bluuebunny/crossref_metadata_2025 huggingface dataset:
Sodium oxybate in maintaining alcohol abstinence in alcoholic patients according to Lesch typologies: A pilot study
Authors: Caputo Fabio , Del Re Arfedele , Brambilla Romeo , Grignaschi Alice , Vignoli Teo , Vigna-Taglianti Federica , Addolorato Giovanni , Zoli Giorgio , Cibin Mauro , Bernardi Mauro
Published: September 2013

Sodium oxybate (SO) is a γ-amino-butyric acid (GABA)-ergic drug currently used for the treatment of alcohol dependence (AD) in some European countries. The aim of this study was to describe the effect of SO administration in alcoholics classified according to Lesch alcoholism typology (LAT). Forty-eight patients were enrolled and classified into four groups according to LAT. All patients were treated with oral SO (50 mg/kg of body weight t.i.d.) for 12 weeks. All patients significantly reduced their alcohol intake ( p<0.001). Alcohol abstinence during the 12 weeks of treatment did not differ between the four groups at the end of treatment. Craving for SO did not significantly differ amongst groups; cases of SO abuse were very limited and were observed in almost 10% of patients. In conclusion, our study showed an overall efficacy of SO in the treatment of AD irrespective of LAT categories. However, our results confirm that alcoholics with psychiatric co-morbidity, particularly with a borderline personality disorder of Axis II, are at a greater risk of developing craving for and abuse of the drug: until craving for alcohol and craving for SO are characterized in depth, SO should be used with caution in these patients.
Antihypertensive drugs and the risk of fall injuries: A systematic review and meta-analysis
Authors: Zang Guiming
Published: September 2013

Objective

A meta-analysis of published studies was performed to determine whether administration of any of five antihypertensive drug classes (thiazide diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers and β-blockers) affected the risk of fall injuries in the elderly (aged ≥60 years).

Methods

Articles reporting the risk of fall injury in elderly people being treated with the five main classes of antihypertensive drugs were retrieved using MEDLINE®, EMBASE, SCOPUS® and the Cochrane Database. Trial eligibility and methodological quality were assessed before data extraction and analysed using odds ratios with 95% confidence intervals.

Results

Sixty-two articles, included in two meta-analyses, were identified. These meta-analyses drew opposite conclusions about the role of antihypertensive drugs in fall injuries in the elderly. However, the present analysis did not reveal a clear association (or the lack of one) between antihypertensive drugs and risk of fall injuries.

Conclusions

There is no clear, statistically significant clinical precedent indicating that the use of any of the antihypertensive drugs considered here increases the risk of fall injuries in the elderly. Nonetheless, in following standard clinical guidelines for hypertension management, physicians need to be aware of the impact of drug therapies on fall injuries.
Criminal Recidivism of Incarcerated Male Nonviolent Offenders in Hong Kong
Authors: Chan Heng Choon (Oliver) , Lo T. Wing , Zhong Lena Y. , Chui Wing Hong
Published: September 2013

Criminal recidivism of the incarcerated population in Hong Kong has rarely been studied. The purpose of this study is to explore the recidivism rates and to identify significant predictors of reoffending among incarcerated male offenders convicted of a nonviolent offense in Hong Kong. Using a self-reported methodological design, 278 offenders were sampled. These offenders’ immediate past incarceration is used as the benchmark for this recidivism study. The 1-, 2-, and 3-year recidivism rates are 21%, 68%, and 87%, respectively. The findings denote that offending history, psychological attributes, interpersonal relationships, and environmental influences are significant reoffending risk factors. These findings, especially the alarming failure rates, highlight the need to seriously assess the effectiveness of intervention strategies used by the Hong Kong correctional system in preventing future offending. Implications for intervention strategies with emphasis on the risk factors for recidivism are discussed.
Political ecology I
Authors: Turner Matthew D.
Published: September 2013

Resilience is an ecological term that has proven to be exceedingly malleable as it has grown in usage across a range of scholarly and policy communities. Despite its malleability, resilience does introduce particular ideas of society-nature relations into scholarly and policy discourse. In this political ecology progress report, I explore the relationship between political ecology and resilience thinking. I first explore common features of the intellectual histories of resilience thinking and political ecology. Despite parallel and common influences and reactions, the two fields diverge significantly along two dimensions: in their normative commitments and adherence to systems thinking. Given these divergences, I argue that intellectual engagement between these fields will prove to be most productive if circumscribed around land-use ecology – an area of inquiry important to both fields.
Analysis of displacement fields from a high-speed impact using shape descriptors
Authors: Burguete Richard L , Lampeas George , Mottershead John E , Patterson Eann A , Pipino Andrea , Siebert Thorsten , Wang Weizhuo
Published: September 2013

A composite bonnet liner subject to a high-velocity (70 m/s), low-energy ( <300 J) impact by a 50-mm-diameter projectile has been investigated using computational simulation and by experiment. High-speed digital image correlation was employed to generate maps of displacement fields over the 1-m2 bonnet at 0.2 ms increments for 0.1 s, that is, 500 datasets, and the results have been compared to those predicted by finite element analysis. Image decomposition was utilised to reduce the dimensionality of both datasets by representing them using adaptive geometric moment descriptors; these descriptors were used to perform quantitative comparisons of the datasets and to test the validity of the model based on all the available data. The model was found to be a good representation of the physical experiment during the first half of the impact event but a less good representation in the remainder of the test, probably because damping effects were not adequately incorporated into the simulation. The methodologies for data comparison and evaluation of model validity proposed and demonstrated in this study represent a significant advance in procedures for ensuring model fidelity and for creating model credibility in the simulation of dynamic engineering events.
The effect of foreign direct investment on the use and success of US sanctions
Authors: Lektzian David , Biglaiser Glen
Published: September 2013

Although the relationship between trade and the use and success of sanctions is frequently studied in international relations, researchers have generally failed to address the importance of foreign direct investment (FDI) on sanctions despite global capital markets dwarfing the exchange of goods and services. Using panel data for 171 countries from 1971 to 2000, we test the effect of FDI on the use and success of sanctions imposed by the USA. We find evidence that a high level of economic engagement in the form of US FDI as a percentage of the recipient county’s gross domestic product reduces the likelihood of the use of US sanctions. We also find that, when sanctions are imposed, declining US FDI generally has a positive and significant effect on sanctions success. However, if non-US firms offset lost US FDI, the probability of sanctions success decreases. The results show that investors may have an important influence on foreign policy outcomes.
Backward, Dumb, and Violent Hillbillies? Rural Geographies and Intersectional Studies on Intimate Partner Violence
Authors: Sandberg Linn
Published: September 2013

Urban and rural geographies should be further included in feminist intersectional research on intimate partner violence (IPV). The article reviews existing research on the challenges facing rural victims of IPV. This research makes visible the specific problems rurality imposes on victims of IPV. However, research on rural IPV risks being misused and subsequently reinforcing othering and stereotypes of rurality and rural inhabitants. The article suggests that researchers alternate between intra- and anti-categorical approaches. On the one hand, rural victims of IPV should be analyzed as a neglected point of intersection, and on the other the diversity of ruralities should be acknowledged.
Hermes as Eros in Plato’s Lysis
Authors: Heyking John von
Published: September 2013

This article examines how Plato uses mythological symbolisms in the Lysis, specifically those of Hermes, to show how our experience of the good makes possible our capacity to love our friend as an individual, and in so doing overturns the static dualities usually associated with Plato’s ‘metaphysics’. Instead of appealing to allegedly impersonal ideas, Plato refigures Greek mythological understandings of Hermes to signal, first, that friendship is a movement of divine love in which human beings participate and to which they are reoriented so that they may behold their friend as an individual, as a person, and second, that this reorientation is needed to place the dialectical inquiry into friendship upon proper starting points. Instead of eclipsing the individual in the shadow of impersonal ideas, Plato appeals to Hermes, the most human, most creative and thus most political, of Olympians, whose name means windfall [ hermaion], to show how we must open ourselves up to the divine in order fully to love our friend as an individual person.
Explanation, understanding and determinism in Pierre Bourdieu’s sociology
Authors: Peters Gabriel
Published: September 2013

This article locates Bourdieu’s sociology within the lasting controversy concerning the nature of causal explanation and interpretative understanding in the social sciences, with a special focus on the classical problem surrounding the alleged (in)compatibility between these procedures. First, it is argued that Bourdieu’s praxeological and relational perspective on the social universe leads him not only to join the ‘compatibility field’ of the debate, but to sustain, more radically, the identity between explanation and understanding. Second, the article defends the view that this methodological proposal is tied to a distinction often ignored among the commentators of Bourdieu’s oeuvre, namely that between objectivism, a mode of knowledge of the social which he intends to integrate and overcome in his structural praxeology, and determinism, adopted by the author as a fundamental scientific principle and, at the same time, a potentially emancipatory ethico-political tool bequeathed by his reflexive sociology. While basically sympathetic to Bourdieu’s perspective, the article concludes in a more critical vein, by defending the need to bridge the gap between the ‘pessimism of the intellect’ that marks his portrayal of the reflexive capabilities of the lay agent, on the one hand, and the ‘optimism of the will’ infused in the critical program of reflexive sociology, on the other.
Effects of tip clearance on performance and characteristics of backflow in a turbopump inducer
Authors: Kim Semi , Choi Changho , Kim Jinhan , Park Junyoung , Baek Jehyun
Published: September 2013

The objectives of the present study were to investigate the effects of tip clearance on the performance and flow characteristics of a turbopump inducer by using computational fluid dynamics. Three different tip-clearance sizes were analyzed for design and off-design conditions. The numerical results were validated by comparison with experimental results. Our detailed investigation of the simulated flow fields shows that backflow penetrates farther upstream for large-tip clearances, which means that performance declines rapidly. On the other hand, for small-tip clearances, the extent of backflow is reduced but the development of hub separation in the middle of the passage causes performance degradation. Our results confirm that a particular value of the tip-clearance limits the development of secondary flow in the passage.
Thyroid nodules in Hispanic patients with systemic lupus erythematosus
Authors: Quintanilla-Flores DL , Hernández-Coria MI , Elizondo-Riojas G , Galarza-Delgado DA , González-González JG , Tamez-Pérez HE
Published: September 2013

A thyroid nodule (TN) is a discrete lesion in the thyroid gland radiologically distinct from the adjacent parenchyma, with a prevalence variable depending on the diagnostic method used and the study population. Thyroid disorders have been identified in more than 50% of patients with systemic lupus erythematosus (SLE); however, the prevalence of TN has not been frequently studied. We identified a prevalence of 27% TN in 55 SLE patients > 16 years of age. One-third of TN were >1 cm with radiological features of malignancy. The mean age of patients with TN was 39 ± 11 years, 93% women, and SLE duration 10 ± 6 years. Among patients, we reported family history of cancer in three cases (20%), thyroid disease in one (7%), and autoimmune disease in six (40%). Regarding treatment, 50% of patients with TN were treated with azathioprine vs. 23% of patients without TN ( p = 0.02), with an OR of 3.94 (95% CI 1.12–13.84, p = 0.03). As a conclusion a high prevalence of TN in SLE patients was found. Prevalence of TN correlated only with history of azathioprine use. We don’t know the long-term implications of our findings; however, a functional and morphological evaluation of the thyroid gland is warranted in all patients with SLE.
Transformative Sustainability Learning: Cultivating a Tree-Planting Ethos in Western Kenya
Authors: Bull Marijoan
Published: September 2013

Given the fundamental objective of ESD—perspective change—it is increasingly being aligned with the theoretical foundation of Mezirow’s Transformative Learning. In 2008, Sipos et al. built upon this connection by proposing a matrix of learning objectives to assess ESD in formal settings. These objectives, grouped under the title of ‘Transformative Sustainability Learning’ (TSL), call for ESD initiatives to integrate heads, hands and heart (HHH) learning while facilitating a change in outlook and ultimately behaviour. Non-formal ESD is also critical to the agenda for change and has salient unique characteristics. Here a case study of an agroforestry initiative in western Kenya is used to test and adapt the TSL matrix of learning objectives to non-formal ESD. The findings contribute to the understanding of effective HHH approaches to ESD in non-formal settings and refining an effective tool for planning and evaluating programmes that fall within the TSL umbrella.
Meta-Analysis and Systematic Review Assessing the Efficacy of Dialectical Behavior Therapy (DBT)
Authors: Panos Patrick T. , Jackson John W. , Hasan Omar , Panos Angelea
Published: September 2013

Objective:

The objective was to quantitatively and qualitatively examine the efficacy of DBT (e.g., decreasing life-threatening suicidal and parasuicidal acts, attrition, and depression) explicitly with borderline personality disorder (BPD) and using conservative assumptions and criteria, across treatment providers and settings.

Method:

Five randomized controlled trials (RCTs) were identified in a systematic search that examined the efficacy of DBT in reducing suicide attempts, parasuicidal behavior, attrition during treatment, or symptoms of depression, in adult patients with BPD.

Results:

Combining effect measures for suicide and parasuicidal behavior (five studies total) revealed a net benefit in favor of DBT (pooled Hedges’ g −0.622). DBT was only marginally better than treatment as usual (TAU) in reducing attrition during treatment in five RCTs (pooled risk difference −0.168). DBT was not significantly different from TAU in reducing depression symptoms in three RCTs (pooled Hedges’ g −0.896).

Discussion:

DBT demonstrates efficacy in stabilizing and controlling self-destructive behavior and improving patient compliance.
Dronabinol Treatment of Refractory Nausea and Vomiting Related to Peritoneal Carcinomatosis
Authors: Hernandez Sarah L. , Sheyner Inna , Stover Karen T. , Stewart Jonathan T.
Published: September 2013

Nausea and vomiting are common and often highly distressing symptoms in advanced cancer and in hospice and palliative medicine practice. Nausea and vomiting generally respond well to correction of the underlying etiology (when possible) and appropriate selection of antiemetic medication, but up to 7% of patients will have refractory symptoms. Dronabinol is extensively studied for chemotherapy-related nausea and vomiting, but there are only a few case reports of its use in nausea and vomiting unrelated to chemotherapy. We report a patient with end-stage ovarian cancer with peritoneal carcinomatosis and refractory nausea and vomiting who responded dramatically to addition of dronabinol. Dronabinol is usually well tolerated and may have several novel mechanisms of antiemetic action; further study of its scope of efficacy is warranted.
Identifying Symptom Co-Occurrence in Persons With Multiple Sclerosis
Authors: Newland Pamela K. , Flick Louise H. , Thomas Florian P. , Shannon William D.
Published: September 2013

Patients with multiple sclerosis (MS) experience a myriad of symptoms. There is some evidence that symptoms may co-occur, or happen in particular combinations. Yet most existing studies focus on single symptoms and practitioners make a priori care decisions based on individual symptoms alone. We examined symptom co-occurrences in patients with relapsing–remitting MS (RRMS), collecting qualitative and quantitative data (mixed methods; N = 140). Content analysis revealed fatigue, heat intolerance, numbness, balance problems, and leg weakness as the most common symptoms. Factor analysis revealed the following factors: urinary, problems with balance, vision, heat, depression, and sleep. These preliminary findings indicate co-occurrence of several disabling symptoms from the overall self-report MS-Related Symptom Scale and 3-month recall. This information will guide health care professionals in developing targeted interventions and improve outcomes.
Topographic Distribution of Papillary Thyroid Carcinoma by Mapping in Coronal Sections of 125 Consecutive Thyroidectomy Specimens
Authors: Mai Kien T. , Gulavita Previn , Lai Chi , Swift Joanne , Levac Joelle , Olberg Bernhard , Purgina Bibianna
Published: September 2013

Introduction. Mapping of different foci in multifocal papillary thyroid carcinoma (PTC) has previously not been done as it is difficult to do so when thyroid specimens are serially sectioned transversely (ie, parallel to the horizontal plane). In this study, thyroidectomy specimens were serially sectioned coronally (ie, parallel to the largest surface of the thyroid gland), which allows for panoramic and 3-dimensional visualization of PTC foci and their relationship to one another. Materials and methods. A total of 125 consecutive total thyroidectomies or lobectomies followed by completion thyroidectomies were serially sectioned coronally and reviewed with identification and characterization of PTC foci. PTCs were grouped into either discrete, encapsulated nodule(s) (EN) of both follicular or papillary architecture, usual variant (UV), or tall cell variant (TCV). Results. The predominant tumor masses were identified in the right lobe, isthmus, and left lobe in 52%, 8%, and 40%, respectively. The largest tumor nodules ranged from 3 to 60 mm (18.8 ± 6.6) with the UV, EN, and TCV groups accounting for 58%, 24%, and 18% of cases, respectively. Three topographic patterns of PTC can be distinguished as follows: ( a) single tumor nodule (37 cases), ( b) main tumor nodule with satellite nodule(s) displaying no or varying degrees of fusion with the main one (30 cases), and ( c) main tumor nodule with either a second large nodule or randomly occurring tumor nodules (58 cases). Bilaterality can be seen in all 3 patterns but was most prevalent in the group comprising the main tumor nodule with either a second large nodule or random tumor nodules. It was least frequent in the EN group without random tumor nodules. The difference in rates of bilaterality between tumors <10 mm and ≥10 mm was statistically significant ( P < .01). For all 3 groups, satellite nodules displayed histopathological features that were similar or dissimilar to the main tumor mass. They may be of a different variant than that of the main tumor nodule. Conclusions. With panaromic and 3-dimensional visualization, individual tumors/satellite or random nodules of multifocal PTC were readily identified in serial coronal sections of thyroidectomy specimens. Bilaterality was frequently observed in tumors associated with random PTC foci, whereas, the EN group tended to be unilateral and was not associated with random foci.
Minimally Invasive Achilles Tendon Repair
Authors: Ozsoy Mehmet Hakan , Cengiz Bertan , Ozsoy Arzu , Aksekili Mehmet Atif Erol , Yucel Mehmet , Fakioglu Onur , Dincel Veysel Ercan , Aydogan Nevres Hurriyet
Published: September 2013

Background:

The purpose of the study was to present the results of a new minimally invasive operative method for Achilles tendon (AT) ruptures that could reduce nerve injuries and add no extra cost.

Methods:

Thirteen patients with acute AT ruptures who were treated with minimally invasive surgery and followed for a minimum of 12 months were included. At the latest follow-up, American Orthopaedic Foot & Ankle Society (AOFAS) score, calf diameters, ability to walk on tiptoe, and ultrasound examination were evaluated. The average age was 42.8 years (range, 31-62 years). Average follow up was 24.5 months (range, 12-34 months).

Results:

AOFAS score was 92.5 (range, 85-100). Average calf diameters on the operated and nonoperated extremities were 38.9 cm (range, 36-44 cm) and 38.9 cm (range, 36-41 cm), respectively. On ultrasound examination, the site of the rupture was found to be 46.2 mm proximal from the calcaneal insertion, and the operated side was found to be significantly thicker than the nonoperated side ( P = .008). There was 1 deep vein thrombosis, which recovered without sequelae. There were no wound problems, reruptures, or nerve injuries.

Conclusions:

This new minimally invasive operative method was successful, showing good functional results and low complication rates. In our experience, the use of 3 continuous polyester sutures was less irritable with 3 knots.

Level of Evidence:

Level IV, retrospective case series.
Adoption of Evidence-Based Clinical Innovations
Authors: Andrews Christina M. , D’Aunno Thomas A. , Pollack Harold A. , Friedmann Peter D.
Published: September 2013

This article examines changes from 2005 to 2011 in the use of an evidence-based clinical innovation, buprenorphine use, among a nationally representative sample of opioid treatment programs and identifies characteristics associated with its adoption. We apply a model of the adoption of clinical innovations that focuses on the work needs and characteristics of staff; organizations’ technical and social support for the innovation; local market dynamics and competition; and state policies governing the innovation. Results indicate that buprenorphine use increased 24% for detoxification and 47% for maintenance therapy between 2005 and 2011. Buprenorphine use was positively related to reliance on private insurance and availability of state subsidies to cover its cost and inversely related to the percentage of clients who injected opiates, county size, and local availability of methadone. The results indicate that financial incentives and market factors play important roles in opioid treatment programs’ decisions to adopt evidence-based clinical innovations such as buprenorphine use.
Why Do Media Academics Keep Off Environmental Reporting?
Authors: Aram Arul
Published: September 2013

Climate change coverage peaks only during the annual global summits on climate change. Even in normal times, the coverage is mostly from sources in the West. Environmentalists and bio-safety activists in India are opposed to the cultivation of edible genetically modified crops for the reasons that it will affect the bio-diversity of brinjal (egg plant) farming, that it is harmful to humans, and pests are likely to develop resistance to Bt toxins. On the other hand, scientists who support Bt brinjal argue that Bt brinjal is needed to reduce crop loss due to pests and to cater to the rising demands for the widely consumed vegetable. These are some of the issues which should be dealt by mandatory environmental studies in colleges. This article examines the following questions. How environmentally-conscious or equipped are media educators in India to teach these areas of concern? How far are these concerns reflected in the journalism curricula? How can environmental education be effectively incorporated as a compulsory part of media and journalism education in the Indian context?
A numerical procedure for the wheel profile optimisation on railway vehicles
Authors: Ignesti Mirko , Innocenti Alice , Marini Lorenzo , Meli Enrico , Rindi Andrea
Published: September 2013

The reduction of wear due to wheel–rail interaction is a fundamental aspect in the railway field, mainly correlated to safety, maintenance interventions and costs. In this work, the authors present an innovative wheel profile optimisation procedure, specifically designed with the aim of improving the wear and stability behaviour of the standard ORE S1002 wheel profile matched with the UIC60 rail profile canted at 1/20 rad, which represents the wheel–rail combination adopted in Italian railway line; this matching shows poor wear performance due to the non-conformal contact. A new wheel profile, conventionally named DR2, has been developed by the authors in collaboration with Trenitalia S.p.A. The DR2 wheel profile is designed to guarantee the same kinematic characteristics of the matching formed by ORE S1002 wheel profile and UIC60 rail profile with inclination angle [Formula: see text] equal to 1/40 rad, widely common in European railways and characterised by good performances in both wear and kinematic behaviour. The evolution of wheel profiles due to wear has been evaluated through a wear model developed and validated by the authors in previous works. In the present research the investigated trainset is the passenger vehicle ALSTOM ALn 501 “Minuetto”, which is usually equipped with wheelsets having the standard ORE S1002 wheel profile in Italian railways. The entire model has been simulated on a virtual track specifically developed to represent a statistical description of the whole Italian line; the innovative statistical approach has been employed to obtain accurate results in reasonable computational times. The data necessary to build the virtual track and the vehicle model were provided by Trenitalia S.p.A. and Rete Ferroviaria Italiana (RFI).
The social construction of violence among Northern Plains tribal members with antisocial personality disorder and alcohol use disorder
Authors: Jervis Lori L. , Spicer Paul , Belcourt Annie , Sarche Michelle , Novins Douglas K. , Fickenscher Alexandra , Beals Janette , Team AI-SUPERPFP
Published: September 2013

Whereas recent reports from national studies have presented extremely high rates for many personality disorders in American Indian communities, persistent concerns about the meaning of these symptoms have left many troubled by these reports. American Indians as a group are known to suffer disproportionately from a number of violent experiences, but the dynamics of this violence have received little attention. This paper examines perspectives on violence in the lives of 15 northern plains tribal members who met criteria for antisocial personality disorder and comorbid alcohol use disorder. It explores how study participants constructed and understood their own violent encounters, as well as the motivations they described (characterized here as reputation, leveling, retaliation, catharsis, and self-defense). Violence was gendered in this study, with men generally presenting as perpetrators and women as victims. Men often described themselves as ready participants in a violent world, while women were quite clear that aggression for them was often simply required as they tried to defend themselves from male violence. While this analysis does not replace clinical analyses of violence in antisocial personality disorder, it does reveal an underlying cultural logic that may play a role in shaping the recourse to violence for that minority of individuals for whom it appears to be the obvious choice.
Evaluation of a medication order writing standards policy in a regional health authority
Authors: Raymond Colette B. , Sproll Barbara , Coates Jan , Woloschuk Donna M. M.
Published: September 2013

Background:

The Winnipeg Regional Health Authority (WRHA) implemented a medication order writing standards (MOWS) policy (including banned abbreviations) to improve patient safety. Widespread educational campaigns and direct prescriber feedback were implemented.

Methods:

We audited orders within the WRHA from 2005 to 2009 and surveyed all WRHA staff in 2011 about the policy and suggestions for improving education and compliance.

Results:

Overall, orders containing banned abbreviations, acronyms or symbols numbered 2261/8565 (26.4%) preimplementation. After WRHA-wide didactic education, the proportion declined to 1358/5461 (24.9%) ( p = 0.043) and then, with targeted prescriber feedback, to 1186/6198 (19.1%) ( p < 0.0001). A survey of 723 employees showed frequent violations of the MOWS, despite widespread knowledge of the policy. Respondents supported ongoing efforts to enforce the policy within the WRHA. Nonprescribers were significantly more likely than prescribers to agree with statements regarding enhancing compliance by defining prescriber/transcriber responsibilities and placing sanctions on noncompliant prescribers.

Discussion:

Education, raising general awareness and targeted feedback to prescribers alone are insufficient to ensure compliance with MOWS policies. WRHA staff supported ongoing communication, improved tools such as compliant preprinted orders and reporting and feedback about medication incidents. A surprising number of respondents supported placing sanctions on noncompliant prescribers.

Conclusion:

Serial audits and targeted interventions such as direct prescriber feedback improve prescription quality in inpatient hospital settings. Education plus direct prescriber feedback had a greater impact than education alone on improving compliance with a MOWS policy. Future efforts at the WRHA to improve compliance will require an expanded focus on incentives, resources and development of action plans that involve all affected staff, not just prescribers. Plans include continued advertising, MOWS summaries in all charts, all-staff education, reminders and exploration of sustainable interventions for targeted feedback for prescribers.
Ultrasound case report of a palmar lipoma causing carpal tunnel syndrome
Authors: Warwick D , Kar S , Harris Maxine
Published: September 2013

Ultrasound as an imaging technique is well established for the assessment of patients presenting with a palpable lump. Lipomata of the hand are relatively rare and are rarely the cause of neuropathy. Previous case reports of these rare types of lipomata have primarily involved imaging with magnetic resonance imaging in order to provide diagnostic information. This case report of a deep-seated lipoma of the flexor digitorum superficialis tendon sheath causing carpal tunnel syndrome and trigger wrist demonstrates that ultrasound can play a key role in the diagnosis and can provide vital diagnostic information for ongoing management and surgical resection without the need for further imaging.
Innate immune pathways in afferent lymph following vaccination with poly(I:C)-containing liposomes
Authors: Burke Melissa L , Veer Michael de , Pleasance Jill , Neeland Melanie , Elhay Martin , Harrison Paul , Meeusen Els
Published: September 2013

Many modern vaccines use defined adjuvants to stimulate the innate immune system and shape the adaptive immune response. The exact nature of these innate signals and whether immune differentiation can originate within the periphery is not known. Here we used an ovine lymphatic cannulation model to characterise the cellular and transcriptomic profile of the afferent lymph following injection of a liposomal vaccine formulation incorporating diphtheria toxoid and the innate stimulator poly(I:C) over a 78-h period. The response to this vaccine featured an early activation of broad pro-inflammatory pathways (e.g. TLR signalling and inflammasome pathways) and the transient recruitment of granulocytes into the lymph. At 24 h a more monocytic cellular profile arose coinciding with a transition to a specific antiviral response characterised by the up-regulation of genes associated with the receptors typical for the viral mimic, poly(I:C) (e.g. TLR3, RIG-I and MDA5). At the latest time points the up-regulation of IL-17A and IL-17F suggested that Th17 cells may participate in the earliest adaptive response to this vaccine. These data provide the most comprehensive picture of the cellular and molecular mechanisms that link the periphery to the draining lymph node following vaccination, and indicate that the immune response is capable of specialising within the periphery.
Arrow behaviour in the vertical plane during and immediately following the power stroke of a recurve bow
Authors: Park James L
Published: September 2013

Arrow behaviour in the vertical plane as it leaves a recurve archery bow is mainly determined by the path taken by the bow’s nocking point during the power stroke. That path is generally not a straight line as a consequence of the arrow not being placed at the geometric centre of the bow. The arrow behaviour is important to the archer in trying to launch the arrow with minimal angle of attack and minimal angular velocity. Pekalski, Kooi and Sparenberg and Park modelled the arrow behaviour in the horizontal plane during the bow’s power stroke using a flexible beam. In this article, the method used by Park has been applied to the arrow’s behaviour in the vertical plane. It is shown that by suitable selection of the arrow’s location on the string, the archer can obtain zero angular velocity and minimal angle of attack. The modelling was tested against the use of the recurve bow in a shooting machine.
Ustekinumab in the treatment of psoriatic arthritis: latest findings and clinical potential
Authors: Gottlieb Alice , Narang Kirti
Published: September 2013

Ustekinumab (UST) is a fully human immunoglobulin G1κ (IgG1κ) monoclonal antibody against common sub-unit p40 of interleukin-12 (IL-12) and interleukin-23 (IL-23). IL-12 and IL-23 are essential components of the Th1 and Th17 inflammatory pathways, respectively, and are the key mediators of psoriasis. Psoriatic arthritis (PsA), an important systemic inflammatory disorder, has similar pathogenesis to psoriasis. Many of PsA patients do not respond to tumor necrosis factor (TNF) inhibitor therapy, highlighting the need for additional treatment modalities with distinct mechanisms of action. Also, many patients stop responding to these agents after a certain period of use. A significant number of patients have a recurrent course or a persistent disease process. To meet these challenges a new agent working on different inflammatory aspect of PsA is needed. UST has been demonstrated to be effective, safe on short-term use and convenient in the treatment of plaque psoriasis and PsA. Long-term safety is still a concern. Until recently, the exact role of UST in the management of PsA had not been very clear. This article reviews the mechanism of action, pharmacokinetics, efficacy, safety profile and the clinical potential of UST in patients with PsA. We also discuss the three major trials conducted to show the efficacy and safety of UST in PsA.
Comparative Perspectives on the Changing Business of Journalism and Its Implications for Democracy
Authors: Nielsen Rasmus Kleis , Esser Frank , Levy David
Published: September 2013

The last decade has seen tremendous change in the commercial news media that play a central role in political processes in democracies around the world, as well as considerable progress in cross-national comparative media research. But despite the impact of Daniel C. Hallin and Paolo Mancini’s book Comparing Media Systems, empirical research into the institutional and systemic preconditions of journalism and news production has not kept pace with the rapid changes in the media, nor with the advances made in other areas of comparative media research (such as studies of news media use, journalists’ role-conceptions, and of news content). In this piece, we call for further institutionally and system-oriented mixed-methods comparative research to advance our understanding of how current changes are impacting journalism, the news media, and ultimately politics in different settings. We suggest that existing conceptions of media systems as ideal types need to be supplemented with more empirically grounded and systematically comparative understanding of media systems as dynamic, evolving real types to capture how journalism is changing today.
Impact of an Outpatient Pharmacist Intervention on Medication Discrepancies and Health Care Resource Utilization in Posthospitalization Care Transitions
Authors: Hawes Emily M. , Maxwell Whitney D. , White Sarah F. , Mangun Jesica , Lin Feng-Chang
Published: September 2013

Purpose: Medication errors related to hospital discharge result in rehospitalization and emergency department (ED) visits, yet no systematic approach has been implemented nationally to decrease these medication errors. Pharmacist involvement during postdischarge transitions of care may be an important strategy to prevent and correct medication discrepancies and reduce costly rehospitalization and ED visits. Methods: This prospective, randomized, open-label, pilot study evaluated the effect of a pharmacy clinic visit focused on medication reconciliation and patient education after hospital discharge on the incidence of rehospitalization and ED visits and the resolution of medication discrepancies. Results: Of the 61 subjects included in the study, 33 (54%) had medication discrepancies identified at discharge. Fifty percent of medication discrepancies were resolved in subjects randomized to the pharmacist intervention arm compared with 9.5% in the usual care arm ( P = .015). Patients randomized to the intervention arm had significantly lower rates of the primary composite outcome of 30-day rehospitalization and ED visits compared with the usual care arm (0% vs 40.5%, P < .001). Conclusion: A pharmacist-driven intervention focused on patient education and medication reconciliation after discharge improved medication use and reduced health care resource utilization in this pilot study.
Using the framework method for the analysis of qualitative data in multi-disciplinary health research
Authors: Gale Nicola K , Heath Gemma , Cameron Elaine , Rashid Sabina , Redwood Sabi
Published: September 2013

Background

The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations.

Discussion

The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study.

Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.
How do motorcyclists manage mental tensions of risky riding?
Authors: Bazargan-Hejazi Shahrzad , Zamani-Alavijeh Fereshteh , Hindman David , Mohamadi Esa , Bazargan Mohsen
Published: September 2013

Background

Road traffic injuries, especially those involving motorcycles, are a particular concern in Iran. We aimed to identify the specific cognitive dissonances and consonances associated with risky riding among Iranian motorcyclists.

Methods

This was a grounded theory qualitative study of male motorcyclists who were ≥18 and were living in one of the three cities of Tehran, Isfahan and Ahwaz. Thirty four (n = 34) motorcyclists participated in 19 in-depth interviews and 5 focus-groups between January 2007 and February 2008.

Results

We identified four categories of motorcycle riders each endorsing a unique risk bias they employed to justify their risky ridings. The categories included: (1) Risk Managers who justified risky riding by doubting that it would result in negative outcomes if they are competent riders. (2) Risk Utilizers who justified risky riding as functional and practical that would enable them to handle daily chores and responsibilities more efficiently. (3) Risk Calculators who justified risky riding by believing that it will help them to avoid road crashes. (4) Risk Takers who justified risky riding by arguing that risky riding is thrilling and brings them peer recognition.

Conclusion

Our findings reveal different groups of motorcyclists according to their different rationalizations for risky riding. Road safety advocates can benefit from our findings by matching relevant and appropriate interventions and incentives to these specific groups.
A new lumbar posterior fixation system, the memory metal spinal system: an in-vitro mechanical evaluation
Authors: Kok Dennis , Firkins Paul John , Wapstra Frits H , Veldhuizen Albert G
Published: September 2013

Background

Spinal systems that are currently available for correction of spinal deformities or degeneration such as lumbar spondylolisthesis or degenerative disc disease use components manufactured from stainless steel or titanium and typically comprise two spinal rods with associated connection devices (for example: DePuy Spines Titanium Moss Miami Spinal System). The Memory Metal Spinal System of this study consists of a single square spinal rod made of a nickel titanium alloy (Nitinol) used in conjunction with connecting transverse bridges and pedicle screws made of Ti-alloy. Nitinol is best known for its shape memory effect, but is also characterized by its higher flexibility when compared to either stainless steel or titanium. A higher fusion rate with less degeneration of adjacent segments may result because of the elastic properties of the memory metal. In addition, the use of a single, unilateral rod may be of great value for a TLIF procedure. Our objective is to evaluate the mechanical properties of the new Memory Metal Spinal System compared to the Titanium Moss Miami Spinal System.

Methods

An in-vitro mechanical evaluation of the lumbar Memory Metal Spinal System was conducted. The test protocol followed ASTM Standard F1717-96, “Standard Test Methods for Static and Fatigue for Spinal Implant Constructs in a Corpectomy Model.”

Static axial testing in a load to failure mode in compression bending,

Static testing in a load to failure mode in torsion,

Cyclical testing to estimate the maximum run out load value at 5.0 x 10^6 cycles.

Results

In the biomechanical testing for static axial compression bending there was no statistical difference between the 2% yield strength and the stiffness of the two types of spinal constructs.

In axial compression bending fatigue testing, the Memory Metal Spinal System construct showed a 50% increase in fatigue life compared to the Titanium Moss Miami Spinal System.

In static torsional testing the Memory Metal Spinal System constructs showed an average 220% increase in torsional yield strength, and an average 30% increase in torsional stiffness.

Conclusions

The in-vitro mechanical evaluation of the lumbar Memory Metal Spinal System showed good results when compared to a currently available spinal implant system. Throughout testing, the Memory Metal Spinal System showed no failures in static and dynamic fatigue.
B-cell translocation gene 2 mediates crosstalk between PI3K/Akt1 and NFκB pathways which enhances transcription of MnSOD by accelerating IκBα degradation in normal and cancer cells
Authors: Sundaramoorthy Santhoshkumar , Ryu Min Sook , Lim In Kyoung
Published: September 2013

Background

B-cell translocation gene 2 (BTG2) belongs to antiproliferative (ARPO) gene family and the expression of BTG2, human ortholog of rat PC3 and mouse TIS21 gene, has been shown to render cancer cells more sensitive to doxorubicin treatment by upregulating MnSOD expression without regulating any other reactive oxygen species (ROS) scavenging enzymes.

Results

In the present study, by employing exogenous and endogenous BTG2/TIS21/Pc3 expression by transfection and transduction analyses, and by knockdown of gene expression using RNA interference or using gene knockout cells, we observed that BTG2 increased the binding of activated NF-κB (p65/RelA) to the enhancer element of MnSOD gene in the 2nd intron, which was regulated by p-Akt1, and the induction of MnSOD by BTG2 was accompanied with subsequent downregulation of ROS level and cyclin B1 biosynthesis along with the increase of p21WAF1, resulting in the G2/M arrest independent of p53.

Conclusions

These results show for the first time that BTG2 mediates crosstalk between PI3K-Akt1 and NF-κB pathways, which regulates p53-independent induction of G2/M phase arrest both in normal and cancer cells.
Identification and characterization of regulatory elements in the promoter of ACVR1, the gene mutated in Fibrodysplasia Ossificans Progressiva
Authors: Giacopelli Francesca , Cappato Serena , Tonachini Laura , Mura Marzia , Di Lascio Simona , Fornasari Diego , Ravazzolo Roberto , Bocciardi Renata
Published: September 2013

Background

TheACVR1gene encodes a type I receptor for bone morphogenetic proteins (BMPs). Mutations in theACVR1gene are associated with Fibrodysplasia Ossificans Progressiva (FOP), a rare and extremely disabling disorder characterized by congenital malformation of the great toes and progressive heterotopic endochondral ossification in muscles and other non-skeletal tissues. Several aspects of FOP pathophysiology are still poorly understood, including mechanisms regulatingACVR1expression. This work aimed to identify regulatory elements that controlACVR1gene transcription.

Methods and results

We first characterized the structure and composition of humanACVR1gene transcripts by identifying the transcription start site, and then characterized a 2.9 kb upstream region. This region showed strong activating activity when tested by reporter gene assays in transfected cells. We identified specific elements within the 2.9 kb region that are important for transcription factor binding using deletion constructs, co-transfection experiments with plasmids expressing selected transcription factors, site-directed mutagenesis of consensus binding-site sequences, and by protein/DNA binding assays. We also characterized a GC-rich minimal promoter region containing binding sites for the Sp1 transcription factor.

Conclusions

Our results showed that several transcription factors such as Egr-1, Egr-2, ZBTB7A/LRF, and Hey1, regulate theACVR1promoter by binding to the -762/-308 region, which is essential to confer maximal transcriptional activity. The Sp1 transcription factor acts at the most proximal promoter segment upstream of the transcription start site. We observed significant differences in different cell types suggesting tissue specificity of transcriptional regulation. These findings provide novel insights into the molecular mechanisms that regulate expression of theACVR1gene and that could be targets of new strategies for future therapeutic treatments.