structure included in the feed. No significant changes in the dominating microbiota in the lower lower gastrointestinal (GI) tract were observed, which indicates that feed structure only has an effect on the upper GI tract. Delaying the spread of C. jejuni in broiler flocks could, at time of slaughter, result in fewer C. jejuni-positive broilers.
Protective Roles of Gadd45 and MDM2 in Blueberry Anthocyanins Mediated DNA Repair of Fragmented and Non-Fragmented DNA Damage in UV-Irradiated HepG2 Cells
Authors: Liu Wei , Lu Xiangyi , He Guangyang , Gao Xiang , Xu Maonian , Zhang Jingkai , Li Meiling , Wang Lifeng , Li Zhenjing , Wang Likui , Luo Cheng
Published: October 2013

Growth Arrest and DNA Damage-inducible 45 (Gadd45) and MDM2 proteins, together with p21 and p53, play important roles in cell cycle checkpoints, DNA repair, and genome integrity maintenance. Gadd45 and MDM2 were activated and transcribed instantly by UV irradiation, whereas blueberry anthocyanins (BA) decreased the gene and protein expression levels in HepG2 cells for up to 24 h, and gradually restored the UV-induced fragmented and non-fragmented DNA damage of the nucleus at a time point of 12 h. Nevertheless, UV-irradiated HepG2 cell arrests occurred mainly in the G1 phase, which indicated G1 as a checkpoint. The proteins, p21 and p53, retain cellular integrity, suppressing the oncogenic transformation by interruption of the G1 phase of the cellular cycle, giving time for repairing the damage to DNA, or apoptosis induction if the damage is too severe to be repaired, while MDM2 and Gadd45 concomitantly ensure the presence of p53 and p21. Thus, we conclude that repair, together with Gadd45 and MDM2 genes, were involved in light and dark reaction mechanisms, however, BA could interfere and assist the repair through restoration, although further studies of the complex of the gene cascades triggered and responded to in BA-assisted DNA repair are needed.
Imbalance between Th17 and Regulatory T-Cells in Sarcoidosis
Authors: Huang Hui , Lu Zhiwei , Jiang Chunguo , Liu Jia , Wang Yanxun , Xu Zuojun
Published: October 2013

Sarcoidosis is a systemic granulomatous disease, which is thought to result from an aberrant immune response. CD4+ T lymphocytes play an important role in the development of granulomas. Previously, the immunopathogenesis of sarcoidosis was focused on Th1/Th2 disturbances. The aim of this study was to evaluate the balance between newer CD4+ T lymphocytes, i.e., Treg and Th17 cells. In our studies, a decrease in Treg cells and an increase in Th17 cells were observed in the peripheral blood and BALF of sarcoidosis patients. A significant increase in the Th17/Treg cell ratio was observed in sarcoidosis patients. After treatment with prednisone, the expression of Foxp3 mRNA was elevated in the peripheral blood, and expression of (ROR)γt mRNA showed a downward trend. These findings suggest that sarcoidosis is associated with an imbalance between Th17 and Treg cells in peripheral blood and BALF. Therefore, targeting the cytokines that affect the Th17/Treg ratio could provide a new promising therapy for pulmonary sarcoidosis.
Neuroprotective Effects of Liraglutide for Stroke Model of Rats
Authors: Sato Kenichiro , Kameda Masahiro , Yasuhara Takao , Agari Takashi , Baba Tanefumi , Wang Feifei , Shinko Aiko , Wakamori Takaaki , Toyoshima Atsuhiko , Takeuchi Hayato , Sasaki Tatsuya , Sasada Susumu , Kondo Akihiko , Borlongan Cesario , Matsumae Mitsunori , Date Isao
Published: October 2013

The number of diabetes mellitus (DM) patients is increasing, and stroke is deeply associated with DM. Recently, neuroprotective effects of glucagon-like peptide-1 (GLP-1) are reported. In this study, we explored whether liraglutide, a GLP-1 analogue exerts therapeutic effects on a rat stroke model. Wistar rats received occlusion of the middle cerebral artery for 90 min. At one hour after reperfusion, liraglutide or saline was administered intraperitoneally. Modified Bederson’s test was performed at 1 and 24 h and, subsequently, rats were euthanized for histological investigation. Peripheral blood was obtained for measurement of blood glucose level and evaluation of oxidative stress. Brain tissues were collected to evaluate the level of vascular endothelial growth factor (VEGF). The behavioral scores of liraglutide-treated rats were significantly better than those of control rats. Infarct volumes of liraglutide-treated rats at were reduced, compared with those of control rats. The level of derivatives of reactive oxygen metabolite was lower in liraglutide-treated rats. VEGF level of liraglutide-treated rats in the cortex, but not in the striatum significantly increased, compared to that of control rats. In conclusion, this is the first study to demonstrate neuroprotective effects of liraglutide on cerebral ischemia through anti-oxidative effects and VEGF upregulation.
Oxidative Stress in Diabetes: Implications for Vascular and Other Complications
Authors: Pitocco Dario , Tesauro Manfredi , Alessandro Rizzi , Ghirlanda Giovanni , Cardillo Carmine
Published: October 2013

In recent decades, oxidative stress has become a focus of interest in most biomedical disciplines and many types of clinical research. Increasing evidence shows that oxidative stress is associated with the pathogenesis of diabetes, obesity, cancer, ageing, inflammation, neurodegenerative disorders, hypertension, apoptosis, cardiovascular diseases, and heart failure. Based on these studies, an emerging concept is that oxidative stress is the “final common pathway” through which the risk factors for several diseases exert their deleterious effects. Oxidative stress causes a complex dysregulation of cell metabolism and cell–cell homeostasis; in particular, oxidative stress plays a key role in the pathogenesis of insulin resistance and β-cell dysfunction. These are the two most relevant mechanisms in the pathophysiology of type 2 diabetes and its vascular complications, the leading cause of death in diabetic patients.
Predicting the Coupling Properties of Axially-Textured Materials
Authors: Fuentes-Cobas Luis , Muñoz-Romero Alejandro , Montero-Cabrera María , Fuentes-Montero Luis , Fuentes-Montero María
Published: October 2013

A description of methods and computer programs for the prediction of “coupling properties” in axially-textured polycrystals is presented. Starting data are the single-crystal properties, texture and stereography. The validity and proper protocols for applying the Voigt, Reuss and Hill approximations to estimate coupling properties effective values is analyzed. Working algorithms for predicting mentioned averages are given. Bunge’s symmetrized spherical harmonics expansion of orientation distribution functions, inverse pole figures and (single and polycrystals) physical properties is applied in all stages of the proposed methodology. The established mathematical route has been systematized in a working computer program. The discussion of piezoelectricity in a representative textured ferro-piezoelectric ceramic illustrates the application of the proposed methodology. Polycrystal coupling properties, predicted by the suggested route, are fairly close to experimentally measured ones.
Chemical Diversity as a Function of Temperature in Six Northern Diatom Species
Authors: Huseby Siv , Degerlund Maria , Eriksen Gunilla , Ingebrigtsen Richard , Eilertsen Hans , Hansen Espen
Published: October 2013

In this study, we investigate how metabolic fingerprints are related to temperature. Six common northern temperate diatoms (Attheya longicornis, Chaetoceros socialis, Chaetoceros furcellatus, Porosira glacialis, Skeletonema marinoi, and Thalassiosira gravida) were cultivated at two different temperatures, 0.5 and 8.5 °C. To exclude metabolic variations due to differences in growth rates, the growth rates were kept similar by performing the experiments under light limited conditions but in exponential growth phase. Growth rates and maximum quantum yield of photosynthesis were measured and interpreted as physiological variables, and metabolic fingerprints were acquired by high-resolution mass spectrometry. The chemical diversity varied substantially between the two temperatures for the tested species, ranging from 31% similarity for C. furcellatus and P. glacialis to 81% similarity for A. longicornis. The chemical diversity was generally highest at the lowest temperature.
Efficient Screening of Marine Extracts for Protease Inhibitors by Combining FRET Based Activity Assays and Surface Plasmon Resonance Spectroscopy Based Binding Assays
Authors: Christopeit Tony , Øverbø Kersti , Danielson U. , Nilsen Inge
Published: October 2013

The screening of extracts from marine organisms is a widely used strategy to discover new drug leads. A common problem in the screening process is the generation of false positive hits through unspecific effects from the complex chemical composition of the crude extracts. In this study, we explored a combination of a fluorescence resonance energy transfer (FRET) based activity assay and a surface plasmon resonance (SPR) based binding assay to avoid this problem. An aqueous extract was prepared from rest raw material of the Norwegian spring spawning herring, and further fractionated by methanol solubility and solid phase extraction. FRET based activity assays were used to determine the influence of each extract on the activity of different proteases. Several extracts showed more than 50% inhibition. The inhibition mechanisms were elucidated by SPR based competition experiments with known inhibitors. For the secreted aspartic proteases 1, 2, 3 and HIV-1 protease, the results indicated that some extracts contain inhibitors interacting specifically with the active site of the enzymes. The study shows that a combination of an activity assay and an SPR based binding assay is a powerful tool to identify potent inhibitors in marine extracts. Furthermore, the study shows that marine vertebrates offer an interesting source for new bioactive compounds, although they have rarely been explored for this purpose.
One-Pot Chemoenzymatic Multicomponent Synthesis of Thiazole Derivatives
Authors: Zheng Hui , Mei Yi-Jia , Du Kui , Cao Xian-Ting , Zhang Peng-Fei
Published: October 2013

A novel chemoenzymatic one-pot multicomponent synthesis of thiazole derivatives was developed. A series of thiazole derivatives were synthesized with high yields up to 94% under mild enzyme-catalyzed conditions. The blank and control experiments reveal that trypsin from porcine pancreas (PPT) displayed great catalytic activity to promote this reaction and showed a wide tolerance range towards different substrate amines. This trypsin-catalyzed multicomponent conversion method provides a novel strategy to synthesize thiazole derivatives and expands the application of enzymes in organic synthesis.
Red-Koji Fermented Red Ginseng Ameliorates High Fat Diet-Induced Metabolic Disorders in Mice
Authors: Kim Chang , Yi Seong , Cho Il , Ku Sae
Published: October 2013

Fermentation of medicinal herbs improves their pharmacological efficacy. In this study, we investigated the effects of red-koji fermented red ginseng (fRG) on high-fat diet (HFD)-mediated metabolic disorders, and those effects were compared to those of non-fermented red ginseng (RG). fRG (500, 250 or 125 mg/kg), RG (250 mg/kg), simvastatin (10 mg/kg), silymarin (100 mg/kg) and metformin (250 mg/kg) were orally administered from 1 week after initiation of HFD supply for 84 days. The diameter of adipocytes in periovarian and abdominal fat pads and the thickness of the abdominal fat were significantly decreased by fRG treatment, while HFD-mediated weight gain was partly alleviated by fRG in a dose-dependent manner. Moreover, biochemical and histomorphometrical analyses clearly indicated that fRG significantly inhibited HFD-induced metabolic disorders such as hyperglycemia, hyperlipidemia, hepatopathy and nephropathy in a dose-dependent manner. More favorable pharmacological effects on HFD-mediated metabolic disorders were also observed with fRG compared to an equal dose of RG. This finding provides direct evidence that the pharmacological activities of RG were enhanced by red-koji fermentation, and fRG could be a neutraceutical resource for the alleviation of obesity-mediated metabolic disorders.
Comprehensive Analysis of Prokaryotes in Environmental Water Using DNA Microarray Analysis and Whole Genome Amplification
Authors: Akama Takeshi , Kawashima Akira , Tanigawa Kazunari , Hayashi Moyuru , Ishido Yuko , Luo Yuqian , Hata Akihisa , Fujitani Noboru , Ishii Norihisa , Suzuki Koichi
Published: October 2013

The microflora in environmental water consists of a high density and diversity of bacterial species that form the foundation of the water ecosystem. Because the majority of these species cannot be cultured in vitro, a different approach is needed to identify prokaryotes in environmental water. A novel DNA microarray was developed as a simplified detection protocol. Multiple DNA probes were designed against each of the 97,927 sequences in the DNA Data Bank of Japan and mounted on a glass chip in duplicate. Evaluation of the microarray was performed using the DNA extracted from one liter of environmental water samples collected from seven sites in Japan. The extracted DNA was uniformly amplified using whole genome amplification (WGA), labeled with Cy3-conjugated 16S rRNA specific primers and hybridized to the microarray. The microarray successfully identified soil bacteria and environment-specific bacteria clusters. The DNA microarray described herein can be a useful tool in evaluating the diversity of prokaryotes and assessing environmental changes such as global warming.
The Innate Immune Playbook for Restricting West Nile Virus Infection
Authors: Quicke Kendra , Suthar Mehul
Published: October 2013

West Nile virus (WNV) is an emerging mosquito-borne flavivirus that causes annual epidemics of encephalitic disease throughout the world. Despite the ongoing risk to public health, no approved vaccines or therapies exist for use in humans to prevent or combat WNV infection. The innate immune response is critical for controlling WNV replication, limiting virus-induced pathology, and programming protective humoral and cell-mediated immunity to WNV infection. The RIG-I like receptors, Toll-like receptors, and Nod-like receptors detect and respond to WNV by inducing a potent antiviral defense program, characterized by production of type I IFN, IL-1β and expression of antiviral effector genes. Recent research efforts have focused on uncovering the mechanisms of innate immune sensing, antiviral effector genes that inhibit WNV, and countermeasures employed by WNV to antagonize innate immune cellular defenses. In this review, we highlight the major research findings pertaining to innate immune regulation of WNV infection.