bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-cementing properties of oil shale solid heat carrier retorting residue
Authors: Talviste Peeter , Sedman Annette , Mõtlep Riho , Kirsimäe Kalle
Published: March 2013

Oil shale-type organic-rich sedimentary rocks can be pyrolysed to produce shale oil. The pyrolysis of oil shale using solid heat carrier (SHC) technology is accompanied by large amount of environmentally hazardous solid residue—black ash—which needs to be properly landfilled. Usage of oil shale is growing worldwide, and the employment of large SHC retorts increases the amount of black ash type of waste, but little is known about its physical and chemical properties. The objectives of this research were to study the composition and self-cementing properties of black ash by simulating different disposal strategies in order to find the most appropriate landfilling method. Three disposal methods were simulated in laboratory experiment: hydraulic disposal with and without grain size separation, and dry dumping of moist residue. Black ash exhibited good self-cementing properties with maximum compressive strength values of >6 MPa after 90 days. About 80% of strength was gained in 30 days. However, the coarse fraction (>125 µm) did not exhibit any cementation, thus the hydraulic disposal with grain size separation should be avoided. The study showed that self-cementing properties of black ash are governed by the hydration of secondary calcium silicates (e.g. belite), calcite and hydrocalumite.
The Puzzle of Apparent Life-Threatening Events in a Healthy Newborn
Authors: Khajeh Ladbon , Cherian Perumpillichira J. , Swarte Renate M. , Smit Liesbeth S. , Lequin Maarten H.
Published: March 2013

Apneic neonatal seizures can present as apparent life-threatening events. We report a newborn with unexplained episodes of apnea associated with cyanosis and desaturation, starting on the first day postpartum. Biochemical tests were normal. Central nervous system infections as well as abnormalities of upper airways and cardiovascular system were excluded. Brain monitoring using amplitude-integrated electroencephalography (aEEG) was inconclusive. Continuous monitoring using video EEG revealed epileptic seizures originating from the left temporal region as the cause of the apneas. Magnetic resonance imaging (MRI) of the brain showed a developmental malformation of the left frontal and temporal lobes. The patient became seizure free after treatment with antiepileptic medication. This report illustrates that brain monitoring using amplitude-integrated EEG alone could miss focal neonatal seizures. When clinical suspicion of apneic seizures is high in infants with apparent life threatening events, multichannel polygraphic video-EEG monitoring is indicated. Prompt diagnosis and treatment can be life saving.
Latin America: Dependency and Super-Exploitation
Authors: Sotelo Valencia Adrián
Published: March 2013

Dependency theory in the tradition of Ruy Mauro Marini emphasized the super-exploitation of labor and helped direct attention to capital’s quest to further expropriate part of the consolidated consumption fund historically won by labor. Marini’s work represented a significant departure from the ECLAC conception of vulnerabilities exhibited by developing countries, opting instead to take Lenin’s theory of imperialism as the key point of departure for analyzing dependency. Marini was critiqued on intellectual grounds by more conservative dependency theorists such as Cardoso, Serra and Cueva, consequently blunting the critical leading edge of dependency theory. This exploration of Marini’s critical Marxist formulation helps contextualize the continuing relevance of dependency theory for comprehending the ongoing class struggle in 21st century Latin America.
Ethnic Disparities in Disability Among Middle-Aged and Older Israeli Adults
Authors: Osman Amira , Walsemann Katrina M.
Published: March 2013

Objectives: We examined the contribution of socioeconomic disadvantage and traumatic life events to ethnic disparities in disability among Israeli adults. Method: We used data from the Survey of Health, Aging and Retirement in Europe (SHARE-Israel), a sample of Israeli adults aged 50 or older ( N = 1,546). Disability measures included functional limitations, limitations in activities of daily living (ADL), and limitations in instrumental activities of daily living (IADL). Results: Arabs and immigrants from the Former Soviet Union (FSU) experienced higher rates of functional limitations and limitations in IADLs compared to veteran Jews. The rate of having limitations in ADLs was similar for Arabs and veteran Jews, but was higher for FSU immigrants compared to veteran Jews. Inclusion of education, income, and traumatic life events attenuated, but did not eliminate ethnic disparities in disability. Discussion: Identifying factors driving ethnic health disparities in Israel is imperative if we hope to achieve health equity.
Boundary conditions for molecular dynamics simulations of water transport through nanotubes
Authors: Docherty Stephanie Y , Nicholls William D , Borg Matthew K , Lockerby Duncan A , Reese Jason M
Published: March 2013

This article compares both new and commonly used boundary conditions for generating pressure-driven water flows through carbon nanotubes in molecular dynamics simulations. Three systems are considered: (1) a finite carbon nanotube membrane with streamwise periodicity and ‘gravity’-type Gaussian forcing, (2) a non-periodic finite carbon nanotube membrane with reservoir pressure control, and (3) an infinite carbon nanotube with periodicity and ‘gravity’-type uniform forcing. Comparison between these focuses on the flow behaviour, in particular the mass flow rate and pressure gradient along the carbon nanotube, as well as the radial distribution of water density inside the carbon nanotube. Similar flow behaviour is observed in both membrane systems, with the level of user input required for such simulations found to be largely dependent on the state controllers selected for use in the reservoirs. While System 1 is simple to implement in common molecular dynamics codes, System 2 is more complicated, and the selection of control parameters is less straightforward. A large pressure difference is required between the water reservoirs in these systems to compensate for large pressure losses sustained at the entrance and exit of the nanotube. Despite a simple set-up and a dramatic increase in computational efficiency, the infinite length carbon nanotube in System 3 does not account for these significant inlet and outlet effects, meaning that a much smaller pressure gradient is required to achieve a specified mass flow rate. The infinite tube set-up also restricts natural flow development along the carbon nanotube due to the explicit control of the fluid. Observation of radial density profiles suggests that this results in over-constraint of the water molecules in the tube.
A reliability analysis of railway switches
Authors: Rama Dovile , Andrews John D
Published: March 2013

Switches and crossings (S&C) are critical elements on railway networks. Any failure of S&C usually leads to train delays and cancelations having a negative impact on the quality of service delivered, railway safety and also operating costs. S&C is a multi-component system and to enable proactive prevention of S&C unit faults, with their undesirable consequences, the ability to predict problems at component level is needed. This paper describes the derivation of lifetime distributions of individual S&C components based on field data collected. Maintenance was identified as a potential contributor towards increased frequency of reported S&C faults. The outcomes of the analysis and lifetime distributions for the elements of the switch units provide a means of predicting the expected number of maintenance activities, and associated costs for these units over any specified period of time. They provide an essential input to the optimisation of maintenance in developing an asset management strategy.
Succession planning and temporality: The influence of the past and the future
Authors: Gill Fiona
Published: March 2013

Although succession planning has been a fertile topic of investigation among rural sociologists, its temporal elements have been neglected. This has resulted in static analyses, with little attention paid to the influences of the past and future on present decision-making. This article introduces a consideration of temporality, examining the influences of past and future on the development and expression of farming identities. I argue that temporality plays a critical role as farmers struggle with conflicting senses of time and responsibilities to different generations.
The social definition of time for university students
Authors: Liao Tim F , Beckman Joshua , Marzolph Emily , Riederer Caitlin , Sayler Jeffrey , Schmelkin Leah
Published: March 2013

In today’s world, universities, in particular those in the West, have increasingly become networked, informationalized, and commercialized, and tend to operate on a clock or chronologic time like a business or corporation, though their demands on individuals are often in real or chronoscopic time terms. In light of the increasing demand in time by the university as corporation, we study in this article a neglected aspect of such a modern university: the social meaning of time for university students. To achieve our goal, we chose a Midwestern public university as our research site – a major American research university of about 40,000 students – and conducted field observations through photography and interviews during the 2009 fall semester. The research setting provided a good opportunity to observe a wide range of categories of time experienced by students. In the article we established a typology of six theoretically informed and empirically observable categories of time – scheduled time, compressed time, timeless time, endless time, wasted time, and time as goal. Our analysis through visual means demonstrates how these six types of time operate and how they are embedded in social situations and social structure. For individual students, scheduled time can confine and structure the other time categories, and it reflects the institutional demand expressed in corporate time by the modern university as corporation.
Does It Really Hurt to Be Out of Step?
Authors: Hollibaugh Gary E. , Rothenberg Lawrence S. , Rulison Kristin K.
Published: March 2013

Scholars have seemingly established that constituents hold “out of step” legislators electorally accountable. Empirically, however, such claims have not been based on measures placing districts and perceptions of legislators’ preferences in the same space. We remedy this using the 2006 and 2008 Cooperative Congressional Election Studies, and Aldrich and McKelvey’s scaling procedure, finding that electoral success is roughly consistent with Downsian logic but not with the blanket statement that out-of-step incumbents are penalized. Voters punish out-of-step incumbents conditional on having a sufficiently more “in step” challenger. Effects are substantial, but so are incumbent advantages.
Case Series
Authors: Vetrayan Jayachandran , Othman Suhana , Victor Paulraj Smily Jesu Priya
Published: March 2013

Objective: To assess the effectiveness and feasibility of behavioral sleep intervention for medicated children with ADHD. Method: Six medicated children (five boys, one girl; aged 6-12 years) with ADHD participated in a 4-week sleep intervention program. The main behavioral strategies used were Faded Bedtime With Response Cost (FBRC) and positive reinforcement. Within a case-series design, objective measure (Sleep Disturbance Scale for Children [SDSC]) and subjective measure (sleep diaries) were used to record changes in children’s sleep. Results: For all six children, significant decrease was found in the severity of children’s sleep problems (based on SDSC data). Bedtime resistance and mean sleep onset latency were reduced following the 4-week intervention program according to sleep diaries data. Gains were generally maintained at the follow-up. Parents perceived the intervention as being helpful. Conclusion: Based on the initial data, this intervention shows promise as an effective and feasible treatment.
An investigation of worn work roll materials used in the finishing stands of the hot strip mill for steel rolling
Authors: Nilsson M , Olsson M
Published: March 2013

The surface failure characteristics of different work roll materials, i.e. high speed steel, high chromium iron and indefinite chill iron, used in the finishing stands of a hot strip mill have been investigated using stereomicroscopy, three-dimensional optical profilometry, scanning electron microscopy and energy-dispersive X-ray spectroscopy. The results show that the surface failure mechanisms of work rolls for hot rolling are very complex, involving plastic deformation, abrasive wear, adhesive wear, mechanical- and thermal-induced cracking, material transfer and oxidation. Despite the differences in chemical composition and microstructure, the tribological response of the different work roll materials was found to be strongly dependent on second phase constituents such as the size, morphology and distribution of different carbide phases and graphite (in the case of indefinite chill iron), which was found to promote cracking. Cracking and chipping of the work roll surfaces, both having a negative impact on work roll wear, are strongly influenced by the presence of carbides, carbide networks and graphite in the work roll surface. Consequently, the amount of carbide-forming elements as well as the manufacturing process must be controlled in order to obtain an optimised microstructure and a predictable wear rate.
Graffiti writer as superhero
Authors: Campos Ricardo
Published: March 2013

In this article, ethnographic research developed within the graffiti community of Lisbon is the starting point for a reflection regarding the social condition of the young members of this community. The graffiti writers live between two social and cultural universes, building complex strategies to manage identity and everyday life. Graffiti represents for many young people a ground for struggle and transgression, a chance to reject the law and hegemonic normatives, an arena where they experiment excitement, risk, heroic conduct and sometimes painful sanctions. In a security-prone society, danger becomes a space for freedom, where young writers challenge the limits of life and normative boundaries. This is often why there is a feeling of release and autonomy and of escaping the disciplinary control of social norms and worldly habits. This is why the nature of their exploits appears to be endowed with greatness and heroism.
Revisiting Scope of Practice Facilitators and Barriers for Primary Care Nurse Practitioners
Authors: Poghosyan Lusine , Nannini Angela , Smaldone Arlene , Clarke Sean , O’Rourke Nancy C. , Rosato Barbara G. , Berkowitz Bobbie
Published: March 2013

Revisiting scope of practice (SOP) policies for nurse practitioners (NPs) is necessary in the evolving primary care environment with goals to provide timely access, improve quality, and contain cost. This study utilized qualitative descriptive design to investigate NP roles and responsibilities as primary care providers (PCPs) in Massachusetts and their perceptions about barriers and facilitators to their SOP. Through purposive sampling, 23 NPs were recruited and they participated in group and individual interviews in spring 2011.The interviews were audio recorded and transcribed. Data were analyzed using Atlas.ti 6.0 software, and content analysis was applied. In addition to NP roles and responsibilities, three themes affecting NP SOP were: regulatory environment; comprehension of NP role; and work environment. NPs take on similar responsibilities as physicians to deliver primary care services; however, the regulatory environment and billing practices, lack of comprehension of the NP role, and challenging work environments limit successful NP practice.
Nanoencapsulated phase change materials based on polyethylene glycol for creating thermoregulating cotton
Authors: Karthikeyan M , Ramachandran T , Sundaram OL Shanmuga
Published: March 2013

Novel nanoencapsulated phase change materials containing polyethylene glycol as the core material and urea formaldehyde as the shell material were prepared with an in situ polymerization method. The prepared nanocapsules were coated onto the cotton fabric using the pad-dry-cure method, and different ratios of nanocapsules to binder agent were evaluated. The morphology and characteristics of the polyethylene glycol and nanoencapsulated phase change materials were measured using scanning electron microscope, transmission electron microscope and Fourier transform infrared spectroscopy. The nanocapsules were found to have a regular spherical shape with a size of 141 nm. The thermal behavior of the textile fabrics was investigated by differential scanning calorimetry and thermal gravimetry analysis. The tensile strength, water absorption and abrasion resistance of the treated and untreated fabrics were also studied. The differential scanning calorimetry results found that the treated fabrics had latent heat storage energy of 0.198, 0.213 and 0.219 J/g, where the measurement was related to the nanocapsules/binder ratio. The thermal gravimetry analysis results showed that the treated fabric with a nanocapsules/binder agent ratio of 3:3 had good thermal stability.
In situ formation of anti-bacterial silver nanoparticles on cotton textiles
Authors: Liu Hongjun , Lee Yeong-Yuh , Norsten Tyler B , Chong Karen
Published: March 2013

The efficiency of chemical biocides as anti-bacterial agents is well documented and there are various methods to incorporate these bactericidal agents onto commonly used substrates, such as textile materials. Silver is known for its excellent inhibitory properties due to its direct action on the morphology of the cellular membrane of the bacteria. The use of silver is, however, limited due to its cost and challenges to incorporate silver into relevant products and materials with minimal loss of efficiency. In this article, we present an ‘in situ’ (one-pot) process for the formation of silver nanoparticles onto cotton fabrics in an aqueous media. Silver nanoparticles are bonded onto the cotton fibers via a surface modification that involves the use of 3-aminopropyltriethoxysilane. This enables the improved bonding of silver nanoparticles onto the textiles, thus mitigating the challenges associated with the leaching of silver into eluents and wash-offs. Anti-bacterial efficiency testing was also carried out on the textiles with more than 99% reduction of bacterial growth within 1 h of contact. Additionally, the textiles have also demonstrated continued anti-bacterial efficiency after prolonged period of washing. Thus, our method can potentially be applied to large-scale manufacturing of anti-bacterial textiles with potential uses in biomedical and consumer clothing industries.
Numerical study of the influence of structural and mechanical parameters on the tensile mechanical behaviour of flax fibres
Authors: Thuault Anthony , Bazin Jérôme , Eve Sophie , Bréard Joël , Gomina Moussa
Published: March 2013

This paper presents the results of a numerical simulation of the ultimate flax fibre ( Linum usitatissimum) tensile mechanical behaviour using finite element analysis. Experimental data were used to develop a numerical multilayer model of the flax fibre. Thus, the influence of some parameters, such as cell wall thicknesses, microfibrils angles (MFAs), biochemical composition and mechanical properties of the biochemical components, on the flax fibre tensile mechanical behaviour has been investigated. Results show that the typical stress–strain curve profile of the flax fibre could be due to the mechanical properties of hydrophilic components (hemicelluloses) and thus to the environmental conditions. A parameter sensitivity study reveals that ultrastructural parameters (hemicelluloses and cellulose Young’s modulus) strongly influence the flax fibre mechanical behaviour and structural parameters (S2 cell wall layer MFA and thickness) significantly influence the fibre longitudinal Young’s modulus. Thus, the knowledge of the fibre ultrastructure seems to be the key of the understanding of the flax fibre mechanical behaviour.
Therapeutic Assessment of Complex Trauma
Authors: Tarocchi Anna , Aschieri Filippo , Fantini Francesca , Smith Justin D.
Published: March 2013

The cumulative effect of repeated traumatic experiences in early childhood incrementally increases the risk of adjustment problems later in life. Surviving traumatic environments can lead to the development of an interrelated constellation of emotional and interpersonal symptoms termed complex posttraumatic stress disorder (CPTSD). Effective treatment of trauma begins with a multimethod psychological assessment and requires the use of several evidence-based therapeutic processes, including establishing a safe therapeutic environment, reprocessing the trauma, constructing a new narrative, and managing emotional dysregulation. Therapeutic Assessment (TA) is a semistructured, brief intervention that uses psychological testing to promote positive change. The case study of Kelly, a middle-aged woman with a history of repeated interpersonal trauma, illustrates delivery of the TA model for CPTSD. Results of this single-case time-series experiment indicate statistically significant symptom improvement as a result of participating in TA. We discuss the implications of these findings for assessing and treating trauma-related concerns, such as CPTSD.
Collaborative Treatment of Choking Phobia in an Older Adult
Authors: Millikin Colleen , Braun-Janzen Colleen
Published: March 2013

This article describes the case of a 69-year-old man with a long history of swallowing difficulties and a past diagnosis of obsessive-compulsive disorder. He was seen for treatment by a speech-language pathologist and a clinical psychologist. Prior to treatment, he ate only one type of sweet dessert and some pureed foods, at restricted times of the day, and without others present. Treatment focused on increasing variety in his diet, increasing bolus size, reducing ritualistic and safety behaviors, and eating in social situations. Treatment methods included surface electromyographic biofeedback and systematic desensitization. After 19 months of treatment (49 sessions), the patient was able to eat a variety of soft/ground foods. He gained weight and was able to eat in social situations. At post-treatment, 8-month and 48-month follow-up, he reported being satisfied with his progress and did not wish to pursue further goals involving eating solid foods or increasing bolus size of liquids.
Early phase trial design for assessing several dose levels for toxicity and efficacy for targeted agents
Authors: Hoering Antje , Mitchell Alan , LeBlanc Michael , Crowley John
Published: March 2013

Background

Traditional phase I trials are designed to be conservative. Many times a traditional phase I trial design stops at a dose level below the maximal tolerated dose (MTD), thus potentially treating patients at a suboptimal level in all subsequent trials. This has been confirmed by our recent simulation studies.

Purpose

We propose a phase I/II trial design to determine the most promising dose level in terms of toxicity and efficacy for cytostatic or targeted agents. This design evaluates three dose levels for efficacy and toxicity using a modified phase II selection design. The dose levels include the phase I recommended dose (RD) in addition to the dose levels immediately below and above that level.

Methods

This phase I/II trial design uses a two-step approach. In the first step, a traditional phase I trial design is used to get close to a good dose level. The second step consists of a modified selection design, randomizing patients to three dose levels: the phase I RD level and the dose levels immediately below and above the phase I RD level. Both efficacy and toxicity are used to determine a good or best dose level. Appropriate toxicity stopping rules in the phase II portion of the trial are implemented as part of such a trial. We perform simulation studies for a variety of toxicity and efficacy scenarios to determine the operating characteristics of this design and compare those to our originally proposed trial where we only explore dose levels at and below the phase I RD in the second phase of the trial, as well as to the traditional setting where a phase I trial is followed by a single-arm phase II trial at the phase I RD.

Results

The 3-arm modified selection design exploring the dose levels immediately above and below as well as the RD performs as well or better than the 2-arm modified selection design or the single-arm design for almost all toxicity and efficacy scenario combinations tested.

Conclusion

We demonstrate that this design has a higher success rate at identifying a good or best dose level when exploring dose levels immediately above and below the RD in the early phase II setting, in most cases without needing larger sample sizes.
Participation, ‘responsivity’ and accountability in neighbourhood policing
Authors: Bullock Karen , Leeney David
Published: March 2013

Neighbourhood policing, a contemporary form of community policing developed in the United Kingdom (UK), has sought to increase public participation in policing and to develop processes through which residents work in co-production with partners and other state agencies to tackle problems. The aim has been to create mechanisms through which residents can hold the police service to account in dealing with the problems that matter to them. Drawing on interviews with neighbourhood policing officers, this article examines the operation of these processes in practice. We focus on the nature of resident participation in neighbourhood policing; the extent to which police officers organize their priorities around those of residents who participate; and the ways in which officers work with other state agencies and residents themselves to tackle certain problems. Ultimately, this article questions the notions of accountability embedded in neighbourhood policing and whether the neighbourhood policing approach offers an effective mechanism for holding officers to account by residents.
Who governs? Democracy, plutocracy, science and prophecy in policing
Authors: Reiner Robert
Published: March 2013

This article critically analyses two key debates about police and policing: the problematic definition of their role, and how they can be rendered democratically accountable. Both issues have been radically altered through the profound transformation of policing produced by the last three decades of neo-liberal hegemony. The article focuses on how this has developed in England and Wales, although there are parallels with other jurisdictions. The complex role of the police has been distilled down to criminal catching. Accountability has become accountancy, under the auspices of New Public Management. The current British Coalition government’s tendentious ‘austerity’ measures make these perennial problems especially acute. The Coalition purports to be democratizing police accountability through elected Police and Crime Commissioners. These claims are critically analysed in principle, but how they work out in practice is hard to prophesy. It is suggested they may play out in ways that frustrate their architects’ hopes, due to the continuing baleful consequences of neoliberalism.
Neuroradiological evaluation of demyelinating disease
Authors: Tillema Jan-Mendelt , Pirko Istvan
Published: March 2013

Central nervous system inflammatory demyelinating disease can affect patients across the life span. Consensus definitions and criteria of all of the different acquired demyelinating diseases that fall on this spectrum have magnetic resonance imaging criteria. The advances of both neuroimaging techniques and important discoveries in immunology have produced an improved understanding of these conditions and classification. Neuroimaging plays a central role in the accurate diagnosis, prognosis, disease monitoring and research efforts that are being undertaken in this disease. This review focuses on the imaging spectrum of acquired demyelinating disease.
Cutaneous Infections in Wrestlers
Authors: Wilson Eugene K. , deWeber Kevin , Berry James W. , Wilckens John H.
Published: March 2013

Context:

Cutaneous infections are common in wrestlers. Although many are simply a nuisance in the everyday population, they can be problematic to wrestlers because such infections may result in disqualification from practice or competition. Prompt diagnosis and treatment are therefore important.

Evidence Acquisition:

Medline and PubMed databases, the Cochrane Database of Systematic Reviews, and UpToDate were searched through 2012 with the following keywords in various combinations: skin infections, cutaneous infections, wrestlers, athletes, methicillin-resistant Staphylococcus aureus, skin and soft tissue infections, tinea corporis, tinea capitis, herpes simplex, varicella zoster, molluscum contagiosum, verruca vulgaris, warts, scabies, and pediculosis. Relevant articles found in the primary search, and selected references from those articles were reviewed for pertinent clinical information.

Results:

The most commonly reported cutaneous infections in wrestlers are herpes simplex virus infections (herpes gladiatorum), bacterial skin and soft tissue infections, and dermatophyte infections (tinea gladiatorum). The clinical appearance of these infections can be different in wrestlers than in the community at large.

Conclusion:

For most cutaneous infections, diagnosis and management options in wrestlers are similar to those in the community at large. With atypical presentations, testing methods are recommended to confirm the diagnosis of herpes gladiatorum and tinea gladiatorum. There is evidence to support the use of prophylactic medications to prevent recurrence of herpes simplex virus and reduce the incidence of dermatophyte infections in wrestlers.
Core Stability Training for Injury Prevention
Authors: Huxel Bliven Kellie C. , Anderson Barton E.
Published: March 2013

Context:

Enhancing core stability through exercise is common to musculoskeletal injury prevention programs. Definitive evidence demonstrating an association between core instability and injury is lacking; however, multifaceted prevention programs including core stabilization exercises appear to be effective at reducing lower extremity injury rates.

Evidence Acquisition:

PubMed was searched for epidemiologic, biomechanic, and clinical studies of core stability for injury prevention (keywords: “core OR trunk” AND “training OR prevention OR exercise OR rehabilitation” AND “risk OR prevalence”) published between January 1980 and October 2012. Articles with relevance to core stability risk factors, assessment, and training were reviewed. Relevant sources from articles were also retrieved and reviewed.

Results:

Stabilizer, mobilizer, and load transfer core muscles assist in understanding injury risk, assessing core muscle function, and developing injury prevention programs. Moderate evidence of alterations in core muscle recruitment and injury risk exists. Assessment tools to identify deficits in volitional muscle contraction, isometric muscle endurance, stabilization, and movement patterns are available. Exercise programs to improve core stability should focus on muscle activation, neuromuscular control, static stabilization, and dynamic stability.

Conclusion:

Core stabilization relies on instantaneous integration among passive, active, and neural control subsystems. Core muscles are often categorized functionally on the basis of stabilizing or mobilizing roles. Neuromuscular control is critical in coordinating this complex system for dynamic stabilization. Comprehensive assessment and training require a multifaceted approach to address core muscle strength, endurance, and recruitment requirements for functional demands associated with daily activities, exercise, and sport.
Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications
Authors: Heidelbaugh Joel J.
Published: March 2013

Proton pump inhibitors (PPIs) remain the superior choice worldwide in antisecretory therapy in the evidence-based treatment of upper gastrointestinal disorders including gastroesophageal reflux disease, erosive esophagitis, dyspepsia and peptic ulcer disease. PPI overutilization in ambulatory care settings is often a result of failure to re-evaluate the need for continuation of therapy, or insufficient use of on-demand and step-down therapy. Nonjudicious use of PPIs creates both preventable financial as well as medical concerns. PPIs have been associated with an increased risk of vitamin and mineral deficiencies impacting vitamin B12, vitamin C, calcium, iron and magnesium metabolism. While these risks are considered to be relatively low in the general population, they may be notable in elderly and malnourished patients, as well as those on chronic hemodialysis and concomitant PPI therapy. No current evidence recommends routine screening or supplementation for these potential vitamin and mineral deficiencies in patients on either short- or long-term PPI therapy. Reducing inappropriate prescribing of PPIs can minimize the potential risk of vitamin and mineral deficiencies.
Flexible cysto-urethroscopy findings in young adults investigated for lower urinary tract symptoms, urinary tract infection and haematuria
Authors: Robinson Richard , Lowe Chris , Mokete Moeketsi
Published: March 2013

Diagnostic flexible cysto-urethroscopy (FC) is widely performed to investigate a variety of symptoms, including haematuria, lower urinary tract symptoms (LUTS) and urinary tract infections (UTIs). The purpose of this study was to examine if FC provides useful diagnostic information in young patients investigated for urological symptoms. All patients under the age of 40 years who underwent FC in a single institution over a 12-month period from April 2009 were identified. Electronic records and case notes were then examined. A total of 270 procedures were performed in the study period. Sixty were excluded and data were unavailable in 28. Of the remaining 182, the median age was 31 and 53.8% were male. UTI was the most common indication for the procedure. Abnormalities were found at FC in only seven patients (3.8%), comprising strictures in three and inflammation in four. Of the 63 patients in whom UTI was the sole indication for performing an FC, a single stricture was the only abnormal finding. One hundred and forty (76.9%) patients underwent upper urinary tract imaging, with abnormalities present in 7.9%. This study has demonstrated a very low detection rate of clinically significant disease in patients under the age of 40 years undergoing FC for the investigation of haematuria, LUTS and UTI. We propose that before FC is used in younger patients, careful thought be given to whether it is absolutely necessary and to whether non-invasive tests may allow FC to be avoided altogether.
A critical role for the retinoic acid signaling pathway in the pathophysiology of gastrointestinal graft-versus-host disease
Authors: Chen Xiao , Dodge Joseph , Komorowski Richard , Drobyski William R.
Published: March 2013

Key Points

RA regulates donor T-cell trafficking during GVHD. The RA receptor-α signaling pathway plays a critical role in the pathophysiology of GVHD.
The C-type lectin receptor CLEC4M binds, internalizes, and clears von Willebrand factor and contributes to the variation in plasma von Willebrand factor levels
Authors: Rydz Natalia , Swystun Laura L. , Notley Colleen , Paterson Andrew D. , Riches J. Jacob , Sponagle Kate , Boonyawat Boonchai , Montgomery Robert R. , James Paula D. , Lillicrap David
Published: March 2013

Key Points

CLEC4M plays a role in the clearance of VWF. CLEC4M polymorphisms contribute to the genetic variability of VWF plasma levels.
White cell count and platelet count associate with histological alcoholic hepatitis in jaundiced harmful drinkers
Authors: Hardy Timothy , Wells Christopher , Kendrick Stuart , Hudson Mark , Day Christopher P , Burt Alastair D , Masson Steven , Stewart Stephen F
Published: March 2013

Background

Patients with suspected alcoholic hepatitis and a Discriminant Function ≥32 underwent liver biopsy to confirm the diagnosis. Of these (n = 58), 43 had histological features of alcoholic hepatitis and 15 (25%) did not.

We aimed to determine the laboratory features that differentiated those patients with a histological diagnosis of alcoholic hepatitis from those without, and assess potential clinical utility.

Methods

Laboratory investigations at presentation for each of the histologically confirmed cases of alcoholic hepatitis (n = 43) were compared to those without (n = 15) to determine whether there were differences between the two groups. Univariate analysis was by Mann Whitney U Test and Multivariate analysis was by a stepwise approach.

Results

White cell count (16.2 ± 10.5 v 6.9 ± 3.5 (× 109/L); p = 0.0001) and platelet count (178 ± 81 v 98.4 ± 43 (× 109/L); p = 0.0005) were higher in the patients with histological features of alcoholic hepatitis than in those without. The area under the ROC curve for AH diagnosis was estimated to be 0.83 (0.73, 0.94) and 0.81 (0.69, 0.93) for white cell count and platelet count respectively.

Conclusions

Clinicians cannot accurately differentiate patients with or without alcoholic hepatitis without liver biopsy. This is critically important when deciding on specific therapies such as corticosteroids or when interpreting data from future trials in which biopsy is not mandated. In situations where liver biopsy is unsuitable or unavailable the white cell and platelet counts can be used to determine the likelihood of histological alcoholic hepatitis and guide treatment.
When the chimney is blocked: malignant renovascular hypertension after endovascular repair of abdominal aortic aneurysm
Authors: Gal-Oz Amir , Wolf Yehuda G , Rosen Galia , Sharon Haggai , Schwartz Idit F , Chernin Gil
Published: March 2013

Background

The Chimney graft (CG) procedure is one of the novel modification techniques of the endovascular aneurysm repair (EVAR) surgery to treat suprarenal and juxtarenal abdominal aortic aneurysms. Other indications for the use of CG placement include thoracic and thoracoabdominal aneurysms with supraortic branches orifice involvement and cases of common iliac artery aneurysms with or without internal iliac artery involvement. The technique is used in patients who due to aortic-neck morphology and lack of adequate fixation and/or sealing zones are not eligible for standard EVAR. In this procedure, a parallel stent-graft is placed adjacent to the main body of the aortic endograft to maintain blood supply to renovisceral or supraortic branches, once the body of the aortic stent-graft is deployed. Symptomatic occlusions of the CG with novel renovascular hypertension were not described until now.

Case presentation

A-64-year-old male patient, presented with new-onset malignant hypertension, 13 months after an EVAR operation with CG placement to the left renal artery. The patient was on preventive clopidrogel therapy, which was withheld temporarily for several days, one month before presentation. Imaging studies revealed a novel form of iatrogenic renovascular hypertension, caused by occlusion of the CG. Any attempt to recanalize the covered stent or revascularize the left kidney was rejected and conservative treatment was chosen. Seven months after presentation, blood pressure was within normal ranges with little need for antihypertensive therapy.

Conclusions

Physicians should be aware that the novel emerging techniques of EVAR to overcome the limitations of the aortic-neck anatomy may still adversely influence the renal outcome with potential development of new-onset hypertension.
The association between social relationships and self-harm: a case–control study in Taiwan
Authors: Wu Chia-Yi , Chang Chin-Kuo , Huang Hui-Chun , Liu Shen-Ing , Stewart Robert
Published: March 2013

Background

Although suicide has been postulated as a result of social breakdown, relatively little attention has been paid to the association between social relationships and non-fatal self-harm. We sought to investigate the extent to which social factors correlate with self-harm in this case–control study.

Methods

The primary outcome was self-harm with hospital presentation. Cases of self-harm from the Emergency Department in a general hospital in Northern Taiwan were recruited, and individually age-and-gender-matched control participants were recruited from non-psychiatric outpatient clinics at the same hospital. The Close Persons Questionnaire was administered and its social support and social network subscales were used to measure social relationships in the 12 months prior to the interview. Other covariates, comprising sociodemographic factors, major life events, physical and mental health, were adjusted in conditional logistic regression models.

Results

A total of 124 case–control pairs were recruited. The mean (standard deviation) age of the case group was 34.7 (12.8) years and 80.6% were female. Higher social isolation score remained significantly associated with self-harm after adjustment (adjusted odds ratio per standard deviation increase 2.92, 95% confidence interval 1.44-5.95) and household size was negatively associated with the outcome (adjusted odds ratio per unit increase 0.54, 95% CI 0.32-0.94).

Conclusions

More limited social networks were associated with self-harm after adjustment for potential confounders. Enhancing social structure and effective networking of people with self-harm to community resources may be important for self-harm management in Asian societies and elsewhere.
Trans-packaging of human immunodeficiency virus type 1 genome into Gag virus-like particles in Saccharomyces cerevisiae
Authors: Tomo Naoki , Goto Toshiyuki , Morikawa Yuko
Published: March 2013

Background

Yeast is recognized as a generally safe microorganism and is utilized for the production of pharmaceutical products, including vaccines. We previously showed that expression of human immunodeficiency virus type 1 (HIV-1) Gag protein in Saccharomyces cerevisiae spheroplasts released Gag virus-like particles (VLPs) extracellularly, suggesting that the production system could be used in vaccine development. In this study, we further establish HIV-1 genome packaging into Gag VLPs in a yeast cell system.

Results

The nearly full-length HIV-1 genome containing the entire 5′ long terminal repeat, U3-R-U5, did not transcribe gag mRNA in yeast. Co-expression of HIV-1 Tat, a transcription activator, did not support the transcription. When the HIV-1 promoter U3 was replaced with the promoter for the yeast glyceraldehyde-3-phosphate dehydrogenase gene, gag mRNA transcription was restored, but no Gag protein expression was observed. Co-expression of HIV-1 Rev, a factor that facilitates nuclear export of gag mRNA, did not support the protein synthesis. Progressive deletions of R-U5 and its downstream stem-loop-rich region (SL) to the gag start ATG codon restored Gag protein expression, suggesting that a highly structured noncoding RNA generated from the R-U5-SL region had an inhibitory effect on gag mRNA translation. When a plasmid containing the HIV-1 genome with the R-U5-SL region was coexpressed with an expression plasmid for Gag protein, the HIV-1 genomic RNA was transcribed and incorporated into Gag VLPs formed by Gag protein assembly, indicative of the trans-packaging of HIV-1 genomic RNA into Gag VLPs in a yeast cell system. The concentration of HIV-1 genomic RNA in Gag VLPs released from yeast was approximately 500-fold higher than that in yeast cytoplasm. The deletion of R-U5 to the gag gene resulted in the failure of HIV-1 RNA packaging into Gag VLPs, indicating that the packaging signal of HIV-1 genomic RNA present in the R-U5 to gag region functions similarly in yeast cells.

Conclusions

Our data indicate that selective trans-packaging of HIV-1 genomic RNA into Gag VLPs occurs in a yeast cell system, analogous to a mammalian cell system, suggesting that yeast may provide an alternative packaging system for lentiviral RNA.
C-reactive protein/oxidised low-density lipoprotein/β2-glycoprotein I complex promotes atherosclerosis in diabetic BALB/c mice via p38mitogen-activated protein kinase signal pathway
Authors: Zhang Rui , Zhou Sai-Jun , Li Chun-Jun , Wang Xiao-Nan , Tang Yun-Zhao , Chen Rui , Lv Lin , Zhao Qian , Xing Qiu-Ling , Yu De-Min , Yu Pei
Published: March 2013

Background

The aim of this study was to investigate the effect of C-reactive protein/oxidised low-density lipoprotein/β2-glycoprotein I (CRP/oxLDL/β2GPI) complex on atherosclerosis (AS) in diabetic BALB/c mice.

Methods

BALB/c mice were fed high-fat and normal diet. Eight weeks later, the mice fed with high-fat diet were injected with streptozotocin (STZ) to induce diabetes. The diabetic mice were respectively injected twice monthly with 20 μg oxLDL, 20 μg β2GPI, 40 μg oxLDL/β2GPI complex, 44 μg CRP/oxLDL/β2GPI complex, and PBS. Aortas were stained with Sudan IV to investigate lipid plaque formation. The infiltration condition of smooth muscle cells (SMCs), macrophages, and T cells in the aortas were determined by immunohistochemistry (IH). The mRNA expressions of receptors associated with lipid metabolism were quantified by real-time PCR. The phosphorylation of p38 mitogen-activated protein kinase (p38MAPK) and MKK3/6 in aorta tissues were assessed by Western blot. The expression of inflammation cytokines was evaluated by protein chip.

Results

The lipid plaques were more extensive, the lumen area was obviously narrower, the ratio of intima and media thickness were increased, and the normal internal elastic lamia structure and endothelial cell disappeared (P < 0.05) in the oxLDL and CRP/oxLDL/β2GPI groups (P < 0.05). CRP/oxLDL/β2GPI complex dramatically promoted infiltration of SMCs, macrophages, and T cells, improved the mRNA expression of ABCA1 and ABCG1, but reduced the mRNA expression of SR-BI and CD36 and increased the phosphorylation of p38MAPK and MKK3/6 (all P < 0.05). The highest expression levels of IL-1, IL-9, PF-4, bFGF, and IGF-II were detected in the CRP/oxLDL/β2GPI group (P < 0.05).

Conclusions

CRP/oxLDL/β2GPI complex aggravated AS in diabetic BALB/c mice by increasing lipid uptake, the mechanism of which may be mediated by the p38MAPK signal pathway.