bluuebunny/crossref_metadata_2025 huggingface dataset:
An unusual cause of overt gastrointestinal bleeding in a malnourished child
Authors: Zanwar Vinay G , Pawar Sunil V , Jain Samit S , Rathi Surabhi P , Contractor Qais Q , Rathi Pravin M
Published: August 2015

Trichuris trichiura ( T. Trichiura) is a known parasite infestation among tropical children. Humans acquire Trichuriasis infection after ingestion of embryonated eggs via contaminated food or water. Most of them are asymptomatic. A severe form of trichuris infestation is known as Trichuris dysentery syndrome (TDS). It manifests as mucous diarrhoea, bleeding, malnutrition and stunting, or even life-threatening anaemia. We are reporting an interesting case of a 7-year-old girl who presented with bloody diarrhoea for 2 years. Her growth was stunted as she was not gaining weight. Severe inflammatory bowel disease was suspected clinically. Physical examination revealed marked pallor, pedal oedema and koilonychia along with sparse and hypopigmented hair. On evaluation T. Trichiura helminths were seen on stool examination and massive worm load was visualised directly on colonoscopy. A diagnosis of TDS was made. She was successfully treated with oral Albendazole (400 mg) and blood transfusion.
Efficacy and safety of pregabalin in generalised anxiety disorder: A critical review of the literature
Authors: Baldwin David S , den Boer Johan A , Lyndon Gavin , Emir Birol , Schweizer Edward , Haswell Hannah
Published: August 2015

The aim of this review is to summarise the literature on the efficacy and safety of pregabalin for the treatment of generalised anxiety disorder (GAD). Of 241 literature citations, 13 clinical trials were identified that were specifically designed to evaluate the efficacy and safety of pregabalin in GAD, including 11 randomised double-blind trials and two open-label studies. Pregabalin efficacy has been consistently demonstrated across the licensed dose range of 150–600 mg/day. Efficacy has been reported for pregabalin monotherapy in elderly patients with GAD, patients with severe anxiety, and for adjunctive therapy when added to a selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitor in patients who have failed to respond to an initial course of antidepressant therapy. The two most common adverse events with pregabalin are somnolence and dizziness, both of which appear to be dose-related. Pregabalin appears to have a low potential for causing withdrawal symptoms when long-term therapy is discontinued; however, tapering over the course of at least one week is recommended. A review of available evidence indicates that pregabalin is a well-tolerated and consistently effective treatment for GAD, with a unique mechanism of action that makes it a useful addition to the therapeutic armamentarium.
Carbon nanotubes as non-contact optical strain sensors in smart skins
Authors: Sun Peng , Bachilo Sergei M , Weisman R Bruce , Nagarajaiah Satish
Published: August 2015

Progress is reported in the development of a novel non-contact strain measurement technology in which the sensors are single-walled carbon nanotubes. This approach exploits the characteristic short-wave infrared fluorescence signatures of semiconducting single-walled carbon nanotubes and the systematic shifts of their fluorescence wavelengths when the nanotubes are axially strained. A strain-sensing smart skin is prepared by coating the surface to be monitored with a thin film of a composite containing well-dispersed single-walled carbon nanotubes embedded in a urethane varnish host. Strain in the surface transfers through the host polymer to the embedded nanotubes. The nanotube strains are then quantitatively monitored by exciting the region of interest with a visible laser beam and capturing and analyzing the resulting single-walled carbon nanotube fluorescence spectrum. High-quality spectra are shown for strain-sensing smart skin films in which the nanotubes were pre-processed by selective extraction with the organic polymer poly(9,9-dioctylfluorenyl-2,7-diyl) and purification by centrifugation. The design of a compact, field-portable optical system for exciting, collecting, and interpreting strain-sensing smart skin spectral data is also described. This system is used to validate the linear dependence of peak shifts with strain in test specimens subjected to multiple tension cycles inducing strains from 0 to 5000 µε. Adequate linearity is found up to 1500 µε; however, minor hysteresis is observed above this level. The gage length for these measurements can be as small as several micrometers, and the strain resolution is currently between 10 and 100 µε (depending on strain magnitude). Cyclic reversible strain measurements are demonstrated, with minor hysteresis being attributed to imperfect adhesion between nanotube sidewalls and the surrounding polymer host.
Tailored star poly (ε-caprolactone) wet-spun scaffolds for in vivo regeneration of long bone critical size defects
Authors: Dini Francesca , Barsotti Giovanni , Puppi Dario , Coli Alessandra , Briganti Angela , Giannessi Elisabetta , Miragliotta Vincenzo , Mota Carlos , Pirosa Alessandro , Stornelli Maria R , Gabellieri Paolo , Carlucci Fabio , Chiellini Federica
Published: August 2015

One of the most challenging requirements of a successful bone tissue engineering approach is the development of scaffolds specifically tailored to individual tissue defects. Besides materials chemistry, well-defined scaffold’s structural features at the micro- and macro-levels are needed for optimal bone in-growth. In this study, polymeric fibrous scaffolds with a controlled internal network of pores and modelled on the anatomical shape and dimensions of a critical size bone defect in a rabbit’s radius model were developed by employing a computer-aided wet-spinning technique. The tailored scaffolds made of star poly(ε-caprolactone) or star poly(ε-caprolactone)–hydroxyapatite composite material were implanted into 20-mm segmental defects created in radial diaphysis of New Zealand white rabbits. Bone regeneration and tissue response were assessed by X-rays and histological analysis at 4, 8 and 12 weeks after surgery. No signs of macroscopic and microscopic inflammatory reactions were detected, and the developed scaffolds showed a good ability to support and promote the bone regeneration process. However, no significant differences in osteoconductivity were observed between star poly(ε-caprolactone) and star poly(ε-caprolactone)–hydroxyapatite scaffolds. Long-term study on implanted star poly(ε-caprolactone) scaffolds confirmed the presence of signs of bone regeneration and remodelling, particularly evident at 24 weeks.
Development and Use of the Leisure Activities Finder™
Authors: Greene Jennifer A. , Kovacs Amy M. , Messer Melissa A.
Published: August 2015

John Holland’s RIASEC theory of workplace personality posits that most people resemble a combination of six personality types. The Self-Directed Search® provides the user with a Summary Code that represents the three personality types to which they are most similar. The Leisure Activities Finder™ (LAF) includes a listing of leisure activities, with corresponding codes, which allows users to search for activities that match their Summary Code. During a recent revision of the LAF, the authors developed a list of new activities to be included and assigned codes to them. In a validation study, participants rated activities corresponding to their Summary Code and corresponding to their opposite code. Overall, they rated activities corresponding to their code to be relatable and interesting. Implications for career counseling are discussed, as well as the potential for use of the LAF across the life span.
What is dignity in prehospital emergency care?
Authors: Abelsson Anna , Lindwall Lillemor
Published: August 2015

Background:

Ethics and dignity in prehospital emergency care are important due to vulnerability and suffering. Patients can lose control of their body and encounter unfamiliar faces in an emergency situation.

Objective:

To describe what specialist ambulance nurse students experienced as preserved and humiliated dignity in prehospital emergency care.

Research design:

The study had a qualitative approach.

Method:

Data were collected by Flanagan’s critical incident technique. The participants were 26 specialist ambulance nurse students who described two critical incidents of preserved and humiliated dignity, from prehospital emergency care. Data consist of 52 critical incidents and were analyzed with interpretive content analysis.

Ethical considerations:

The study followed the ethical principles in accordance with the Declaration of Helsinki.

Findings:

The result showed how human dignity in prehospital emergency care can be preserved by the ambulance nurse being there for the patient. The ambulance nurses meet the patient in the patient’s world and make professional decisions. The ambulance nurse respects the patient’s will and protects the patient’s body from the gaze of others. Humiliated dignity was described through the ambulance nurse abandoning the patient and by healthcare professionals failing, disrespecting, and ignoring the patient.

Discussion:

It is a unique situation when a nurse meets a patient face to face in a critical life or death moment. The discussion describes courage and the ethical vision to see another human.

Conclusion:

Dignity was preserved when the ambulance nurse showed respect and protected the patient in prehospital emergency care. The ambulance nurse students’ ethical obligation results in the courage to see when a patient’s dignity is in jeopardy of being humiliated. Humiliated dignity occurs when patients are ignored and left unprotected. This ethical dilemma affects the ambulance nurse students badly due to the fact that the morals and attitudes of ambulance nurses are reflected in their actions toward the patient.
The Symptoms Prevalence, Medical Interventions, and Health Care Service Needs for Patients With End-Stage Renal Disease in a Renal Palliative Care Program
Authors: Kwok Annie O. , Yuen Sze-kit , Yong David S. , Tse Doris M.
Published: August 2015

A retrospective study was conducted to evaluate the symptoms prevalence and interventions initiated in the last 2 weeks of life, health care service utilization, and causes of death of patients with end-stage renal disease (ESRD under a renal palliative care (RPC) program. A total of 335 RPC patients were included, of which 226 patients died during the study period. The 5 most prevalent symptoms were dyspnea (63.7%), fatigue (51.8%), edema (48.2%), pain (44.2%), and anorexia (38.1%); and the 5 most prevalent interventions initiated were oxygen (69.5%), parenteral infusion (67.3%), antibiotics (53.5%), bladder catheterization (44.7%), and analgesic (39.8%) in the last 2 weeks of life. Each patient received 3.5 ± 4.4 outpatient clinic visit, 3.4 ± 10.3 home care visits, and 3.1 ± 2.7 hospital admissions. Besides ESRD (51.8%), the most common causes of death were cardiovascular events (18.6%) and infection (17.2%).
Examining the Preliminary Efficacy of a Dating Violence Prevention Program for Hispanic Adolescents
Authors: Gonzalez-Guarda Rosa Maria , Guerra Jessica E. , Cummings Amanda A. , Pino Karen , Becerra Maria M.
Published: August 2015

The purpose of this study is to evaluate the preliminary efficacy of a dating violence (DV) prevention program for Cuban American adolescents ( JOVEN/YOUTH: Juntos Opuestos a la Violence Entre Novios/Together Against Dating Violence). A randomized-controlled experimental design with a delayed condition was used to evaluate the effects on DV victimization and perpetration ( N = 82). Self-administrated assessments were completed at baseline, 1 week, 3 months, and 12 months after the intervention to assess for psychological victimization and perpetration and physical and sexual victimization and perpetration. Effect sizes were estimated, and generalized estimating equations were generated to test intervention effects over time and potential gender interactions. The intervention had medium to strong effects on DV victimization and perpetration for male participants but not for females. However, intervention effects were not statistically significant over time. More research is needed to enhance intervention effects of JOVEN on DV outcomes and to evaluate these effects among a larger and more diverse sample.
Impact of a Multidisciplinary Heart Failure Post-hospitalization Program on Heart Failure Readmission Rates
Authors: Jackevicius Cynthia A. , de Leon Noelle K. , Lu Lingyun , Chang Donald S. , Warner Alberta L. , Mody Freny Vaghaiwalla
Published: August 2015

Background: Specialized chronic heart failure (HF) clinics have demonstrated significant reductions in readmissions. Limited evidence is available regarding HF clinics in the immediate post-discharge period. Objective: To evaluate the effect of a multidisciplinary HF clinic on 90-day readmission rates and all-cause mortality in those recently discharged from a HF hospitalization. Methods: In this retrospective cohort study, patients discharged with a primary HF diagnosis who attended the HF postdischarge clinic in 2010-2012 were compared with controls from 2009. During 6 clinic visits, patients were seen by a physician assistant, clinical pharmacist specialist, and case manager, with care overseen by a cardiologist. The program focused on optimizing therapy, identifying HF etiology/precipitating factors, medication titration, education, and medication adherence. The primary outcome was 90-day HF readmission. A multivariate Cox proportional hazards model was used to compare outcomes. Results: Among the 277 patients (144 clinic, 133 control) in the study, 7.6% of patients in the clinic and 23.3% of patients in the control group were readmitted for HF within 90 days (aHR (adjusted hazard ratio) = 0.17; 95% CI = 0.07-0.41; P < 0.001; ARR (absolute risk reduction) = 15.7%; NNT (number needed to treat) = 7). Clinic patients had lower 90-day time-to-first HF readmission or all-cause mortality (9.0% vs 28.6%; aHR = 0.28; 95% CI = 0.06-0.31; P < 0.001; ARR = 19.6%; NNT = 6). Conclusions: The multidisciplinary HF posthospitalization outpatient program was associated with a significant reduction in 90-day HF readmissions in patients who were recently discharged from a HF hospitalization.
Cutaneous Squamous Cell Carcinomas of the Lower Extremities Show Distinct Clinical and Pathologic Features
Authors: Solus Jason F. , Murphy George F. , Kraft Stefan
Published: August 2015

Cutaneous squamous cell carcinomas mainly affect older, predominantly male patients. Most are due to chronic ultraviolet exposure, and associated with actinic keratoses. On the lower extremities, they occur more commonly in women. However, data on these tumors as a distinct group are scarce. We evaluated 61 squamous cell carcinomas of the lower extremities. Overall, 69% of patients were female. Mean age was 75 years. More than 90% of tumors were well differentiated, 3% showed perineural invasion, and none lymphovascular invasion. In all, 63.9% showed evidence of severe chronic sun damage. Associated actinic keratoses were identified in only 13% of cases. By contrast, 80% were associated with distinctive basal epidermal proliferations with a retiform growth pattern. These proliferations were evaluated immunohistochemically for keratinocyte stem cell markers, p53 and Notch1 in 15 cases. All cases were positive for cytokeratin 14, p53, and Notch1 (with variable intensity in the latter 2), and predominantly negative for cytokeratin 19. Interestingly, basal retiform proliferations were positive for cytokeratin 15 in 66% of cases. Fifteen head and neck squamous cell carcinomas were evaluated in comparison. Those lacked associated basal retiform proliferations except in 1 case. In contrast, 87% were associated with actinic keratoses and 100% with severe chronic sun damage. Actinic keratoses associated with head and neck tumors showed cytokeratin 15 staining only in 7% of cases ( P = .003 compared with cytokeratin 15 in basal retiform proliferations associated with leg carcinomas). These findings support the hypothesis that lower extremity squamous cell carcinomas are distinct and may exhibit a pathogenesis less reliant on actinic damage.
Thrombin Generation Assay in Hospitalized Nonsurgical Patients
Authors: Espitia Olivier , Fouassier Marc , Hardouin Jean-Benoît , Pistorius Marc-Antoine , Agard Christian , Planchon Bernard , Trossaert Marc , Pottier Pierre
Published: August 2015

Background:

Assessment of venous thromboembolism (VTE) risk is important to determine optimal primary prophylaxis in hospitalized patients. The Padua score helps to recognize patients with high VTE risk, but quantifying a VTE risk is often challenging in medical patients. Thrombin generation assay (TGA) reflects the pro-/anticoagulant balance and thus could help to better quantify VTE risk in medical hospitalized patients.

Aim:

To analyze the relation between TGA and VTE risk according to Padua score in medical hospitalized patients.

Methods:

Between May and October 2013, 105 patients were included in an unselected cohort group of patients admitted to an internal medicine department in a large, university hospital. Within the 36 hours after admission and before any anticoagulant therapy, Padua score was calculated and sample for TGA was collected for each patient. Thrombin generation assay (velocity, peak, and endogenous thrombin potential [ETP]) was performed with 1 and 5 picomol/l (pM) tissue factor (TF) reagent.

Results:

In patients with high Padua score (n = 29), velocity, peak, and ETP differed from patients with low Padua score. This difference was present at 1 and 5 pM TF, in ETP ( P < .0001 and P = .003 respectively), in peak ( P < .0001 in both conditions), and in velocity ( P < .0001). According to multivariate analysis, myeloid disorders, older age, higher body mass index, myocardial infarction, C-reactive protein >5 mg/L, reduced mobility with bed rest significantly increased velocity 1 pM TF value.

Conclusion:

Single thrombin generation measurement could help to identify patients at risk of VTE in medical hospitalized patients.
Value orientations of student physical education teachers learning to teach on school-based initial teacher education courses in England
Authors: Capel Susan
Published: August 2015

There has been considerable interest in the socialisation of (student) physical education (PE) teachers, the beliefs and values developed as a result of this socialisation and the impact of these on teachers’ learning, behaviours and practices and the curriculum. Many studies looking at the beliefs and values of PE teachers have used the values orientation instrument (VOI). However, as far as we know, in England there has only been one study using the VOI to study the value orientations of PE teachers and none which has studied the value orientations of student PE teachers. Therefore, the purpose of this study was to look at the value orientations of secondary student PE teachers learning to teach in England. Two hundred and seventy two student PE teachers studying on both one year postgraduate certificate of education and four year undergraduate PE initial teacher education (ITE) courses at four universities in England completed the revised VOI (VOI-2) once during the academic year. Means and standard deviations were used to calculate the score for each value orientation across the whole sample, Pearson product–moment correlation coefficients were computed to determine the relationships between value orientations and one way analysis of variance tests were used to test for any differences between the groups according to gender and course/year on course for undergraduate student PE teachers. Results showed some variability in the value orientations given highest and lowest priority by different groups of student PE teachers in this study. However, with a few exceptions, learning process, ecological integration and self-actualisation were consistently given highest priority, whilst social responsibility and disciplinary mastery were consistently given lowest priority. There were some relationships between value orientations, but the only difference between groups was between male and female student PE teachers on learning process. Results are compared to the results of a similar study in England, and discussed in relation to possible reasons for the results, practical implications for meeting the aims and outcomes of the PE curriculum and for student PE teachers’ development on ITE courses and into their induction year.
Anthropometric trends and the risk of cardiovascular disease mortality in a Lithuanian urban population aged 45–64 years
Authors: Luksiene Dalia , Tamosiunas Abdonas , Virviciute Dalia , Bernotiene Gailute , Peasey Anne
Published: August 2015

Aims: To estimate trends in anthropometric indexes from 1992 to 2008 and to evaluate the risk of cardiovascular disease mortality in relation to anthropometric indexes (body mass index, waist circumference, waist:hip ratio, waist:height ratio). Methods: Data from the three surveys (1992–2008) are presented. A random sample of 5147 subjects aged 45–64 years was selected for statistical analysis. During follow-up there were 141 deaths from cardiovascular disease (excluding those with cardiovascular disease at entry). Cox’s regression was used to estimate the associations between anthropometric indexes and cardiovascular disease mortality. Results: During a 17-year period among men, the prevalence of obesity (body mass index ⩾30 kg/m2) increased from 18.4% to 32.1% ( p<0.001) and a high level of waist:hip ratio (>0.9) from 59.3% to 72.9% ( p<0.001). The risk profile of obesity did not change in women, but prevalence of a high level of waist:hip ratio (>0.85) increased from 25.9% to 41.5% ( p<0.001). Multivariable-adjusted Cox’s regression models showed that body mass index, waist circumference, waist:hip ratio, waist:height ratio were associated with cardiovascular disease mortality risk only in men (hazard ratios 1.40, 1.45, 1.49, 1.46 respectively ( p<0.01)). Conclusions: Our data indicate that anthropometric measures such as body mass index, waist circumference, waist:hip ratio and waist:height ratio are good indicators of cardiovascular disease mortality risk only in men aged 45–64 years.
Why did life expectancy in Central and Eastern Europe suddenly improve in the 1990s? An analysis by cause of death
Authors: Mackenbach Johan P. , Karanikolos Marina , Lopez Bernal Jamie , Mckee Martin
Published: August 2015

Background: The upturn of life expectancy in Central and Eastern Europe in the 1990s, after a period of stagnation or even decline, is one of the main events in European population history of the late 20th century, but has not been satisfactorily explained. Data and methods: Turning points in total and cause-specific mortality in the Czech Republic, Bulgaria, Hungary, Poland, Romania and Slovakia were determined using joinpoint regression. Changes in life expectancy in the 10 years following country-specific turning points were decomposed by age and cause of death using Arriaga’s method. Results: Among men, the turning points for all-cause mortality coincided with those for ischaemic heart disease in all six countries, and sometimes also with those for liver cirrhosis, road traffic accidents and lung cancer. Among women, the pattern was more diffuse. In the 10 years since the turning point for all-cause mortality, life expectancy increased by around four years for men and three years for women in most countries. Declines in mortality from cardiovascular disease explain between a third and a half of the increase in life expectancy in all countries, but beyond this the contributing causes of death often varied considerably. Conclusions: Although the upturn of life expectancy in Central and Eastern Europe started at different points in time, improvements in prevention and/or treatment of ischaemic heart disease appear to have played a role in all six countries. Other factors, such as changes in alcohol consumption and road traffic safety, have, however, also made important contributions in some countries.
How does joint procurement affect the design, customisation and usability of a hospital ePrescribing system?
Authors: Lee Lisa , Williams Robin , Sheikh Aziz
Published: August 2015

The aim of this article is to explore the effect of the joint procurement model adopted during the English National Programme for Information Technology (NPfIT) on the customisation, design and usability of a hospital ePrescribing system. Drawing on qualitative data collected at two case study sites deploying an ePrescribing system jointly procured within one of the NPfIT’s geographical clusters, we explain how procurement decisions, difficult relationships with the supplier and strict contractual arrangements contributed to usability issues and difficulties in the customisation process. While some limited change requests made by users were taken up by the developers, these were seen by users as insufficient to meet local clinical needs and practices. A joint procurement approach, such as the NPfIT, thus limited the opportunity and scope of the changes to the ePrescribing system, which impinged not only on the perceived success of the implementation but also on the system’s usability.
Dynamic parameters’ identification for the feeding system of computer numerical control machine tools stimulated by G-code
Authors: Chen Guangsheng , Zhu Shuai , Zheng Qingzhen
Published: August 2015

This study proposed a dynamic parameters’ identification method for the feeding system of computer numerical control machine tools based on internal sensor. A simplified control model and linear identification model of the feeding system were established, in which the input and output signals are from sensors embedded in computer numerical control machine tools, and the dynamic parameters of the feeding system, including the equivalent inertia, equivalent damping, worktable damping, and the overall stiffness of the mechanical system, were solved by the least square method. Using the high-order Taylor expansion, the nonlinear Stribeck friction model was linearized and the parameters of the Stribeck friction model were obtained by the same way. To verify the validity and effectiveness of the identification method, identification experiments, circular motion testing, and simulations were conducted. The results obtained were stable and suggested that inertia and damping identification experiments converged fast. Stiffness identification experiments showed some deviation from simulation due to the influences of geometric error and nonlinear of stiffness. However, the identification results were still of reference significance and the method is convenient, effective, and suited for industrial condition.
Risk assessment of fuel quantity indicator replacement in ATR 72 aircraft
Authors: Marretta Rosario M Ardito , Bedson John A Drew
Published: August 2015

Aircraft maintenance activities are rife with opportunities for error. The concurrent in-flight failure of all of the engines of a non-scheduled airline flight and the following list of human lives highlight one of these opportunities. As commonly recognized among flight operators, each flight safety agency follows the criteria of the International Civil Aviation Organization Annex 16 in which all the evidences of the technical investigation pave the way for avoiding future flight accidents or incidents. On the other hand, when the Italian penal procedure code was applied for the Tuninter aircraft ATR 72 (identification code TS-LBB) crash at issue on 6 August 2005 near Palermo (Italy), the investigation is also carried out for finding (if concurrent or not) the personal and professional responsibilities. This was the task of the first author (R.M.A.M.). Now, this article briefly reports the findings of the investigation and discusses more in detail how both human factors of design and human factors in the published instructions for the completion of a maintenance task contributed to this accident.
Commissioning for menopause specialist services: A local perspective: An internet-based survey to assess the potential demand for menopause care in West Cheshire and the skills of local primary care clinicians in this field, with a view to informing future commissioning locally
Authors: Wilkinson Jane F , Short Hannah L , Wilkinson Sam , Mander Anthony
Published: August 2015

Objective

This study explores the perceived volume of women affected by peri- or post-menopausal issues that present to primary care clinicians in West Cheshire, plus the self-reported confidence of those clinicians in managing the menopause, and whether or not they feel that they and their patients should have access to a specialist menopause service.

Study design

Completion of an electronic survey.

Population

General practitioners and practice nurses working in West Cheshire.

Main outcome measure

To provide evidence for future local commissioning of menopause services.

Results

Ninety-one clinicians working within West Cheshire were sent an email request to complete the survey with 53 responses received (58%). The majority were general practitioners and were within the 35–54 year age range. The majority perceived that, each week in their clinical practice, they see between one and eight women who are affected by peri- or post-menopausal symptoms. Regarding their self-reported skills and knowledge in managing the menopause, almost half felt they had ‘good’ knowledge but ‘recognised (they) had learning needs’. Seven of the 53 (13%) felt their skills were ‘not good’. Two-thirds of those clinicians who completed the survey felt that they and their patients should have access to a specialist menopause service locally.

Conclusions

In the area covered by West Cheshire clinical commissioning group, there is no currently commissioned menopause service. This study has demonstrated that a substantial number of women present each week to clinicians working in this area who are felt to have peri- or post-menopausal symptoms. The clinicians have self-reported learning needs. Qualitative data from the survey would suggest training can be difficult to access. There is a clear need, both ethically and medically, for the commissioning of a West Cheshire specialist menopause service, with the proposed model being an integrated and holistic care model. Menopause care, and post-reproductive healthcare generally, provides an opportunity for collaboration and partnership working within an outcomes-based commissioning model. This study could be reviewed and replicated in other areas for comparison.
Treatment of Atopic Dermatitis From the Perspective of Traditional Persian Medicine
Authors: Choopani Rasool , Mehrbani Mehrzad , Fekri Alireza , Mehrabani Mitra
Published: August 2015

There is a strong current trend for using complementary and alternative medications to treat atopic dermatitis. Atopic dermatitis is a common, chronic, pruritic, and inflammatory skin disease. It can have a profound, negative effect on patients’ quality of life. Mild cases of atopic dermatitis can be controlled by the application of moisturizers and topical corticosteroids. However, in severe cases, application of immunosuppressive medication is unavoidable but it can have adverse effects. In traditional Persian medicine, diseases similar to resistant atopic dermatitis are treated with whey in combination with decoction of field dodder. Both whey and field dodder have anti-inflammatory properties. Consumption of whey can also aid skin repair, mitigate pruritus, and help combat the high level of stress experienced by patients. Therefore, it is hypothesized that consumption of traditional medicinal treatment of whey with decoction of field dodder can be applied as a complementary treatment for atopic dermatitis.
Is the Technology in Your Car Driving You to Distraction?
Authors: Strayer David L.
Published: August 2015

Driver distraction is increasingly recognized as a significant source of injuries and fatalities on the roadway. Distraction can arise from visual/manual interference, for example, when a driver takes his or her eyes off the road to interact with a device. Impairments also come from cognitive sources of distraction when attention is withdrawn from the processing of information necessary for the safe operation of a motor vehicle. In the latter case, the driver’s eyes may be on the roadway and his or her hands on the steering wheel, but he or she may not be attending to the information critical for safe driving. Concern over distracted driving is growing as more and more wireless devices are being integrated into the vehicle. We developed and validated a metric of distraction associated with the diversion of attention from driving. Our studies show that the distraction potential can be reliably measured, that cognitive workload systematically varies as a function of the secondary task performed by the driver, and that some activities, particularly newer voice-based interactions in the vehicle, are associated with surprisingly high levels of mental workload. Changing the culture of distracted driving will require a combination of scientifically based education concerning the hazards of inattention, regulations that target the root causes of distraction, and enforcement of the distracted driving laws.
Low forced expiratory volume is associated with earlier death in sickle cell anemia
Authors: Kassim Adetola A. , Payne Amanda B. , Rodeghier Mark , Macklin Eric A. , Strunk Robert C. , DeBaun Michael R.
Published: August 2015

Key Points

Among adults with SCA, decreased FEV1 percent predicted was associated with earlier death. Obstructive and restrictive pulmonary function patterns do not predict earlier death in adults with SCA.
SUMOylation-disrupting WAS mutation converts WASp from a transcriptional activator to a repressor of NF-κB response genes in T cells
Authors: Sarkar Koustav , Sadhukhan Sanjoy , Han Seong-Su , Vyas Yatin M.
Published: August 2015

Key Points

SUMOylatable-WASp trans-activates and non-SUMOylatable-WASp trans-represses NF-κB response genes mediating adaptive immunity. HDAC inhibitors reverse the immunodeficient and proinflammatory phenotype caused by SUMOylation-deficient WASp in TH1 cells.
NFI-A disrupts myeloid cell differentiation and maturation in septic mice
Authors: McClure Clara , Ali Ekram , Youssef Dima , Yao Zhi Q , McCall Charles E , El Gazzar Mohamed
Published: August 2015

Mounting evidence supports that sepsis-associated immunosuppression increases mortality. As potential contributors to poor sepsis outcomes, myeloid-derived suppressor cells, which are Gr1+ CD11b+ innate-immune cell progenitors unable to differentiate and possess suppressive activities, expand dramatically in septic mice by a process requiring increased microRNA-21 and microRNA-181b expression. The inhibition of these microRNAs in vivo in septic mice restores Gr1+ CD11b+ cell differentiation and maturation and improves survival. Here, we show that during sepsis-induced generation of myeloid-derived suppressor cells, transcription factor nuclear factor 1 A type represses cyclin-dependent kinase inhibitor p21 to arrest differentiation of Gr1+ CD11b+ cells. Our findings include the following: 1) Gr1+ CD11b+ myeloid cells from late septic mice genetically lacking nuclear factor 1 A type cannot suppress CD4+ T cell proliferation and activation; 2) the reconstitution of nuclear factor 1 A type in microRNA-21 and microRNA-181b-depleted Gr1+ CD11b+ myeloid-derived suppressor cells inhibits cyclin-dependent kinase inhibitor p21 and restores the immune-suppressor phenotype; 3) ex vivo nuclear factor 1 A type knockdown in Gr1+ CD11b+ myeloid-derived suppressor cells from late septic mice restores cyclin-dependent kinase inhibitor p21 expression and promotes monocyte and dendritic cell differentiation; and 4) ectopic nuclear factor 1 A type expression in normal Gr1+ CD11b+ cells generates an immunosuppressive phenotype. We suggest that therapeutically targeting nuclear factor 1 A type during late sepsis might improve survival.
Intestinal Obstruction in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study
Authors: Madenci Arin L. , Fisher Stacey , Diller Lisa R. , Goldsby Robert E. , Leisenring Wendy M. , Oeffinger Kevin C. , Robison Leslie L. , Sklar Charles A. , Stovall Marilyn , Weathers Rita E. , Armstrong Gregory T. , Yasui Yutaka , Weldon Christopher B.
Published: August 2015

Purpose

For adult survivors of childhood cancer, knowledge about the long-term risk of intestinal obstruction from surgery, chemotherapy, and radiotherapy is limited.

Methods

Intestinal obstruction requiring surgery (IOS) occurring 5 or more years after cancer diagnosis was evaluated in 12,316 5-year survivors in the Childhood Cancer Survivor Study (2,002 with and 10,314 without abdominopelvic tumors) and 4,023 sibling participants. Cumulative incidence of IOS was calculated with second malignant neoplasm, late recurrence, and death as competing risks. Using piecewise exponential models, we assessed the associations of clinical and demographic factors with rate of IOS.

Results

Late IOS was reported by 165 survivors (median age at IOS, 19 years; range, 5 to 50 years; median time from diagnosis to IOS, 13 years) and 14 siblings. The cumulative incidence of late IOS at 35 years was 5.8% (95% CI, 4.4% to 7.3%) among survivors with abdominopelvic tumors, 1.0% (95% CI, 0.7% to 1.4%) among those without abdominopelvic tumors, and 0.3% (95% CI, 0.1% to 0.5%) among siblings. Among survivors, abdominopelvic tumor (adjusted rate ratio [ARR], 3.6; 95% CI, 1.9 to 6.8; P < .001) and abdominal/pelvic radiotherapy within 5 years of cancer diagnosis (ARR, 2.4; 95% CI, 1.6 to 3.7; P < .001) increased the rate of late IOS, adjusting for diagnosis year; sex; race/ethnicity; age at diagnosis; age during follow-up (as natural cubic spline); cancer type; and chemotherapy, radiotherapy, and surgery within 5 years of cancer diagnosis. Developing late IOS increased subsequent mortality among survivors (ARR, 1.8; 95% CI, 1.1 to 2.9; P = .016), adjusting for the same factors.

Conclusion

The long-term risk of IOS and its association with subsequent mortality underscore the need to promote awareness of this complication among patients and providers.
Synthesis and Chiral Recognition Ability of a Novel Fullerene-functionalized Cellulose Derivative
Authors: Gao Bo , Xu Zeyu , Fan Luan , Xu Xiaodong , Bai Jianwei , Shen Xiande
Published: August 2015

The fullerene-functionalized cellulose derivative 1 was synthesized and coated onto silica gel as chiral stationary phase (CSP) for high-performance liquid chromatography (HPLC). The chiral recognition ability of the obtained chiral packing material (CPM) was evaluated by HPLC with ten types of racemates 2–11. This CPM could be used in the eluents including chloroform and terahydrofuran (THF), which are usually unsuitable solvents for conventional coating-type CPMs. Hence the scope of application of this CPM is wider than conventional coating CPM.
Obese Nondiabetic Pregnancies and High Maternal Glycated Hemoglobin at Delivery as an Indicator of Offspring and Maternal Postpartum Risks: The Prospective PEACHES Mother-Child Cohort
Authors: Ensenauer Regina , Brandlhuber Lena , Burgmann Maximiliane , Sobotzki Christina , Zwafink Carina , Anzill Sabine , Holdt Lesca , Teupser Daniel , Hasbargen Uwe , Netz Heinrich , Roscher Adelbert A , von Kries Rüdiger
Published: August 2015

BACKGROUND

We investigated whether obese pregnant women negative for gestational diabetes (GDM) still experience dysglycemia, as indicated by high glycated hemoglobin (Hb A1c) at delivery, and whether this impacts offspring and long-term maternal outcomes.

METHODS

Data of 462 mother-child pairs of our prospective Programming of Enhanced Adiposity Risk in Childhood – Early Screening (PEACHES) cohort study were analyzed. Of 885 obese and normal-weight pregnancies prospectively enrolled after GDM testing according to the International Association of Diabetes and Pregnancy Study Groups criteria, 462 GDM-negative mothers and their offspring were investigated. We assessed associations of maternal Hb A1c at delivery with large-for-gestational-age (LGA) birth weights, cord-blood C-peptide, and biomarkers of glucose metabolism and inflammation in obese mothers followed for 2.9 years (median) postpartum (n = 42).

RESULTS

Cumulative distribution analysis in GDM-negative normal-weight women (n = 155) revealed that 12% had Hb A1c ≥5.7% at delivery (high Hb A1c). Among obese GDM-negative women (n = 307), 31.9% (95% CI, 26.7%–37.4%) equaled or exceeded this cutoff. In obese GDM-negative women with Hb A1c ≥5.7% (n = 98) vs <5.7% (n = 209) at delivery, newborns were more likely to be born LGA [adjusted odds ratio 3.56 (95% CI, 1.64–8.02)], and mean cordblood serum C-peptide was increased by 0.09 ng/mL (95% CI, 0.01–0.17 ng/mL). In the mothers at follow-up, mean postpartum Hb A1c, fasting glucose, high-sensitivity C-reactive protein, and fibrinogen concentrations were higher by 0.3% (95% CI, 0.1%–0.5%), 6.0 mg/dL (95% CI, 2.4–9.5 mg/dL), 6.8 mg/L (95% CI, 1.4–12.3 mg/L), and 74.9 mg/dL (95% CI, 13.6–136.2 mg/dL), respectively.

CONCLUSIONS

Increased Hb A1c in obese GDM-negative women at delivery indicates gestational dysglycemia, potentially conferring offspring and long-term maternal health risks. These findings should raise awareness as to careful monitoring of obese pregnancies. Measurement of Hb A1c at delivery could help select women who may need closer postpartum health checks.
Distancia y malentendidos frente a la escritura
Authors: Bernardin Jacques , Jaimes Carvajal Gladys
Published: August 2015
La lectura intertextual en la universidad. Apuntes didácticos sobre la relación literatura-cómic
Authors: Valencia Leguizamón Mariana , Rodríguez León Daniel Mauricio , Caro Lopera Miguel Ángel
Published: August 2015

Este artículo describe los resultados de una investigación en Didáctica de la Literatura, desarrollada con estudiantes universitarios, entre 2011 y 2012, para estimular la lectura intertextual de tres obras literarias. La investigación se basa, principalmente, en el modelo teórico y metodológico de Antonio Mendoza Fillola y el grupo FRAC (2008), y apela a un ejercicio hermenéutico que intenta reconocer el lenguaje del cómic presente en las tres novelas. De la aplicación y evaluación de las estrategias fundamentales de la intervención, se concluye, entre otros aspectos, la incidencia de la nominalización en la apropiación que el lector hace de la obra; el valor del intertexto lector en la identificación  lector-personaje; la relación afectiva de los estudiantes universitarios con el mundo de los superhéroes; el impacto de la lectura intertextual en la apreciación estética del hecho literario; y el fortalecimiento de la competencia literaria, gracias el paso de la literatura al cómic
Encuentros y desencuentros: familia y escuela. Barreras y Desafíos para la formación
Authors: Rivillas Díaz Jhoanna
Published: August 2015

El presente artículo parte de la reflexión y puesta en escena de un proyecto de aula  emprendido por tres docentes de Básica Primaria. Reflexión sobre el papel de la escuela y la familia en la época actual y los vínculos que se establecen entre ambas instituciones. Dicha reflexión se enmarca desde la observación cotidiana  de los docentes  con respecto al desempeño de los  estudiantes y el acompañamiento realizado por los padres y/o acudientes en la formación de los niños y niñas; y bien, algunas entrevistas cuyo propósito era extraer información de tipo cualitativo sobre las actividades que realizan los niños en sus hogares y la composición familiar. Trascendiendo a la perspectiva teórica de las dos instituciones sociales: familia – escuela. Como alternativa pedagógica se plantea la experiencia vivida al interior de las aulas de clase con el proyecto de aula “aprendiendo en familia”, describiendo y narrando en qué consiste dicho proyecto, su propósito; igualmente se socializan experiencias propias de los padres de familia y docentes. 
La lectoescritura en nuestra actualidad: revisión crítica
Authors: Parra Pinto Fabiola
Published: August 2015

La  tecnología y los avances culturales inciden en el crecimiento y experiencias de los niños afectando notablemente su aprendizaje lecto-escritor.

Importante, generar una lectura analítica-reflexiva  permitiendo interpretar en forma correcta lo que el autor  quiso plasmar en un texto. Así, la lectura y la escritura son herramientas básicas en el aprendizaje y la formación integral de los estudiantes, vías principales de acceso al conocimiento y a la cultura.  

De esta forma, la formación de tipo mediático digital  debe ser manejada por quienes hacen parte de la comunidad, pues crecer en un mundo mediático afecta notablemente tanto la capacidad lectora como escritural de quienes en este medio se desenvuelven, observándose  un rendimiento académico positivo, generando manejo adecuado de los diferentes medios de comunicación de tipo digital y mediático que van surgiendo con el transcurrir del tiempo. Necesaria la reflexión y análisis frente a la incorporación de las TIC no solo en las aulas sino en la  cotidianidad de cada persona.
Simulación interactiva para la apropiación de la ciencia y la tecnología
Authors: Flórez Llanos Cindy Alejandra , Cristancho Sastoque Nelson Javier , Barón Velandia Julio
Published: August 2015

En este documento se presenta el avance del proyecto de investigación para la conformación de un entorno de simulación interactiva, como herramienta de apoyo a la enseñanza, mediante la aplicación de los avances de la informática, permitiendo a los niños la interacción con fenómenos que se estudian de forma didáctica, divertida y segura, aprovechando la familiaridad que ellos tienen con los dispositivos tecnológicos (tabletas, smartphones, etc.), presentado con herramientas multimedia como las utilizadas en los video juegos que capturan fácilmente su atención para presentar fenómenos del mundo de la física, mediante simulaciones interactivas de carácter lúdico que en cortos periodos de tiempo le permitan reforzar los conceptos adquiridos, a través de escenarios diseñados como apoyo a las actividades y sesiones realizadas en el aula. 
Gestión del espectro radioeléctrico en Colombia
Authors: Cadena Muñoz Ernesto , Eslava Blanco Hermes Javier , Franco Calderón José Alejandro
Published: August 2015

Este artículo presenta una revisión del estado del arte de la gestión del espectro radioeléctrico. Se definen conceptos básicos que permiten reconocer su alcance e importancia para el sector y se hace un análisis de los diferentes modelos de gestión del espectro, destacando las características, fortalezas y debilidades de cada uno para su aplicación. Se analiza el contexto del país, en el cual se observa que el modelo de gestión tradicional utilizado no es eficiente y genera pérdidas económicas para el país en uno de los recursos más importantes en materia de Telecomunicaciones, lo que nos lleva a replantear el modelo actual de gestión del espectro radioeléctrico en Colombia.Finalmente, se presentan las tendencias en la gestión del espectro y se resalta la necesidad de analizar el modelo basado en el mercado de servicios de telecomunicaciones y los requerimientos para su aplicación en el país, así como las dificultades que puede encontrar.