bluuebunny/crossref_metadata_2025 huggingface dataset:
The incidence of diagnostic error in medicine
Authors: Graber Mark L
Published: June 2013

A wide variety of research studies suggest that breakdowns in the diagnostic process result in a staggering toll of harm and patient deaths. These include autopsy studies, case reviews, surveys of patient and physicians, voluntary reporting systems, using standardised patients, second reviews, diagnostic testing audits and closed claims reviews. Although these different approaches provide important information and unique insights regarding diagnostic errors, each has limitations and none is well suited to establishing the incidence of diagnostic error in actual practice, or the aggregate rate of error and harm. We argue that being able to measure the incidence of diagnostic error is essential to enable research studies on diagnostic error, and to initiate quality improvement projects aimed at reducing the risk of error and harm. Three approaches appear most promising in this regard: (1) using ‘trigger tools’ to identify from electronic health records cases at high risk for diagnostic error; (2) using standardised patients (secret shoppers) to study the rate of error in practice; (3) encouraging both patients and physicians to voluntarily report errors they encounter, and facilitating this process.
Implementing an interprofessional patient safety learning initiative: insights from participants, project leads and steering committee members
Authors: Jeffs Lianne , Abramovich Ilona Alex , Hayes Chris , Smith Orla , Tregunno Deborah , Chan Wai-Hin , Reeves Scott
Published: June 2013

Introduction

Effective teamwork and interprofessional collaboration are vital for healthcare quality and safety; however, challenges persist in creating interprofessional teamwork and resilient professional teams. A study was undertaken to delineate perceptions of individuals involved with the implementation of an interprofessional patient safety competency-based intervention and intervention participants.

Methods

The study employed a qualitative study design that triangulated data from interviews with six steering committee members and five members of the project team who developed and monitored the intervention and six focus groups with clinical team members who participated in the intervention and implemented local patient safety projects within a large teaching hospital in Canada.

Results

Our study findings reveal that healthcare professionals and support staff acquired patient safety competencies in an interprofessional context that can result in improved patient and work flow processes. However, key challenges exist including managing projects amidst competing priorities, lacking physician engagement and sustaining projects.

Conclusions

Our findings point to leaders to provide opportunities for healthcare teams to engage in interprofessional teamwork and patient safety projects to improve quality of patient care. Further research efforts should examine the sustainability of interprofessional safety projects and how leaders can more fully engage the participation of all professions, specifically physicians.
Prehospital use in emergency patients of a laryngeal mask airway by ambulance paramedics is a safe and effective alternative for endotracheal intubation
Authors: Bosch J , de Nooij J , de Visser M , Cannegieter S C , Terpstra N J , Heringhaus C , Burggraaf J
Published: June 2013

Background

In Dutch ambulance practice, failure or inability to intubate patients with altered oxygenation and/or ventilation leaves bag-valve mask ventilation as the only alternative, which is undesirable for patient outcome. A novel Laryngeal Mask Airway Supreme (LMA-S) device may be a suitable alternative.

Aim

To evaluate the effectiveness and suitability of the LMA-S for emergency medical services in daily out-of-hospital emergency practice.

Methods

After a period of theoretical and practical training of ambulance paramedics in the use of the LMA-S, prospective data were collected on the utilisation of LMA-S in an observational study. Procedures for use were standardised and the evaluation included the number of direct intubation attempts before using LMA-S, attempts required, failure rate and the adequacy of ventilation. Data were analysed taking patient characteristics such as age and indication for ventilatory support into account.

Results

The LMA-S was used 50 times over a period of 9 months (33 involving cardiorespiratory arrest, 14 primary and three rescue). The LMA-S could be applied successfully in all 50 cases (100%) and was successful in the first attempt in 49 patients (98%). Respiratory parameters showed adequate oxygenation. All paramedics were unanimously positive about the utilisation of LMA-S because of the easiness of the effort of insertion and general use, and emphasised its value as a useful resource for patients in need.

Conclusions

Ensuring ventilation support by using LMA-S by paramedics in prehospital emergency practice is safe and effective.
Intrauterine device insertions: which variables matter?
Authors: Brown Windy Mary , Trouton Konia
Published: June 2013

Objectives

Many factors are suspected to influence the intrauterine device (IUD) insertion process. This study sought to examine the effects of a few key variables on IUD insertion tolerability, complications and follow-up issues.

Methods

A retrospective chart review was undertaken of all IUD insertions over an 11-month period at an urban Canadian women's clinic. Linear regression analysis of 354 insertions assessed the effects of parity, age, local anaesthesia and other variables on insertion pain. Chi square (χ2) and analysis of variance statistics were employed to evaluate differences in insertion complications by parity and age. A χ2test was performed to compare follow-up expulsion or removal rates by parity.

Results

Statistically significant differences were found, with nulliparous women and those who received local anaesthesia reporting more insertion pain. Age, IUD type and recent abortion status did not affect insertion pain. Nulliparous women did not experience significantly more insertion difficulty or complications, nor did they have higher rates of expulsion or removal at follow-up.

Conclusions

These findings suggest that the practice of providing cervical anaesthesia at IUD insertion may cause slightly more pain, without any obvious additional benefit. The difference in insertion pain by parity, although statistically significant, is small enough to be of questionable clinical importance. Overall, these findings add to the growing body of evidence for IUDs being safe and well-tolerated in nulliparous women.
Misperceptions, misinformation and myths about modern contraceptive use in Ghana
Authors: Hindin Michelle J , McGough Laura J , Adanu Richard M
Published: June 2013

Objective

Ghana, like the rest of West Africa, has very low contraceptive prevalence and is one of a few nations that reports declines in contraceptive use over time based on two of the most recent national surveys. Fear of side effects is a leading cause of non-use of contraception, based on national surveys. The objective of this study was to gain a more holistic understanding of why Ghanaian women are not using contraception.

Methods

We used focus groups with vignettes to elicit normative beliefs about contraception. We recruited 91 women from three different clinics within Legon Hospital in Accra, Ghana: the antenatal clinic, the student clinic and the child welfare clinic. Focus groups were homogeneous with regard to age group and union status.

Results

We found that women were most concerned with the menstrual irregularities caused by hormonal methods. In addition, women believed strongly that the hospital was the best place to get contraception as blood tests were needed to match women with the appropriate method. Knowledge of how methods worked and of basic reproductive biology was low.

Conclusions

Poor knowledge of how to use modern methods combined with myths and misinformation should be the targets of programmes to increase modern contraceptive prevalence in Ghana.
COMPARING COURNOT DUOPOLY AND MONOPOLY WITH ASYMMETRIC COMPLEMENTARY GOODS
Authors: CHANG MING CHUNG , LIN YUN-CHIEH , LIN CHIU FEN
Published: June 2013

This paper concerns an industry with two complementary goods. It is demonstrated that if a good is active in Cournot equilibrium, then it is active in either one of the socially optimal solution and the monopoly solution; but, the converse is not true. When demands are linear, a good is active in the monopoly solution if and only if it is socially desirable. Therefore, the monopoly would be socially better than the Cournot duopoly in selecting products. We establish that each Cournot output falls below its corresponding monopoly output regardless of whether the solutions are interior or not. However, in the monopoly solution, a good should be cross-subsidized if and only if it is a supplemental good. This result has two implications. First, a small decrease in the output level of a supplemental good raises the welfare, implying that when there exists a supplement good, lower quantities are not necessarily worse in welfare terms. Second, if each good is a base good, then the Cournot equilibrium indeed is less welfare-efficient than the monopoly solution. In order to verify whether it is possible to have a welfare reversal, we consider the case where demands are linear. We demonstrate that prices are lower in the monopoly solution, and that lower prices are better in the welfare terms. These two results imply that welfare is higher in the monopoly solution. Again, these results hold regardless of whether the solutions are interior or not.
ON THE ORIGIN OF R-PARITY VIOLATION IN SUPERSYMMETRY
Authors: FILEVIEZ PÉREZ PAVEL
Published: June 2013

The fate of R-parity in supersymmetric theories is discussed in detail. We make a strong case for R-parity violation showing that the simplest theories based on the local B - L symmetry predict the spontaneous breaking of R-parity at the SUSY scale. The possible implications for the searches at the Large Hadron Collider are discussed.
THE POWER DISTRIBUTION NETWORK EXPANSION PLANNING BASED ON STACKELBERG MINIMUM WEIGHT K-STAR GAME
Authors: LIAO CHEN , WANG JIA , HU SHIYAN
Published: June 2013

The reliability of power distribution network is important. For high reliability, it is necessary for some nodes to have backup connections to other feeders in the network. The substation operator wants to expand the network such that some nodes have k redundant connection lines (i.e., k redundancy) in case the current feeder line does not work. The corporation is given this task to design the expansion planning to construct new connection lines. The substation operator will choose the minimum charged k redundant connection lines based on both of the existing network and the expansion network, which is designed by the corporation. The existing network has the cost for the redundant connection due to the operational expense. The corporation proposes the design with its own price, which may include the operational expense and the construction expense. Thus, for the corporation, how to assign the low price on the connection lines while maximizing the revenue becomes a Stackelberg minimum weight k-star game for the power distribution network expansion.

A heuristic algorithm is proposed to solve this Stackelberg minimum weight k-star game for the power distribution network expansion, using three heuristic rules for price setting in a scenario by scenario fashion. The experimental results show that the proposed algorithm always outperforms the greedy algorithm which is natural to k-star game in terms of corporation revenue. Compared to the greedy algorithm, the proposed algorithm improves up to 60.7% in the corporation revenue in the chosen minimum weight k-star, which is the minimum charged k connection lines. The average improvement is 7.5%. This effectively handles k redundancy in the power distribution network expansion while maximizing the corporation revenue.
HIGH-SPEED MODULAR MULTIPLIERS BASED ON A NEW BINARY SIGNED-DIGIT ADDER TREE STRUCTURE
Authors: ZHANG MINGDA , WEI SHUGANG
Published: June 2013

Modular multiplication is a very important arithmetic operation in residue-based real-time computing systems. In this paper, we present multipliers using a modified binary tree of the modulo m signed-digit (SD) number adders where m = 2n + μ(μ = ±1, 0). To simplify the residue SD adder, new addition rules are used for generating the intermediate sum and carry with an 1-bit binary encoded number representation. By using the new encoding method, the proposed residue addition requires less hardware and shorter delay time than previous one. A modulo m multiplier can be implemented by a binary modulo m adder tree which has a depth of log 2 n. In order to introduce a binary SD adder tree with the new addition rules, two novel modulo m adders have been proposed in this paper. Finally, the evaluation apparently shows that the proposed two kinds of modulo m adders are performed more efficiency by comparing with the modulo SD adder which is mentioned in our previous work, and a new binary SD adder tree structure has been proposed.
VERIFICATION OF APPLICABILITY OF MACRO-ELEMENT IMPLEMENTATION IN A FINITE ELEMENT CODE FOR SHALLOW FOUNDATIONS
Authors: NI PENGPENG
Published: June 2013

It has been found that the above article authored by Pengpeng Ni, includes works of Dr. António A. Correia from LNEC, Portugal, and Dr. Raffaele Figini from Enel Produzione, Ingegneria Civile e Idraulica, Milano, Italy (described in Secs. 2 and 3), and hence, Mr. Ni does not justify the publication with a single author name. This article was therefore, retracted from its publication in IJSSD. A statement of retraction is published in Int. J. Struct. Stab. Dyn., Volume 14, Issue 7 (2014) http://dx.doi.org/10.1142/S0219455414930018.
Id proteins are critical downstream effectors of BMP signaling in human pulmonary arterial smooth muscle cells
Authors: Yang Jun , Li Xiaohui , Li Ying , Southwood Mark , Ye Lingying , Long Lu , Al-Lamki Rafia S. , Morrell Nicholas W.
Published: June 2013

Bone morphogenetic protein type II receptor (BMPR-II) mutations are responsible for over 70% of cases of heritable pulmonary arterial hypertension (PAH). Loss of BMP signaling promotes pulmonary vascular remodeling via modulation of pulmonary artery smooth muscle cell (PASMC) proliferation. Id proteins (Id1–4) are major downstream transcriptional targets of BMP signaling. However, the impact of BMPR-II mutation on the expression of the range of Id proteins and the contribution of individual Id proteins to abnormal PASMC function remain unclear. Human PASMCs were used to determine the expression of Id proteins (Id1–4) by real-time PCR and immunoblotting. The BMP responses in control cells were compared with PASMCs harboring BMPR-II mutations and cells in which BMPR-II was knocked down by siRNA transfection. Id3 expression in pulmonary vessels was also investigated in BMPR-II mutant mice and in patients with heritable PAH. BMP4 and BMP6, but not BMP9, induced mRNA expression of Id1, Id2, and Id3. The BMP-stimulated induction of Id1 and Id3 was markedly reduced in BMPR-II mutant PASMCs and in control PASMCs following siRNA silencing of BMPR-II. Pulmonary arteries in BMPR-II mutant mice and patients with heritable PAH demonstrated reduced levels of Id3 compared with control subjects. Lentiviral overexpression of Id3 reduced cell cycle progression and inhibited proliferation of PASMCs. Lipopolysaccharide further reduced Id3 expression in mutant PASMCs. In conclusion, Id proteins, and particularly Id1 and Id3, are critical downstream effectors of BMP signaling in PASMCs. Loss of BMPR-II function reduces the induction of Id genes in PASMCs, Id1, and Id3 regulate the proliferation of PASMCs via cell cycle inhibition, an effect that may be exacerbated by inflammatory stimuli.
Attenuation of Proinflammatory Responses byS-[6]-Gingerol via Inhibition of ROS/NF-Kappa B/COX2 Activation in HuH7 Cells
Authors: Li Xiao-Hong , McGrath Kristine C. Y. , Tran Van H. , Li Yi-Ming , Duke Colin C. , Roufogalis Basil D. , Heather Alison K.
Published: June 2013

Introduction. Hepatic inflammation underlies the pathogenesis of chronic diseases such as insulin resistance and type 2 diabetes mellitus.S-[6]-Gingerol has been shown to have anti-inflammatory properties. Important inflammatory mediators of interleukins include nuclear factorκB (NFκB) and cyclooxygenase 2 (COX2). We now explore the mechanism of anti-inflammatory effects ofS-[6]-gingerol in liver cells.Methods. HuH7 cells were stimulated with IL1βto establish anin vitrohepatic inflammatory model.Results.S-[6]-Gingerol attenuated IL1β-induced inflammation and oxidative stress in HuH7 cells, as evidenced by decreasing mRNA levels of inflammatory factor IL6, IL8, and SAA1, suppression of ROS generation, and increasing mRNA levels of DHCR24. In addition,S-[6]-gingerol reduced IL1β-induced COX2 upregulation as well as NFκB activity. Similar to the protective effects ofS-[6]-gingerol, both NS-398 (a selective COX2 inhibitor) and PDTC (a selective NFκB inhibitor) suppressed mRNA levels of IL6, IL8, and SAA1. Importantly, PDTC attenuated IL1β-induced overexpression of COX2. Of particular note, the protective effect ofS-[6]-gingerol against the IL1β-induced inflammatory response was similar to that of BHT, an ROS scavenger.Conclusions. The findings of this study demonstrate thatS-[6]-gingerol protects HuH7 cells against IL1β-induced inflammatory insults through inhibition of the ROS/NFκB/COX2 pathway.
Complex Composite Odontoma with Characteristic Histology
Authors: Govindrajan Sujatha , Muruganandhan J. , Shamsudeen Shaik , Kumar Nalin , Ramasamy M. , Prasad Srinivasa
Published: June 2013

Odontomas are the most commonly occurring odontogenic tumors, which are considered by many to be hamartomas rather than neoplasms. These clinically asymptomatic tumors are classified into complex and compound odontomas. They are usually discovered in radiographs and rarely cause bony expansion or infection. This paper discusses a case report of a complex odontoma exhibiting all the structural features and defects of enamel, dentine, and cementum in succession, with an overview on its etiology.
Contaminated Sites in Europe: Review of the Current Situation Based on Data Collected through a European Network
Authors: Panagos Panos , Van Liedekerke Marc , Yigini Yusuf , Montanarella Luca
Published: June 2013

Under the European Union (EU) Thematic Strategy for Soil Protection, the European Commission has identified soil contamination as a priority for the collection of policy-relevant soil data at European scale. In order to support EU soil management policies, soil-related indicators need to be developed which requires appropriate data collection and establishment of harmonized datasets for the EU Member States. In 2011-12, the European Soil Data Centre of the European Commission conducted a project to collect data on contaminated sites from national institutions in Europe using the European Environment Information and Observation Network for soil (EIONET-SOIL). This paper presents the results obtained from analysing the soil contaminated sites data submitted by participating countries. According to the received data, the number of estimated potential contaminated sites is more than 2.5 million and the identified contaminated sites around 342 thousand. Municipal and industrial wastes contribute most to soil contamination (38%), followed by the industrial/commercial sector (34%). Mineral oil and heavy metals are the main contaminants contributing around 60% to soil contamination. In terms of budget, the management of contaminated sites is estimated to cost around 6 billion Euros (€) annually.
Essentials of Oncothermia
Authors: Szasz Oliver
Published: June 2013

Oncothermia is a method of hyperthermia in oncology, controlling the locally applied deep heat by selectively targeting the cellular membrane of the malignant cells. The selection of the method is based on various biophysical and biochemical achievements. There are various differences between the malignant and healthy cells, which could be used for their selection by heat targeting. The primary selection factor is a different metabolic activity which creates distinguishable environments of the malignant cells. The other factor is the clear difference of dielectric properties of the membrane and near-membrane extracellular electrolytes, marking off the malignancies. There is also a structural factor, which is clear in the different pathological patterns of the malignancy from their healthy counterparts. This last is described by fractal pattern evaluation technique, in which dynamic time-fractal transformation is used for further discernment of the malignancy. My objective is to show a new heating method, which makes oncological hyperthermia controllable and effective.
Radiation Damage in Electronic Memory Devices
Authors: Fetahović Irfan , Pejović Milić , Vujisić Miloš
Published: June 2013

This paper investigates the behavior of semiconductor memories exposed to radiation in order to establish their applicability in a radiation environment. The experimental procedure has been used to test radiation hardness of commercial semiconductor memories. Different types of memory chips have been exposed to indirect ionizing radiation by changing radiation dose intensity. The effect of direct ionizing radiation on semiconductor memory behavior has been analyzed by using Monte Carlo simulation method. Obtained results show that gamma radiation causes decrease in threshold voltage, being proportional to the absorbed dose of radiation. Monte Carlo simulations of radiation interaction with material proved to be significant and can be a good estimation tool in probing semiconductor memory behavior in radiation environment.
Targeting Microglial KATPChannels to Treat Neurodegenerative Diseases: A Mitochondrial Issue
Authors: Rodríguez Manuel J. , Martínez-Moreno Margot , Ortega Francisco J. , Mahy Nicole
Published: June 2013

Neurodegeneration is a complex process involving different cell types and neurotransmitters. A common characteristic of neurodegenerative disorders is the occurrence of a neuroinflammatory reaction in which cellular processes involving glial cells, mainly microglia and astrocytes, are activated in response to neuronal death. Microglia do not constitute a unique cell population but rather present a range of phenotypes closely related to the evolution of neurodegeneration. In a dynamic equilibrium with the lesion microenvironment, microglia phenotypes cover from a proinflammatory activation state to a neurotrophic one directly involved in cell repair and extracellular matrix remodeling. At each moment, the microglial phenotype is likely to depend on the diversity of signals from the environment and of its response capacity. As a consequence, microglia present a high energy demand, for which the mitochondria activity determines the microglia participation in the neurodegenerative process. As such, modulation of microglia activity by controlling microglia mitochondrial activity constitutes an innovative approach to interfere in the neurodegenerative process. In this review, we discuss the mitochondrial KATPchannel as a new target to control microglia activity, avoid its toxic phenotype, and facilitate a positive disease outcome.
The Feasibility of Using Near-Infrared Spectroscopy and Chemometrics for Untargeted Detection of Protein Adulteration in Yogurt: Removing Unwanted Variations in Pure Yogurt
Authors: Xu Lu , Yan Si-Min , Cai Chen-Bo , Wang Zhen-Ji , Yu Xiao-Ping
Published: June 2013

Untargeted detection of protein adulteration in Chinese yogurt was performed using near-infrared (NIR) spectroscopy and chemometrics class modelling techniques. sixty yogurt samples were prepared with pure and fresh milk from local market, and 197 adulterated yogurt samples were prepared by blending the pure yogurt objects with different levels of edible gelatin, industrial gelatin, and soy protein powder, which have been frequently used for yogurt adulteration. A recently proposed one-class partial least squares (OCPLS) model was used to model the NIR spectra of pure yogurt objects and analyze those of future objects. To improve the raw spectra, orthogonal projection (OP) of raw spectra onto the spectrum of pure water and standard normal variate (SNV) transformation were used to remove unwanted spectral variations. The best model was obtained with OP preprocessing with sensitivity of 0.900 and specificity of 0.949. Moreover, adulterations of yogurt with 1% (w/w) edible gelatin, 2% (w/w) industrial gelatin, and 2% (w/w) soy protein powder can be safely detected by the proposed method. This study demonstrates the potential of combining NIR spectroscopy and OCPLS as an untargeted detection tool for protein adulteration in yogurt.
Mental Strain and Chronic Stress among University Students with Symptoms of Irritable Bowel Syndrome
Authors: Gulewitsch Marco D. , Enck Paul , Schwille-Kiuntke Juliane , Weimer Katja , Schlarb Angelika A.
Published: June 2013

Aim. To investigate the degree of mental strain and chronic stress in a German community sample of students with IBS-like symptoms.Methods and Materials. Following an internet-based survey about stress, this study recruited 176 German university students (23.45±2.48years; 48.3% males) with IBS-like symptoms according to Rome III and 181 students without IBS (23.55±2.82years; 50.3% males) and compared them regarding current mental strain (SCL-90-R) and the extend of chronic stress. Beyond this, IBS subtypes, IBS severity, and health care utilization were assessed.Results. Students fulfilling IBS criteria showed significantly elevated values of mental strain and chronic stress. Nearly 40% of the IBS group (versus 20% of the controls) reached a clinically relevant value on the SCL-90-R global severity scale. IBS subtypes did not differ in terms of mental distress or chronic stress. Somatization, anxiety, and the chronic stressors “work overload,” “social tension,” and “dissatisfaction with job” were most closely connected to IBS symptom severity. Regarding health care utilization, our results show that consulting a physician frequently was not associated significantly with elevated mental strain or chronic stress but with IBS symptom severity.Conclusion. Our data contribute additional evidence to the distinct association between psychological stress and IBS in community samples.
Changes among US Cancer Survivors: Comparing Demographic, Diagnostic, and Health Care Findings from the 1992 and 2010 National Health Interview Surveys
Authors: Buchanan Natasha D. , King Jessica B. , Rodriguez Juan L. , White Arica , Trivers Katrina F. , Forsythe Laura P. , Kent Erin E. , Rowland Julia H. , Sabatino Susan A.
Published: June 2013

Background. Differences in healthcare and cancer treatment for cancer survivors in the United States (US) have not been routinely examined in nationally representative samples or studied before and after important Institute of Medicine (IOM) recommendations calling for higher quality care provision and attention to comprehensive cancer care for cancer survivors. Methods. To assess differences between survivor characteristics in 1992 and 2010, we conducted descriptive analyses of 1992 and 2010 National Health Interview Survey (NHIS) data. Our study sample consisted of 1018 self-reported cancer survivors from the 1992 NHIS and 1718 self-reported cancer survivors from the 2010 NHIS who completed the Cancer Control (CCS) and Cancer Epidemiology (CES) Supplements. Results. The prevalence of reported survivors increased from 1992 to 2010 (4.2% versus 6.3%). From 1992 to 2010, there was an increase in long-term cancer survivors and a drop in multiple malignancies, and surgery remained the most widely used treatment. Significantly fewer survivors (<10 years after diagnosis) were denied insurance coverage. Survivors continue to report low participation in counseling or support groups. Conclusions. As the prevalence of cancer survivors continues to grow, monitoring differences in survivor characteristics can be useful in evaluating the effects of policy recommendations and the quality of clinical care.
CFS in Children and Adolescent: Ten Years of Retrospective Clinical Evaluation
Authors: Elgen Irene , Hikmat Omar , Aspevik Tora N. , Hagen Ellen Merete
Published: June 2013

Aim. To estimate number of children being diagnosed with chronic fatigue syndrome (CFS).Methods. For a period of 10 years (2002–2011) data from children being referred for fatigue symptoms were collected retrospectively.Results. Thirty-seven children were referred. Four were excluded due to incorrect coding. Six (18%) patients received other diagnoses at the end of evaluation time. Of the 27 who received the diagnosis G93.3, four had a previous chronic illness, while 23 patients were previously healthy. All patients reported onset of fatigue symptom in relation to an infection, and all tested positive for IgG to either Epstein-Barr virus, cytomegalovirus or borrelia, indicating previous infection. There were 16 (59%) boys among the 27 patients. The mean age at the debut of fatigue symptoms was 141 months (SD 30) for boys and 136 months (SD 31) for girls, respectively. Being underweight, defined as BMI < 17.5, was found in 12 (44%) patients.Conclusion. An increasing number of children and adolescents are evaluated for CFS. The clinical assessment of children and adolescents with possible CFS need systematically evaluation. Nutritional status, possible eating disorder, and psychosocial issues need to be addressed and evaluated carefully. A multidisciplinary approach is essential when assessing CFS in children and adolescents. There is a need for European guidelines.
The Effects of Pioglitazone on Biochemical Markers of Bone Turnover in the Patients with Type 2 Diabetes
Authors: Xiao Wen-hua , Wang Yan-rong , Hou Wen-fang , Xie Chao , Wang Hai-ning , Hong Tian-pei , Gao Hong-wei
Published: June 2013

Aim.To investigate whether pioglitazone had detrimental effects on biochemical markers of bone turnover in patients with type 2 diabetes (T2DM).Methods.Seventy patients with T2DM were included in this study. The patients remained on their previous antihyperglycemic therapies during the trial. Pioglitazone was then added on their regimen for 3 months.Results.After 3 months of treatment with pioglitazone, the levels of fasting blood glucose and HbA1cwere significantly decreased (7.9±1.5 mmol/L versus9.1±1.6 mmol/L and7.1±1.0%versus8.2±1.4%, resp.,P<0.01), compared with baseline in the overall patients. Serum concentrations of P1NP and BAP were significantly decreased from baseline (45.0±20.0 μg/L versus40.6±17.9 μg/L and13.23±4.7 μg/L versus12.3±5.0 μg/L, resp.,P<0.01) in female group, but not in male group. The serum levels of OC and CTX were unchanged in both female and male subgroups. In addition, the levels of serum BAP and P1NP were significantly decreased after pioglitazone treatment in postmenopausal subgroup, comparing with baseline.Conclusion.Pioglitazone inhibits bone formation and does not seem to affect bone resorption. Postmenopausal female patients rather than premenopausal or male patients are particularly vulnerable to this side effect of pioglitazone.
The Neural Mechanism by Which the Dorsal Vagal Complex Mediates the Regulation of the Gastric Motility by Weishu (RN12) and Zhongwan (BL21) Stimulation
Authors: Wang Hao , Shen Guo-ming , Liu Wei-jian , Huang Shun , Zhang Meng-ting
Published: June 2013

A large number of studies have been conducted to explore the mechanism of Back-Shu and Front-Mu points. While several lines of evidence addressed the acupuncture information of Shu acupoints and Mu acupoints gathering in the spinal cord, whether the convergence is extended to the high centre still remains unclear. The study selected gastric Mu points (RN12) and gastric Shu points (BL21) regulating gastric motility and its central neural mechanisms as the breakthrough point, using the technique of immunochemistry, nuclei lesion, electrophysiology, and nerve transection. Here, we report that gastric motility regulation of gastric Shu and Mu acupoints and their synergistic effect and the signals induced by electroacupuncture (EA) stimulation of acupoints RN12 and RN12 gather in the dorsal vagal complex (DVC), increasing the levels of gastrointestinal hormones in the DVC to regulate gastric motility through the vagus. In sum, our data demonstrate an important role of DVC and vagus in the regulation of gastric motility by EA at gastric Shu and Mu points.
The Inhibitory Effect of Ellagic Acid on Cell Growth of Ovarian Carcinoma Cells
Authors: Chung Yuan-Chiang , Lu Li-Cheng , Tsai Ming-Hsiu , Chen Yu-Jen , Chen Yi-Ying , Yao Shih-Ping , Hsu Chih-Ping
Published: June 2013

Ellagic acid (EA) is able to inhibit the growth of several cancer cells; however, its effect on human ovarian carcinoma cells has not yet been investigated. Ovarian carcinoma ES-2 and PA-1 cells were treated with EA (10~100 μM) and assessed for viability, cell cycle, apoptosis, anoikis, autophagy, and chemosensitivity to doxorubicin and their molecular mechanisms. EA inhibited cell proliferation in a dose- and time-dependent manner by arresting both cell lines at the G1 phase of the cell cycle, which were from elevating p53 and Cip1/p21 and decreasing cyclin D1 and E levels. EA also induced caspase-3-mediated apoptosis by increasing the Bax : Bcl-2 ratio and restored anoikis in both cell lines. The enhancement of apoptosis and/or inhibition of autophagy in these cells by EA assisted the chemotherapy efficacy. The results indicated that EA is a potential novel chemoprevention and treatment assistant agent for human ovarian carcinoma.
Analysis of Facial Height between Prepubertal and Postpubertal Subjects in Rivers State, Nigeria
Authors: Akinbami B. O. , Ikpeama Mark
Published: June 2013

Background. Appropriate craniofacial growth is vital both for aesthesis and normal growth of the brain. Cranial indices and facial heights are relevant parameters that are useful for anthropometric analyses of the growth of the entire craniofacial skeletal complex. The aim of this study was to determine differences in facial heights between prepubertal and postpubertal subjects. Method. The study consists of four hundred subjects, two hundred males and two hundred females who were selected at random on the ages ranging 12–16 and 17–25 years and were categorized into prepubertal and postpubertal. The facial parameters that were measured were upper facial height, lower facial height, and posterior facial height. Result. There was no significant difference found in the upper facial height between prepubertal and postpubertal females (). Conclusion. This study has shown that facial parameters are sexually dimorphic between male and female subjects and that male facial dimension was significantly higher than that of females. Also, it has been established that prepubertal subjects had higher facial dimension compared to corresponding postpubertal subjects.
The Effects of Vitamin D on Gentamicin-Induced Acute Kidney Injury in Experimental Rat Model
Authors: Hur Ender , Garip Alev , Camyar Asuman , Ilgun Sibel , Ozisik Melih , Tuna Sena , Olukman Murat , Narli Ozdemir Zehra , Yildirim Sozmen Eser , Sen Sait , Akcicek Fehmi , Duman Soner
Published: June 2013

Introduction. Acute kidney injury (AKI) pathogenesis is complex. Findings of gentamicin nephrotoxicity are seen in 30% of the AKI patients. Vitamin D has proven to be effective on renin expression, inflammatory response, oxidative stress, apoptosis, and atherosclerosis. We aimed to investigate the effect of vitamin D in an experimental rat model of gentamicin-induced AKI.Methods. Thirty nonuremic Wistar albino rats were divided into 3 groups: Control group, 1 mL saline intramuscular (im) daily; Genta group, gentamicin 100 mg/kg/day (im); Genta + vitamin D, gentamicin 100 mg/kg/day (im) in addition to 1α, 25 (OH)2D30.4 mcg/kg/day subcutaneously for 8 days. Blood pressures and 24-hour urine were measured. Blood urea and creatinine levels and urine tubular injury markers were measured. Renal histology was semiquantitatively assessed.Results. Urea, creatinine and urine neutrophil gelatinase-associated lipocalin, and kidney injury molecule-1 were all increased in Genta group indicating AKI model. Systolic blood pressure decreased, but urine volume and glutathione increased in Genta + Vit D group compared to Control group. Histological scores indicating tubular injury increased in Genta and Genta + Vit D groups.Conclusions. Vitamin D does not seem to be effective on histological findings although it has some beneficial effects via RAS system and a promising effect on antioxidant system.
Neonauclea reticulata(Havil.) Merr Stimulates Skin Regeneration after UVB Exposure via ROS Scavenging and Modulation of the MAPK/MMPs/Collagen Pathway
Authors: Chiang Hsiu-Mei , Chen Hsin-Chun , Chiu Hua-Hsien , Chen Chien-Wen , Wang Ssu-Meng , Wen Kuo-Ching
Published: June 2013

In this study, we investigated whether the protective effects ofNeonauclea reticulatawater extract against ultraviolet B (UVB) irradiation in human skin fibroblast cell cultures (Hs68) are governed by its ability to protect against oxidative stress and expression of matrix metalloproteinases (MMPs). We found thatNeonauclea reticulataextract exhibited DPPH scavenging activity and inhibited AAPH-induced haemolysis of erythrocytes in a dose- and time-dependent manner. We also found that pretreatment of fibroblasts withNeonauclea reticulatawater extract resulted in markedly lower levels of MMP-1, -3, and -9 expressions. Furthermore, our results indicate thatNeonauclea reticulataextract inhibits the expression of MMPs by inhibiting ERK, JNK, and p38 phosphorylation. Our results also demonstrate that treatment withNeonauclea reticulataextract protects against UVB-induced depletion of collagen. In addition,Neonauclea reticulataextract did not have a cytotoxic effect. These findings indicate that the antioxidant activity ofNeonauclea reticulataextract resulted in inhibition of MMP-1, -3, and -9 expressions and in increased levels of collagen activity. Our results suggest thatNeonauclea reticulataextract can protect against photoaging.
Weighted Kappas for3×3Tables
Authors: Warrens Matthijs J.
Published: June 2013

Weighted kappa is a widely used statistic for summarizing inter-rater agreement on a categorical scale. For rating scales with three categories, there are seven versions of weighted kappa. It is shown analytically how these weighted kappas are related. Several conditional equalities and inequalities between the weighted kappas are derived. The analytical analysis indicates that the weighted kappas are measuring the same thing but to a different extent. One cannot, therefore, use the same magnitude guidelines for all weighted kappas.
Multiple Chemical Sensitivity and the Workplace: Current Position and Need for an Occupational Health Surveillance Protocol
Authors: Martini A. , Iavicoli S. , Corso L.
Published: June 2013

Multiple chemical sensitivity, commonly known as environmental illness, is a chronic disease in which exposure to low levels of chemicals causes correlated symptoms of varying intensity. With the continuous introduction of new substances, people with MCS suffer significant limitations to their living environment and frequently to their workplace. This paper describes the current situation as regards MCS and the critical points in its case definition, which is still not generally agreed upon; this makes it difficult to recognize with certainty, especially, its precise relationship with work. Other problems arise in relation to the occupational physician’s role in diagnosing and managing the worker with the disorder, the question of low levels of exposure to chemicals, and the best measures possible to prevent it. A diagnostic “route” is proposed, useful as a reference for the occupational physician who is often called in first to identify cases suspected of having this disease and to manage MCS workers. Work-related problems for people with MCS depend not only on occupational exposure but also on the incompatibility between their illness and their work. More occupational physicians need to be “sensitive” to MCS, so that these workers are recognized promptly, the work is adapted as necessary, and preventive measures are promoted in the workplace.
Understanding Jordanian Psychiatric Nurses’ Smoking Behaviors: A Grounded Theory Study
Authors: Aldiabat Khaldoun M. , Clinton Michael
Published: June 2013

Purpose. Smoking is prevalent in psychiatric facilities among staff and patients. However, there have been few studies of how contextual factors in specific cultures influence rates of smoking and the health promotion role of psychiatric nurses. This paper reports the findings of a classical grounded theory study conducted to understand how contextual factors in the workplace influences the smoking behaviors of Jordanian psychiatric nurses (JPNs).Method. Semi-structured individual interviews were conducted with a sample of eight male JPNs smokers at a psychiatric facility in Amman, Jordan.Findings. Constant comparative analysis identifiedbecoming a heavy smokeras a psychosocial process characterized by four sub-categories: normalization of smoking; living in ambiguity; experiencing workplace conflict; and, facing up to workplace stressors.Conclusion. Specific contextual workplace factors require targeted smoking cessation interventions if JPNs are to receive the help they need to reduce health risks associated with heavy smoking.
Univex Interval-Valued Mapping with Differentiability and Its Application in Nonlinear Programming
Authors: Li Lifeng , Liu Sanyang , Zhang Jianke
Published: June 2013

Interval-valued univex functions are introduced for differentiable programming problems. Optimality and duality results are derived for a class of generalized convex optimization problems with interval-valued univex functions.
Key Schemes for Security Enhanced TEEN Routing Protocol in Wireless Sensor Networks
Authors: Lee Saewoom , Noh Youngtae , Kim Kiseon
Published: June 2013

In wireless sensor networks (WSNs), hierarchical routing protocol is commonly used for energy efficiency. In particular, the TEEN (Threshold sensitive Energy Efficient sensor Network) protocol is used widely as a basic clustered multihop routing protocol. However, energy efficient routing protocols without proper security suffer from many security vulnerabilities. Hence, in this paper, we propose a hybrid key scheme specially for the TEEN protocol: a symmetric key scheme for the intracluster and a public key scheme for the intercluster. The simulation results show that network lifetime of the proposed hybrid key scheme decreases about 8% than the TEEN protocol and about 4% compared with the TEEN protocol with symmetric key scheme. On the other hand, a hybrid key scheme provides better probability of successful transmission than that of the symmetric key scheme.
A Low-Cost Polytetrafluoroethylene-Framed TiO2Electrode Decorated with Oleic Acid-Capped CdSe Quantum Dots for Solar Cell
Authors: Ayele Delele Worku , Su Wein-Nien , Hwang Bing-Joe
Published: June 2013

Colloidal CdSe QDs have been assembled, as quantum dot-sensitized solar cells (QDSSCs), on a novel architecture comprising a polytetrafluoroethylene- (PTFE-) framed TiO2electrode for the first time. CdSe QDs are anchored on the surface of the film using a linker molecule (3-mercaptopropionic acid, MPA). The resulting photoelectrode comprises a TiO2compact layer and a PTFE-framed structural layer with average respective thicknesses of 2 μm for the compact layer and either 23 μm or 28 μm for the PTFE-framed structural layer. UV-vis absorption spectra show that more CdSe quantum dots are anchored on the surface of the modified with MPA TiO2film compared to direct absorption onto an unmodified film. Energy conversion efficiencies of up to 0.18% can be achieved with cells prepared from a TiO2(25 μm)/MPA/CdSe QD electrode. Electrochemical impedance measurements show that the recombination resistance is relatively higher for a cell assembled with TiO2(25 μm)/MPA/CdSe QD photoanode than with TiO2(25 μm)/CdSe QD resulting in an increase of cell efficiency. The PTFE-framed structure along with the compact layer is a new approach to QDSSC application that provides a tunable film thickness and a cost-effective preparation technique for the large-scale production of the photoanode.
Multisensor Network System for Wildfire Detection Using Infrared Image Processing
Authors: Bosch I. , Serrano A. , Vergara L.
Published: June 2013

This paper presents the next step in the evolution of multi‐sensor wireless network systems in the early automatic detection of forest fires. This network allows remote monitoring of each of the locations as well as communication between each of the sensors and with the control stations. The result is an increased coverage area, with quicker and safer responses. To determine the presence of a forest wildfire, the system employs decision fusion in thermal imaging, which can exploit various expected characteristics of a real fire, including short‐term persistence and long‐term increases over time. Results from testing in the laboratory and in a real environment are presented to authenticate and verify the accuracy of the operation of the proposed system. The system performance is gauged by the number of alarms and the time to the first alarm (corresponding to a real fire), for different probability of false alarm (PFA). The necessity of including decision fusion is thereby demonstrated.
Physical Investigations on ZnO:Ni Layers Deposited by Spray Pyrolysis
Authors: Rajendraprasad Reddy M. , Supriya V. , Sugiyama M. , Reddy K. T. Ramakrishna
Published: June 2013

Nickel-doped ZnO (ZnO:Ni) layers have been deposited on glass substrates by a spray pyrolysis method using zinc acetate and nickel sulphate as precursors. The layers were grown at different substrate temperatures, Ts, that vary in the range 250–350°C. During deposition, the precursor concentration and Ni-doping content were maintained constant at 0.1 M and 10%, respectively. The X-ray diffraction (XRD) analysis showed that all the layers were polycrystalline in nature with the (002) plane as the preferred orientation and exhibited hexagonal wurtzite structure. A sharp increment in the intensity of predominant peak with the substrate temperature was observed consistently that indicated an improvement in the crystallinity of the layers. The Raman studies confirmed the hexagonal wurtzite crystal structure of ZnO and indicated defect states. The X-ray photoelectron spectroscopy (XPS) studies revealed the characteristic peaks of the elements involved in the films and their ionic states. The optical transmittance of the films was higher than 80% and the evaluated energy band gap decreased from 3.17 eV to 3.13 eV with the increase of substrate temperature.
Learning Curve for D2 Lymphadenectomy in Gastric Cancer
Authors: Luna Alexis , Rebasa Pere , Montmany Sandra , Navarro Salvador
Published: June 2013

Background. D2 lymphadenectomy is a demanding technique which is associated with high morbidity in the West. We report our experience with D2 lymphadenectomy after a training period in Japan. Methods. Prospective, descriptive study in 133 consecutive patients undergoing radical gastrectomy for gastric adenocarcinoma from 2005 to 2011. We analysed the number of lymph nodes removed, observed morbidity/mortality compared with the predictions of POSSUM and O-POSSUM, survival, and disease-free interval for patients with D1 and D2 lymphadenectomy. Results. The morbidity rate in patients with D1 lymphadenectomy was 59.4%. For D2 it was 47.7%. The mortality rate in patients with D1 was 6.7%. In the D2 group it was 6.8%. Median survival was 42.9 months in D1 and 55 months in D2. The disease-free interval was 49 months for D1 and 58 months for D2. Conclusion. The learning curve for D2 lymphadenectomy presents acceptable rates of morbidity and mortality, providing that the technique is learnt at a center with extensive experience.