bluuebunny/crossref_metadata_2025 huggingface dataset:
Dietetic practice in the management of gestational diabetes mellitus: A survey of Australian dietitians
Authors: MORRISON Melinda K. , COLLINS Clare E. , LOWE Julia M.
Published: August 2011

Aim:  To examine current Australian dietetic practice in the management of gestational diabetes, to identify models of dietetic care and to determine the need for national evidence‐based dietetic practice guidelines for gestational diabetes.

Methods:  A 55‐item cross‐sectional survey of Australian dietitians practicing in the area of gestational diabetes was undertaken. Participants were recruited via Dietitians Association of Australia interest group membership, public and private hospital maternity and diabetes services across Australia. The survey examined dietetic service provision, interventions, management recommendations, postnatal care, current guideline use and the perceived need for Australian evidence‐based dietetic management guidelines.

Results:  A total of 220 eligible dietitians participated in the survey. The majority (77%) reported that all women with gestational diabetes attending their service were referred to a dietitian. Group (33%) and individual consults (93%) were provided and 67% provided one to two dietetic consults per client. Fifty‐four per cent (54%) believed that their service currently offered adequate antenatal dietetic interventions and 8% adequate postnatal follow up for women with gestational diabetes. There were differences in the implementation of medical nutrition therapy by Australian dietitians in regards to nutrient recommendations. However, consistency was seen in key components of nutrition education. Dietitians perceived that there was a need for evidence‐based gestational diabetes dietetic practice guidelines (86%) and nutrition recommendations (87%).

Conclusion:  The survey results strongly indicate there is a need for evidence‐based gestational diabetes practice guidelines and nutritional recommendations and provide baseline data for future practice of Australian dietitians working in gestational diabetes.
Information in dementia care: sense making and a public health direction for the UK?
Authors: Clarke Charlotte L. , Alexjuk Jo , Gibb Catherine E.
Published: August 2011

clarke c.l., alexjuk j. & gibb c.e. (2011) Information in dementia care: sense making and a public health direction for the UK? International Journal of Older People Nursing6, 237–243

doi: 10.1111/j.1748‐3743.2011.00288.x

Providing information is a core focus of policy and practice in dementia care. Information is a vehicle through which people can be enabled or disabled, so it is essential that we ensure that information is available in a way that is accessible and relevant for people with dementia and that it enables personal aspiration and collective identity to be advanced in a way that is to the benefit of those living with dementia. People with dementia need information to support autonomy in making decisions and in acting on those decisions. Information must be provided in a way that is appropriate to the individual and to achieve that requires knowledge of the needs of that individual. However, maintaining autonomy includes, but involves much more than, the provision of information – others need to listen and hear their views and be prepared to act on them. As professionals, we must be aware that the (dementia) information we provide may disrupt the biographical narrative that people with dementia value. Thus, a person‐centred approach encourages the sharing of knowledge and information. The (mis)use of information also impacts on the way that society disables, discriminates and applies barriers against people with disability.
Information provision services in dementia care
Authors: Corbett Anne , Ballard Clive
Published: August 2011

corbett a. & ballard c. (2011) Information provision services in dementia care. International Journal of Older People Nursing6, 217–226

doi: 10.1111/j.1748‐3743.2011.00289.x

There are currently 25 million people with dementia worldwide, and this number is rising. Dementia has been highlighted as a major priority for health care and research because of the enormous economical and health burden associated with it. Consultations with people with dementia and carers have highlighted that timely well‐targeted information services are a key priority for enabling them to ‘live well with dementia’. Despite this, the evidence base for the optimal design and delivery of an information provision service is limited. Findings from randomised controlled trials and other studies have indicated that information provision does confer some benefit in carer outcomes and in the symptoms and well‐being of people with dementia. However, there is limited understanding of the optimal design of such a service because of the variety of approaches that have been evaluated, the wide range of settings and locations and the lack of a clear conceptual framework. The existing evidence base supports the importance of an optimised information provision service and strongly indicates the need for a large‐scale RCT to identify the most effective and cost‐effective design for people with dementia and their carers.
Antioxidant and Antiproliferation Effects of Extractable and Nonextractable Polyphenols Isolated from Apple Waste Using Different Extraction Methods
Authors: Tow Wei Wei , Premier Robert , Jing Hao , Ajlouni Said
Published: August 2011

Abstract:  Fruits and vegetables waste byproducts could be utilized as a good source of cheap antioxidants for improving human health and reducing the risks of some chronic diseases. Results from examining industrial apple waste revealed that the total polyphenolic content in nonextractable polyphenols (NEPPs) reached 539.84 ± 8.90 mg as gallic acid equivalents/1 g of dry wt. in comparison to 77.26 ± 11.53 mg dry wt. of extractable polyphenols (EPPs). The antioxidant activities of NEPPs reported as percentage reduction in 2,2‐Diphenyl‐1‐picrylhydrazyl and 2′.2′‐azinobis(3‐ethylbenzothiazline‐6‐sulfonic acid) diammonium salt were 89.76 ± 0.93% and 99.78 ± 0.38%, respectively. In addition, the antiproliferation study on human HeLa, HepG2, and HT‐29 cancer cells showed that NEPPs at the concentration of 1 mg/mL had significant inhibitory effects against all tested cancer cells (46.2% to 95%), where EPP showed lower effect (3.9% to 22.2%). These results clearly indicated that NEPPs from industrial apple waste could be a good source of natural antioxidants with significant antiproliferation efficacy against human cancer cells.
A novel test tube method of screening for hemoglobin E
Authors: TATU T. , KASINRERK W.
Published: August 2011

Introduction:  Hemoglobin (Hb) E is a β‐structural variant common worldwide. This Hb disorder can form a compound heterozygous state with the β‐thalassemia gene, leading to life‐threatening hereditary hemolytic anemia, HbE/β‐thalassemia. Screening of HbE has proven to be a challenging practice in prevention and control of the HbE/β‐thalassemia.

Methods:  A novel test tube method for HbE screening using diethyl aminoethyl (DEAE)‐cellulose resin was described. With the developed system, HbE/A2 did not bind to the resin and remained dissolved in the supernatant, whereas other Hbs completely bound to the resin. The red color of the supernatant observed in the test tube indicated the presence of HbE. Colorless or markedly pale color of the supernatant indicates the absence of HbE.

Results:  Accuracy and efficiency of the established method in detecting HbE was comparable with the standard cellulose acetate electrophoresis method. The developed method is cheap and simple with no requirement of sophisticated equipment. The reagent could be stored at 4 °C for up to 5 months. Hemolysate samples aged up to 5 months were still suitable for this test.

Conclusion:  The described novel test tube method could be an alternative method of mass population screening for HbE, particularly in small health care facilities.
Strategies for discovery and improvement of enzyme function: state of the art and opportunities
Authors: Kaul Praveen , Asano Yasuhisa
Published: August 2011

Developments in biocatalysis have been largely fuelled by consumer demands for new products, industrial attempts to improving existing process and minimizing waste, coupled with governmental measures to regulate consumer safety along with scientific advancements. One of the major hurdles to application of biocatalysis to chemical synthesis is unavailability of the desired enzyme to catalyse the reaction to allow for a viable process development. Even when the desired enzyme is available it often forces the process engineers to alter process parameters due to inadequacies of the enzyme, such as instability, inhibition, low yield or selectivity, etc. Developments in the field of enzyme or reaction engineering have allowed access to means to achieve the ends, such as directed evolution, de novo protein design, use of non‐conventional media, using new substrates for old enzymes, active‐site imprinting, altering temperature, etc. Utilization of enzyme discovery and improvement tools therefore provides a feasible means to overcome this problem. Judicious employment of these tools has resulted in significant advancements that have leveraged the research from laboratory to market thus impacting economic growth; however, there are further opportunities that have not yet been explored. The present review attempts to highlight some of these achievements and potential opportunities.
The post‐illumination pupil response of melanopsin‐expressing intrinsically photosensitive retinal ganglion cells in diabetes
Authors: Feigl Beatrix , Zele Andrew J. , Fader Samantha M. , Howes Annelisa N. , Hughes Catherine E. , Jones Kris A. , Jones Rawlyn
Published: August 2011

Purpose:  This study investigates the clinical utility of the melanopsin‐expressing intrinsically photosensitive retinal ganglion cell (ipRGC) controlled post‐illumination pupil response (PIPR) as a novel technique for documenting inner retinal function in patients with Type II diabetes without diabetic retinopathy.

Methods:  The PIPR was measured in seven patients with Type II diabetes, normal retinal nerve fibre thickness and no diabetic retinopathy compared to healthy age‐similar controls. A 488‐ and 610‐nm, 7.15‐diameter stimulus was presented in Maxwellian view to the right eye and the left consensual pupil light reflex was recorded.

Results:  The group data for the blue PIPR (488 nm) identified a trend of reduced ipRGC function in patients with diabetes with no retinopathy. The transient pupil constriction was lower on average in the diabetic group. The relationship between duration of diabetes and the blue PIPR amplitude was linear, suggesting that ipRGC function decreases with increasing diabetes duration.

Conclusion:  This is the first report to show that the ipRGC‐controlled PIPR may have clinical applications as a non‐invasive technique for determining the progression of inner neuroretinal changes in patients with diabetes before they are ophthalmoscopically or anatomically evident. The lower transient pupil constriction amplitude indicates that outer retinal photoreceptor inputs to the pupil light reflex may also be affected in diabetes.
Two‐year follow‐up of a randomized trial of spectacles alone or combined with Bangerter filters for treating anisometropic amblyopia
Authors: Agervi Pia , Kugelberg Ulla , Kugelberg Maria , Zetterström Charlotta
Published: August 2011

Purpose:  To compare spectacle correction alone to spectacle correction with Bangerter filters as treatments for anisometropic amblyopia in children 1 year after completion of a 1‐year randomized trial.

Methods:  In a randomized clinical trial, 80 children (mean age, 4.4 years) with anisometropic amblyopia and a best median visual acuity (VA) in the amblyopic eye of 0.4 logarithm of the minimum angle of resolution (logMAR) were assigned to treatment with either spectacles or spectacles in combination with a Bangerter filter for 1 year. After 1 year, treatment with spectacles continued. If the VA differed by ≥2 lines, treatment with Bangerter filters was continued if originally prescribed. The main outcome measure was the median change in VA of the amblyopic eye after 2 years.

Results:  The median change in VA of the amblyopic eye did not differ significantly between the groups (0.4 log unit for both groups) at the 2‐year visit. At that time, the VA in the amblyopic eyes and the fellow eyes was 0.0 median logMAR in both groups. Between years 1 and 2, the median VA improved in the amblyopic eyes; in the spectacles group (p = 0.0181) and in the Bangerter filter group (p = 0.0342). The median anisometropia decreased in both groups (p < 0.0001 for both comparisons).

Conclusion:  We found stability in the VA improvement in both groups. The magnitude of the VA change 2 years after treatment with spectacles alone did not differ significantly from that after treatment with spectacles and a Bangerter filter for anisometropic amblyopia.
Bupleurum candollei var. paucefulcrans comb. nov. (Apiaceae) from Guizhou, China: comparison of allied species based on morphology, anatomy and molecular data
Authors: Wang Chang‐Bao , Ma Xiang‐Guang , He Xing‐Jin
Published: August 2011

The new combination, Bupleurum candollei Wallich ex de Candolle var. paucefulcrans (C. Y. Wu) X. J. He & C. B. Wang, is proposed. The status of this taxon, endemic to Guizhou, China, has been confused since it was first described in 1963. Morphological and anatomical evidence, based primarily on bractlet number and length, umbel number and length, fruit size and shape, and stem structure indicated that B. hamiltonii N. P. Balakrishnan var. paucefulcrans C. Y. Wu is more closely related to B. candollei than to B. hamiltonii. To evaluate the credibility of the morphological similarity, the phylogenetic relationship of B. candollei var. candollei, B. hamiltonii var. hamiltonii and B. candollei var. paucefulcrans were inferred by Bayesian analysis of nrDNA ITS sequences. The molecular analysis is fully congruent with the morphological data and supports the transfer of the variety to B. candollei.
Morphology and development of anthers and ovules in Croton and Astraea (Euphorbiaceae)
Authors: Cavalari De‐Paula Orlando , das Graças Sajo Maria
Published: August 2011

We examined the embryological development of anthers and ovules from Astraea (A. lobata and A. praetervisa) and Croton (C. floribundus, C. fuscescens, C. glandulosus, C. lundianus, C. piptocalyx, C. urucurana and C. triqueter) focusing on features with systematic significance for the group. Some of these features are common in Euphorbiaceae including: a dicotyledonous type of anther wall formation, a secretory tapetum, a mixed origin of the outer ovule integument, an epidermal origin of the inner ovule integument, the occurrence of many archesporial cells inside the ovules and a megagametophyte of the Polygonum‐type. Other features, such as the presence of styloid crystals in the tapetum, an idioblast with a druse in the endothecium, simultaneous and successive microsporogenesis, and a functional micropylar megaspore, have not previously been reported in the family. These characters appear to distinguish Croton and Astraea from other Euphorbiaceae and possibly represents autapomorphies for the tribe Crotoneae.
Prangos hulusii sp. nov. (Apiaceae) from West Anatolia, Turkey
Authors: Gökhan Şenol Serdar , Yıldırım Hasan , Seçmen Özcan
Published: August 2011

Prangos hulusii S. G. Şenol, H. YıIdırım & Ö. Seçmen (Apiaceae) is described as a new species from Izmir province (West Anatolia, Turkey). Latin diagnosis, taxonomic description, and an illustration of the new species are provided. The novelity is compared with the related species P. ilanae, P. turcica, P. trifida and P. odontalgica. Geographic distributions of the new species and other related species are mapped.
Potamogeton ×jutlandicus, a binominal for the hybrid between P. lucens and P. praelongus (Potamogetonaceae)
Authors: Zalewska‐Gałosz Joanna
Published: August 2011

Because the name Potamogeton ×babingtonii has been synonymised with P. ×angustifolius, no valid binominal exists for the hybrid P. lucens×praelongus. A morphological and anatomical study presented here demonstrates that specimens regarded by Hagström as Potamogeton ×babingtonii f. danicus really represent the hybrid between P. lucens and P. praelongus. As a consequence, a new binominal for this hybrid is introduced and its basionym Potamogeton ×babingtonii f. danicus is lectotypified. Morphological and anatomical characters of Potamogeton ×jutlandicus nom. nov. (=P. lucens×praelongus) are provided and its taxonomic delimitation is discussed.
Aspidistra albiflora sp. nov. (Asparagaceae) from southwestern Guangxi, China
Authors: Lin Chun‐Rui , Xu Wei‐Bin , Liu Yan
Published: August 2011

Aspidistra albiflora C. R. Lin, W. B. Xu & Yan Liu (Asparagaceae) is described and illustrated as a new species from limestone areas in Guangxi, China. The new species is similar to A. cerina G. Z. Li & S. C. Tang, but differs in having the perianth white by the sides, white pistils, bracts longer than the perianth, anthers only 2 mm long, pistil obconical and stigma slightly enlarged, 4–5 mm in diameter. The new species is currently only known from the type locality in southwestern Guangxi, near the border to northern Vietnam.
Factors impacting on early detection of dementia in older people of Asian background in primary healthcare
Authors: Lee Sook Meng , Lin Xiaoping , Haralambous Betty , Dow Briony , Vrantsidis Freda , Tinney Jean , Blackberry Irene , Lautenschlager Nicola , Giudice Dina Lo
Published: August 2011

Introduction

The prevalence of dementia in people from Culturally and Linguistically Diverse (CALD) backgrounds is predicted to increase. By 2026, Chinese and Vietnamese languages are projected to be the first and fourth most prevalent languages spoken by older people from CALD backgrounds living in Australia. Varying expressions of dementia literacy within these groups sometimes result in presentation to health services at a later stage of the disease.

Methods

This paper aims to present a literature review on factors impacting on the early diagnosis of dementia in primary care. Cultural factors pertaining to older people of Chinese and Vietnamese backgrounds are identified and described.

Results

The review found that despite the benefits and emphasis on early diagnosis of dementia, GPs′ uncertainty, insufficient training, ambivalent attitude and therapeutic nihilism have contributed to delayed diagnosis of dementia in CALD populations in primary care. Other factors included time pressures, poor remuneration and lack of CALD appropriate diagnostic tools and services. From the older Chinese and Vietnamese people and their families′ perspective, living arrangements, level of dementia literacy, symptom interpretation, stigma associated with dementia and their concept of morality significantly impacted on health‐seeking behaviour, contributing to delayed presentation to GPs. Language barriers and lack of bilingual GPs were also found to be deterring factors.

Discussion

There is a need to remove barriers impacting on the timely diagnosis of dementia in primary healthcare for older people from CALD backgrounds. Increasing CALD‐appropriate services, workforce training, public awareness and removing stigma may assist.
Psychological distress of women working in banks
Authors: Bez Yasin , Emhan Abdurrahim
Published: August 2011

Introduction

We aim to identify burnout and psychological distress levels in employees of three different types of banks, including conventional banks (government and private) and interest‐free banks.

Methods

All branches of the three different types of banks were visited in Diyarbakir, the largest city in the southeastern part of Turkey. The Maslach Burnout Inventory (MBI), the Symptom Check List‐90 Revised (SCL‐90‐R), and a demographic form were delivered to 235 bank employees in July 2009. Data from the 163 respondents were analyzed.

Results

Employment of women in private banks was higher than in government and interest‐free banks. The mean scores of somatization, obsessive‐compulsiveness, depression, anxiety, phobic anxiety, paranoid ideation, general symptom index in the SCL‐90‐R and emotional exhaustion were higher in women than in men. Younger employees felt less personal accomplishment than their older colleagues. Additionally, less experienced employees were under greater stress from working directly with people. They did not feel successful in their jobs. The three groups were similar in terms of burnout levels, but the SCL‐90‐R showed significantly different scores between the groups.

Discussion

Women employed in the banking sector were at risk for psychological distress and emotional exhaustion. Younger employees felt a decreased sense of personal accomplishment. Private bank employees experienced a larger level of psychological distress which was not reflected in their burnout levels.
Pilot study of the prevalence of alcohol, substance use and mental disorders in a cohort of Iraqi, Afghani, and Iranian refugees in Vancouver
Authors: Miremadi Saman , Ganesan Soma , McKenna Mario
Published: August 2011

Introduction

This study investigated the prevalence rate of current alcohol, substance use, post‐traumatic stress disorder (PTSD) and depression in a cohort of Middle‐Eastern government‐assisted refugees (GAR) to British Columbia.

Methods

A group of GARs (32 men and 36 women) were interviewed and assessed using four clinical assessments (AUDIT, DUDIT, IES‐R, PHQ‐9) at an intake facility in Metro Vancouver.

Results

Men had a higher prevalence of alcohol use compared to women (15.6% versus 0%, P < .05). Substance use was low for both men and women (3.1% and 2.8%) and consisted of Tylenol 3 use. Approximately the same proportion of male and female GARs had PTSD as a clinical concern (21.8% and 22.2%). GARs that were Iraqi, Muslim, had attended university, or had children had higher IES‐R scores compared to other GARs. Depression as a clinical concern was found in female and male GARs (16.7% and 21.9%). Total PHQ‐9 scores were higher for GARs who were unmarried.

Discussion

It would be beneficial for mental health care providers who treat Middle‐Eastern GARs to review screening methods for PTSD, depression, and substance use. This may also include additional training in the screening of GARs for appropriate mental health services. Mental health services must be linguistically and culturally matched to the recipient for optimal therapeutic benefit.
Oral cancer in young non‐habituè females: a report of four cases and review of the literature
Authors: Beena VT , Chauhan I , Heera R , Rajeev R
Published: August 2011

Background:  The aim of this study is to highlight the growing incidence of oral cancer in young females without apparent traditional risk factors.

Methods:  We present a case series of young female patients with histopathologically diagnosed squamous cell carcinoma of the tongue and no known exposure to major risk factors, reporting to our institution over one year. A review of the literature was carried out to find documented studies on oral cancer in young females.

Results:  We found an increase in the number of young female patients presenting with squamous cell carcinomas on the lateral border of the tongue who did not have any of the traditional risk factors associated with the disease, which is in contrast with the number of male patients presenting with the same disease.

Conclusions:  Our study highlights the increasing incidence of oral cancer in young females without apparent traditional risk factors, an area of growing concern. Published studies in this particular group are limited. Nevertheless, the situation is alarming owing to the seriousness this problem poses for the community. More research is required to determine the aetiological and risk factors associated with this outcome.
The treatment of oral cancer: an overview for dental professionals
Authors: Deng H , Sambrook PJ , Logan RM
Published: August 2011

Oral cancer is a serious life‐threatening disease. Dental professionals may be the first individuals to identify/suspect these lesions before referring to oral and maxillofacial surgeons and oral medicine specialists. Because the general dentist will likely follow on with the patient’s future oral health, it is important that he or she has a basic understanding of the various treatments involved in treating oral malignancies and their respective outcomes. The four main modalities discussed in this review include surgery alone, radiotherapy alone, surgery with radiotherapy, and chemotherapy with or without surgery and radiotherapy. Chemotherapy has become an area of great interest with the introduction of new ‘targeted therapies’ demonstrating promising results in conjunction with surgery. Despite these results, the toxicities associated with chemotherapy regimens are frequent and can be severe, and therefore may not be suitable for all patients. Treatment modalities have improved significantly over the decades with overall decreases in recurrence rates, improved disease‐free and overall survival, and an improved quality of life. Prognosis, however, is still ultimately dependent on the clinical stage of the tumour at the initial diagnosis with respect to size, depth, extent, and metastasis as recurrence rates and survival rates plummet with disease progression.
Four‐year follow‐up of two chronic hepatitis B recipients of hepatitis B surface antigen‐positive cadaveric liver grafts from asymptomatic carriers
Authors: Jiao Zuoyi , Zhang Youcheng , Han Lin , Zeng Yong , Yan Lunan
Published: August 2011

Aim:  Only seven cases of liver transplantation (OLT) with positive serum hepatitis B surface antigen (HBsAg) grafts have been reported in the world till now. Here we report the 4‐year follow‐up results and clinical pathologic characteristics of two recipients of chronic hepatitis B transplanted with HBsAg‐positive cadaveric liver grafts from asymptomatic carriers.

Methods:  Lamivudine combined with hepatitis B immune globulin were used for the control of hepatitis B virus (HBV) infection in both of the recipients post‐OLT. The liver functions, virus status and pathologic characteristics of two recipients were followed up according to the rounte protocol of Liver Transplantation Center of West China Hospital.

Results:  The serum HBV deoxyribonucleic acid (DNA) turned negative within 30 days post‐OLT, but HBsAg remained positive for both of the recipients during follow up. HBV breakthrough occurred in one recipient at the month 12 post‐OLT, with detectable serum HBV‐DNA (740 copies/mL) and tyrosine‐methionine‐aspartate‐aspartate motif mutation (rtM204I and rtM204V). After the replacement of lamivudine by adefovir dipivoxil 10 mg daily for 2 months, serum HBV‐DNA of this recipient became undetectable again and maintained undetectable during follow up. Both of the recipients have survived for more than 4 years post‐OLT, with stable liver function and mild hepatitis.

Conclusion:  Due to extreme scarcity of liver graft, we think that HBsAg‐positive liver graft without active HBV‐DNA replication and severe pathological manifestation from asymptomatic carriers may deserve consideration when no other graft is available in a bearable waiting time.
Diagnostic criteria of acute liver failure: A report by the Intractable Hepato‐Biliary Diseases Study Group of Japan
Authors: Mochida Satoshi , Takikawa Yasuhiro , Nakayama Nobuaki , Oketani Makoto , Naiki Takafumi , Yamagishi Yoshiyuki , Ichida Takafumi , Tsubouchi Hirohito
Published: August 2011

The diagnostic criteria of fulminant hepatitis in Japan are different from those of acute liver failure in Europe and the United States, both in regard to the histological features in the liver and the cutoff values of the prothrombin time. Thus, the Intractable Hepato‐Biliary Disease Study Group established novel diagnostic criteria for “acute liver failure” in Japan based on the demographic and clinical features of the patients. Patients showing prothrombin time values of 40% or less of the standardized values or international normalized ratios of 1.5 or more caused by severe liver damage within 8 weeks of onset of the symptoms are diagnosed as having “acute liver failure”, where the liver function prior to the current onset of liver damage is estimated to be normal. Acute liver failure is classified into “acute liver failure without hepatic coma” and “acute liver failure with hepatic coma,” depending on the severity of the hepatic encephalopathy; the latter is further classified into two types, the “acute type” and the “subacute type”, in which grade II or more severe hepatic coma develops within 10 days and between 11 and 56 days, respectively, after the onset of disease symptoms. Patients without histological findings of hepatitis, such as those with liver damage caused by drug toxicity, circulatory disturbance or metabolic disease, are also included in the disease entity of “acute liver failure”, while acute‐on‐chronic liver injuries, such as liver injury caused by alcohol, are excluded. A nationwide survey of “acute liver failure” in Japan based on the novel criteria is proposed.
Social Protection and Socioeconomic Security in Nepal
Authors: Koehler Gabriele
Published: August 2011

Nepal, with a population of 27.6 million people, is a ‘least developed country’ in many ways. The country is characterised by significant socioeconomic insecurity, comprising structurally‐generated income poverty, a politically and socially fragile post‐conflict situation, threats to the environment, and deeply entrenched forms of social exclusion. At the same time, it is a country characterised by interesting socio‐political policy innovations, triggered by the end of a ten‐year violent conflict. Building on a discussion of the country's challenges, the paper explores the policy responses in the domain of social protection devised by the interim government to address the various dimensions of insecurity, and to show their novelty as well as their limitations. The final section offers some ideas on policy areas which would be needed to improve socioeconomic security.
Computer‐aided measurement of mandibular cortical width on dental panoramic radiographs for identifying osteoporosis
Authors: Kavitha Muthu Subash , Samopa Febriliyan , Asano Akira , Taguchi Akira , Sanada Mitsuhiro
Published: August 2011

Aim:  To develop a computer‐aided diagnosis system to continuously measure mandibular inferior cortical width on dental panoramic radiographs and evaluate the system’s efficacy in identifying postmenopausal women with low‐skeletal bone mineral density.

Methods:  Mandibular inferior cortical width was continuously measured by enhancing the original X‐ray image, determining cortical boundaries, and evaluating all distances between the upper and lower boundaries in the region of interest. The system’s efficacy in identifying osteoporosis at the lumbar spine and the femoral neck was evaluated for 100 women (≥50 years): 50 in the development of the tool and 50 in its validation.

Results:  The sensitivity and specificity of the cortical measurements for identifying the development patients were 90% (95% confidence interval shown in parentheses) (63.0–87.0) in women with low spinal bone mineral density, and 81.8% (70.1–91.8) and 69.2% (56.2–81.8) in those with low femoral bone mineral density, respectively. Corresponding values in the validation patients were 93.3% (85.9–100) and 82.9% (71.4–92.7) at the lumbar spine, and 92.3% (84.5–99.5) and 75.7% (63.0–87.0) at the femoral neck, respectively.

Conclusion:  Our new computer‐aided diagnosis system is a useful procedure in triage screening for osteoporosis.
Role of pharmacists in the management of patients with epilepsy
Authors: Koshy Samuel
Published: August 2011

Objectives

The aim of this article is to highlight the roles that pharmacists currently have in the management of patients with epilepsy and the opportunities and challenges associated with these roles.

Key findings

There are many opportunities for pharmacists in the management of patients with epilepsy owing to the accessibility and extensive knowledge of drug therapy. The role of pharmacists extends beyond dispensing medications. The pharmacists have a significant role in the education of patients about the disease and therapy, encouraging adherence and explaining side effects and providing information on potential drug-drug interactions, resulting in improved clinical outcomes and decreased costs. Physicians prefer pharmacists as information sources for medication profile and drug interaction screening for patients with epilepsy. However, there are certain challenges which the pharmacists should overcome if effective medication therapy management services are to be provided on a routine basis. Educational interventions are required to improve the knowledge and skills of pharmacists. The gap between patients' and pharmacists' views of the pharmacist's role has to be narrowed to ensure enhanced role of the pharmacists in this patient group.

Conclusions

There are a lot of opportunities and challenges for pharmacists to provide medication therapy management services for patients with epilepsy. Evidence in the literature provides justification for such services. However more research is required to provide foundation for routine provision of such services in all healthcare facilities.
Subjective judgements of synergistic risks: A cognitive reasoning perspective
Authors: Dawson Ian G. J. , Johnson Johnnie E. V. , Luke Michelle A.
Published: August 2011

Mounting evidence that certain hazard combinations present synergistic risks for adverse outcomes, including violent crime, cancer, and species extinction, highlights the importance of understanding the risk attributable to combined hazards. However, previous studies indicate that individuals often misjudge synergistic risks as additive or sub‐additive risks, and there is little research that explores the cognitive reasoning that may lead individuals to make such judgements. This study aims to fill this gap. Participants were asked to review several scenarios that described the risk magnitude presented by a combined hazard. They were required to judge whether each scenario was possible and to explain the reasoning that led to their judgement. The results show that many participants demonstrated an awareness of synergistic risk and that their reasoning was typically characterized by rudimentary knowledge of an underlying causal mechanism for the increased risk (e.g., a chemical reaction between drugs). Conversely, several participants adopted a line of reasoning that precluded the concept of synergistic risk. Many of these participants appeared to employ an additive model of risk, corresponding to the notion of ‘adding’ one hazard to another. Contrary to much previous research, we found little evidence to indicate that people tend to employ a sub‐additive model of risk for combined hazards. Implications for future research and the improvement of risk communications concerning synergistic risks are discussed.
Implications of group III and IV muscle afferents for high‐intensity endurance exercise performance in humans
Authors: Amann Markus , Blain Gregory M. , Proctor Lester T. , Sebranek Joshua J. , Pegelow David F. , Dempsey Jerome A.
Published: August 2011

Non‐Technical Summary  We investigated the influence of group III/IV muscle afferents on central motor drive, the development of peripheral locomotor muscle fatigue, and endurance performance time during high‐intensity constant‐load cycling exercise to exhaustion. Our findings suggest that, on the one hand, afferent feedback ensures adequate circulatory and ventilatory responses to exercise which optimizes muscle O2 transport and thereby facilitates exercise performance by preventing premature peripheral fatigue. On the other hand, afferent feedback inhibits central motor drive, which is reflected in the restriction of the neural excitation of the locomotor musculature and the reduced tolerance for peripheral muscle fatigue, and thereby limits exercise performance. Taken together, the current investigation revealed the net effects of sensory afferent feedback on time to exhaustion during high‐intensity constant‐load cycling exercise and showed that intact group III/IV muscle afferent feedback is a vital component in achieving optimal endurance performance.
Orai channel‐dependent activation of phospholipase C‐δ: a novel mechanism for the effects of calcium entry on calcium oscillations
Authors: Thompson Jill L. , Shuttleworth Trevor J.
Published: August 2011

Non‐Technical Summary  Agonist‐induced oscillatory changes in intracellular calcium represent a critical mechanism for the selective regulation of various discrete cellular activities, as different responses are activated at different frequencies of calcium oscillations. An important determinant of oscillation frequency is the rate of agonist‐induced calcium entry, although precisely how this effect is achieved remains controversial. Here we show that calcium entering via a specific calcium channel that is regulated by agonist‐induced increases in arachidonic acid (the ARC channel) stimulates the enzyme phosopholipase C‐δ (PLCδ), whose activity is known to result in an increase in cellular levels of inositol trisphosphate – a key determinant in the regulation of the release of calcium from intracellular stores, thereby increasing oscillation frequency. Interestingly, this activation of PLCδ by calcium entering via the ARC channels occurs in a highly localized manner, and is not duplicated by equivalent calcium entry via co‐existing store‐operated calcium channels.
Endothelin‐converting enzyme‐1 regulates trafficking and signalling of the neurokinin 1 receptor in endosomes of myenteric neurones
Authors: Pelayo Juan‐Carlos , Poole Daniel P. , Steinhoff Martin , Cottrell Graeme S. , Bunnett Nigel W.
Published: August 2011

Non‐Technical Summary  The movement of receptors to and from the surface of nerve cells determines whether nerves can detect and respond to stimulants in the extracellular fluid. It is well established that stimulated receptors move from the surface of nerves to intracellular compartments, but the processes that control movement of internalized receptors back to the surface are poorly understood. We show that an intracellular enzyme, endothelin‐converting enzyme‐1, controls the translocation of receptors back to the surface of neurones of the intestinal tract that control the normal process of digestion. This process is likely to regulate digestion, and abnormalities in the mechanism could cause digestive diseases.
Ligand stoichiometry of the cold‐ and menthol‐activated channel TRPM8
Authors: Janssens Annelies , Voets Thomas
Published: August 2011

Non‐Technical Summary  The ion channel TRPM8, which is present in nerves that innervate the skin and mouth, mediates the sensation of cold temperatures and of chemical substances that evoke a cold sensation, such as menthol or eucalyptol. The molecular structures and biophysical mechanisms that allow this and related channels to integrate thermal and chemical information are poorly understood. In this work, we demonstrate that TRPM8 is able to bind up to four menthol molecules, and that every bound menthol molecule causes an equivalent stabilization of the open state of the channel. These results provide important fundamental insight into the working mechanism of temperature‐sensitive channels, and may assist in the development of drugs to treat oversensitivity to cold temperatures and pain.
Endoscopic management of postcholecystectomy biliary leaks
Authors: Sharma Hemant , Bird George
Published: August 2011

Objective

To evaluate the nature of bile duct injuries following cholecystectomy and the success of endoscopic retrograde cholangiopancreatography (ERCP) in their identification and management.

Design

All patients referred for ERCP with a diagnosis of a postcholecystectomy bile leak were identified prospectively from October 1994 to August 2008.

Setting

The study was carried out in a district general hospital with the endoscopies performed by a single operator.

Patients

All patients had undergone imaging with at least two of abdominal ultrasound scanning, CT scanning orMR cholangiopancreatography.

Interventions

ERCP with treatment of a biliary leak by sphincterotomy and insertion of a temporary 7 Fr plastic biliary stent.

Main outcome measurements

Clinical healing of the injury was assessed as resolution of symptoms with normalisation of liver function tests, cessation of external drain output and a repeat ERCP with removal of the indwelling stent within 2–8 weeks and no further complications.

Results

46 patients were identified, of whom 42 responded well to endoscopic treatment. Four patients ultimately needed surgery, of whom three had recurrent strictures. One patient had complete transection of the biliary duct and endoscopic treatment was not attempted.

Conclusion

ERCP, with sphincterotomy and temporary plastic stent placement, is successful in the early management of patients with postcholecystectomy biliary leaks, which most commonly involve the cystic duct stump. ERCP carried out in a district general hospital identifies those patients requiring further specialised hepatobiliary care in a tertiary centre.
Irresponsible dog ownership
Authors: Roger Paul
Published: August 2011

Your neighbours buy two beagles and house them in a purpose‐built compound. During the week, both occupants leave for work early and return in the evening, and they are often away at weekends. A paid dog walker exercises the dogs for about 50 minutes a day during the week and spends a further 10 minutes feeding them and cleaning up. Before and after being walked, the dogs bay periodically throughout the day, which is starting to get on your nerves. At weekends the dogs are not walked, but they are allowed to run around a terraced garage roof. How should you proceed?
Comments on the dilemma in the July/August issue: ‘Regulation breach on farm’
Authors: Mullan Siobhan
Published: August 2011

The dilemma in the July/August issue concerned a farmer client requesting a veterinary examination of a pregnant suckler cow (In Practice, July/August 2011, volume 33, page 362). Examination revealed an infected, ulcerated growth on its third eyelid that was provisionally diagnosed as squamous cell carcinoma. The farmer was advised that removal of the mass under local anaesthetic was the best course of action, but that by the time the cow had calved and reared its calf, the growth would probably have returned and culling would then be recommended. The client insisted on palliative treatment with a time limit, without removal of the mass, but a courtesy visit one week later revealed that the cow was showing signs of pain as a result of the growth. In addition, several untagged dead calves and two dead sheep were observed in a ditch at the entrance to the farmer's land. Mike Steele commented that it was the vet's role to remind the farmer immediately of his responsibilities to both the cow's welfare and the dead animals. A solution for the suckler cow may have been to cull it only if early signs of regrowth revealed themselves after removal of the mass, potentially allowing the animal to live longer. The dead animals were ultimately the farmer's responsibility, irrespective of whether they belonged to him, because they were on his land. The fact that they were not tagged may have contravened the Rural Payment Agency's tagging rules, depending on the calves' ages, and dumping of carcases in watercourses would be treated very seriously by the authorities. However, the vet should question the farmer on why the animals were dumped, to identify potential underlying problems such as a lack of finances to send them to the knacker (implying an inability to care for the animals properly), or a disease outbreak that needed addressing.
Diagnosis and management of osteoarthritis in cats
Authors: Godfrey David
Published: August 2011

Osteoarthritis is one of the most significant conditions affecting older cats and can be difficult to diagnose. Inactivity is a common sign but owners often do not recognise this as a clinical issue and many older cats have a sedentary lifestyle anyway. Treatment can be very effective in relieving the pain associated with this condition and improving an animal's quality of life. This article describes the general approach to osteoarthritis in cats and discusses some options for management.
Nonexistence of a “local suppression” in the ionization of hydrogen atoms by a low-frequency laser field of arbitrary strength
Authors: Gavrilenko V.P. , Oks E.
Published: August 2011

Further development of an analytical model for the tunneling ionization of atoms using a low-frequency laser field of arbitrary strength, including the strong-field region, is presented. The model uses a very accurate approximation of the true ionization barrier–potential in the Schrödinger equation by the effective parabolic barrier–potential based on the algorithm suggested by Miller and Good and later employed by Kulyagin and Taranukhin (KT) for calculating the ionization rate, W(F), of hydrogen atoms from the ground state by a linearly polarized laser field. We point out and eliminate a number of principal errors made by KT and calculate W(F) much more accurately. We demonstrate that the dependence of the ionization rate on the strength of the linearly polarized laser field is monotonic and does not show any effect of the stabilization (“local ionization suppression”) claimed by KT. Our results for W(F) are in good agreement with the results of quantum fully numerical simulations. The analytical method, further developed in the present paper, can be extended without difficulty to calculations of the tunneling ionization for a number of other quantum systems. The most immediate extensions are to hydrogen atoms in an elliptically polarized laser field and atoms described by the Thomas–Fermi model.
Chemiluminescent NiO* emissions: band systems and spectral simulation
Authors: Gattinger R.L. , Evans W.F.J. , Llewellyn E.J.
Published: August 2011

Following the renewed interest in metal oxide emissions in the night airglow, high-resolution laboratory observations of NiO* in the visible and near-infrared regions of the spectrum are reviewed, and approximate spectroscopic constants are derived to augment those already available in the literature. A preliminary spectral band simulation model is developed for the relevant NiO systems. Franck–Condon factors, calculated using the preliminary spectroscopic constants, are used in the model to conduct an iterative comparison with low-resolution NiO* chemiluminescent emissions observed in the laboratory. Relative vibrational level populations are estimated, and shortcomings of the model are noted. The existence of a new NiO band system is also suggested.
Some exact and explicit solutions to a two-component, discrete, nonlinear Schrödinger model
Authors: Aslan İsmail
Published: August 2011

Natural processes and phenomena often display discrete structure. The discrete nonlinear Schrödinger equations are used in both physics and biology to model periodic optical structures and energy transfer in proteins. In this study, we present a new application of the (G′/G)-expansion method to special, coupled, discrete, nonlinear Schrödinger-type equations. This application is shown to be an effective tool for constructing solitary and periodic wave profiles with arbitrary parameters. In addition, we provide rational solutions that have not been explicitly computed before.