bluuebunny/crossref_metadata_2025 huggingface dataset:
Does day case pediatric tonsillectomy increase postoperative pain compared to overnight stay pediatric tonsillectomy? A prospective comparative audit
Authors: Norrington Amy C. , Flood Liam M. , Meek Tim , Tremlett Michael R.
Published: May 2013

Background

Clinical and financial pressures in the United Kingdom's National Health Service have been a stimulus for change from overnight stay to day case surgery for many procedures, including pediatric tonsillectomy. There are no prospective studies to assess whether such a change in practice alters children's experiences of pain and perioperative morbidity. Therefore, we undertook a prospective audit to measure these adverse outcomes during this change of practice in our unit.

Methods

Sixty children aged between 3 and 15 years who required tonsillectomy were recruited to this prospective comparative audit. Children received treatment on either an overnight stay (n = 28) or day case (n = 32) basis following a strict perioperative care pathway. The primary endpoints were the pain scores reported using a visual analogue scale, and secondary endpoints were vomiting, consultation with healthcare providers, readmission and patient satisfaction. Outcome data were collected from parents at 24 h and 7 days.

Results

There was a small, but significant, risk of greater baseline pain scores in the day case surgery group during the first 24 h. However, there was no difference in the worst pain experienced during the first 24 h, or any pain experienced at 7 days. There was no difference in any of the secondary outcome measures between the groups.

Conclusions

Change in practice from overnight stay to day case surgery for pediatric tonsillectomy requires careful consideration of how to extend effective analgesia for this painful procedure into the home.
Development and utilization of novel SSRs in foxtail millet [Setaria italica (L.) P. Beauv.]
Authors: Gupta Sarika , Kumari Kajal , Muthamilarasan Mehanathan , Subramanian Alagesan , Prasad Manoj
Published: May 2013

Although the foxtail millet [Setaria italica (L.) P. Beauv.] is recently regarded as a model crop for studying functional genomics of biofuel grasses, its genetic improvement to some extent was limited due to the non‐availability of molecular markers, particularly the microsatellite markers and the saturated genetic linkage map. Considering this, we attempted to generate a significant number of microsatellite markers in cultivar ‘Prasad’. Two hundred and fifty‐six clones were sequenced to generate 41.82‐kb high‐quality sequences retrieved from genomic library enriched with dinucleotide repeat motifs. Microsatellites were identified in 194 (76%) of the 256 positive clones, and 64 primer pairs (pp) were successfully designed from 95 (49%) unique SSR‐containing clones. The 67.4% primer designing ability, 100% PCR amplification efficiency and 45.3% polymorphic potential in the parents of F2 mapping population established the efficacy of genomic microsatellites. All the 64 microsatellite markers displayed high level of cross‐species amplification (~67%) in 10 millets and non‐millets species. These experimental findings suggest the utility and efficacy of SSRs in diverse genotyping applications, resolving QTLs, phylogenetic relationships and transferability in several important grass species.
Maternal overprotection score of the Parental Bonding Instrument predicts the outcome of cognitive behavior therapy by trainees for depression
Authors: Asano Motoshi , Esaki Kosei , Wakamatsu Aya , Kitajima Tomoko , Narita Tomohiro , Naitoh Hiroshi , Ozaki Norio , Iwata Nakao
Published: May 2013

Aims

The purpose of this study was to predict the outcome of cognitive behavior therapy (CBT) by trainees for major depressive disorder (MDD) based on the Parental Bonding Instrument (PBI). The hypothesis was that the higher level of care and/or lower level of overprotection score would predict a favorable outcome of CBT by trainees.

Methods

The subjects were all outpatients with MDD treated with CBT as a training case. All the subjects were asked to fill out the Japanese version of the PBI before commencing the course of psychotherapy. The difference between the first and the last Beck Depression Inventory (BDI) score was used to represent the improvement of the intensity of depression by CBT. In order to predict improvement (the difference of the BDI scores) as the objective variable, multiple regression analysis was performed using maternal overprotection score and baseline BDI score as the explanatory variables.

Results

The multiple regression model was significant (P = 0.0026) and partial regression coefficient for the maternal overprotection score and the baseline BDI was −0.73 (P = 0.0046) and 0.88 (P = 0.0092), respectively. Therefore, when a patient's maternal overprotection score of the PBI was lower, a better outcome of CBT was expected.

Conclusion

The hypothesis was partially supported. This result would be useful in determining indications for CBT by trainees for patients with MDD.
Excessive dosing and polypharmacy of antipsychotics caused by pro re nata in agitated patients with schizophrenia
Authors: Fujita Junichi , Nishida Atsushi , Sakata Mutsumi , Noda Toshie , Ito Hiroto
Published: May 2013

Aims

It has been recommended that for patients with schizophrenia, antipsychotics should be prescribed simply, using an optimal dose. However, pro re nata (p.r.n., meaning to use on an as‐needed basis) antipsychotics may increase the risk of excessive dosing (defined as mean chlorpromazine‐equivalent doses above 1000 mg) and polypharmacy (combination use of different antipsychotics). This study aimed to investigate the increased risk caused by p.r.n. antipsychotics.

Method

The subjects included 413 patients with schizophrenia from 17 acute psychiatric wards in nine hospitals. Over a 24‐h period on a survey day, data on regular medication and the use of p.r.n. were collected. The analysis focused on p.r.n. antipsychotics in agitated patients. We used McNemar's test to evaluate differences in the proportions of patients prescribed antipsychotics with excessive dosing or polypharmacy before (i.e., regular medication only) and after prescribed p.r.n. antipsychotics were added to regular medication (i.e., regular medication plus p.r.n. antipsychotics).

Results

Of 413 patients, 312 (75.5%) were prescribed p.r.n. for agitated status. Of those, 281 (90.1%) were prescribed p.r.n. antipsychotics. The total doses were significantly higher and more compounded in case patients prescribed p.r.n. antipsychotics than in those who were not. Seventeen patients (4.1%) were actually administered p.r.n. antipsychotics. Their total medication, including p.r.n. on the current day, represented excessive dosing or polypharmacy of antipsychotics.

Conclusion

The use of p.r.n. antipsychotics may cause hidden excessive dosing and polypharmacy. Our results indicate the importance of careful monitoring of p.r.n. antipsychotics to agitated patients with schizophrenia.
Protective Effect of Tropical Highland Blackberry Juice (Rubus adenotrichos Schltdl.) Against UVB‐Mediated Damage in Human Epidermal Keratinocytes and in a Reconstituted Skin Equivalent Model
Authors: Calvo‐Castro Laura , Syed Deeba N. , Chamcheu Jean C. , Vilela Fernanda M. P. , Pérez Ana M. , Vaillant Fabrice , Rojas Miguel , Mukhtar Hasan
Published: May 2013

Solar ultraviolet (UV) radiation, particularly its UVB (280–320 nm) spectrum, is the primary environmental stimulus leading to skin carcinogenesis. Several botanical species with antioxidant properties have shown photochemopreventive effects against UVB damage. Costa Rica's tropical highland blackberry (Rubus adenotrichos) contains important levels of phenolic compounds, mainly ellagitannins and anthocyanins, with strong antioxidant properties. In this study, we examined the photochemopreventive effect of R. adenotrichos blackberry juice (BBJ) on UVB‐mediated responses in human epidermal keratinocytes and in a three‐dimensional (3D) reconstituted normal human skin equivalent (SE). Pretreatment (2 h) and posttreatment (24 h) of normal human epidermal keratinocytes (NHEKs) with BBJ reduced UVB (25 mJ cm−2)‐mediated (1) cyclobutane pyrimidine dimers (CPDs) and (2) 8‐oxo‐7,8‐dihydro‐2′‐deoxyguanosine (8‐oxodG) formation. Furthermore, treatment of NHEKs with BBJ increased UVB‐mediated (1) poly(ADP‐ribose) polymerase cleavage and (2) activation of caspases 3, 8 and 9. Thus, BBJ seems to alleviate UVB‐induced effects by reducing DNA damage and increasing apoptosis of damaged cells. To establish the in vivo significance of these findings to human skin, immunohistochemistry studies were performed in a 3D SE model, where BBJ was also found to decrease CPDs formation. These data suggest that BBJ may be developed as an agent to ameliorate UV‐induced skin damage.
Skeletal anomalies in reared European fish larvae and juveniles. Part 2: main typologies, occurrences and causative factors
Authors: Boglione Clara , Gisbert Enric , Gavaia Paulo , E. Witten Paul , Moren Mori , Fontagné Stéphanie , Koumoundouros Giorgos
Published: May 2013

The presence of skeletal anomalies in farmed teleost fish is currently a major problem in aquaculture, entailing economical, biological and ethical issues. The common occurrence of skeletal abnormalities in farmed fish and the absence of effective solutions for avoiding their onset or definitely culling out the affected individuals as early as possible from the productive cycle, highlight the need to improve our knowledge on the basic processes regulating fish skeletogenesis and skeletal tissues differentiation, modelling and remodelling. Severe skeletal anomalies may actually occur throughout the entire life cycle of fish, but their development often begins with slight aberrations of the internal elements. Comprehensive investigation efforts conducted on reared larvae and juveniles could provide a great contribution in filling the gap in knowledge, as skeletogenesis and skeletal tissue differentiation occur during these early life stages. The aim of this review is to provide a synthetic but comprehensive picture of the actual knowledge on the ontogeny, typologies and occurrence of skeletal anomalies, and on the proposed causative factors for their onset in larvae and juveniles of European farmed fish. The state‐of‐art of knowledge of these issues is analysed critically intending to individualize the main gaps of knowledge that require to be filled, in order to optimize the morphological quality of farmed juveniles.
Cascading Ecological Responses to an In‐Stream Restoration Project in a Midwestern River
Authors: Heinrich Kaleb K. , Whiles Matt R. , Roy Charlotte
Published: May 2013

River restoration projects are increasingly common, but assessments of ecological responses and overall success of the vast majority of efforts are lacking. Information on potential positive ecological effects of restoration efforts can be used to justify further projects and refine methods. We examined responses of multiple trophic levels, aquatic insects and riparian birds, to a series of rock weirs installed in an Illinois river to stabilize the channel. We quantified adult insect emergence and performed weekly point counts of birds in spring at four weir and four non‐weir (control) sites. Emerging insect abundance was higher at control sites, but species richness and diversity were higher at weir sites. Total insect emergence production did not differ between site types, but emergence production of larger‐bodied taxa was higher at weir sites. Ordinations and analysis of similarity indicated differences in insect and bird assemblages between site types. Birds showed a positive numerical response to large‐bodied emerging insects, and total bird abundance was higher at weir sites. Clutch size and feeding rates of a focal bird species,Prothonotaria citrea(Prothonotary Warbler), did not differ between sites, but the number of hatchlings and fledglings was higher at control sites.Molothrus ater(cowbird) parasitism was higher at weir sites, likely because of increased edge habitat associated with weir construction activities. Results show positive ecological impacts of in‐stream restoration and provide justification for further efforts. However, forest disturbance associated with construction could offset some benefits to some species, and thus refinements to procedures may be necessary.
Evaluating Ecological Restoration Success: A Review of the Literature
Authors: Wortley Liana , Hero Jean‐Marc , Howes Michael
Published: May 2013

Assessing the success of ecological restoration projects is critical to justify the use of restoration in natural resource management and to improve best practice. Although there are extensive discussions surrounding the characteristics that define and measure successful restoration, monitoring or evaluation of projects in practice is widely thought to have lagged behind. We conducted a literature review to determine trends in evaluations of restoration projects and identify key knowledge gaps that need to be addressed. We searched the Web of Knowledge plus two additional restoration journals not found in the database for empirical papers that assessed restoration projects post‐implementation. We quantified the extent that key attributes of success, including ecological (vegetation structure, species diversity and abundance, and ecosystem functioning) and socioeconomic, were addressed by these papers along with trends in publication and restoration characteristics. Encouragingly, we found the number of empirical evaluations has grown substantially in recent years. The increased age of restoration projects and number of papers that assessed ecological functions since previous reviews of the literature is also a positive development. Research is still heavily skewed toward United States and Australia, however, and identifying an appropriate reference site needs further investigation. Of particular concern is the dearth of papers identified in the literature search that included any measure of socioeconomic attributes. Focusing future empirical research on quantifying ecosystem services and other socioeconomic outcomes is essential for understanding the full benefits and costs of ecological restoration and to support its use in natural resource management.
Effect of nutritional status in individuals with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation
Authors: Günay Ersin , Kaymaz Dicle , Selçuk Nursel Türkoglu , Ergün Pinar , Sengül Fatma , Demir Nese
Published: May 2013

Background and objective

Chronic obstructive pulmonary disease (COPD) is considered a worldwide major public health problem. Weight loss, muscle and fat mass depletion are common nutritional problems in COPD patients and are determinant factors in pulmonary function, health status, disability and mortality. We aimed to assess the relationships between nutritional status and perception of dyspnoea, pulmonary function tests (PFT), exercise capacity and health‐related quality of life (HRQoL) using the subjective global assessment (SGA) in COPD patients who were referred for pulmonary rehabilitation programme.

Methods

A total of 163 patients with stable COPD who are candidates for outpatient pulmonary rehabilitation programme were included in this study. Nutritional status for all patients was assessed by SGA. Association of SGA scores (A, B and C) and anthropometric measurements, PFT, dyspnoea scales (Medical Research Council and resting BORG scale), HRQoL (St. George Respiratory Questionnaire and Chronic Respiratory Diseases Questionnaire) and exercise testing (shuttle walking test) were studied for statistical significance.

Results

Based on SGA, 9.2% of patients were severely malnourished (SGA‐C). There were significant decreases in forced expiratory volume in the first second (FEV1) (P = 0.009), Medical Research Council scales (P < 0.001) and exercise capacity (incremental shuttle walking test (P = 0.001) and endurance shuttle walking test (P = 0.009)) in SGA‐C. Deterioration in anthropometric measurements and HRQoL measures were observed in malnourished patients.

Conclusions

Identifying the nutritional status and determining any requirement for nutritional supplement is an important component of comprehensive pulmonary rehabilitation programme. SGA is an easy and practical method to assess nutritional status in pulmonary rehabilitation candidate patients with stable COPD.
Role of permeability barriers in alluvial hydromorphic palaeosols: The Eocene Pondaung Formation, Myanmar
Authors: Licht Alexis , Cojan Isabelle , Caner Laurent , Soe Aung Naing , Jaeger Jean‐Jacques , France‐Lanord Christian
Published: May 2013

This study examines the lateral distribution of hydromorphy in the fine‐grained alluvial deposits of the Eocene Pondaung Formation, central Myanmar. Through detailed outcrop analysis and using a combined sedimentological and pedological approach, this study proposes a reconstruction of Pondaung overbank floodplain palaeoenvironments. The variations of hydromorphic features in the different overbank sub‐environments are then discussed and used to build a model of hydromorphic variability in alluvial deposits. Two main architectural associations with distinctive lithofacies and pedogenic features were identified, corresponding to different sub‐environments: heterolithic deposits and extensive mudstone successions. The heterolithic deposits display variegated fine‐grained lithofacies and contain poorly developed palaeosols with gley and vertic features, which are interpreted to reflect a seasonal wetlands landscape, developed in actively aggrading avulsion belts. Extensive mudstone successions with Vertisols that locally exhibit mukkara‐style pseudogley features are interpreted to represent a distal open‐forested environment. The palaeosols of both sub‐environments display dense local hydromorphic variations they are also characterized by a gradual shift from gley‐dominated to pseudogley‐dominated features with increasing distance from the avulsion belt. The clay‐dominated lithology of the floodplain parent material, which forms numerous subsurface permeability barriers, is shown to have acted as a fundamental control in limiting water‐table dynamics in coarse‐grained parts of the succession, thereby favouring hydromorphic variability. Palaeosol sequences of the Pondaung Formation contrast with the soil‐landscape associations described in other studies and provide an alternative model with which to account for the hydromorphic variability in poorly drained, alluvial soils. The model proposed as an outcome of this study demonstrates that hydromorphic variations can be dramatic in floodplains where permeability barriers are numerous. Further, the model stresses the importance of undertaking detailed lateral palaeosol analyses prior to making interpretations regarding hydromorphic variability.
Human papillomavirus reactivation following treatment of genital graft‐versus‐host disease
Authors: Sri T. , Merideth M.A. , Pulanic T. Klepac , Childs R. , Stratton P.
Published: May 2013

Vaginal chronic graft‐versus‐host disease (cGVHD) is a common complication of stem cell transplantation. Human papillomavirus (HPV) disease can reactivate after transplantation, presumably because of immune factors affecting systemic immunity, such as waning antibody titers, impaired T‐ and B‐lymphocyte responses, and the use of immunosuppressive therapies. However, a relationship between the use of local immunosuppressive agents and HPV reactivation and spread has not been previously described, to our knowledge. A 30‐year‐old woman, 2 years post transplant receiving systemic cyclosporine for cGVHD, was treated with vaginal dilators, topical corticosteroids, and estrogen for vaginal cGVHD. Colposcopy and biopsy for abnormal cytology revealed condylomatous cervicitis. Over the next 4 months, while continuing dilator therapy, linear verrucous lesions developed in the vagina and vulva, and were successfully treated with laser therapy. Use of local immunosuppression and dilators for genital GVHD can enhance spread of HPV infection. Integration of HPV screening and treatment into the care of women with genital cGVHD and development of strategies to manage both conditions simultaneously are warranted.
Record fragmentation due to transfusion at multiple health care facilities: a risk factor for delayed hemolytic transfusion reactions
Authors: Unni Nisha , Peddinghaus Marie , Tormey Christopher A. , Stack Gary
Published: May 2013

Background

Patients transfused at more than one health care facility face safety risks, because their transfusion record is fragmented. Blood group antibodies documented at one facility may be unknown to others. Because many antibodies are evanescent, access to prior antibody records is important for preventing incompatible transfusions and delayed hemolytic reactions. The study goal was to quantify multisite transfusion activity and its impact on antibody record accuracy.

Study Design and Methods

Patients (n = 100) undergoing hospital transfusion testing were surveyed to determine the locations and dates of any prior transfusions. Also, transfusion records were examined to determine whether patients (n = 200) known to be alloimmunized at one hospital had antibody testing done at another nearby hospital and, if so, how often the results were discrepant.

Results

Twenty‐three percent (23/100) of patients undergoing type‐and‐screen testing reported receiving transfusions at 24 other facilities. Locations of transfusions that occurred elsewhere were 54.2% (13/24) at eight other in‐state hospitals, 12.5% in bordering states, 20.8% in more distant states, and 12.5% during military service. Twenty‐one percent (42/200) of patients known to be alloimmunized at one hospital had antibody test results on record at another nearby hospital. Antibody discrepancies were noted in 64.3% (27/42) of cases. The most common discrepancy was the failure of one facility to detect an antibody.

Conclusion

Multisite transfusions were common. For patients seen at both of two nearby hospitals, antibody records were frequently discrepant. The findings support the need for interfacility sharing of transfusion records, particularly at the regional level.
High prevalence of infectious events in thrombotic thrombocytopenic purpura and genetic relationship with toll‐like receptor 9 polymorphisms: experience of the French Thrombotic Microangiopathies Reference Center
Authors: Morgand Marjolaine , Buffet Marc , Busson Marc , Loiseau Pascale , Malot Sandrine , Amokrane Kahina , Fortier Catherine , London Jonathan , Bonmarchand Guy , Wynckel Alain , Provôt François , Poullin Pascale , Vanhille Philippe , Presne Claire , Bordessoule Dominique , Girault Stéphane , Delmas Yahsou , Hamidou Mohamed , Mousson Christiane , Vigneau Cécile , Lautrette Alexandre , Pourrat Jacques , Galicier Lionel , Azoulay Elie , Pène Frédéric , Mira Jean‐Paul , Rondeau Eric , Ojeda‐Uribe Mario , Charron Dominique , Maury Eric , Guidet Bertrand , Veyradier Agnès , Tamouza Ryad , Coppo Paul ,   Thrombotic Microangiopathies Reference Center
Published: May 2013

Background

Infectious events have been reported as major environmental triggers of thrombotic thrombocytopenic purpura (TTP). We detail here the potential association between infections and TTP.

Study Design and Methods

We recruited randomly and prospectively a cohort of 280 consecutive TTP patients during a 9‐year period. Features of infection were systematically recorded.

Results

Features consistent with an infectious event were observed in 114 patients (41%) at time of TTP diagnosis. Infectious agents were documented in 34 cases and were mainly Gram‐negative bacilli. At time of diagnosis infected patients more frequently had fever (p < 0.001). Infections at diagnosis did not impact prognosis and outcome. Thirty‐six percent of patients experienced an infectious event during hospitalization, which resulted in more exacerbation of TTP (p = 0.02). Infections were not overrepresented during treatment in patients who received steroids and/or rituximab. Further genetic analysis of toll‐like receptor (TLR)‐9 functionally relevant polymorphisms revealed that TLR‐9 +2848 G and TLR‐9 +1174 A genotypes were more frequent in TTP patients than in controls (p = 0.04 and p = 0.026, respectively) and more particularly in patients negative for the Class II human leukocyte antigen system susceptibility allele DRB1*11 (p = 0.001 and p = 0.002, respectively). Haplotypes estimation showed that 1174A‐2848G haplotype was significantly more frequent in TTP (p = 0.004), suggesting a primary role for this haplotype variation in conferring a predisposition for acquired TTP.

Conclusion

Infections should be considered as an aggravating factor during the course of TTP. Particular polymorphisms in TLR‐9 gene may represent risk factors for TTP.
Establishing an antigen‐negative red blood cell inventory in a hospital‐based blood bank
Authors: Le Nguyet , Harach Mary E. , Kay Julie K. , Brown Rosemary P. , Everetts Jovanna N. , Herman Jay H.
Published: May 2013

Background

Our blood bank is part of a large academic institution with an active sickle cell anemia program. We provide sickle patients with blood phenotypically matched for C/c, E/e, and K antigens. Since licensed reagents are available for phenotyping C/c, E/e, and K on an automated blood analyzer, we decided to evaluate whether establishing our own inventory of blood negative for those antigens would result in cost savings and decreased turnaround time (TAT).

Study Design and Methods

Antigen typing of blood units for C/c, E/e, and K was validated. From March 1, 2012, to August 31, 2012, a total of 1033 units from our own donor center and from our suppliers were phenotyped. We compared direct cost savings and TAT for blood availability with historical data before we began phenotyping.

Results

Thirty‐eight percent of typed antigen‐negative (AG–) units were transfused to sickle patients. An additional 35% were transfused to nonsickle patients needing AG– blood. Twenty‐one percent were used by patients without antibodies to prevent outdating. The remaining 6% had not yet been transfused by the end of the study period. From March 1, 2011, to August 31, 2011, we spent almost $200,000 on obtaining AG– blood. In the 6 months since we started antigen typing, we have saved approximately $110,000, the majority of which resulted from AG– blood provided to sickle patients. In addition, TAT for AG– units from our inventory significantly improved to 1 to 2 hours versus approximately 6 hours when obtained from our suppliers.

Conclusion

Establishing an AG– inventory in a hospital‐based blood bank is cost‐effective and time‐efficient.
Blood safety and availability: continuing challenges in China's blood banking system
Authors: Shi Ling , Wang Jing‐Xing , Stevens Lori , Ness Paul , Shan Hua
Published: May 2013

Social and economic development, along with increased health care coverage, has caused a sharp increase in the clinical demand for blood in China. Whole blood collection has increased rapidly in the past decade but has failed to keep pace with the ever‐increasing demand. Overall, the country's blood safety has been improved with 99% of whole blood donations collected from voluntary unpaid donors. However, the unmet clinical demand for blood and the increasing incidence of human immunodeficiency virus and syphilis in the general population pose new challenges to China's blood banking system. To ensure a safe and adequate blood supply, continued efforts are required to recruit and retain a sufficient number of low‐risk voluntary blood donors, improve donor prescreening and blood testing process, ease donor restrictions, and strengthen patient blood management.
A novel technique for ventral orbital stabilization: the masseter muscle flap
Authors: Sivagurunathan Amilan , Boy Sonja C. , Steenkamp Gerhard
Published: May 2013

Loss of the caudal maxilla and ventral orbit after tumor resections can have negative functional and esthetic influences on the eye involved. This article reports on a case of a caudal maxillary acanthomatous ameloblastoma involving the ventral orbit that was resected and stabilized with a masseter muscle flap. The masseter muscle flap was generated from the superficial belly of the masseter muscle in order to close a defect in the orbital rim, created by a caudal maxillectomy. None of the published complications such as enophthalmos, excessive lacrimation, globe deviation, or strabismus were noted, 8 months following the procedure. The only clinical sign present at the time of re‐evaluation was mild lacrimation. The authors propose the use of a masseter muscle flap as a viable technique in stabilizing the ventral orbit after caudal maxillectomy and ventral orbitectomy, preventing the complications associated with this surgery.
THE DIVINE SPIRIT AS CAUSAL AND PERSONAL
Authors: Oord Thomas Jay
Published: May 2013

Theists in general and Christians in particular have good grounds for affirming divine action in relation to twenty‐first‐century science. Although humans cannot perceive with their five senses the causation—both divine and creaturely—at work in our world, they have reasons to believe God acts as an efficient, but never sufficient, cause in creation. The essential kenosis option I offer overcomes liabilities in other kenosis proposals, while accounting for a God who acts personally, consistently, persuasively, and yet in diversely efficacious ways. We can reasonably infer that the love, beauty, and truth expressed in creation derive from divine and creaturely causation.
ERNAN MCMULLIN ON CONTINGENCY, COSMIC PURPOSE, AND THE ATEMPORALITY OF THE CREATOR
Authors: Stoeger William R.
Published: May 2013

This article reviews, and offers supportive reflections on, the main points of Ernan McMullin's provocative 1998 article, “Cosmic Purpose and the Contingency of Human Evolution,’’ reprinted in this issue of Zygon. In it he addresses the important science‐theology issue of how the Creator's purpose and intention to assure the emergence of human beings is consonant with the radical contingency of the evolutionary process. After discussing cosmic and biological evolution and critically summarizing recent solutions to this question by Keith Ward, John Polkinghorne, Arthur Peacocke, Alvin Plantinga, and others, who presuppose in different ways that God is subject to time, McMullin compellingly argues for the traditional position, that God is unconditioned by time, and this enables God to work purposefully through contingency, randomness, and chance just as easily as through law‐like regularity.
AN AUGUSTINIAN PHILOSOPHER BETWEEN DUALISM AND MATERIALISM: ERNAN MCMULLIN ON HUMAN EMERGENCE
Authors: Allen Paul L.
Published: May 2013

In claiming the independence of theology from science, Ernan McMullin nevertheless saw the danger of separating these disciplines on questions of mutual significance, as his accompanying article “Biology and the Theology of the Human” in this edition of Zygon shows. This paper analyzes McMullin's adoption of emergence as a qualified endorsement of a view that avoids the excesses of both dualism and materialism. I argue that McMullin's distinctive contribution is the conceptual clarification of emergence in the light of a precise understanding of matter, in light of Aristotelian metaphysics and Darwinian theory. As applied to human nature, McMullin retains an Augustinian outlook that sees spirit as emergent in the human body and which posits a credible biblical hermeneutic. I indicate briefly how McMullin's perspective could be fortified by a fuller natural theology.
TENSIONS IN INTELLIGENT DESIGN'S CRITIQUE OF THEISTIC EVOLUTIONISM
Authors: Kojonen Erkki Vesa Rope
Published: May 2013

“Intelligent Design” (ID) is a contemporary intellectual movement arguing that there is scientific evidence for the existence of some sort of creator. Its proponents see ID as a scientific research program and as a way to build a bridge between science and theology, while many critics see it merely as a repackaged form of religiously motivated creationism: both bad science and bad theology. In this article, I offer a close reading of the ID movement's critique of theistic evolutionism and argue that this critique is ultimately in tension with the movement's broader thought.
HUMANS CREATED ACCORDING TO THE IMAGO DEI: AN ALTERNATIVE PROPOSAL
Authors: Fergusson David
Published: May 2013

Classical approaches to the idea of the imago Dei in the theology of creation have tended to postulate a distinctive element of the human being not found in other creatures, with the possible exception of angels. This is often combined with attempts to use the imago concept as an organizing principle within Christian theology. Such approaches are now problematic not merely on account of their exegetical findings, but for methodological reasons. In light of recent exegesis, the imago Dei in Genesis 1:26–27 should be seen as a signifier of human life under God, rather than a single determining characteristic or essential attribute. Following the wisdom literature, the imago Dei can be understood, in a more diffused manner, as represented by human persons over long periods of evolutionary history in their characteristic quotidian forms of life, thus signifying the providential ordering of human life everywhere. The recent work of David Kelsey on theological anthropology is engaged in this context.
Early treatment causes clinicoradiological reversal of myelopathy due to vitamin B12deficiency
Authors: Verma Rajesh , Kori Prakash , Patil Tushar B , Praharaj Heramba Narayan
Published: May 2013

Vitamin B12deficiency has a wide spectrum of clinical presentation with a variety of neurological symptoms and signs. As a result, many patients lack classic features of advanced severe deficiency. Early diagnosis and treatment are crucial in order to prevent the irreversible damage to the nervous system. We describe a 25-year-old man, who presented with predominant sensory symptoms without any signs on clinical evaluation. His serum vitamin B12levels were low and neuroimaging revealed myelopathy. The patient was treated promptly with cyanocobalamin injections, which lead to a rapid resolution of symptoms and radiological abnormalities.
Ophthalmoplegic migraine with trigeminal nerve involvement
Authors: Sharma Bhawna , Sannegowda Raghavendra Bakki , Kumar Sunil , Dubey Parul
Published: May 2013

We report a 25-year-old man with a history of uncontrolled migrainous headaches who developed third nerve palsy and sensory loss over V1 distribution of trigeminal nerve, during an attack of severe migraine. Gadolinium-enhanced MRI of the brain and cavernous sinus was normal and did not disclose nerve enhancement. CT angiogram was also normal. The patient recovered uneventfully in 2 weeks on oral steroids. The commonest cranial nerve implicated in ophthalmoplegic migraine is the occulomotor nerve. Involvement of the fifth nerve has never been reported.
Acute MI in a young hypertensive woman: could it be due to tranexamic acid?
Authors: Gupta Prabha Nini , Mullamalla Ullas R , P Sabin , Vellappan Praveen
Published: May 2013

The case report illustrates an acute myocardial infarction (MI) in a 41-year-old hypertensive woman possibly because of an intake of a combination of tranexamic acid and mefenamic acid for dysmenorrhoea and menorrhagia. There are multiple case reports of MI occurring in the setting of the use of antifibrinolytic agents including tranexamic acid. The present case serves as a warning that, even in patients with an apparently low risk for arterial thrombosis, these drugs may be implicated as a precipitant of MI.
Serial assessment of local peripheral vascular function after eccentric exercise
Authors: Stacy Mitchel R. , Bladon Kallie J. , Lawrence Jennifer L. , McGlinchy Sarah A. , Scheuermann Barry W.
Published: May 2013

Muscle damage is a common response to unaccustomed eccentric exercise; however, the effects of skeletal muscle damage on local vascular function and blood flow are poorly understood. This study examined serial local vascular responses to flow-mediated (endothelial-dependent) and nitroglycerin-mediated (endothelial-independent) dilation in the brachial artery after strenuous eccentric exercise and serially assessed resting blood flow. Ten healthy males performed 50 maximal eccentric unilateral arm contractions to induce muscle damage to the biceps brachii. Changes in maximal isometric strength and vascular responses were assessed 1, 24, 48, and 96 h after exercise. Mean blood velocities and arterial diameters, measured with Doppler ultrasound, were used to calculate blood flow and shear stress (expressed as area under the curve). Eccentric exercise resulted in impaired maximal isometric strength for up to 96 h (p < 0.001). Reductions in flow-mediated dilation (before exercise, 9.4% ± 2.6%; 1 h after exercise, 5.1% ± 2.2%) and nitroglycerin responses (before exercise, 26.3% ± 6.5%; 1 h after exercise, 20.7% ± 4.7%) were observed in the 1 h after exercise and remained lower for 96 h (p < 0.05). The shear stress response was attenuated immediately after exercise and remained impaired for 48 h (p < 0.05). Resting blood pressure and muscle blood flow remained similar throughout the study. Results suggest that muscle damage from eccentric exercise leads to impaired local endothelial and vascular smooth muscle function. Lower shear stress after exercise might contribute to the observed reduction in flow-mediated dilation responses, but the mechanism responsible for the attenuated endothelial-independent vasodilation remains unclear.
Evaluation of a single-layer desulphurized tailings cover
Authors: Dobchuk Bonnie , Nichol Craig , Wilson G. Ward , Aubertin Michel
Published: May 2013

The potential effectiveness for long-term closure of a desulphurized tailings cover placed on reactive tailings at the Detour Lake Mine was assessed. The single-layer cover was aimed at reducing oxygen ingress using high water saturation to limit oxygen diffusion and consumption of oxygen in the cover by residual sulphide minerals. The cover was 1.0 to 1.5 m thick and met desulphurization targets, but was coarser grained than the design. One-dimensional unsaturated flow and oxygen diffusion modelling was used to predict water content profiles, depth of oxygen penetration, and diffusive oxygen fluxes. Effective diffusion and reaction rate coefficients estimated from field data matched laboratory measurements. Depth to water table was identified as the most important factor for reducing tailings oxidation. The deeper (4 m) water tables measured at the cover edges led to a lower degree of saturation and higher oxygen flux. Finer grain size and higher air-entry values in the cover materials helped maintain saturation, and a capillary break (fine over coarse) cover reduced oxygen fluxes to <5% of fluxes to uncovered tailings. The as-built cover (coarse over fine) reduced oxygen influx by at most 50% and as low as <1% of uncovered tailings.
Analysis of a damaged 12-storey frame-wall concrete building during the 2010 Haiti earthquake Part I: Dynamic behaviour assessment
Authors: Boulanger Benoit , Lamarche Charles-Philippe , Proulx Jean , Paultre Patrick
Published: May 2013

Despite all the damages encountered during the 2010 Haiti earthquake, the 12-storey reinforced-concrete Digicel building behaved well, sustaining only reparable damages. Visual assessment to characterize the damages sustained and ambient vibration tests (AVT) were carried out to identify the building’s key dynamics properties (natural vibration frequencies, mode shapes, and damping ratios). ETABS was used to generate finite element (FE) models before and after the AVT, to evaluate the capabilities of common modelling assumptions to predict the dynamic behaviour of structures. Nonautomated model updating was carried out to generate a model representing the building’s actual dynamic behaviour in its damaged state. The study showed that the finite element method (FEM) is reliable for predicting the dynamic behaviour of structures, but is very sensitive to the modelling assumptions. The models could predict the vibration frequencies precisely, but an accurate representation of the mode shapes required careful model updating.
Potentiation of NMDA Receptors byWithania somniferaon Hippocampal CA1 Pyramidal Neurons
Authors: Bhattarai Janardhan Prasad , Park Soo Joung , Han Seong Kyu
Published: May 2013

In Ayurveda,Withania somnifera (WS) is used as a medicine to maintain mental and physical health as well as to enhance memory. In this study, the methanolic extract of WS(mWS) was tested for its electrical influence on hippocampal CA1 pyramidal neurons using a patch clamp technique. In current clamp mode under a high chloride pipette solution, mWS (400 ng/μl) induced remarkable membrane depolarization (9.75 ± 2.54 mV, n = 6) of CA1 neurons. The mWS-induced depolarization was dose-dependent, reproducible, and persistent in the presence of 0.5 μM tetrodotoxin (TTX, 10.17 ± 0.04 mV, n = 6). In voltage clamp mode (holding potential = -60 mV), mWS induced a dose-dependent non-desensitizing inward current that persisted in the presence of TTX (0.5 μM), suggesting that the response induced by mWS was purely a postsynaptic event. Interestingly, these inward currents were partially blocked by strychnine, a glycine receptor blocker. Further, mWS potentiated the NMDA response in hippocampal CA1 neurons at low concentrations. Overall, these results suggest that there are compounds in WS with possible glycine mimetic activities, which may be potential targets for inducing memory consolidation in hippocampal CA1 neurons.
Maternal Administration of the Herbal Medicine Toki-Shakuyaku-San Promotes Fetal Growth and Placental Gene Expression in Normal Mice
Authors: Li Heng , Wada Etsuko , Wada Keiji
Published: May 2013

Toki-shakuyaku-san (TSS), an herbal formula based on traditional Chinese medicine, is commonly used in obstetrics. To examine the effects of TSS on the normal mouse fetus and placenta, TSS was administered to normal pregnant mice and their placentas and fetuses were studied. First, the effects of maternal TSS treatment on implantation were investigated. Administration of TSS from gestation day 0.5 (G0.5) to G6.5 showed that litter size was not altered at embryonic day 11.5 (E11.5), but the number of resorbed fetuses was slightly decreased. Then, to investigate effects on fetal and placental growths after implantation, TSS was administered from G5.5. At E14.5, the body weight of fetuses from TSS-treated dams was significantly increased. Gene expression of insulin-like growth factor 2 (Igf2), one of the most important modulators of fetal growth, was significantly increased in the placentas and fetuses of TSS-treated dams. In addition, the expression of particular placental developmental genes and nutrient transporter genes was significantly increased in TSS-treated placentas. At E18.5, after longer-term administration of TSS, fetal and placental weights were not altered, but the expression of the placental developmental and nutrient transporter genes remained elevated compared with controls. These results suggest that maternal TSS treatment in normal mice enhances the expression of Igf2, placental developmental genes and nutrient transporter genes, resulting in increased fetal weight. No obvious changes were observed in the expression of these genes after longer-term maternal TSS treatment.
Hexane Fraction fromSargassum fulvellumInhibits Lipopolysaccharide-Induced Inducible Nitric Oxide Synthase Expression in RAW 264.7 Cells via NF-κB Pathways
Authors: Gwon Wi-Gyeong , Lee Min-Sup , Kim Jong-Soon , Kim Jae-Il , Lim Chi-Won , Kim Nam-Gil , Kim Hyeung-Rak
Published: May 2013

Sargassum fulvellum (Turner) C. Agardh has been used to treat various inflammatory diseases, including lump, dropsy, swollen and painful scrotum, and urination problems for several centuries with no side effects. This study aims to investigate the anti-inflammatory effect of the hexane fraction of S. fulvellum (HFS) in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells and phorbol 12-myristate 13-acetate (PMA)-induced mouse-ear edema. The anti-inflammatory activity of HFS in LPS-stimulated RAW 264.7 cells was investigated by assessing the inhibition of nitric oxide (NO) and pro-inflammatory cytokine production during Griess reaction and enzyme-linked immunosorbent assay (ELISA), respectively. The molecular mechanisms that underlie the anti-inflammatory action of HFS were investigated by analyzing the activation of transcription factor and its upstream signaling proteins. Additionally, an in vivo study of the anti-inflammatory effect of HFS was carried out using PMA-induced mouse-ear edema. HFS inhibited LPS-induced NO production in a dose-dependent manner and suppressed the expression of inducible NO synthase (iNOS) in the RAW 264.7 cells. Further, HFS reduced the production of pro-inflammatory cytokines in the LPS-stimulated RAW 264.7 cells. HFS significantly inhibited LPS-induced nuclear factor kappa B (NF-κB) transcriptional activity and NF-κB translocation into the nucleus by preventing degradation of inhibitor κB-α. Moreover, HFS inhibited the activation of Akt and mitogen-activated protein kinases (MAPKs) in the LPS-stimulated RAW 264.7 cells. Furthermore, HFS suppressed PMA-induced mouse-ear edema. The above data indicate that the anti-inflammatory effects of HFS on LPS-stimulated cells are associated with the suppression of NF-κB through the inhibition of MAPKs and Akt phosphorylation.
5,7,3′-Triacetyl Hesperetin Suppresses Adjuvant-Induced Arthritis in Rats through Modulating JAK2/STAT3 Pathway
Authors: Ren Dan Yang , Xu Tao , Li Rong , Huang Cheng , Huang Yan , Li Ren Qiu , Li Hui Ying , Li Jun
Published: May 2013

This work was designed to identify the effect of 5,7,3′-triacetyl hesperetin (TAHP) on rat adjuvant arthritis (AA) and further clarify the possible role of TAHP on modulating Janus kinase signal transducers and activators (JAK/STAT in this process. Freund's complete adjuvant was used to induce AA in rats. TAHP (33, 66, 132 mg/kg) was administered intragastrically. Secondary paw swelling, polyarthritis index, index of immune organs and histopathological assessment were used to evaluate the effects of TAHP on AA in rats. IL-6 in serum and in synovial tissues was examined with ELISA and RT-PCR. In addition, JAK2/STAT3 pathway-related key molecules mRNA expression in synovial tissues of AA rats were detected by RT-PCR and western blot respectively. It was found that TAHP (66, 132 mg/kg) could significantly inhibit secondary paw swelling, restore the index of immune organs and reduce polyarthritis index. Results of histopathological assessment showed that TAHP clearly ameliorated the pathological changes in AA rats. TAHP could downregulate the level of IL-6 in serum and in synovial tissues of AA rats. Besides, treatment with TAHP could decrease mRNA expressions of STAT3 and JAK2, as well as the ratio of p-JAK2/JAK2 protein and p-STAT3/STAT3 protein from synovial tissues. Thus, the paper demonstrated that TAHP had a therapeutic effect on AA in rats and the mechanisms were partly associated with modulating proinflammatory cytokine IL-6 production in serum and in synovial tissues and inhibiting excessive activation of JAK2/STAT3 signaling pathway which might play a crucial role in the pathogenesis of AA.