bluuebunny/crossref_metadata_2025 huggingface dataset:
Adherence to hepatitis A virus vaccination in HIV-infected men who have sex with men
Authors: Kourkounti Sofia , Paparizos Vassilios , Leuow Kirsten , Paparizou Eleni , Antoniou Christina
Published: November 2014

Although vaccination against hepatitis A virus (HAV) is essential for human immunodeficiency virus (HIV)-infected patients, the uptake of HAV vaccine is reported to be very low. From 2007 to 2012, 912 HIV-infected men in Athens, Greece were screened for exposure to HAV. Two doses of an HAV vaccine were recommended to 569 eligible patients. Reminder cards with scheduled vaccination visits were given to each patient. Among eligible patients, 62.2% (354/569) received both doses. Patients who were fully vaccinated compared with non-adherent patients were natives, older, had undetectable HIV viral load, higher CD4 T cell counts and lower nadir CD4 T cell counts. Multivariate logistic regression revealed that the patient’s country of origin ( p = 0.024; OR = 2.712; 95% CI, 1.139–6.457), CD4 T cell count ( p < 0.001) and nadir CD4 T cell count ( p < 0.001) were factors directly associated with adherence. In conclusion, adherence to HAV vaccination was better than in previously published data. Because many of the factors related to vaccination completion are parameters of HIV infection, it appears that physician interest in HIV care and vaccination planning is crucial to enhancing vaccine uptake.
Acute prostatitis probably due to Listeria monocytogenes in an HIV-infected patient
Authors: Roca B , Díaz MD , Roca M
Published: November 2014

We report a unique case of acute bacterial prostatitis probably caused by Listeria monocytogenes in an HIV-infected patient. For the best of our knowledge, this is the first case reported of a patient with this association. Our case illustrates the protean clinical presentations that L. monocytogenes infections may adopt, particularly in immunocompromised patients.
Members of the receptor for advanced glycation end products axis as potential therapeutic targets in patients with lupus nephritis
Authors: Yu S L , Wong C K , Szeto C C , Li E K , Cai Z , Tam L S
Published: November 2014

The relationship of inflammation and the expression of full-length receptor for advanced glycation end products (flRAGE) on monocytes, plasma levels of RAGE ligand high mobility group box protein 1 (HMGB1), soluble RAGE (sRAGE) and endogenous secretory RAGE (esRAGE) was assessed to elucidate the effect of HMGB1/DNA/RAGE-mediated innate inflammatory responses in patients with lupus nephritis. Cell surface expression of flRAGE was elevated on the monocytes of lupus patients, correlated with plasma HMGB1 levels. Plasma sRAGE level negatively correlated with systemic lupus erythematosus (SLE) disease activity index. Plasma esRAGE level was significantly lower in SLE patients with flare while esRAGE/sRAGE ratio negatively correlated with complement C3 level. HMGB1 alone could moderately induce ex vivo IL-6 production from monocytes, resulting in activation of intracellular p38 mitogen-activated protein kinase (MAPK), c-Jun N-terminal kinase and nuclear factor (NF)-κB. Moreover, toll-like receptor-9 ligand together with HMGB1 exhibited a synergistic effect on IL-6 and IL-12p70 secretions and the phosphorylation of p38 MAPK and NF-κB. Therefore, over-expression of flRAGE in lupus may lead to the amplification of RAGE ligands-mediated inflammatory responses through the activation of p38 MAPK and NF-κB. Plasma sRAGE may serve as a potential biomarker for disease activity and a future therapeutic target in SLE.
Bayesian inference for joint modelling of longitudinal continuous, binary and ordinal events
Authors: Li Qiuju , Pan Jianxin , Belcher John
Published: November 2014

In medical studies, repeated measurements of continuous, binary and ordinal outcomes are routinely collected from the same patient. Instead of modelling each outcome separately, in this study we propose to jointly model the trivariate longitudinal responses, so as to take account of the inherent association between the different outcomes and thus improve statistical inferences. This work is motivated by a large cohort study in the North West of England, involving trivariate responses from each patient: Body Mass Index, Depression (Yes/No) ascertained with cut-off score not less than 8 at the Hospital Anxiety and Depression Scale, and Pain Interference generated from the Medical Outcomes Study 36-item short-form health survey with values returned on an ordinal scale 1–5. There are some well-established methods for combined continuous and binary, or even continuous and ordinal responses, but little work was done on the joint analysis of continuous, binary and ordinal responses. We propose conditional joint random-effects models, which take into account the inherent association between the continuous, binary and ordinal outcomes. Bayesian analysis methods are used to make statistical inferences. Simulation studies show that, by jointly modelling the trivariate outcomes, standard deviations of the estimates of parameters in the models are smaller and much more stable, leading to more efficient parameter estimates and reliable statistical inferences. In the real data analysis, the proposed joint analysis yields a much smaller deviance information criterion value than the separate analysis, and shows other good statistical properties too.
Applying compositional data methodology to nutritional epidemiology
Authors: Leite Maria Léa Corrêa
Published: November 2014

The purpose of epidemiological studies of nutrition and disease is to investigate the effects of specific dietary components regardless of total energy intake, but this is sometimes hampered by the compositional nature of dietary data. Compositional data are those that measure parts of a whole, such as percentages or proportions, and particular methodologies have been developed to allow their statistical analysis and theoretical and practical applications in various sciences. This paper describes the use of a compositional data perspective for statistical analyses in the field of nutritional epidemiology. The approach is based on isometric log-ratio transformation and has been previously proposed for the construction of regression models using compositional explanatory variables. The new isometric log-ratio variables allow full inferences about each element of dietary composition and adjustment by total energy intake. Using data from an Italian population-based study, logistic regression models were fitted to evaluate the effects of the intake of macronutrients (proteins, fats and carbohydrates) on the odds of having metabolic syndrome in middle-aged subjects.
Fracture behavior investigation for a pileup of edge dislocations interacting with a nanoscale inhomogeneity with interface effects
Authors: Fan M , Yi DK , Xiao ZM
Published: November 2014

Elastic-plastic stress investigation for a pileup of edge dislocations interacting with a nanoscale inhomogeneity has been carried out in the form of Zener–Stroh crack. The interface and size effects of the inhomogeneity based on the Gurtin–Murdoch model are considered. The fracture behavior of the crack with plastic zone correction is examined by the generalized Irwin model for mixed loading conditions, in which von Mises yielding criterion is fulfilled in the plastic zone area. The stress intensity factor (SIF), the plastic zone size (PZS), and the crack tip opening displacement (CTOD) of the crack are evaluated. For a nanoscale inhomogeneity (inclusion), the size and interface properties have great influence on the fracture behavior of the crack, which is completely different to a classical crack-inclusion interaction problem. Numerical examples are given to show the effects of the inhomogeneity radius, interface properties and crack-inhomogeneity distance, as well as the dislocation loading ratio on the normalized SIFs, PZS, and CTOD of the Zener–Stroh crack. It is found that for different intrinsic lengths, the normalized SIFs, PZS, and CTOD are very different. This influence will be even greater when the crack is closer to the nano-inhomogeneity. For the mixed-mode problem, the dislocation loading ratio does not have too much effect on the normalized SIFs, but does have significant influence on the normalized PZS and CTOD.
Arterial Anatomy of the Tibialis Posterior Tendon
Authors: Manske Mary Claire , McKeon Kathleen E. , Johnson Jeffrey E. , McCormick Jeremy J. , Klein Sandra E.
Published: November 2014

Background:

Tibialis posterior tendon dysfunction is a common disorder leading to pain, deformity, and disability, although its pathogenesis is unclear. A vascular etiology has been proposed, but there is controversy regarding the existence of a hypovascular region that may render the tendon vulnerable. The purpose of this study was to provide a description of the arterial anatomy supplying the tibialis posterior tendon.

Methods:

Sixty adult cadaveric lower extremities were obtained from a university-affiliated body donation program. Thirty specimens obtained within 72 hours of death were used for microscopic analysis. Thirty specimens were previously frozen and used for macroscopic analysis. The tibialis anterior, tibialis posterior, and peroneal arteries were injected with India Ink and Ward’s Blue Latex. The specimens used for macroscopic analysis were debrided with sodium hypochlorite to expose the extratendinous anatomy. For the microscopic analysis, the tendon was cleared using a modified Spälteholz technique to expose the intratendinous vascular anatomy.

Results:

Macroscopically, an average of 2.5 ± 0.7 vessels entered the tendon proximal to the navicular insertion. In all, 28/30 (93.3%) specimens had a vessel entering 4.1 ± 0.6 cm proximal to the medial malleolus and 24/30 (80.0%) specimens had a vessel entering 1.7 ± 0.9 cm distal to the medial malleolus. Microscopically, an average of 1.9 ± 0.3 vessels entered each tendon proximal to the navicular insertion. In total, 27/30 (90%) specimens had a vessel entering the tendon 4.8 ± 0.8 cm proximal to the medial malleolus and 30/30 (100%) specimens had a vessel entering the tendon 1.9 ± 0.8 cm distal to the medial malleolus. In all specimens, a hypovascular region was observed, starting 2.2 ± 0.8 cm proximal to the medial malleolus and ending 0.6 ± 0.6 cm proximal to the medial malleolus with an average length of 1.5 ± 1.0 cm. The insertion of the tendon was well vascularized both on microscopic and macroscopic specimens.

Conclusion:

The tibialis posterior tendon was supplied by 2 vessels entering the tendon approximately 4.5 cm proximal and 2.0 cm distal to the medial malleolus. A retromalleolar hypovascular region was observed.

Clinical Relevance:

Improved understanding of the vascularity of the tibialis posterior tendon may be helpful in clinical practice and potentially provides a basis for further evaluation of the causative factors of tibialis posterior tendinopathy.
Assessing Impression Management With the MMPI-2 in Child Custody Litigation
Authors: Arce Ramón , Fariña Francisca , Seijo Dolores , Novo Mercedes
Published: November 2014

Forensic psychological evaluation of parents in child custody litigation is primarily focused on evaluating parenting capacity and underreporting. The biased responses of underreporting have been classified as Impression Management (IM) or as Self-Deceptive Positivity (S-DP), which are regarded to be conscious or unconscious in nature, respectively. A field study was undertaken to assess impression management on the Minnesota Multiphasic Personality Inventory–2 (MMPI-2) in child custody cases, the accuracy of the MMPI-2 scales in classifying IM, and what parents in child custody litigation actually manipulate in terms of IM. A total of 244 parents in child custody litigation and 244 parents under standard instructions were administered the MMPI-2. The results revealed that the L, Mp, Wsd, and Od scales discriminated between both samples of parents; the rate of satisfactory classification (i.e., odds ratio ranged from 5.7 for Wsd to 23.3 for Od) and an incremental validity of Od over Mp and Wsd. As for the effects of IM, the results show IM effects in the Basic Clinical Scales, the Restructured Clinical Scales, the Personality Psychopathology Five Scales, the Content Scales, and the Supplementary Scales. The implications of the results are discussed in relation to the forensic evaluation of parents in child custody litigation.
Nonlinear dynamics analysis of a thin rectangular plate in subsonic airflow
Authors: Meng Ling-Chang , Li Feng-Ming , Yao Guo , Zhang Wei
Published: November 2014

The bifurcation and chaotic motion of a fully simply-supported thin rectangular plate considering nonlinear deflection subjected to axial subsonic airflow and transverse harmonic excitation is analyzed. Based on von Karman’s large deformation theory, the partial differential equation of motion of the structural system is formulated using Hamilton’s principle, and it is transformed into a set of ordinary differential equations (ODEs) through Galerkin’s method. The three-dimensional (3D) aerodynamic pressure induced by the transverse motion of the plate is derived from the linear potential flow theory, and the validity of the aerodynamic model is verified. For the structural system, Melnikov’s method is adopted to give an analytical expression of the necessary condition for the chaotic motion of the plate. The influences of the flow velocity and the external harmonic excitation on the chaotic motion of the plate are investigated. Numerical simulations are carried out to obtain the bifurcation diagrams, displacement time histories, phase portraits, and Poincaré maps of the nonlinear system to verify the validity of the analytical results. The results show that when the flow velocity increases, the plate will be unstable, and chaotic motion of the plate will occur.
Picturing Industrial Landscapes
Authors: Lozowy Andriko
Published: November 2014

The work of the photographer-researcher is marked by a practice-based approach to explore living in relation to place mediated by the visual, in this case, refinery landscapes. Using a methodology of the photographer-researcher and a theory of visualicity, the Strathcona (Edmonton, Alberta, Canada) refineries are photographed and reflected upon through text. A discussion of Edward Burtynsky follows as a means to contextualize multi-modal approaches to relationships of people and place. These photographs represent refinery landscapes, industrial production, and regimes of security.
Enriching practice of dialectic behaviour therapy with the dynamic maturational model of attachment and adaptation
Authors: Wilkinson Simon R
Published: November 2014

The major challenge for a clinician is integration of the wisdom available in the wide range of therapeutic paradigms available. I have found the principles guiding dialectic behaviour therapy (DBT; see Miller, Rathus, & Linehan, 2007, for applying DBT to adolescents) extremely useful in my practice running a general adolescent unit; similarly, the understanding of the different information processing and learning principles associated with each of the Type A and C attachment strategies, as understood in dynamic maturational model (DMM), has guided me through the dark corners of treatment. Specifically, how does DMM inform practice of DBT? As a ‘DBTer’ might say, ‘Where is the wisdom in both points of view?’ Nevertheless, DMM is not primarily about treatment. It concerns how different ways of adapting to developmental contingencies bias perceptual propensities, and hence the information available for reflective brain function. Recognition of these twists to knowing what is going on can then be used to inform a variety of therapeutic approaches. The purpose of this article is to look for the signposts in DBT and DMM which together help navigate the comprehensive approach necessary in complicated therapy. In the process, hopefully some more general principles for addressing discomfited adolescents arise for informing future practice. Although many steer shy of using personality disorder diagnoses for adolescents, clinicians are nevertheless addressing, directly or indirectly, the personality development of all adolescents in treatment, regardless of their classical axis I diagnoses, including both those with developing emotional instability and a group of avoidant over-controlled adolescents, which in Norway is growing in prominence.
Ethical issues in the psychosocial assessment of bariatric surgery candidates
Authors: Rouleau Codie R , Rash Joshua A , Mothersill Kerry J
Published: November 2014

Psychosocial evaluation is recommended prior to bariatric surgery. Practice guidelines have been published on assessment methods for bariatric surgery candidates, but they have not emphasized ethical issues with this population. This review outlines ethical and professional considerations for behavioral healthcare providers who conduct pre-surgical assessments of bariatric surgery candidates by merging ethical principles for mental health professionals with current practices in pre-surgical assessments. Issues discussed include the following: (a) establishing and maintaining competence, (b) obtaining informed consent, (c) respecting confidentiality, (d) avoiding bias and discrimination, (e) avoiding and addressing dual roles, (f) selecting and using psychological tests, and (g) acknowledging limitations of psychosocial assessments.
Surviving cancer: The psychosocial outcomes of childhood cancer survivors and its correlates
Authors: Castellano-Tejedor Carmina , Pérez-Campdepadrós Marta , Capdevila Lluís , Blasco-Blasco Tomás
Published: November 2014

This study assessed the psychosocial outcomes of adolescent cancer survivors and their relationship with personal and socio-familiar factors. Using a cross-sectional design, 41 survivors answered the four psychosocial dimensions of the KIDSCREEN-52 questionnaire and measures for social support and coping. Similarly, 41 parents answered coping and cancer-related distress measures. All psychosocial scores were within normative values (50 ± 10). Multiple linear regression analyses revealed four models with a range of explained variance between 9.4 percent and 31.9 percent that include the informative and emotional support, parental distress, and coping. This study contributes to the understanding of psychosocial outcomes of childhood cancer survivors and its correlates.
Between vigilantism and bureaucracy: Improving our understanding of police work in Nigeria and South Africa
Authors: Cooper-Knock Sarah Jane , Owen Olly
Published: November 2014

To date, much of the analytical scholarship on policing in Africa has centred on non-state actors. In doing so, it risks neglecting state actors and statehood, which must be understood on their own terms as well as through the eyes of the people they supposedly serve. This article seeks to develop our theoretical and empirical understanding in this respect by exploring the contexts in which citizens seek to engage state police in Nigeria and South Africa. In doing so it highlights three particularly important uses that police contact may serve, that are currently being overlooked. State police can permit, authorize or limit crime control performed by others through informal regulatory intervention. They can exercise a unique bureaucratic power by opening a case which is valued as a record of right and wrongs to be used in the negotiation of everyday life, not simply as a means to legal prosecution. And finally, taking action ‘off the books’, the police can exercise a coercive power that can be termed ‘police vigilantism’, which citizens may try to harness for their own ends. We therefore argue that we should recognize the continued high public demand for the services of state police forces even in contexts where they fall short of expectations, and more closely analyse the ways in which people utilize and help to reproduce the police forces they condemn.
Tainted blood: Probing safety practices in the Danish blood system
Authors: Deleuran Ida , Sheikh Zainab Afshan , Hoeyer Klaus
Published: November 2014

The existing literature on donor screening in transfusion medicine tends to distinguish between social concerns about discrimination and medical concerns about safety. In this article, we argue that the bifurcation into social and medical concerns is problematic. We build our case on a qualitative study of the historical rise and current workings of safety practices in the Danish blood system. Here, we identify a strong focus on contamination in order to avoid ‘tainted blood’, at the expense of working with risks that could be avoided through enhanced blood monitoring practices. Of further significance to this focus are the social dynamics found at the heart of safety practices aimed at avoiding contamination. We argue that such dynamics need more attention, in order to achieve good health outcomes in transfusion medicine. Thus, we conclude that, to ensure continuously safe blood systems, we need to move beyond the bifurcation of the social and medical aspects of blood supply as two separate issues and approach social dynamics as key medical safety questions.
Adolescents’ sense-making of alcohol-related risks: The role of drinking situations and social settings
Authors: Katainen Anu , Lehto Anna-Sofia , Maunu Antti
Published: November 2014

The article explores how young people understand the risks of alcohol use and how these understandings are associated with differing drinking situations and social settings. By taking account of situational factors, the aim is to demonstrate how young people have highly nuanced notions of drinking styles that suit different drinking situations and of associated risks. The data for the research were gathered in 18 group interviews with Finnish ninth graders aged 14–15 years. Short film clips portraying young people in different drinking situations were used as stimulus material for the interviews. Data analysis focussed on the risk factors related to the social situations illustrated in the film clips. The results show that young people’s risk assessments are not based on alcohol itself, but the magnitude of risk is estimated in relation to the social setting of the drinking situation. What is relevant for young people is whether the social situation allows them to make choices with which they feel comfortable. At the opposite pole of problem drinking was social drinking for the purpose of having fun together with other people in such a way that one remains in control of the drinking situation. From a prevention point of view, a key implication is that awareness of the risks is closely associated with situational and social factors. However, the awareness of those risks does not necessarily prevent young people from drinking because they may be accepted as part of the drinking experience.
Making games normal: Computer gaming discourse in the 1980s
Authors: Kirkpatrick Graeme
Published: November 2014

Based on a study of 1980s UK computer and gaming magazines, this article argues that a gaming discourse emerges in the middle of the decade with the strategic goal of normalizing the activity. It succeeds – gaming spreads – but fails in that to present gaming effectively as an attractive leisure pursuit, gaming discourse has to absorb accusations of abnormality that were levelled at computer culture from the outset. Hence, ‘addictive’ gameplay becomes a good thing; the gamer is distinguished from the computer obsessive but is still defined as a ‘freak’, and gaming, having been presented as a realm of creative self-expression within the computer culture, becomes subject to the discourse of normal and correct computational practice. Gaming cannot escape the logic of its field, which determines that it will always try to be something more and better than gaming.
Anti-pendulation analysis of parallel wave compensation systems
Authors: Hu Yongpan , Tao Limin , Lv Wei
Published: November 2014

Parallel wave compensation systems, which are essentially cable-suspended parallel mechanisms with dynamic base platforms, have potential applications in offshore cargo handling. This article investigates the anti-pendulation properties of parallel wave compensation systems. For a kinematically determined cable-suspended parallel mechanism, anti-pendulation is equivalent to keeping all the cables taut. Based on this consideration, the concept of anti-pendulation workspace is proposed to evaluate the anti-pendulation capability of a cable-suspended parallel mechanism. Since the anti-pendulation workspace depends on the initial interactive tensions, a method is given to calculate the optimal interactive tensions that guarantee the best anti-pendulation capability. Then, a boundary search method of workspace determination is presented, which can improve the computational efficiency comparing to the conventional discretization method. Parametric analysis shows that enlarging the geometric dimensions is useful to improve the anti-pendulation capability, which is validated by experiments of scaled cable-suspended parallel mechanisms.
Beyond the Barrio—Ladies and Gentlemen, Let’s Get Ready for . . . Graeme Turner and Horace Newcomb
Authors: Miller Toby
Published: November 2014

This is a homage to the work of Horace Newcomb and Graeme Turner.
The Labor of Creativity in Images of Networking Children
Authors: Tanti Melissa
Published: November 2014

Children’s programming today reveals an alarming trend in the number of storylines involving ’tween and teenage entrepreneurs. From Disney’s songwriting duo Austin and Ally to True Jackson VP’s teen executives, these programs reflect the idealization of creative labor and naturalize the exploitation of the commons that drives biopolitical power in an increasingly immaterial global economy. These shows hyper-realize the contemporary emphasis on futurity by almost entirely doing away with childhood as child newsmakers, fashion designers, web programmers, and professional celebrities struggle each week to balance the stresses of adolescence within the framework of demanding careers. This paper will show the ways a variety of programs airing on Disney and Nickelodeon channels exemplify the conversion of social life to productive time that characterizes the late capitalist ethos and the consequent ramifications for political life, with particular attention paid to the impact of immaterial circuits of production to young women’s developing subjectivities.
A novel approach for designing nonwoven hybrid wound dressings: Processing and characterisation
Authors: Uzun Muhammet , Anand Subhash C , Shah Tahir
Published: November 2014

The paper focuses on the development of novel absorbent nonwoven structures by using natural biodegradable carboxymethylcellulose (CMC), alginate and polylactic acid (PLA) fibres. These fibres have been blended and reinforced with synthetic hollow polyester (HPES), polypropylene (PP) and hollow viscose (HV) fibres. The main aim was to enhance the wicking properties of the structures for minimising the pooling of exudate and maceration. It is also aimed to enhance the integrity of structures to minimise the contamination of wounds due to loose fibres. The incorporation of PLA into wound dressings has been attempted for the first time and their functional properties have been studied. The single-fibre, blended and hybrid fabrics have been engineered. The results demonstrate that HPES reinforcement has a critical importance for CMC fabric in terms of wicking properties, tensile properties and air permeability. It has also been demonstrated that the contribution of PLA in the wound dressings is to enhance the properties such as absorbency, wicking, flexural rigidity and air permeability.
Technology Advances in Hospital Practices
Authors: Rosiek Anna , Leksowski Krzysztof
Published: November 2014

Laparoscopic cholecystectomy is widely considered as the treatment of choice for acute cholecystitis. The safety of the procedure and its minimal invasiveness made it a valid treatment option for a patient not responding to antibiotic therapy. Our research shows that patients positively assess this treatment method, but the world’s tendency is to turn to a more sophisticated method utilizing robot-assisted surgery as a gold standard. Providing patient with minimally invasive surgical procedures that utilize the state-of-the-art equipment like the da Vinci Robotic Surgical System underscores the commitment to high-quality patient care while enhancing patient safety. The advantages include minimal invasive scarring, less pain and bleeding, faster recovery time, and shorter hospital stay. The move toward less invasive and less morbid procedures and a need to re-create the true open surgical experience have paved the way for the development and application of robotic and computer-assisted systems in surgery in Poland as well as the rest of the world.
Proof-of-the-Concept Study on Mathematically Optimized Magnetic Resonance Spectroscopy for Breast Cancer Diagnostics
Authors: Belkić Dževad , Belkić Karen
Published: November 2014

Magnetic resonance (MR)-based modalities aid breast cancer detection without exposure to ionizing radiation. Magnetic resonance imaging is very sensitive but costly and insufficiently specific. Molecular imaging through magnetic resonance spectroscopy (MRS) can provide information about key metabolites. Here, the measured/encoded time signals cannot be interpreted directly, necessitating mathematics for mapping to the more manageable frequency domain. Conventional applications of MRS are hampered by data analysis via the fast Fourier transform (FFT) and postprocessing by fitting techniques. Most in vivo MRS studies on breast cancer rely upon estimations of total choline (tCHO). These have yielded only incremental improvements in diagnostic accuracy. In vitro studies reveal richer metabolic information for identifying breast cancer, particularly in closely overlapping components of tCHO. Among these are phosphocholine (PC), a marker of malignant transformation of the breast. The FFT cannot assess these congested spectral components. This can be done by the fast Padé transform (FPT), a high-resolution, quantification-equipped method, which we presently apply to noisy MRS time signals consistent with those encoded in breast cancer. The FPT unequivocally and robustly extracted the concentrations of all physical metabolites, including PC. In sharp contrast, the FFT produced a rough envelope spectrum with a few distorted peaks and key metabolites absent altogether. As such, the FFT has poor resolution for these typical MRS time signals from breast cancer. Hence, based on Fourier-estimated envelope spectra, tCHO estimates are unreliable. Using even truncated time signals, the FPT clearly distinguishes noise from true metabolites whose concentrations are accurately extracted. The high resolution of the FPT translates directly into shortened examination time of the patient. These capabilities strongly suggest that by applying the FPT to time signals encoded in vivo from the breast, MRS will, at last, fulfill its potential to become a clinically reliable, cost-effective method for breast cancer detection, including screening/surveillance.
Evaluation of Mathematical Algorithms for Automatic Patient Alignment in Radiosurgery
Authors: Williams Kenneth M. , Schulte Reinhard W. , Schubert Keith E. , Wroe Andrew J.
Published: November 2014

Image registration techniques based on anatomical features can serve to automate patient alignment for intracranial radiosurgery procedures in an effort to improve the accuracy and efficiency of the alignment process as well as potentially eliminate the need for implanted fiducial markers. To explore this option, four two-dimensional (2D) image registration algorithms were analyzed: the phase correlation technique, mutual information (MI) maximization, enhanced correlation coefficient (ECC) maximization, and the iterative closest point (ICP) algorithm. Digitally reconstructed radiographs from the treatment planning computed tomography scan of a human skull were used as the reference images, while orthogonal digital x-ray images taken in the treatment room were used as the captured images to be aligned. The accuracy of aligning the skull with each algorithm was compared to the alignment of the currently practiced procedure, which is based on a manual process of selecting common landmarks, including implanted fiducials and anatomical skull features. Of the four algorithms, three (phase correlation, MI maximization, and ECC maximization) demonstrated clinically adequate (ie, comparable to the standard alignment technique) translational accuracy and improvements in speed compared to the interactive, user-guided technique; however, the ICP algorithm failed to give clinically acceptable results. The results of this work suggest that a combination of different algorithms may provide the best registration results. This research serves as the initial groundwork for the translation of automated, anatomy-based 2D algorithms into a real-world system for 2D-to-2D image registration and alignment for intracranial radiosurgery. This may obviate the need for invasive implantation of fiducial markers into the skull and may improve treatment room efficiency and accuracy.
Single-Plane Magnetically Focused Elongated Small Field Proton Beams
Authors: McAuley Grant A. , Slater James M. , Wroe Andrew J.
Published: November 2014

We previously performed Monte Carlo simulations of magnetically focused proton beams shaped by a single quadrapole magnet and thereby created narrow elongated beams with superior dose delivery characteristics (compared to collimated beams) suitable for targets of similar geometry. The present study seeks to experimentally validate these simulations using a focusing magnet consisting of 24 segments of samarium cobalt permanent magnetic material adhered into a hollow cylinder. Proton beams with properties relevant to clinical radiosurgery applications were delivered through the magnet to a water tank containing a diode detector or radiochromic film. Dose profiles were analyzed and compared with analogous Monte Carlo simulations. The focused beams produced elongated beam spots with high elliptical symmetry, indicative of magnet quality. Experimental data showed good agreement with simulations, affirming the utility of Monte Carlo simulations as a tool to model the inherent complexity of a magnetic focusing system. Compared to target-matched unfocused simulations, focused beams showed larger peak to entrance ratios (26% to 38%) and focused simulations showed a two-fold increase in beam delivery efficiency. These advantages can be attributed to the magnetic acceleration of protons in the transverse plane that tends to counteract the particle outscatter that leads to degradation of peak to entrance performance in small field proton beams. Our results have important clinical implications and suggest rare earth focusing magnet assemblies are feasible and could reduce skin dose and beam number while delivering enhanced dose to narrow elongated targets (eg, in and around the spinal cord) in less time compared to collimated beams.
Combining Mindfulness Meditation With Cognitive Behavior Therapy and Medication Taper for Hypnotic-Dependent Insomnia in Older Adults
Authors: Lunde Linn-Heidi , Skjøtskift Svein
Published: November 2014

Sleep medication is the most common treatment for insomnia in older adults. However, prolonged use of hypnotics has several negative side-effects and can lead to a pattern of tolerance and dependence. Recent research has found promising results for interventions that included both supervised gradual medication withdrawal and cognitive behavior therapy (CBT) for the treatment of hypnotic-dependent insomnia. Furthermore, there is increasing evidence that incorporating mindfulness meditation can result in a more potent CBT intervention for insomnia. In this article, the authors describe and discuss the effects of a broadly focused intervention for treating hypnotic-dependent insomnia in an older adult. The treatment simultaneously targets insomnia symptoms, comorbid symptoms such as pain, dependency issues, and the discontinuation of hypnotic medication.
Narrative Exposure Therapy for Treating PTSD With Psychotic Features
Authors: Katsounari Ioanna
Published: November 2014

Posttraumatic stress disorder (PTSD) with secondary psychotic features is a syndrome that comprises PTSD symptoms followed in time by the additional appearance of psychotic features. Although diagnostic criteria for this condition are not available, the clinical description of this condition has been described especially in individuals who have experienced severe, chronic, multiple traumatic events. This case study presents the treatment of a survivor of torture with severe PTSD and concomitant psychotic features using the psychosocial approach as a theoretical framework of the clinical presentation and narrative exposure therapy (NET) as a psychotherapeutic intervention. NET could be a useful psychotherapeutic tool in relieving symptoms related to severe PTSD with secondary psychotic features. The overall implications involved in working with survivors of torture are also discussed.
The Effects of a 6-Month Tai Chi Qigong Training Program on Temporomandibular, Cervical, and Shoulder Joint Mobility and Sleep Problems in Nasopharyngeal Cancer Survivors
Authors: Fong Shirley S. M. , Ng Shamay S. M. , Lee H. W. , Pang Marco Y. C. , Luk W. S. , Chung Joanne W. Y. , Wong Janet Y. H. , Masters Rich S. W.
Published: November 2014

Introduction. Nasopharyngeal cancer (NPC) survivors often sustain head–neck–shoulder impairments from conventional treatments, which could disturb sleep. This novel study aimed to examine the efficacy of Tai Chi (TC) Qigong in optimizing temporomandibular joint (TMJ), cervical, and shoulder joint mobility and reducing sleep problems in NPC survivors. Methods. Fifty-two NPC survivors participated in the study. The experimental group (n = 25) received 6 months of TC Qigong training (1.5 h/session; 4 sessions/wk including self-practice) while the control group (n = 27) received no training. Cervical side flexion and rotation, shoulder flexion and horizontal flexion range of motion (ROM), mouth opening capacity (interincisor distance), and sleep problems (Medical Outcomes Study Sleep Scale) were assessed at baseline, mid-intervention (3 months), immediately after TC Qigong training, and at 6-month follow-up. Results. Intention-to-treat analysis revealed improvement in cervical side flexion ROM only ( P < .008) and unchanged shoulder and TMJ mobility ( P > .008) after the TC Qigong training. Deterioration was observed in shoulder flexion ROM and mouth opening capacity in the no-training controls over time ( P < .008). Sleep problems also decreased in the TC Qigong group ( P < .008), and this effect was most profound during the follow-up period. In addition, improvement in cervical side flexion ROM was associated with a reduction in sleep problems in the experimental group after TC Qigong training ( P < .05). Conclusions. The 6-month TC Qigong intervention improved neck mobility, maintained TMJ and shoulder joint mobility, and reduced sleep problems for NPC survivors. TC Qigong could be an effective nonpharmacological intervention for managing progressive trismus, chronic neck and shoulder hypomobility, and reducing sleep problems among NPC survivors.
What Drove Anders Breivik?
Authors: Richards Barry
Published: November 2014

Political psychologist Barry Richards looks behind the anti-Muslim motive which appeared to drive Norwegian mass murderer Anders Breivik. While agreeing with the court’s judgment that Breivik was responsible for his actions, he finds a deeply deluded and paranoid person for whom the massacre of young political activists (mainly non-Muslim) was a desperate attempt to defend his fragile masculinity.
Childless… or Childfree?
Authors: Blackstone Amy
Published: November 2014

In the context of declining birth rates, sociologist Amy Blackstone examines the choice not to become a parent and considers social responses to that choice.
Beyond Bullying
Authors: Fields Jessica , Mamo Laura , Gilbert Jen , Lesko Nancy
Published: November 2014

Sociologists Jessica Fields and Laura Mamo, along with education researchers, Jen Gilbert and Nancy Lesko, report on their high school storytelling project, Beyond Bullying, that invited teachers, students and community members to record stories of LGBTQ sexuality that moved beyond tales of depression, bullying and suicide towards ordinary narratives of love, loss, friendship and family.
Don’t kill this goose: Government policy should facilitate India to become pharmacy of the world
Authors: Adige Ramesh
Published: November 2014

India is of great interest to the world of pharmaceuticals. The domestic market ($13b) is growing at almost 10% compound annual growth rate (CAGR). The exports of pharmaceuticals from India ($15b) is growing at 12% CAGR. All the well-known names in the global sphere are now present in the Indian pharma market, and many are having formulation manufacturing units here. It is widely believed that companies in India can soon become the biggest suppliers of generic drugs to the world. Apart from affordable cost, the emphasis is now shifting to Current Good Manufacturing Practices (cGMP)/Current Good Manufacturing/Clinical/Lab/etc Practices (cGXP). What should a pharma manufacturer know about the present status of issues in India which will reflect on the future performance of this country. Can India really be the pharmacy of the world? Only time will tell, but the conditions of the road will more or less be understood through this article.
Lipoatrophy in Children With Type 1 Diabetes
Authors: Kordonouri Olga , Biester Torben , Schnell Kerstin , Hartmann Reinhard , Tsioli Christiana , Fath Maryam , Datz Nicolin , Danne Thomas
Published: November 2014

Objectives:

The objectives were to evaluate the current prevalence of lipoatrophy at insulin injection sites in young patients with type 1 diabetes.

Methods:

Standardized examination of insulin injection sites in all 678 patients with type 1 diabetes treated in 2013 in our outpatient clinic were conducted. In case of lipoatrophy photo documentation and standardized interview with parents and patients were performed.

Methods:

We identified a total of 16 patients (43.8% male) with lipoatrophy (overall prevalence 2.4%). The current mean age (±SD) of the affected patients was 14.4 ± 3.9 years, age and diabetes duration at onset of lipoatrophy were 11.5 ± 3.8 years and 5.4 ± 3.6 years, respectively. All patients were using analogs at the onset of lipoatrophy. In all, 14 of 16 patients (87.5%) were on insulin pump compared with 52% without lipoatrophy ( P = .0018). The use of steel needle and Teflon catheter was equal between the pump patients. Concomitant autoimmune diseases were present in 37.5% of the patients (thyroiditis: n = 3, thyroiditis and celiac disease: n = 2, celiac disease: n = 1) compared with 15.0% in those without lipoatrophy ( P = .0128).

Conclusions:

Lipoatrophy was present in young patients treated with modern insulins and pumps; however, the prevalence was relatively low as expected with the use of modern insulins. Our data may support the hypothesis that a constant mechanical element such as a subcutaneous catheter may trigger the development of lipoatrophy, particularly in those patients with more than 1 autoimmune disease.
Correlation of Advanced Glycation Endproducts Estimated From Skin Fluorescence in First-Degree Relatives
Authors: Báez Eileen A. , Shah Shreepal , Felipe Dania , Maynard John , Chalew Stuart
Published: November 2014

Objective:

The objective was to assess the relationship of skin advanced glycation endproducts (AGEs) between first-degree relatives estimated from skin fluorescence (SF) after adjustment for skin pigmentation.

Study design:

SF was excited by LEDs centered at 375, 405, and 420 nm from children with type 1 diabetes and their mothers. Data were adjusted to generate measures of skin intrinsic fluorescence (SIF) at the various excitation wavelengths, using 2 different pairs of correction coefficients for excitation (kx) and emission (km): kx = 0.5, km = 0.5 (not associated with skin pigmentation) and kx = 1.0, km = 0.0 (strongly associated with skin pigmentation). Pearson correlation analysis was performed, as well as a multiple variable analysis with maternal SIF adjusted for the effects of maternal age and race.

Results:

There were 50 matched pairs of children and their mothers. Children were 13.3 ± 3.7 years of age and there were 19 boys/31 girls and 15 black/35 white. Mothers were 41.8 ± 6.8 years of age. The age of mother and child was highly correlated, r = .64, P < .0001. In Pearson correlation analysis, child’s SIF (kx = 1.0, km = 0.0) the had strongest association with maternal SIF, while with SIF (kx = 0.5, km = 0.5) there was a trend for association. In the multiple variable model child SIF was associated with maternal SIF for all corrections and wavelengths but was stronger for kx = 1.0, km = 0.0.

Conclusion:

Even after adjustment for skin pigmentation and race, correlation of SIF between family members persists, suggesting that other genetic and/or environmental factors shared by parent and child may influence estimated skin AGEs.
Jorge Lobo’s disease: a case of keloidal blastomycosis (lobomycosis) in a nonendemic area
Authors: Arju Rezina , Kothadia Jiten P. , Kaminski Monica , Abraham Sherly , Giashuddin Shah
Published: November 2014

Lobomycosis or lacaziosis is a chronic subcutaneous fungal infection, caused by the fungus Lacazia loboi, which is phylogenetically related to Coccidioides, Blastomyces, Histoplasma, and Paracoccidioides. The disease was first recognized in 1931 by Jorge Lobo, who found the disease to be a keloidal blastomycosis and named it Jorge Lobo’s disease. This case was perplexing initially as this fungal infection is very uncommon in the USA. However, with the ever-increasing frequency of international travel, many more cases of lobomycosis have been diagnosed in areas of nonendemicity, such as the USA, Europe, and South Africa. The clinical histories of such imported fungal infections often illustrate their long latency periods. In lobomycosis, the onset of the disease is usually insidious and often difficult to document. We describe a case of a New York resident who presented with multiple skin nodules over both his arms and forearms, and was subsequently diagnosed with Jorge Lobo’s disease. The case, diagnosis, histopathologic findings, complication, and management of this rare clinical disease are discussed.
Immunizing Children
Authors: Macdonald Geraldine Jody , McIntyre Margaret A. , Barry Maureen A.
Published: November 2014

This article addresses the complex contexts within which Canadian health professionals engage in immunizing children and focuses on the Canadian practice guidelines and current scientific evidence that direct Canadian health professional competencies. The article begins by presenting two current global vaccine initiatives and links these to immunization in Canada. A selected literature review identifies current best immunization practices. With the purpose of promoting quality improvement, three key Canadian immunization competencies for health professional are highlighted: communication with parents, including those who are experiencing vaccine hesitancy; administration of immunizing agents; and documentation of immunizations. Health professionals are encouraged to reflect on immunization competencies and ensure evidence-based practices underpin vaccine delivery in their primary care settings.
Cell rigidity and shape override CD47’s “self”-signaling in phagocytosis by hyperactivating myosin-II
Authors: Sosale Nisha G. , Rouhiparkouhi Tahereh , Bradshaw Andrew M. , Dimova Rumiana , Lipowsky Reinhard , Discher Dennis E.
Published: November 2014

Key Points

Rigidity of an opsonized red cell that contacts a macrophage is found to hyperactivate myosin-II and thus overpowers CD47’s self-signaling. Red cell shape modulates CD47’s signaling of self and highlights biophysical contributions to phagocytosis.