bluuebunny/crossref_metadata_2025 huggingface dataset:
The Gluten-Free Diet: Testing Alternative Cereals Tolerated by Celiac Patients
Authors: Comino Isabel , De Lourdes Moreno María , Real Ana , Rodríguez-Herrera Alfonso , Barro Francisco , Sousa Carolina
Published: October 2013

A strict gluten-free diet (GFD) is the only currently available therapeutic treatment for patients with celiac disease, an autoimmune disorder of the small intestine associated with a permanent intolerance to gluten proteins. The complete elimination of gluten proteins contained in cereals from the diet is the key to celiac disease management. However, this generates numerous social and economic repercussions due to the ubiquity of gluten in foods. The research presented in this review focuses on the current status of alternative cereals and pseudocereals and their derivatives obtained by natural selection, breeding programs and transgenic or enzymatic technology, potential tolerated by celiac people. Finally, we describe several strategies for detoxification of dietary gluten. These included enzymatic cleavage of gliadin fragment by Prolyl endopeptidases (PEPs) from different organisms, degradation of toxic peptides by germinating cereal enzymes and transamidation of cereal flours. This information can be used to search for and develop cereals with the baking and nutritional qualities of toxic cereals, but which do not exacerbate this condition.
Airborne Downward Looking Sparse Linear Array 3-D SAR Heterogeneous Parallel Simulation
Authors: Peng Xueming , Wang Yanping , Hong Wen , Tan Weixian , Wu Yirong
Published: October 2013

The airborne downward looking sparse linear array three dimensional synthetic aperture radar (DLSLA 3-D SAR) operates nadir observation with the along-track synthetic aperture formulated by platform movement and the cross-track synthetic aperture formulated by physical sparse linear array. Considering the lack of DLSLA 3-D SAR data in the current preliminary study stage, it is very important and essential to develop DLSLA 3-D SAR simulation (echo generation simulation and image reconstruction simulation, including point targets simulation and 3-D distributed scene simulation). In this paper, DLSLA 3-D SAR imaging geometry, the echo signal model and the heterogeneous parallel technique are discussed first. Then, heterogeneous parallel echo generation simulation with time domain correlation and the frequency domain correlation method is described. In the following, heterogeneous parallel image reconstruction simulation with two imaging algorithms, e.g., 3-D polar format algorithm, polar formatting and L1 regularization algorithm is discussed. Finally, the point targets and the 3-D distributed scene simulation are demonstrated to validate the effectiveness and performance of our proposed heterogeneous parallel simulation technique. The 3-D distributed scene employs airborne X-band DEM and P-band Circular SAR image of the same area as simulation scene input.
Derivation of Daily Evaporative Fraction Based on Temporal Variations in Surface Temperature, Air Temperature, and Net Radiation
Authors: Lu Jing , Tang Ronglin , Tang Huajun , Li Zhao-Liang
Published: October 2013

Based on surface energy balance and the assumption of fairly invariant evaporative fraction (EF) during daytime, this study proposes a new parameterization scheme of directly estimating daily EF. Daily EF is parameterized as a function of temporal variations in surface temperature, air temperature, and net radiation. The proposed EF parameterization scheme can well reproduce daily EF estimates from a soil-vegetation-atmosphere transfer (SVAT) model with a root mean square error (RMSE) of 0.13 and a coefficient of determination (R2) of 0.719. When input variables from in situ measurements at the Yucheng station in North China are used, daily EF estimated by the proposed method is in good agreement with measurements from the eddy covariance system corrected by the residual energy method with an R2 of 0.857 and an RMSE of 0.119. MODIS/Aqua remotely sensed data were also applied to estimate daily EF. Though there are some inconsistencies between the remotely sensed daily EF estimates and in situ measurements due to errors in input variables and measurements, the result from the proposed parameterization scheme shows a slight improvement to SEBS-estimated EF with remotely sensed instantaneous inputs.
A Highly Sensitive Fiber Optic Sensor Based on Two-Core Fiber for Refractive Index Measurement
Authors: Guzmán-Sepúlveda José , Guzmán-Cabrera Rafael , Torres-Cisneros Miguel , Sánchez-Mondragón José , May-Arrioja Daniel
Published: October 2013

A simple and compact fiber optic sensor based on a two-core fiber is demonstrated for high-performance measurements of refractive indices (RI) of liquids. In order to demonstrate the suitability of the proposed sensor to perform high-sensitivity sensing in a variety of applications, the sensor has been used to measure the RI of binary liquid mixtures. Such measurements can accurately determine the salinity of salt water solutions, and detect the water content of adulterated alcoholic beverages. The largest sensitivity of the RI sensor that has been experimentally demonstrated is 3,119 nm per Refractive Index Units (RIU) for the RI range from 1.3160 to 1.3943. On the other hand, our results suggest that the sensitivity can be enhanced up to 3485.67 nm/RIU approximately for the same RI range.
Comparison of Clean-Up Methods for Ochratoxin A on Wine, Beer, Roasted Coffee and Chili Commercialized in Italy
Authors: Prelle Ambra , Spadaro Davide , Denca Aleksandra , Garibaldi Angelo , Gullino Maria
Published: October 2013

The most common technique used to detect ochratoxin A (OTA) in food matrices is based on extraction, clean-up, and chromatography detection. Different clean-up cartridges, such as immunoaffinity columns (IAC), molecular imprinting polymers (MIP), Mycosep™ 229, Mycospin™, and Oasis® HLB (Hydrophilic Lipophilic balance) as solid phase extraction were tested to optimize the purification for red wine, beer, roasted coffee and chili. Recovery, reproducibility, reproducibility, limit of detection (LOD) and limit of quantification (LOQ) were calculated for each clean-up method. IAC demonstrated to be suitable for OTA analysis in wine and beer with recovery rate >90%, as well as Mycosep™ for wine and chili. On the contrary, MIP columns were the most appropriate to clean up coffee. A total of 120 samples (30 wines, 30 beers, 30 roasted coffee, 30 chili) marketed in Italy were analyzed, by applying the developed clean-up methods. Twenty-seven out of 120 samples analyzed (22.7%: two wines, five beers, eight coffees, and 12 chili) resulted positive to OTA. A higher incidence of OTA was found in chili (40.0%) more than wine (6.6%), beers (16.6%) and coffee (26.6%). Moreover, OTA concentration in chili was the highest detected, reaching 47.8 µg/kg. Furthermore, three samples (2.5%), two wines and one chili, exceeded the European threshold.
Mouse in Vivo Neutralization of Escherichia coli Shiga Toxin 2 with Monoclonal Antibodies
Authors: Cheng Luisa , Henderson Thomas , Patfield Stephanie , Stanker Larry , He Xiaohua
Published: October 2013

Shiga toxin-producing Escherichia coli (STEC) food contaminations pose serious health concerns, and have been the subject of massive food recalls. STEC has been identified as the major cause of the life-threatening complication of hemolytic uremic syndrome (HUS). Besides supportive care, there currently are no therapeutics available. The use of antibiotics for combating pathogenic E. coli is not recommended because they have been shown to stimulate toxin production. Clearing Stx2 from the circulation could potentially lessen disease severity. In this study, we tested the in vivo neutralization of Stx2 in mice using monoclonal antibodies (mAbs). We measured the biologic half-life of Stx2 in mice and determined the distribution phase or t1/2 α to be 3 min and the clearance phase or t1/2 β to be 40 min. Neutralizing mAbs were capable of clearing Stx2 completely from intoxicated mouse blood within minutes. We also examined the persistence of these mAbs over time and showed that complete protection could be passively conferred to mice 4 weeks before exposure to Stx2. The advent of better diagnositic methods and the availability of a greater arsenal of therapeutic mAbs against Stx2 would greatly enhance treatment outcomes of life threatening E. coli infections.
Aflatoxin, Fumonisin and Shiga Toxin-Producing Escherichia coli Infections in Calves and the Effectiveness of Celmanax®/Dairyman’s Choice™ Applications to Eliminate Morbidity and Mortality Losses
Authors: Baines Danica , Sumarah Mark , Kuldau Gretchen , Juba Jean , Mazza Alberto , Masson Luke
Published: October 2013

Mycotoxin mixtures are associated with Shiga toxin-producing Escherichia coli (STEC) infections in mature cattle. STEC are considered commensal bacteria in mature cattle suggesting that mycotoxins provide a mechanism that converts this bacterium to an opportunistic pathogen. In this study, we assessed the mycotoxin content of hemorrhaged mucosa in dairy calves during natural disease outbreaks, compared the virulence genes of the STECs, evaluated the effect of the mucosal mycotoxins on STEC toxin expression and evaluated a Celmanax®/Dairyman’s Choice™ application to alleviate disease. As for human infections, the OI-122 encoded nleB gene was common to STEC genotypes eliciting serious disease. Low levels of aflatoxin (1–3 ppb) and fumonisin (50–350 ppb) were detected in the hemorrhaged mucosa. Growth of the STECs with the mycotoxins altered the secreted protein concentration with a corresponding increase in cytotoxicity. Changes in intracellular calcium indicated that the mycotoxins increased enterotoxin and pore-forming toxin activity. A prebiotic/probiotic application eliminated the morbidity and mortality losses associated with the STEC infections. Our study demonstrates: the same STEC disease complex exists for immature and mature cattle; the significance of the OI-122 pathogenicity island to virulence; the significance of mycotoxins to STEC toxin activity; and, finally, provides further evidence that prebiotic/probiotic applications alleviate STEC shedding and mycotoxin/STEC interactions that lead to disease.
Effect of Thioridazine on Erythrocytes
Authors: Lang Elisabeth , Modicano Paola , Arnold Markus , Bissinger Rosi , Faggio Caterina , Abed Majed , Lang Florian
Published: October 2013

Background: Thioridazine, a neuroleptic phenothiazine with antimicrobial efficacy is known to trigger anemia. At least in theory, the anemia could result from stimulation of suicidal erythrocyte death or eryptosis, which is characterized by cell shrinkage and by phospholipid scrambling of the cell membrane with phosphatidylserine exposure at the erythrocyte surface. Triggers of eryptosis include increase of cytosolic Ca2+-concentration ([Ca2+]i) and activation of p38 kinase. The present study explored, whether thioridazine elicits eryptosis. Methods: [Ca2+]i has been estimated from Fluo3-fluorescence, cell volume from forward scatter, phosphatidylserine exposure from annexin-V-binding, and hemolysis from hemoglobin release. Results: A 48 hours exposure to thioridazine was followed by a significant increase of [Ca2+]i (30 µM), decrease of forward scatter (30 µM), and increase of annexin-V-binding (≥12 µM). Nominal absence of extracellular Ca2+ and p38 kinase inhibitor SB203580 (2 µM) significantly blunted but did not abolish annexin-V-binding following thioridazine exposure. Conclusions: Thioridazine stimulates eryptosis, an effect in part due to entry of extracellular Ca2+ and activation of p38 kinase.
Les « maladies nerveuses » et leurs thérapeutiques populaires au Brésil
Authors: Aubrée Marion
Published: October 2013

RÉSUMÉ- Cet article a pour but de mettre en valeur la diversité des thérapies religieuses auxquelles recourt une grande partie des Brésiliens les plus démunis pour soigner, en particulier, les « maladies nerveuses ». Chaque courant religieux réserve un traitement qui lui est spécifique à cet ensemble très vaste de troubles psychosomatiques ; l'article analyse la façon dont les cultes afro-brésiliens, l'univers du pentecôtisme et le spiritisme kardéciste font face à cette demande particulière.
Le café, culture exemplaire du Brésil
Authors: Grandjean Pernette , Tulet Jean-Christian
Published: October 2013

RESUMO- A cafeicultura brasileira pode ser apresentada como uma economia «exemplar» deste país. Seus traços característicos e suas transformações evidenciam os aspectos da evolução do conjunto das atividades produtivas do Brasil. A importância histórica da cafeicultura é considerável (valorização de espaços pioneiros, base de um povoamento de origem europeia, ponto de apoio do processo de industrialização). Ela permanece sendo um setor económico estratégico considerando-se que o Brasil se mantém como primeiro produtor e exportador mundial. As significativas evoluções que caracterizam a cafeicultura desde o século XIX (deslocamento de áreas de produção, modernização das técnicas culturais, forte presença estatal seguida de sua diminução, descentralização das instâncias de decisão...) são reveladoras das transformações da agricultura brasileira. Recentemente, no novo contexto de liberalização dos mercados, a procura da qualidade do produto esta mobilizando o conjunto dos atores envolvidos. Ela reponde à uma certa preocupação, presente em muitos setores agrícolas, aquela da inserção mais ativa do café nos mercados internacionais competitivos e exigentes.
The Impact of the Destination's Online Initiatives on Word of Mouth
Authors: Morosan Cristian
Published: October 2013

An already complex destination marketing advertising landscape became even more complex as new social media were added in recent years. Within this context, it is increasingly difficult for destinations to ascertain which combination of advertising media channels generates the highest
impact on destinations by persuading potential travelers to visit the destination. Using data from a medium-sized destination from Midwestern US, this study found that travelers' intentions to visit a destination's website and its social media pages influence their intentions to visit the
destination. In turn, travelers' intentions to visit the destination influence their intentions to develop positive word of mouth and intentions to share their experiences online.
Inclusion of chloroplast genes that have undergone expansion misleads phylogenetic reconstruction in the Chlorophyta
Authors: Novis Phil M. , Smissen Rob , Buckley Thomas R. , Gopalakrishnan Kishore , Visnovsky Gabriel
Published: October 2013

• Premise of the study: Chlorophytes comprise a substantial proportion of green plant diversity. However, sister‐group relationships and circumscription of the classes Chlorophyceae, Trebouxiophyceae, and Ulvophyceae have been problematic to resolve. Some analyses support a sister relationship between the trebouxiophycean Leptosira and chlorophyceans, potentially altering the circumscription of two classes, also supported by a shared fragmentation in the chloroplast gene rpoB. We sought to determine whether the latter is a synapomorphy or whether the supporting analyses are vulnerable to systematic bias.

• Methods: We sequenced a portion of rpoB spanning the fragmented region in strains for which it had not previously been sampled: four Chlorophyceae, six counterclockwise (CCW) group (ulvophyceans and trebouxiophyceans) and one streptophyte. We then explored the effect of subsampling proteins and taxa on phylogenetic reconstruction from a data set of 41 chloroplast proteins.

• Key results: None of the CCW or streptophyte strains possessed the split in rpoB, including inferred near relatives of Leptosira, but it was found in all chlorophycean strains. We reconstructed alternative phylogenies (Leptosira + Chlorophyceae and Leptosira + Chlorellales) using two different protein groups (Rpo and Rps), both subject to coding‐region expansion. A conserved region of RpoB remained suitable for analysis of more recent divergences.

• Conclusions: The Rps sequences can explain earlier findings linking Leptosira with the Chlorophyceae and should be excluded from phylogenetic analyses attempting to resolve deep nodes because their expansion violates the assumptions of substitution models. We reaffirm that Leptosira is a trebouxiophycean and that fragmentation of rpoB has occurred at least twice in chlorophyte evolution.
Regioselective carbon–carbon bond formation of 5,5,5-trifluoro-1-phenylpent-3-en-1-yne
Authors: Naka Motoki , Kawasaki-Takasuka Tomoko , Yamazaki Takashi
Published: October 2013

The regioselective carbon–carbon bond formation was studied using 5,5,5-trifluoro-1-phenylpent-3-en-1-yne as a model substrate, and predominant acceptance of electrophiles β to a CF3 group as well as a deuterium trap experiment of the lithiated species led to the conclusion that the obtained regioselectivity is kinetically determined for the reactions with electrophiles, under equilibration of the possible two anionic species.
Structural characterization and Biological Activity of Sulfolipids from selected Marine Algae
Authors: El Baz F. K. , El Baroty G. S. , Abd El Baky H. H. , Abd El-Salam O. I. , Ibrahim E. A.
Published: October 2013

The sulfolipid classes (SLs) in the total lipids of five species of marine algae, two species of Rhodophyta (Laurencia popillose, Galaxoura cylindriea), one species of Chlorophyta (Ulva fasciata), and two species of Phaeophyta (Dilophys fasciola, Taonia atomaria) were separated and purified on DEAE-cellulose column chromatography. The SLs component was identified by IR, gas chromatography MS/MS and liquid chromatography MS/MS. The level of SLs contents va ried from 1.25% (in L. papillose) to 11.82% (in D. fasciola) of the total lipid contents. However, no significant differences in sulfate content (0.13 – 0.21%) were observed among all these algae species. All SLs were characterized by high contents of palmitic acid (C 16:0), which ranged from 30.91% in G. cylindriea to 63.11% in T. atomatia. The main constitutes of algal sulfolipids were identified as sulfoquinovosyl-di-acylglycerol and sulfoquinovosyl acylglycerol.
The sulfolipids of different algal species exhibited remarkable antiviral activity against herps simplex virus type 1 (HSV-1) with an IC50 ranging from 18.75 to 70. 2 μg mL–1. Moreover, algal sulfolipid inhibited the growth of the tumor cells of breast and liver human cancer cells with IC50 values ranging from 0.40 to 0.67 μg mL–1 for human breast adenocarcinoma cells (MCF7).
Enzyme-aided cold pressing of flaxseed (Linum usitatissimum L.): Enhancement in yield, quality and phenolics of the oil
Authors: Anwar F. , Zreen Z. , Sultana B. , Jamil A.
Published: October 2013

The effect of different enzyme preparations (Viscozyme L, Kemzyme, and Feedzyme) on the yield and physicochemical and antioxidant properties of cold pressed flaxseed oil were assessed. The oil yield (35.2-38.0%) from enzyme-treated cold pressed flaxseeds (ETCPF), although lower than Soxhlet extracted oil (SEO) yield, was considerably higher when compared with the control (32.5%) while the contents of protein, fiber, and ash were unaffected by the enzymatic treatment. Most of the physicochemical parameters such as refractive index, density, iodine number, free fatty acid contents, saponification value, color and fatty acid profile did not vary significantly among the ETCPF oil, SEO and the control. Interestingly, the oxidation status in terms of peroxide value, para-anisidine value, conjugated dienes and triens and induction period (Rancimat method) as well as the sensory score of the ETCPF oil were superior compared with the control. An appreciably higher amount of tocopherols (350-400 mg kg–1) was determined in the ETCPF oil, compared to the control (270 mg kg–1), showing an increase of 22.8-32.5% in the recovery of total tocopherols. Moreover, ETCPF oil exhibited greater antioxidant activity as well as total phenolics and individual phenolic acid content. This study advocates the exploration of enzyme-assisted cold pressing as a viable alternative to conventional cold-pressing for improving not only the extraction yield but also the functional food quality of flaxseed-like high-value oils.
Cruzada, herejía e inquisición en las tierras de la Corona de Aragón (siglos XII-XIII)
Authors: Smith Damian
Published: October 2013

Este estudio explora tres asuntos conectados con el tema general de la heterodoxia en el siglo XIII: la Cruzada contra los Albigenses, el aumento de la herejía en las tierras de la Corona de Aragón y el desarrollo de la Inquisición. Nos preguntamos, primero, si las decisiones tomadas por Jaime I fueron la consecuencia necesaria de la derrota en la batalla de Muret para evitar un conflicto directo con el Papado y Francia. Segundo, examinamos dónde estuvo presente y dónde ausente la herejía en las tierras de la Corona de Aragón. Tercero, sugerimos las razones por las qué la Inquisición adoptó una forma distintiva en las tierras catalano-aragonesas.
Teologia, ordini religiosi e rapporti politici: la questione dell’Immacolata Concezione di Maria tra Roma e Madrid (1614-1663)
Authors: Broggio Paolo
Published: October 2013

El artículo analiza los primeros años de las polémicas doctrinales alrededor de la definición dogmática de la Inmaculada Concepción de la Virgen desde el punto de vista de las relaciones entre la Santa Sede y la Monarquía española, gestionadas por el nuncio Antonio Caetani. Sobre la base de la correspondencia epistolar del nuncio con la Curia romana se evidencia la voluntad, por parte de Roma, de evitar los “escándalos” de los alborotos populares y de buscar una mediación entre las órdenes religiosas en lucha (dominicos, franciscanos y jesuitas). Estas polémicas fueron una ocasión más, para la Monarquía hispana de Felipe III (y luego de Felipe IV), para afirmar su propio derecho de intervención en asuntos doctrinales y eclesiásticos en virtud de su prerogativa de defensa de la Iglesia de Roma.
Voice recognition is here comma like it or not period
Authors: Fox Matthew A , Aschkenasi Carl J , Kalyanpur Arjun
Published: October 2013

Voice recognition (VR) technology needs improvement, but is as integral to the current practice of radiology as Radiology Information Systems and Picture Archival and Communication Systems. In the 1990s, the radiology community gave VR technology a rather lukewarm reception, but since then it has emerged as the predominant method of radiology reporting in the United States. In this article, we examine how VR technology works, outline the positive and negative aspects of VR technology on work flow, identify common VR transcription errors and review the discussion on VR adoption in the recent literature. We add to the discussion our personal experiences in an international teleradiology group.
High-resolution ultrasound imaging of cutaneous lesions
Authors: Mandava Anitha , Ravuri Prabhakar Rao , Konathan Rajyalaxmi
Published: October 2013

High-resolution variable frequency ultrasound imaging is increasingly being used in the noninvasive evaluation of various cutaneous diseases. It plays a complimentary role to physical examination in the assessment of cutaneous lesions. It is the only imaging modality useful in the evaluation of superficial cutaneous lesions that are too small to be evaluated on computed tomography (CT) or magnetic resonance imaging (MRI) and is helpful in reducing invasive procedures like biopsies and fine needle aspirations. In this article, we seek to describe the relevance and basic principles of cutaneous ultrasound, imaging findings of normal skin, current applications of high-resolution ultrasound in the diagnosis and management of various dermatological conditions, along with the features of some commonly encountered lesions.
Variations of celiac axis, common hepatic artery and its branches in 600 patients
Authors: Sureka Binit , Mittal Mahesh Kumar , Mittal Aliza , Sinha Mukul , Bhambri Narendra Kumar , Thukral Brij Bhushan
Published: October 2013

Purpose: To evaluate the spectrum of celiac axis, common hepatic artery (CHA), right, left, middle hepatic artery and gastroduodenal artery variations by using spiral computed tomography (CT). Materials and Methods: A retrospective review of Multidetector CT (MDCT) abdominal angiography scans was performed in patients sent for various liver and other abdominal pathologies between January 2012 and February 2013. A total of 600 patients were evaluated. Definitions of CHA, ambiguous celiac axis, course and division patterns of CHA, replaced hepatic artery, accessory hepatic artery and middle hepatic artery were used as proposed by Song et al., Covey et al., and Wang et al. The pattern of the aortic origin of branches of celiac axis, common hepatic artery and its branches was analyzed. Results: Six types of celiac axis anatomic variations were identified in our study. A total of 546 of the 600 patients had a normal celiac axis anatomy. Anatomic variations were seen in 5.5% of patients. Ambiguous anatomy was seen in 3.5% of the patients. CHA originated from celiac axis in 95.83% of the patients. Variations in anatomic origin of CHA were seen in 8 patients. Ambiguous dual pathway was seen in 4 patients. Normal Sp-preportal course of CHA was identified in 97.78% of cases, Sp-retroportal course in 7 patients, Tp-preportal course in 2, Tp-retroportal in 1, Ip-preportal in 1 and through Ligamentum venosum in 2 patients. Normal origin of RHA from HAP was seen in 79.6% patients. Replaced origin of RHA was seen in 15.16% cases and Accessory origin of RHA was seen in 5.16% cases. LHA originated from HAP in 81.5% patients. Replaced LHA origin was seen in 10.8% cases and Accessory LHA origin seen in 7.6% cases. MHA originated from RHA in 41.3% patients, LHA in 27.83% and from CHA in 4.5% cases. Origin of MHA could not be defined in 26.3% of patients. GDA originated from CHA in 97.6% of patients, from celiac axis in 1.6%, from RHA in 0.33% in patients. Trifurcation of CHA was seen in 7.16% and quadrifurcation of CHA in 2.16%. Conclusion: CT Angiography is a safe and highly sensitive and accurate modality for evaluation of arterial anatomy and its variants.
CT imaging findings and endovascular management of isolated spontaneous dissecting aneurysm of celiac artery
Authors: Rama Krishnan RS , Murali K , Madan R , Francis G
Published: October 2013

Isolated spontaneous dissecting aneurysm of celiac artery without concomitant involvement of aorta is a rare entity and only a few cases are reported in the literature. More cases are being detected recently with greater advancements in CT technology. Clinicians and emergency physicians should be aware of this condition and should include it in the differential diagnosis of patients who present with refractory postprandial epigastric pain, particularly in middle-aged men. We present a case of a 45-year-old male with isolated spontaneous dissecting celiac artery aneurysm, with special emphasis on CT findings and the role of endovascular management.
Depression and sleep disturbances in patients with multiple sclerosis and correlation with associated fatigue
Authors: Nagaraj Karthik , Taly Arun B. , Gupta Anupama , Prasad Chandrajit , Christopher Rita
Published: October 2013

Objective: To observe prevalence of depression and sleep disturbances in multiple sclerosis (MS) patients and their correlation with associated fatigue. Study Design and Setting: Prospective observation study in a university tertiary research hospital in India. Materials and Methods: Thirty‑one patients (6 male and 25 female) with definite MS (McDonald’s criteria) presented in out‑patient/admitted in the department of neurology (between February 2010 and December 2011) were included in the study. Depression was assessed using Beck’s Depression Inventory (BDI). Sleep quality was assessed using Pittsburg Sleep Quality Index (PSQI). Disease severity was evaluated using the Kurtzke’s expanded disability status scale (EDSS). Fatigue was assessed using Krupp’s fatigue severity scale (FSS). We tried to observe correlation of depression and sleep disturbance with associated fatigue in MS patients. Results: The age of patients varied between 16 and 50 years (30.1 ± 9.1). The mean age at first symptom was 25.2 ± 6.4 years (range 14-39 years). The prevalence of sleep disturbance and depression was 51.6% (16/31) each and fatigue 58.1% (18/31) in the study group. The PSQI scores were significantly greater in the patients with fatigue as compared with those without fatigue indicating poorer sleep quality is associated with fatigue in MS (P = 0.005). The BDI scores were also significantly higher in the fatigue group showing that severity of depression also strongly correlated with fatigue (P = 0.001). Conclusions: Depression and sleep disturbance in patients with MS is significantly correlated with associated fatigue
Disseminated neurocysticercosis presenting as affective mood disorder with chronic tension type headache
Authors: Chatterjee Krishnarpan , Ghosh Gopal Chandra
Published: October 2013

Neurocysticercosis is a common parasitic infection in India presenting usually with seizues, headache, focal neurological deficits. Neurocysticercosis presenting as a psychiatric illness is rare. Disseminated cysticercosis with involvement of central nervous system and head and neck muscles is rare even in endemic areas. We present a case of disseminated cysticercosis, which presented with chronic tension type headache and affective mood disorder. Treatment with cysticidal drugs led to complete remission of psychiatric complaints. In endemic areas history suggestive of mood disorder should not be used as supportive evidence of a primary headache syndome like tension type headche without ruling out secondary causes. Making an early diagnosis can prevent morbidity.
Giant cystic intradural extramedullary pilocytic astrocytoma of Cauda equina
Authors: Kumar Amandeep , Sharma Bhawani S. , Kale Shashank S. , Garg Ajay , Sharma M. C.
Published: October 2013

Astrocytomas of Conus‑Cauda equina region are rare. Astrocytomas, which are intramedullary tumors, may rarely have an extramedullary component. However, primary intradural extramedullary astrocytomas are extremely rare, with very few cases reported in the literature. We describe a giant extramedullary pilocytic astrocytoma of Cauda equina in a 20‑year‑old male. To the best of our knowledge, this is the first report of such a case in the available literature. This case highlights the fact that astrocytomas can be primarily extramedullary and emphasizes the need to consider pilocytic astrocytoma in the differential diagnosis of cystic Cauda equina tumors.
A case of multiple myeloma presenting as scalp swelling with intracranial extension
Authors: Senapati Satya Bhusan , Mishra Sudhansu Sekhar , Dhir Manmath Kumar , Das Srikanta , Tripathy Kalpalata
Published: October 2013

Multiple myeloma is a malignant neoplasm of bone marrow affecting plasma cells. It is usually detected in skull bone with characteristic features of multiple punched-out lesions. Its presentation as a solitary scalp swelling with underlying skull bone erosion and intracranial extension is very rare. A 35-year-old female presented to us with complains of rapidly growing left-side scalp swelling with right-side paresis and simple partial seizure of right upper limb. Local examination, X-ray skull, CT scan, and MRI of brain were suggestive of a malignant lesion. Near total excision of lesion was done. Histopathological study was suggestive of plasmacytoma of skull. Bone marrow study further confirmed it as a case of multiple myeloma. Cases presenting with solitary osteolytic skull lesions, possibility of plasmacytoma, or multiple myeloma should be kept in mind.
Reliability of motor parameters for follow.up after local steroid injection in carpal tunnel syndrome
Authors: Gupta Salil , Tewari A. K. , Gupta Aditya , Nair Velu
Published: October 2013

Background: Local steroid injection is one of the treatment modalities for carpal tunnel syndrome (CTS). Symptomatic and electrophysiological improvement has been previously documented. The electrophysiological parameter, which represents the most consistent change after local steroid injection, is not well‑known. Objective: The objective of this study was to evaluate the changes in electrophysiological parameters 1 month after local steroid injection and to determine the parameter that is able to depict improvement across the severity spectrum of CTS. Materials and Methods: Forty‑seven patients (27 with bilateral disease, 74 hands totally) were included. The electrophysiological parameters studied at baseline included sensory onset latency, sensory nerve action potential amplitude, sensory conduction velocity (CV), distal motor latency, compound muscle action potential amplitude and motor CV. All patients were injected with 40 mg triamcinalone at the wrist. After 1 month, symptomatic improvement from baseline was documented using visual analog score of 100. Electrophysiology was repeated. Paired t tests were done between baseline electrophysiology parameters and those obtained 1 month after steroid injection for significant improvement. Subgroup analyses were performed in hands with mild to moderate (Grade 3 or less by Bland’s classification) and severe disease (Grades 4 and 5). Results: All patients showed a symptomatic improvement. Distal motor latency showed most consistent improvement irrespective of the severity of CTS. In mild to moderate CTS (Grade 3 or less of the classification given by Bland) sensory parameters were recordable and showed significant improvement in addition to distal motor latency. In the subcategory of severe CTS (Grades 4 and 5 of Bland) where sensory parameters are not recordable distal motor latency and the motor CV showed a significant improvement. Conclusion: One month after local steroid injection among the electrophysiological parameters studied distal motor latencies showed most consistent and recordable improvement across the severity spectrum of CTS. This can be used as a single objective parameter to follow‑up patients after a local steroid injection to document improvement or relapse. They can also be considered as objective parameter to follow‑up patients after surgery.
Patient-centered care at Joslin: Reflections of a mirror
Authors: Madden Paul
Published: October 2013

This personal communication describes the practical aspects of patient-centered care (PCC), as viewed by a person with diabetes, who is also a diabetes educator. He describes his encounters with two leading diabetologists, who practiced the real essence of PCC. The author also explains the impact these patient-centered doctors had on him, and how it has shaped his personal as well as professional life, over the past half century.
Echocardiographic Assessment of Left Ventricular Geometric Patterns in Hypertensive Patients in Nigeria
Authors: Adebayo Rasaaq A. , Bamikole Olaniyi J. , Balogun Michael O. , Akintomide Anthony O. , Adeyeye Victor O. , Bisiriyu Luqman A. , Mene-Afejuku Tuoyo O. , Ajayi Ebenezer A. , Abiodun Olugbenga O.
Published: October 2013

Left ventricular (LV) hypertrophy is an important predictor of morbidity and mortality in hypertensive patients, and its geometric pattern is a useful determinant of severity and prognosis of heart disease. Studies on LV geometric pattern involving large number of Nigerian hypertensive patients are limited. We examined the LV geometric pattern in hypertensive patients seen in our echocardiographic laboratory. A two-dimensional, pulsed, continuous and color flow Doppler echocardiographic evaluation of 1020 consecutive hypertensive patients aged between 18 and 91 years was conducted over an 8-year period. LV geometric patterns were determined using the relationship between the relative wall thickness and LV mass index. Four patterns of LV geometry were found: 237 (23.2%) patients had concentric hypertrophy, 109 (10.7%) had eccentric hypertrophy, 488 (47.8%) had concentric remodeling, and 186 (18.2%) had normal geometry. Patients with concentric hypertrophy were significantly older in age, and had significantly higher systolic blood pressure (BP), diastolic BP, and pulse pressure than those with normal geometry. Systolic function index in patients with eccentric hypertrophy was significantly lower than in other geometric patterns. Doppler echocardiographic parameters showed some diastolic dysfunction in hypertensive patients with abnormal LV geometry. Concentric remodeling was the most common LV geometric pattern observed in our hypertensive patients, followed by concentric hypertrophy and eccentric hypertrophy. Patients with concentric hypertrophy were older than those with other geometric patterns. LV systolic function was significantly lower in patients with eccentric hypertrophy and some degree of diastolic dysfunction were present in patients with abnormal LV geometry.
The Effect of Societal Values on Local Government Transparency: Applying Hofstede’s Cultural Dimmensions
Authors: Frías-Aceituno Jose , Rodríguez-Ariza Lázaro , González-Bravo María-Isabel
Published: October 2013

In the last decade, a growing number of organizations worldwide have started reporting on issues concerning their economic, social and environmental behaviour. However, public administrations show a delay in this regard although there is growing interest from citizens regarding sustainability transparency. This paper contributes to intra-country analyses of non-financial reporting in the public sector by studying transparency concerning sustainability in municipalities; it analyses the coherence between societal values, identified using Hofstede’s cultural dimensions, and local governments’ corporate social responsibility disclosures. We undertook a content analysis of 101 Colombian, Portuguese and Spanish local government websites and employed different graphical and statistical techniques to analyse the extent of disclosure and the relationship with societal expectations of transparency. The results showed several thematic differences between countries in disclosure preferences relating to societal cultural values of collectivism, femininity, tolerance and equity. Countries with equilibrium in all cultural values are more transparent; those with a prevalence of masculine and uncertainty avoidance cultural dimensions are particularly oriented to social perspectives and show a higher preference for strategic and economic information.
Information Technology Improves Emergency Department Patient Discharge Instructions Completeness and Performance on a National Quality Measure
Authors: Bell E.J. , Takhar S.S. , Beloff J.R. , Schuur J.D. , Landman A.B.
Published: October 2013

Objectives: To compare the completeness of Emergency Department (ED) discharge instructions before and after introduction of an electronic discharge instructions module by scoring compliance with the Centers for Medicare and Medicaid Services (CMS) Outpatient Measure 19 (OP-19).

Methods: We performed a quasi-experimental study examining the impact of an electronic discharge instructions module in an academic ED. Three hundred patients discharged home from the ED were randomly selected from two time intervals: 150 patients three months before and 150 patients three to five months after implementation of the new electronic module. The discharge instructions for each patient were reviewed, and compliance for each individual OP-19 element as well as overall OP-19 compliance was scored per CMS specifications. Compliance rates as well as risk ratios (RR) and risk differences (RD) with 95% confidence intervals (CI) comparing the overall OP-19 scores and individual OP-19 element scores of the electronic and paper-based discharge instructions were calculated.

Results: The electronic discharge instructions had 97.3% (146/150) overall OP-19 compliance, while the paper-based discharge instructions had overall compliance of 46.7% (70/150). Electronic discharge instructions were twice as likely to achieve overall OP-19 compliance compared to the paper-based format (RR: 2.09, 95% CI: 1.75 – 2.48). The largest improvement was in documentation of major procedures and tests performed: only 60% of the paper-based discharge instructions satisfied this criterion, compared to 100% of the electronic discharge instructions (RD: 40.0%, 95% CI: 32.2% – 47.8%). There was a modest difference in medication documentation with 92.7% for paper-based and 100% for electronic formats (RD: 7.3%, 95% CI: 3.2% – 11.5%). There were no statistically significant differences in documentation of patient care instructions and diagnosis between paper-based and electronic formats.

Conclusions: With careful design, information technology can improve the completeness of ED patient discharge instructions and performance on the OP-19 quality measure.

Citation: Bell EJ, Takhar SS, Beloff JR, Schuur JD, Landman AB. Information technology improves emergency department patient discharge instructions completeness and performance on a national quality measure: A quasi-experimental study. Appl Clin Inf 2013; 4: 499–514 http://dx.doi.org/10.4338/ACI-07-RA-0046
A General, Abstract Model of Incremental Dialogue Processing
Authors: Schlangen David , Skantze Gabriel
Published: October 2013

We present a general model and conceptual framework for specifying architectures for incremental processing in dialogue systems, in particular with respect to the topology of the network of modules that make up the system, the way information flows through this network, how information increments are ‘packaged’, and how these increments are processed by the modules. This model enables the precise specification of incremental systems and hence facilitates detailed comparisons between systems, as well as giving guidance on designing new systems. In particular, the model can serve as a framework for specifying module communication in such systems, as we illustrate with some examples.
Semantics-based Question Generation and Implementation
Authors: Yao Xuchen , Bouma Gosse , Zhang Yi
Published: October 2013

This paper presents a question generation system based on the approach of semantic rewriting. The state-of-the-art deep linguistic parsing and generation tools are employed to convert (back and forth) between the natural language sentences and their meaning representations in the form of Minimal Recursion Semantics (MRS). By carefully operating on the semantic structures, we show a principled way of generating questions without ad-hoc manipulation of the syntactic structures. Based on the (partial) understanding of the sentence meaning, the system generates questions which are semantically grounded and purposeful. And with the support of deep linguistic grammars, the grammaticality of the generation results is warranted. Further, with a specialized ranking model, the linguistic realizations from the general purpose generation model are further refined for our the question generation task. The evaluation results from QGSTEC2010 show promising prospects of the proposed approach.
Question Generation from Concept Maps
Authors: Olney Andrew M. , Graesser Arthur C. , Person Natalie K.
Published: October 2013

In this paper we present a question generation approach suitable for tutorial dialogues. The approach is based on previous psychological theories that hypothesize questions are generated from a knowledge representation modeled as a concept map. Our model automatically extracts concept maps from a textbook and uses them to generate questions. The purpose of the study is to generate and evaluate pedagogically-appropriate questions at varying levels of specificity across one or more sentences. The evaluation metrics include scales from the Question Generation Shared Task and Evaluation Challenge and a new scale specific to the pedagogical nature of questions in tutoring.
G-Asks: An Intelligent Automatic Question Generation System for Academic Writing Support
Authors: Liu Ming , Calvo Rafael A. , Rus Vasile
Published: October 2013

Many electronic feedback systems have been proposed for writing support. However, most of these systems only aim at supporting writing to communicate instead of writing to learn, as in the case of literature review writing. Trigger questions are potentially forms of support for writing to learn, but current automatic question generation approaches focus on factual question generation for reading comprehension or vocabulary assessment. This article presents a novel Automatic Question Generation (AQG) system, called G-Asks, which generates specific trigger questions as a form of support for students' learning through writing. We conducted a large-scale case study, including 24 human supervisors and 33 research students, in an Engineering Research Method course at The University of Sydney and compared questions generated by G-Asks with human generated question. The results indicate that G-Asks can generate questions as useful as human supervisors (`useful' is one of five question quality measures) while significantly outperforming Human Peer and Generic Questions in most quality measures after filtering out questions with grammatical and semantic errors. Furthermore, we identified the most frequent question types, derived from the human supervisors' questions and discussed how the human supervisors generate such questions from the source text.
A Uniform Syntax and Discourse Structure: the Copenhagen Dependency Treebanks
Authors: Hardt Daniel
Published: October 2013

I present arguments in favor of the Uniformity Hypothesis: the hypothesis that discourse can extend syntax dependencies without conflicting with them. I consider arguments that Uniformity is violated in certain cases involving quotation, and I argue that the cases presented in the literature are in fact completely consistent with Uniformity. I report on an analysis of all examples in the Copenhagen Dependency Treebanks involving violations of Uniformity. I argue that they are in fact all consistent with Uniformity, and conclude that the CDT should be revised to reflect this.
A corpus of science journalism for analyzing writing quality
Authors: Louis Annie , Nenkova Ani
Published: October 2013

We introduce a corpus of science journalism articles, categorized in three levels of writing quality. The corpus fulï¬lls a glaring need for realistic data on which applications concerned with predicting text quality can be developed and evaluated. In this article we describe how we identiï¬ed, guided by the judgements of renowned writers, samples of extraordinarily well-written pieces and how these were expanded to a larger set of typical journalistic writing. We provide details about the corpus and the text quality evaluations it can support. Our intention is to further extend the corpus with annotations of phenomena that reveal quantiï¬able differences between levels of writing quality. Here we introduce two of the many types of annotation on the sentence level that distinguish amazing from typical writing: text generality/speciï¬city and communicative goal. We explore the feasibility of acquiring annotations automatically, and verify that such features are indeed predictive of writing quality. We ï¬nd that the annotation of general/speciï¬c on sentence level can be performed reasonably accurately fully automatically, while automatic annotations of communicative goal reveals salient characteristics of journalistic writing but does not align with categories we wish to annotate in future work.