bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional Cortical Reorganization after Low-Frequency Repetitive Transcranial Magnetic Stimulation plus Intensive Occupational Therapy for Upper Limb Hemiparesis: Evaluation by Functional Magnetic Resonance Imaging in Poststroke Patients
Authors: Yamada Naoki , Kakuda Wataru , Senoo Atsushi , Kondo Takahiro , Mitani Sugao , Shimizu Masato , Abo Masahiro
Published: May 2013

Background

Low-frequency repetitive transcranial magnetic stimulation of the nonlesional hemisphere combined with occupational therapy significantly improves motor function of the affected upper limb in poststroke hemiparetic patients, but the recovery mechanism remains unclear.

Aims

To investigate the recovery mechanism using functional magnetic resonance imaging.

Methods

Forty-seven poststroke hemiparetic patients were hospitalized to receive 12 sessions of 40-min low-frequency repetitive transcranial magnetic stimulation over the nonlesional hemisphere and daily occupational therapy for 15 days. Motor function was evaluated with the Fugl–Meyer Assessment and Wolf Motor Function Test. The functional magnetic resonance imaging with motor tasks was performed at admission and discharge. The laterality index of activated voxel number in Brodmann areas 4 and 6 on functional magnetic resonance imaging was calculated (laterality index range of −1 to +1). Patients were divided into two groups based on functional magnetic resonance imaging findings before the intervention: group 1: patients who showed bilateral activation ( n = 27); group 2: patients with unilateral activation ( n = 20).

Results

Treatment resulted in improvement in Fugl–Meyer Assessment and Wolf Motor Function Test in the two groups ( P < 0.01). The treatment also resulted in a significant increase in laterality index in group 1 ( P < 0.05), suggesting a shift in activated voxels to the lesional hemisphere. Patients of group 2 showed a significant increase in lesional hemisphere activation ( P < 0.05).

Conclusions

The results of serial functional magnetic resonance imaging indicated that our proposed treatment can induce functional cortical reorganization, leading to motor functional recovery of the affected upper limb. Especially, it seems that neural activation in the lesional hemisphere plays an important role in such recovery in poststroke hemiparetic patients.
Outbreak of febrile respiratory illness associated with human adenovirus type 14p1 in Gansu Province, China
Authors: Huang Guohong , Yu Deshan , Zhu Zhen , Zhao Hai , Wang Peng , Gray Gregory C. , Meng Lei , Xu Wenbo
Published: May 2013

Objectives

Human adenovirus (HAdV) type 14 had been infrequently associated with outbreaks of febrile respiratory illness (FRI) until the HAdV‐14p1 emerged in 2006 and rapidly spread in the United States. Here, we report an outbreak of FRI caused by HadV‐14p1 that occurred in 2011 at a primary and middle school in China.

Design

The basic information of the outbreak was recored; throat swabs were collected from 17 patients, polymerase chain reaction, A549 cell culture, and sequencing were used to identify the pathogen of the outbreak..

Results

Total of 43 students were infected in this outbreak. Boys were more than girls. We identified 11 HAdV‐positive specimens and 6 HAdV isolates. Genetic analysis showed that the complete hexon, fiber, and E1A sequences of isolates were nearly 100% identical with other HAdV‐14p1 sequences deposited in GenBank.

Conclusions

HadV‐14p1 has caused outbreaks of pneumonia and mortality among adults in the United States and Europe. It may cause similar conditions among Chinese adults due to poor hygiene and sanitation. It seems prudent for China to develop a national surveillance system to determine the etiology of severe respiratory diseases and deaths among adults and school‐aged children.
Where is God Now?
Authors: Henry Martin
Published: May 2013

This article raises the question whether Christianity might itself, at
least in part, be responsible for the modern waning of belief in God because
of its New Testament teaching, unlike that of the Old Testament, that God is
‘love.’ After examining whether the Bible does in fact present two
incompatible views of God, the article looks at some signs of how the
traditional Western view of God might be changing, in response to modern
sensibilities. It concludes by considering how it might still be possible to
speak about the God of Christianity despite the new cultural conditions of
today.
Evil, Privation, Depression and Dread
Authors: Robson Mark Ian Thomas
Published: May 2013

In this essay I examine the idea that evil is to be understood as a kind
of absence or a privation. I put forward two arguments against this idea.
The first claims that if evil is an absence it becomes causally powerless,
which seems strongly contradicted by experience and revelation. The other
argument says that the idea that evil is an absence cannot do justice to the
evil of depression. Depression is a set of feelings which are all too real,
and so cannot be understood as literally identical with a set of
absences.
Atlantis: a time‐value model in e‐commerce
Authors: Mousavi Khaneghah Ehsan , Mirtaheri Seyedeh Leili , Minaei‐Bidgoli Behrouz , Sharifi Mohsen , Mani Yekta Mohammad Reza , Saleh Ardestani Abbas , Bornaee Zarrintaj
Published: May 2013

This paper presents a model for resolving two main issues of time in e‐commerce. The first issue is the time value of e‐commerce that represents the value of each moment of the commerce time from the perspective of buyers and sellers. Buyers and sellers can use this model to calculate the time value at each moment of time and accordingly decide whether it is profitable to buy or sell at that moment. The second issue is to allow buyers or sellers to increase their savings or decrease their costs by changing each of the factors governing the time value model of the concerned e‐commerce. We present relevant model specifically for Amazon e‐commerce to present a proof of concept of our proposed models.
Cognitive strategies for controlling emotional contagion
Authors: Rempala Daniel M.
Published: May 2013

This study examined strategies for limiting susceptibility to “catching” negative emotions from others. Participants watched 3 videos of happy or sad individuals, as though they were therapists interacting with clients. The entire process was videotaped. Emotional contagion was measured by facial affect and self‐reports. Prior to viewing the videos, participants were assigned one of 4 cognitive strategies: (a) empathic imagery; (b) dissociation; (c) reflection; or (d) no instruction (control). Empathic imagery was expected to increase contagion vs. the control, while dissociation and reflection were expected to decrease contagion. Results indicated that only dissociation decreased contagion on both measures.
Self‐reported attitude scales: current practice in adequate assessment of reliability, validity, and dimensionality
Authors: Hendrick Tamara A. M. , Fischer Arnout R. H. , Tobi Hilde , Frewer Lynn J.
Published: May 2013

The development of methods to create self‐reported attitude scales has lost momentum, in part because of increased research focused on implicit measures. This paper reviews 162 papers on methodological approaches applied to the validation and assessment of attitude scales. Assessment of methodological approaches applied indicates that neither reliability, validity, nor dimensionality assessments are consistently used according to standard operating procedures or in accordance with best practice. Within current practices in the field of attitude scale development, the full potential of self‐report scales is not met, in part because of such methodological issues. The improvement of existing practices and adoption of promising new developments in attitude scale construction and evaluation are discussed, together with recommendations for best practice in scale validation.
Two basic ethical problems of incidental findings in population‐based, non‐intervening magnetic resonance imaging (MRI) research
Authors: Hoffmann Martin
Published: May 2013

Population‐based magnetic resonance imaging (MRI) generates many beneficial consequences for future generations of patients. But there are also some unintended implications for present patients and research subjects. The most important of these implications is the occurrence of incidental findings. In what follows, I will explicate two basic ethical problems concerning incidental findings. I will first argue that the main cause of these two problems lies in the conflicted nature of the medical researcher's role. I will then clarify the two problems, which involves appealing to two basic ethical requirements. The first problem originates from specific empirical conditions of epidemiological MRI research, which indicate shortcomings in the process of obtaining informed consent. The second problem is due to a conflict between obligations of beneficence for the research subjects and the researcher's duty to produce valid and generalizable study results. Finally, I will develop some preliminary perspectives for the solution of these problems.
Until RCT proven? On the asymmetry of evidence requirements for risk assessment
Authors: Osimani Barbara
Published: May 2013

The problem of collecting, analysing and evaluating evidence on adverse drug reactions is an example of the more general class of epistemological problems related to scientific inference and prediction, as well as a central problem of health care practice. Philosophical discussions have analysed critically the methodological pitfalls and epistemological implications of evidence assessment in medicine; however, they have focused predominantly on evidence of treatment efficacy. Most of this work is devoted to statistical methods of causal inference with a special focus on the privileged role assigned to randomized controlled trials (RCTs) in evidence‐based medicine. Regardless of whether the RCT's privilege holds for efficacy assessment, it is nevertheless important to make a distinction between causal inference in relation to intended and unintended effects, in that the unknowns at stake are heterogeneous in the two contexts. This point has been emphasized by epidemiologists in the last decade. Their primary focus is methodological and regards the fact that bias and confounding factors do not affect studies on intended and unintended effects in the same way. However, deeper concerns ground the intuition for such a distinction; these are related to the constraints we impose on evidence and their epistemological justification. My thesis is that such constraints ought to be understood as being different in evidence for risk versus for efficacy. I present the recent debate on the causal association between acetaminophen and asthma in order to illustrate the point at issue. The upshot of my analysis is that different epistemologies confer different methodological choices, which in turn bring about relevant practical implications such as the decision to restrict or suspend drug use rather than leaving it on the market. Thus, it is worth considering the criteria underlying our evidence constraints because they may be ill suited to the purpose for which they are used.
Ex nihilo nihil fit? Medicine rests on solid foundations
Authors: Little Miles
Published: May 2013

Rationale

There seem to be some misunderstandings abroad in the literature about medical epistemology and person‐centered medicine concerning the nature of ‘modest’ or aetiological foundationalism, and some vagueness about ‘emergence’.

Aims and objectives

This paper urges a greater tolerance for a modest, Humean variety of foundationalism, not least because it seems to offer significant support for person‐centred medicine. It also suggests a closer examination of emergence as an explanation or justification for medicine, since emergence is a complex concept that does nothing to rule out foundationalism.

Methods

Reading of relevant literatures relating to foundationalism, emergence and person‐centered medicine, and reflection on the arguments they contain.

Results

Foundationalism has been condemned tout court without recognizing that it comes in various styles and degrees. Emergence has been used as a property of medicine to dismiss any need to seek its foundations. But emergence too comes in different forms, not all of them at odds with modest foundationalism. Modest or aetiological foundationalism is far more flexible than Cartesian foundationalism, and is compatible with modern understandings of emergence.

Conclusions

Modest foundationalism and a particular understanding of emergence support the ontological and epistemological underpinning of person‐centered medicine.
The tribunal of modern life: the case of UZ Brussels in the light of Odo Marquard's discussion on autonomy and theodicy
Authors: Devisch Ignaas
Published: May 2013

Recently, a court in Belgium awarded a sum of 400 000 euros to the parents of a child with disability who at that point had already died of Sanfilippo syndrome. Their charge was not that the baby was born with disability, but that the child was born. The charge was brought in the child's name, and so effectively, the child had sued against its own birth.

This so‐called ‘unique case’ is analyzed with the work of the German philosopher Odo Marquard. Marquard's work on theodicy, and the question of suffering and evil, is very useful to explain why this case is the current apotheosis of a logic present in modernity: existence as a tribunal. This paper explains why Marquard's work sheds an interesting light on this case for today's medicine.
Metaphysics and medical education: taking holism seriously
Authors: Wilson Bruce
Published: May 2013

Medical education is now suffused with concepts that have their source outside the traditional scientific and medical disciplines: concepts such as holism, connectedness and reflective practice. Teaching of these, and other problematic concepts such as medical uncertainty and error, has been defined more by the challenge they pose to the standard model rather than being informed by a strong positive understanding. This challenge typically involves a critical engagement with the idea of objectivity, which is rarely acknowledged as an inherently metaphysical critique. Consequently, these ideas prove to be difficult to teach well. I suggest that the lack of an integrating, positive narrative is the reason for teaching difficulty, and propose that what is needed is an explicit commitment to teach the metaphysics of medicine, with the concept of holism being the fulcrum on which the remaining concepts turn. An acknowledged metaphysical narrative will encompass the scientific realism that medical students typically bring to their tertiary education, and at the same time enable a bigger picture to be drawn that puts the newer and more problematic concepts into context.
The frustrations of virtue: the myth of moral neutrality in psychotherapy
Authors: Hamilton Richard
Published: May 2013

This article questions a number of widely held views of the role of values in psychotherapy. It begins with a discussion of the now largely discredited view that psychotherapy can be value free. It also broadens this challenge to question the popular idea that values form an inescapable part of the therapeutic encounter. While this view is correct in outline, it is necessary to reject the underlying conception of values as largely arbitrary preferences that the client and the therapist bring to the encounter, as this fails to do justice to the inherently ethical nature of psychotherapy. It argues that we should recover the Greek notion of therapy as essentially concerned with the character of a person. In other words, the goal of therapy is virtue.
‘Understanding it makes it normal’: is it a reasoning fallacy or not?
Authors: Gurova Lilia
Published: May 2013

In 1973, P. Meehl drew attention to the fact that some clinicians tend to interpret the otherwise clear symptomatic behaviour of their patients as ‘normal’ if they are given a plausible causal story of patients' behaviours. He claimed that this way of thinking is, in fact, fallacious and gave the alleged fallacy the ‘catchy’ name ‘understanding it makes it normal’.

Thirty years later, the cognitive psychologists W.K. Ahn, L. Novick and N. Kim questioned the fallacy status of ‘understanding it makes it normal’ by arguing that this way of reasoning is not only quite common among clinicians but that it is in fact rational.

The controversy over whether ‘understanding it makes it normal’ is a reasoning fallacy or not is still unresolved and this is evident from the recent discussion about the proposed removal of the ‘normal grief’ exclusion criterion for Major Depressive Disorder from DSM‐5.

This paper proposes an analysis of what stands behind the two opposing claims about ‘understanding it makes it normal’. The analysis builds on the distinction between validity and utility of psychiatric diagnoses and reaches the following conclusions: (1) the fallacy claim is consistent with the assumption that the psychiatric diagnoses are valid descriptions of real mental disorders; (2) the non‐fallacy claim is consistent with the opposite assumption that current psychiatric diagnoses are not valid but only useful descriptions and their utility varies across different contexts; (3) if we agree that there is not enough evidence for the validity of the diagnostic categories embedded in DSM‐4 and ICD‐10, we should also agree that the behaviour of those mental health professionals who change their diagnoses under the influence of the causal context is rational; (4) nevertheless, the ‘understanding it makes it normal’ reasoning strategy should be considered a bias insofar as it takes into account only part of the causal context: the causes of the symptoms but not what they themselves might cause. The neglect of the latter might have dramatic negative consequences in clinical practice. In addition, some recent studies suggest that this bias probably has cultural roots.
Uncovering values‐based practice:VBP's implicit commitments to subjectivism and relativism
Authors: Cassidy Ben
Published: May 2013

Despite assertions to the contrary,KWM Fulford's values‐based practice is implicitly committed to subjectivism when it comes to reasoning about values. This renders the approach unworkable. The act of merely uncovering underlying values is not enough to effect change and, therefore, resolve problems if we have no way, even in principle, of determining which values are right and which are wrong.Fulford's only departure from subjectivism about value is his commitment to ‘framework values’, which seems grounded in a version of ethical relativism.Iargue that we need to reject both subjectivism and relativism if progress within ethical discussions about practice is to be meaningful and a real possibility.
Lactose malabsorption diagnosed by 50‐g dose is inferior to assess clinical intolerance and to predict response to milk withdrawal than 25‐g dose in an endemic area
Authors: Ghoshal Uday C , Kumar Sunil , Misra Asha , Mittal Balraj
Published: May 2013

Background

Lactose malabsorption (LM), diagnosed currently using lactose hydrogen breath and tolerance tests (LHBT, LTT) with a high, nonphysiological dose (50‐g), may mimic irritable bowel syndrome (IBS). In LM‐endemic areas, clinically significant malabsorption (lactose intolerance) may be better diagnosed using a lesser dose, and positive results so obtained may predict response to milk withdrawal more effectively.

Methods

Fifty patients each with IBS (Rome III) were evaluated using LHBT and LTT with 50‐g, 25‐g, and 12‐g lactose. Sensitivity and specificity of LHBT and LTT with different dosages (gold standard: lactase gene C/T‐13910 polymorphism) and symptom development were evaluated. Effect of milk withdrawal was studied.

Result

Of 150 patients, 37/50 (74%) and 28/50 (56%) had LM by LHBT and LTT using 50‐g lactose; 41/50 (82%) and 31/50 (62%) had LM using 25‐g lactose, and 14/50 (28%) and 29/50 (58%) using 12‐g lactose, respectively. Sensitivity and specificity of LHBT using 50‐g, 25‐g, and 12‐g lactose were 92.6%, 52.0%, and 94%, 60%, and 36.4%, 88.2%, and those of LTT, 92%, 80.0%, and 84.8%, 82.4%, and 66.7%, 58.8%, respectively. Breath hydrogen correlated with lactose dose. Though patients developing symptoms with 50‐g lactose exhaled more hydrogen than those remaining asymptomatic, hydrogen levels did not differ following 25‐g and 12‐g dosages in relation to symptom development. Patients' milk intake was 335 ± 92 mL/d (≈ 16.7 ± 9.6‐g lactose). Positive LHBT using 25‐g dose better predicted symptom resolution than by 50‐g and 12‐g lactose.

Conclusion

Twenty‐five gram is the ideal dose of lactose for LHBT and LTT in LM‐endemic areas.
Variants in CCK and CCKAR genes to susceptibility to biliary tract cancers and stones: A population‐based study in Shanghai, China
Authors: Xu Hong‐Li , Hsing Ann W. , Vogtmann Emily , Chu Lisa W. , Cheng Jia‐Rong , Gao Jing , Tan Yu‐Ting , Wang Bing‐Sheng , Shen Ming‐Chang , Gao Yu‐Tang
Published: May 2013

Background and Aim

Altered motility of the gallbladder is associated with an increased risk of gallstones and can result in biliary tract cancers. Cholecystokinin (CCK) is an important modulator of gallbladder motility which functions by activating CCK type‐A receptor (CCKAR). The aim of this study was to determine whether genetic variants in CCK and CCKAR are associated with the risk of biliary tract cancers and stones.

Methods

We investigated the associations between nine single nucleotide polymorphisms in CCK and CCKAR in a population‐based case–control study, including 439 biliary tract cancer cases (253 gallbladder, 133 extrahepatic bile duct, and 53 ampulla of Vater cancer cases), 429 biliary stone cases, and 447 population controls in Shanghai, China.

Results

We found that women with the CCKAR rs1800855 AA genotype had an increased risk of gallbladder cancer (odds ratio = 2.37, 95% confidence interval (CI): 1.36–4.14) compared with subjects with the TT genotype, and remained significant after Bonferroni correction (P = 0.0056). Additionally, female carriers of the CCKAR haplotype C‐T‐C‐T (rs2071011‐rs915889‐rs3822222‐rs1800855) had a reduced risk of gallbladder cancer (odds ratio = 0.61, 95% confidence interval: 0.43–0.86) compared with those with the G‐C‐C‐A haplotype; the association also remained significant after Bonferroni correction.

Conclusions

These findings suggest that variants in the CCKAR gene may influence the risk of gallbladder cancer in women. Additional studies are needed to confirm our findings.
Discovery of diamond in the Tromsø Nappe, Scandinavian Caledonides (N. Norway)
Authors: Janák M. , Krogh Ravna E. J. , Kullerud K. , Yoshida K. , Milovský R. , Hirajima T.
Published: May 2013

We report the first finding of diamond in crustal rocks from the Tromsø Nappe of the North Norwegian Caledonides. Diamond occurs in situ as inclusions in garnet from gneiss at Tønsvika near Tromsø. The rock is composed essentially of garnet, biotite, white mica, quartz and plagioclase, minor constituents include kyanite, zoisite, rutile, tourmaline, amphibole, zircon, apatite and carbonates (magnesite, dolomite, calcite). The microdiamond, identified by micro‐Raman spectroscopy, is cuboidal to octahedral in shape and ranges from 5 to 50 μm in diameter. The diamond occurs as single grains and as composite diamond + carbonate inclusions. Diamond vibration bands show a downshift from 1 332 to 1 325 cm−1, the majority of Raman peaks are centred between 1 332 and 1 330 cm−1 and all peaks exhibit a full width at half maximum between 3 and 5 cm−1. Several spectra show Raman bands typical for disordered and ordered graphite (sp2‐bonded carbon) indicating partial transformation of diamond to graphite. The calculated peak P–T conditions for the diamond‐bearing sample are 3.5 ± 0.5 GPa and 770 ± 50 °C. Metamorphic diamond found in situ in crustal rocks of the Tromsø Nappe thus provides unequivocal evidence for ultrahigh pressure metamorphism in this allochthonous unit of the Scandinavian Caledonides. Deep continental subduction, most probably in the Late Ordovician and shortly before or during the initial collision between Baltica and Laurentia, was required to stabilize the diamond at UHP conditions.
Bite force measurements with hard and soft bite surfaces
Authors: Serra C. M. , Manns A. E.
Published: May 2013

Bite force has been measured by different methods and over a wide variety of designs. In several instruments, the fact that bite surface has been manufactured with stiff materials might interfere in obtaining reliable data, by a more prompt activation of inhibitory reflex mechanisms. The purpose of this study was to compare the maximum voluntary bite force measured by a digital occlusal force gauge (GM10 Nagano Keiki, Japan) between different opponent teeth, employing semi‐hard or soft bite surfaces. A sample of 34 young adults with complete natural dentition was studied. The original semi‐hard bite surface was exchanged by a soft one, made of leather and rubber. Maximum voluntary bite force recordings were made for each tooth group and for both bite surfaces. Statistical analyses (Student's t‐test) revealed significant differences, with higher scores while using the soft surface across sexes and tooth groups (P < 0·05). Differential activation of periodontal mechanoreceptors of a specific tooth group is mainly conditioned by the hardness of the bite surface; a soft surface induces greater activation of elevator musculature, while a hard one induces inhibition more promptly. Thus, soft bite surfaces are recommended for higher reliability in maximum voluntary bite force recordings.
Salivary antioxidants in patients with systemic sclerosis
Authors: Zalewska Anna , Knaś Małgorzata , Gińdzieńska‐Sieśkiewicz Ewa , Waszkiewicz Napoleon , Klimiuk Anna , Litwin Katarzyna , Sierakowski Stanisław , Waszkiel Danuta
Published: May 2013

Background

In spite of relatively large amount of evidence that oxidative stress is implicated in the pathogenesis of systemic sclerosis, there is no study analyzing antioxidants profile of the saliva of these patients. The aim of this study was to compare salivary antioxidants in subjects with systemic sclerosis and the healthy controls.

Methods

The unstimulated and stimulated salivary flow and the specific activity of peroxidase, superoxide dismutase 1, the total amount of uric acid, and total antioxidant status were determined in two subgroups of systemic sclerosis women and healthy controls.

Results

A significant increase in the specific activity of peroxidase, a significant decrease in the total amount of uric acid and total antioxidants status in unstimulated saliva as well as a significant increase in all antioxidants examined in stimulated saliva of group with normal salivary flow rate as compared to the healthy controls were observed. Our results showed a significant decrease in the specific activity of peroxidase in unstimulated and a significant decrease in all antioxidants examined in stimulated saliva of the group with hyposalivation as compared to the group with normal salivary flow rate.

Conclusions

Our results prove that impairment of the salivary glands in the course of systemic sclerosis may be attributed to free radicals, and it is correlated with disease duration.
Occurrence and Phylogenetic Analysis of Potyviruses, Carlaviruses and Allexiviruses in Garlic in Sudan
Authors: Salih Mohammed Heyam , Zicca Stefania , Manglli Ariana , Elaiderous Mohamed Moawia , El Siddig Marmar A. R. , El Hussein Adil Ali , Tomassoli Laura
Published: May 2013

Allium sativum L. samples of three cultivars grown in Sudan were shown to contain several of the common garlic viruses of the genera Potyvirus, Carlavirus and Allexivirus. In particular, Onion yellow dwarf virus (OYDV), Leek yellow stripe virus (LYSV), Garlic common latent virus (GarCLV), Garlic virus A (GVA), Garlic virus B (GVB), Garlic virus C (GVC) and Garlic virus X (GVX) were detected by reverse transcription polymerase chain reaction (RT‐PCR) assay using degenerate genus‐specific and virus‐specific primer sets. Multiple viral infections with members of all three genera were found in all but one sample. Further, molecular and phylogenetic analysis of nucleotide and deduced amino acid sequences revealed that Sudanese isolates of LYSV, GarCLV and of Allexivirus genus were significantly divergent in partial coat protein genomic region from isolates of the same species retrieved from GenBank. This is the first report and study on viruses infecting garlic in Sudan.
Further mulinane diterpenoids from Azorella compacta
Authors: Areche Carlos , Rojas-Alvarez Francisca , Campos-Briones Carolina , Lima Carlos , Pérez Edwin G , Sepúlveda Beatriz
Published: May 2013

Objectives

The chemical study of a dichloromethane extract from Azorella compacta was directed to the isolation of characteristic mulinane and azorellane diterpenoids in order to determine their gastroprotective activity.

Methods

Usual chromatographic techniques on the extract led to the isolation of 12 compounds, which were identified by their spectroscopic properties. The HCl/ethanol-induced gastric lesions model in mice was used to determine the gastroprotective activity.

Key findings

The new diterpenoids, 13β-hydroxymulinane (1), mulin-11,13-dien-20-ol (2), 13α-methoxyazorellanol (3) and mulin-11,13-dien-18-acetoxy-16,20-dioic acid (12) were isolated from A. compacta. The known diterpenoids mulin-11,13-dien-20-oic acid (4), 13α-hydroxyazorellane (5), 13β-hydroxyazorellane (6), mulinic acid (7), mulinolic acid (8) and azorellanol (9), and the aromatic compounds 5,7-dihydroxychromone (10) and isoflavonoid biochanin A (11), were also obtained from the extract. Compounds 6, 9 and 12 at 20 mg/kg reduced gastric lesions by 69%, 71% and 73%, respectively, being statistically similar to lansoprazole at the same dose.

Conclusions

The results corroborate the intraspecific chemical variations detected previously in specimens of A. compacta collected at different Chilean latitudes. A high concentration of azorellanol (9) could account in part for some of the therapeutic properties attributed to this species, in particular in ulcer treatment. Most of the mulinane and azorellane diterpenoids isolated in this study showed relevant gastroprotective activity at a low dose in the bioassay.
Dynamic Properties of Golden Delicious and Red Delicious Apple under Normal Contact Force Models
Authors: Barikloo Hossein , Ahmadi Ebrahim
Published: May 2013

Dynamic forces cause the most bruise damage during fruit transport and handling. In order to reduce this damage, it is necessary to model the impact forces. Limited information is available in the literature about the behavior dynamic and dynamic modeling for apple. The normal force‐displacement relationship between a viscoelastic sphere (fruit apple) and an impactor was analyzed using the Kuwabara and Kond and Tsuji models as normal force models. Fruits were subjected to dynamic loading by means of a pendulum at impact levels. In order to estimate the parameters (spring, “k” and damping, “c”) of the mentioned models for normal impacts, the nonlinear least squares technique (optimization method) was used.

Practical Applications

A very promising approach for the simulation of fruit impact damage during transport and handling is the contact force discrete element method (DEM). In order to do so, models for the forces acting between particles (like fruits) in contact need to be specified. Forces acting between the two particles are decomposed into normal and tangential components. In this paper, the focus is set on normal contacts. The presented research determines the parameters of normal contact forces models suited for DEM simulation of viscoelastic materials (fruit).
Effect of Ovariohysterectomy at the Time of Tumor Removal in Dogs with Benign Mammary Tumors and Hyperplastic Lesions: A Randomized Controlled Clinical Trial
Authors: Kristiansen V.M. , Nødtvedt A. , Breen A.M. , Langeland M. , Teige J. , Goldschmidt M. , Jonasdottir T.J. , Grotmol T. , Sørenmo K.
Published: May 2013

Background

Nonmalignant mammary tumors (NMT) are common in intact female dogs. Little is known about the clinical significance of these tumors, and the effect of ovariohysterectomy (OHE) on their development.

Hypothesis

Ovarian hormone ablation through OHE decreases the risk of new tumors and thereby improves long‐term prognosis for dogs with NMT.

Animals

Eighty‐four sexually intact bitches with NMT.

Methods

Dogs were allocated to undergo OHE (n = 42) or not (n = 42) at the time of NMT removal in a randomized clinical trial. Tumor diagnosis was confirmed histologically in all subjects. Information about new tumor development was collected via follow‐up phone calls and recheck examinations. Separate survival analyses were performed with the endpoints new tumor development and death. Cause of death was classified as related or unrelated to mammary tumor. In addition to OHE status, the influence of age, body weight, breed, tumor size, tumor number, tumor duration, type of surgery, and tumor histology was investigated.

Results

New mammary tumor(s) developed in 27 of 42 (64%) intact dogs and 15 of 42 (36%) ovariohysterectomized dogs (hazard ratio 0.47, P = .022). Nine of the 42 dogs (21%) which developed new tumors were euthanized because of mammary tumor. Survival was not significantly different between the 2 treatment groups. In the intact group, nine dogs subsequently developed ovarian–uterine diseases.

Conclusion

Ovariohysterectomy performed at the time of mammary tumor excision reduced the risk of new tumors by about 50% among dogs with NMT. Survival was not significantly affected. Adjuvant OHE should be considered in adult dogs with mammary tumors.
Impact of deep sedation on the accuracy of hepatic and portal venous pressure measurements in patients with cirrhosis
Authors: Reverter Enric , Blasi Annabel , Abraldes Juan G. , Martínez‐Palli Graciela , Seijo Susana , Turon Fanny , Berzigotti Annalisa , Balust Jaume , Bosch Jaume , García‐Pagán Juan C.
Published: May 2013

Background & Aims

Measurement of the hepatic venous pressure gradient (HVPG) offers valuable prognostic information in patients with cirrhosis. In specific circumstances, (children, agitated patients, TIPS placement) deep sedation is required. This study aims to assess the impact of deep sedation on the accuracy of hepatic/portal pressure measurements.

Methods

Forty‐four patients were included. Measurements of baseline HVPG (n = 30), HVPG response to i.v. propranolol (n = 11), portal pressure gradient (PPG) after TIPS (n = 27) and of cardio‐pulmonary pressures (n = 25) were obtained in awake conditions and under deep sedation with propofol and remifentanil.

Results

During deep sedation, a marked oscillation within respiratory cycle was observed in abdominal pressures. End‐expiratory sedated HVPG showed a better agreement with awake HVPG (intra‐class correlation coefficient – ICC 0.864) than end‐inspiratory HVPG (ICC 0.796). However, in almost half of the patients both values differed by more than 10%. Accuracy was not improved by using mean HVPG along the respiratory cycle. Similarly, changes in HVPG caused by propranolol while under sedation had a poor agreement to those obtained in awake conditions. Indeed, about a half of patients were misclassified according to the 10% HVPG reduction target. After TIPS, PPG values obtained under sedation were significantly different to awake PPG, usually underestimating the awake value. The systemic hemodynamic changes induced by sedation were not associated to a greater variability of PPG/HVPG measurements.

Conclusion

Deep sedation with propofol and remifentanil adds substantial variability and uncertainty to HVPG/PPG measurements. This must be considered when using these values to estimate prognosis, or targeting HVPG/PPG reductions.
Effect of lifetime alcohol consumption on the histological severity of non‐alcoholic fatty liver disease
Authors: Kwon Hellan K. , Greenson Joel K. , Conjeevaram Hari S.
Published: May 2013

Background & Aims

Non‐alcoholic fatty liver disease (NAFLD) is defined based on recent alcohol consumption; however, remote or lifetime alcohol consumption is not taken into account. It is not known whether lifetime alcohol consumption contributes to the severity of disease in patients with NAFLD. To determine the effect of lifetime alcohol consumption on the histological severity in patients with NAFLD.

Patients & Methods

Adults >18 years of age with presumed NAFLD and alcohol consumption <40 g/week were enrolled. Lifetime alcohol consumption was determined using a questionnaire. Patients with a history of long‐term alcohol abuse or dependence were excluded. A liver biopsy was reviewed by a single pathologist in a blinded fashion. Demographic, clinical and histological findings were compared in those who had regular alcohol consumption and those who did not.

Results

A total of 77 patients had fatty liver on biopsy. Fifty‐two patients had a history of regular alcohol consumption. The median lifetime cumulative alcohol intake was 24 gram‐years. On multivariable analysis, increasing age (OR 1.07, 95% CI 1.01–1.14) was associated with severe liver disease, whereas alcohol consumption of ≥24 gram‐years was associated with less severe disease (OR 0.26, 95% CI 0.07–0.97, P = 0.04). Patients who continued to consume alcohol or had been abstinent for ≤1 year had less severe disease.

Conclusion

Some degree of regular alcohol consumption over the course of a lifetime compared to minimal intake appears to have a protective effect on the histological severity of liver disease among patients with strictly defined NAFLD.
Hydrodynamic performance of the flippers of large‐bodied cetaceans in relation to locomotor ecology
Authors: Weber Paul W. , Howle Laurens E. , Murray Mark M. , Reidenberg Joy S. , Fish Frank E.
Published: May 2013

Cetaceans evolved flippers that are unique in both size and shape probably due to selection pressures associated with foraging and body size. Flippers function as control surfaces for maneuverability and stability. Flippers of cetaceans and engineered hydrofoils are similar with streamlined cross‐sections and wing‐like planforms, which affect lift, drag and hydrodynamic efficiency. Scale models of the flippers from large‐bodied (body length > 6 m) cetaceans (fin whale, killer whale, sperm whale) were constructed from computed tomography (CT) scans of flippers. Flipper planforms were highly tapered for the fin whale, a rounded, paddle‐like design for the killer whale, and a square geometry for the sperm whale. Hydrodynamic properties of the models at varying angles of attack (−40º to 40o) were determined in a water tunnel with a multi‐axis load cell. The flippers were found to have hydrodynamic characteristics similar to engineered wings. Differences in flipper morphology of large‐bodied cetaceans and their hydrodynamic performance are associated with the requirements of aquatic locomotion involved with ecology of the whales. The flippers of the killer whale provided the greatest maneuverability, whereas the flippers of the fin whale had low drag for lunging and the flippers of the sperm whale provided lift for diving.
Spatial and temporal analysis of killer whale (Orcinus orca) strandings in the North Pacific Ocean and the benefits of a coordinated stranding response protocol
Authors: Barbieri Michelle M. , Raverty Stephen , Bradley Hanson M. , Venn‐Watson Stephanie , Ford John K. B. , Gaydos Joseph K.
Published: May 2013

Killer whales (Orcinus orca) are widely distributed throughout the world's oceans, yet little has been documented about their stranding patterns. Knowledge of stranding patterns improves our ability to examine and sample carcasses and provides a foundation for understanding killer whale natural history, diet, reproduction, anthropogenic stressors, emerging diseases, and patterns of unusual mortality. We compiled published and unpublished killer whale stranding data to describe stranding patterns in the North Pacific Ocean. Between 1925 and 2011, 371 stranded killer whales were reported in Japan (20.4%), Russia (3.5%), Alaska (32.0%), British Columbia (27.4%), Washington (4.0%), Oregon (2.7%), California (5.1%), Mexico (3.8%), and Hawaii (0.8%). Strandings occurred at all times of year, but regionally specific seasonal differences were observed. Mortality and annual census data from Northern and Southern Resident populations were extrapolated to estimate that across the North Pacific, an average of 48 killer whales die annually. However, over the last two decades, an average of only 10 killer whale carcasses were recovered annually in this ocean, making each event a rare opportunity for study. Publication of a standardized killer whale necropsy protocol and dedicated funding facilitated the number of complete postmortem necropsies performed on stranded killer whales from 1.6% to 32.2% annually.
No evidence for the persistence of Schmallenberg virus in overwintering mosquitoes
Authors: SCHOLTE E. J. , MARS M. H. , BRAKS M. , DEN HARTOG W. , IBAÑEZ‐JUSTICIA A. , KOOPMANS M. , KOENRAADT C. J. M. , DE VRIES A. , REUSKEN C.
Published: May 2013

In 2011, Schmallenberg virus (SBV), a novel member of the Simbu serogroup, genus Orthobunyavirus, was identified as the causative agent of a disease in ruminants in Europe. Based on the current knowledge on arthropods involved in the transmission of Simbu group viruses, a role of both midges and mosquitoes in the SBV transmission cycle cannot be excluded beforehand. The persistence of SBV in mosquitoes overwintering at SBV‐affected farms in the Netherlands was investigated. No evidence for the presence of SBV in 868 hibernating mosquitoes (Culex, Anopheles, and Culiseta spp., collected from January to March 2012) was found. This suggests that mosquitoes do not play an important role, if any, in the persistence of SBV during the winter months in northwestern Europe.
Blow fly responses to semiochemicals produced by decaying carcasses
Authors: JOHANSEN H. , SOLUM M. , KNUDSEN G. K. , HÅGVAR E. B. , NORLI H. R. , AAK A.
Published: May 2013

Volatiles from mouse carcasses in decay stages ranging from fresh to 33 days old were used to investigate oriented flight and landings in male and female blow flies of Calliphora vicina Robineau‐Desvoidy (Diptera: Calliphoridae). Oriented flight increased significantly from 36% towards fresh carcasses to 68%, 61% and 65% towards carcasses aged 3 days, 6 days and 9 days, respectively. Carcasses aged 20 days and 33 days were significantly less attractive, achieving 51% and 41% attraction, respectively. No differences emerged between the sexes in oriented flight, but a significant increase in female landings at the most attractive carcasses was observed. Headspace collections from the different stages of decay showed a succession in the volatile profile emitted from the carcasses and identified nine chemicals which peak in quantity in concurrence with the most attractive stages of decay. Three of these chemicals also showed dose–response effects as indicated by a significant correlation between the amount present and the proportion of flies responding. Blow flies are important pests and efficient traps are needed. The significant interaction between fly sex and carcass age highlights behavioural differences between male and female blow flies which can be exploited in blow fly trapping. Three new volatile chemicals, butylated hydroxyl toluene, 3‐hydroxy‐2‐butanone and nonanal, emitted from dead mice are suggested as potential attractants.
A Critical Appraisal of the Evidence for Botulinum Toxin Type A in the Treatment for Cervico‐Thoracic Myofascial Pain Syndrome
Authors: Desai Mehul J. , Shkolnikova Tatyana , Nava Andrew , Inwald Danielle
Published: May 2013

Myofascial pain syndrome (MPS) is a musculoskeletal condition characterized by regional pain and muscle tenderness associated with the presence of myofascial trigger points (MTrPs). The last decade has seen an exponential increase in the use of botulinum toxin (BTX) to treat MPS. To understand the medical evidence substantiating the role of therapeutic BTX injections and to provide useful information for the medical practitioner, we applied the principles of evidence‐based medicine to the treatment for cervico‐thoracic MPS. A search was conducted through MEDLINE (PubMed, OVID, MDConsult), EMBASE, SCOPUS and the Cochrane database for the period 1966 to 2012 using the following keywords: myofascial pain, muscle pain, botulinum toxin, trigger points, and injections. A total of 7 trials satisfied our inclusion criteria and were evaluated in this review. Although the majority of studies found negative results, our analysis identified Gobel et al.'s as the highest quality study among these prospectively randomized investigations. This was due to appropriate identification of diagnostic criteria, excellent study design and objective endpoints. The 6 other identified studies had significant failings due to deficiencies in 1 or more major criteria. We conclude that higher quality, rigorously standardized studies are needed to more appropriately investigate this promising treatment modality.
Concern for Pain in the Pre‐Operative Period‐ Is the Internet Being Used for Information By Patients?
Authors: Kurup Viji , Dabu‐Bondoc Susan , Senior Audrey , Dai Feng , Hersey Denise , Vadivelu Nalini
Published: May 2013

Objectives

This study was conducted to provide information regarding prevalence of pain, type of provider managing pain, and use of Internet for information regarding pain, among patients coming for presurgical anesthesia consultation at a major academic institution.

Methods

With IRB approval, patients were invited to participate in a voluntary and anonymous 14 question survey given to them when they presented for anesthesia consultation prior to their surgical procedure. The qualitative/categorical data were summarized by number (percentage [%]) and analyzed by Chi‐square test or Fisher's exact test as appropriate. All data analyses were performed using the statistical software SAS, v9.2.

Results

A total of 1039 patients were asked to complete the survey and 670 patients returned their responses (response rate = 64.5%). 83% of patients had a history of prior surgery. 57% were concerned about postoperative pain. 30% of patients had chronic pain for more than 3 months pre‐operatively. 16% of patients had looked online for information regarding pain. Pain physicians were involved in pain management only in 3.8% of these patients.

Discussion

Patients are presenting for surgery with significant pre‐operative pain issues. Knowing this information pre‐operatively will help healthcare personnel manage postsurgical pain more effectively. Patients are also using the Internet to obtain information regarding pain. As providers, there may be value to directing patients to reliable information online during consultation. As all physicians will eventually be managing chronic pain in their patients, pain education should be given priority in medical school curriculum.