bluuebunny/crossref_metadata_2025 huggingface dataset:
Environmental Contaminants in Hospital Settings and Progress in Disinfecting Techniques
Authors: Messina Gabriele , Ceriale Emma , Lenzi Daniele , Burgassi Sandra , Azzolini Elena , Manzi Pietro
Published: October 2013

Medical devices, such as stethoscopes, and other objects found in hospital, such as computer keyboards and telephone handsets, may be reservoirs of bacteria for healthcare-associated infections. In this cross-over study involving an Italian teaching hospital we evaluated microbial contamination (total bacterial count (TBC) at 36°C/22°C,Staphylococcusspp., moulds,Enterococcusspp.,Pseudomonasspp.,E. coli, total coliform bacteria,Acinetobacterspp., andClostridium difficile) of these devices before and after cleaning and differences in contamination between hospital units and between stethoscopes and keyboards plus handsets. We analysed 37 telephone handsets, 27 computer keyboards, and 35 stethoscopes, comparing their contamination in four hospital units. Wilcoxon signed-rank and Mann-Whitney tests were used. Before cleaning, many samples were positive forStaphylococcusspp. and coliforms. After cleaning, CFUs decreased to zero in most comparisons. The first aid unit had the highest and intensive care the lowest contamination (P<0.01). Keyboards and handsets had higher TBC at 22°C (P=0.046) and mould contamination (P=0.002) than stethoscopes. Healthcare professionals should disinfect stethoscopes and other possible sources of bacterial healthcare-associated infections. The cleaning technique used was effective in reducing bacterial contamination. Units with high patient turnover, such as first aid, should practise stricter hygiene.
Modeling and Analysis of the Weld Bead Geometry in Submerged Arc Welding by Using Adaptive Neurofuzzy Inference System
Authors: Akkas Nuri , Karayel Durmuş , Ozkan Sinan Serdar , Oğur Ahmet , Topal Bayram
Published: October 2013

This study is aimed at obtaining a relationship between the values defining bead geometry and the welding parameters and also to select optimum welding parameters. For this reason, an experimental study has been realized. The welding parameters such as the arc current, arc voltage, and welding speed which have the most effect on bead geometry are considered, and the other parameters are held as constant. Four, three, and five different values for the arc current, the arc voltage, and welding speed are used, respectively. So, sixty samples made of St 52-3 material were prepared. The bead geometries of the samples are analyzed, and the thickness and penetration values of the weld bead are measured. Then, the relationship between the welding parameters is modeled by using artificial neural network (ANN) and neurofuzzy system approach. Each model is checked for its adequacy by using test data which are selected from experimental results. Then, the models developed are compared with regard to accuracy. Also, the appropriate welding parameters values can be easily selected when the models improve.
Effect of Low-Level Laser Stimulation on EEG Power in Normal Subjects with Closed Eyes
Authors: Wu Jih-Huah , Chang Yang-Chyuan
Published: October 2013

In a previous study, we found that the low-level laser (LLL) stimulation at the palm with a frequency of 10 Hz was able to induce significant brain activation in normal subjects with opened eyes. However, the electroencephalography (EEG) changes to LLL stimulation in subjects with closed eyes have not been studied. In the present study, the laser array stimulator was applied to deliver insensible laser stimulations to the palm of the tested subjects with closed eyes (the laser group). The EEG activities before, during, and after the laser stimulation were collected. The EEG amplitude powers of each EEG frequency band at 19 locations were calculated. These power data were then analyzed by SPSS software using repeated-measure ANOVAs and appropriate posthoc tests. We found a pronounced decrease in the EEG power in alpha-bandwidth during laser simulation and then less decrease in the EEG power in delta-bandwidth in normal subjects with laser stimulation. The EEG power in beta-bandwidth in the right occipital area also decreased significantly in the laser group. We suggest that LLL stimulation might be conducive to falling into sleep in patients with sleep problems.
Extensive Growth of an Anaplastic Meningioma
Authors: Ahmeti Hajrullah , Maslehaty Homajoun , Petridis Athanasios K. , Doukas Alexandros , Mahvash Mehran , Barth Harald , Mehdorn H. M.
Published: October 2013

We present the case of a 30-year-old male patient with an almost complete destruction of the calvarial bone through an anaplastic meningioma diagnosed in line with dizziness. Neuroimaging revealed an extensive growing, contrast enhancing lesion expanding at the supra- and infratentorial convexity, infiltrating and destroying large parts of the skull, and infiltrating the skin. Due to progressive ataxia and dysarthria with proven tumor growth in the posterior fossa in the continuing course, parts of the tumor were resected. A surgical procedure with the aim of complete tumor resection in a curative manner was not possible. Six months after the first operation, due to a new tumor progression, most extensive tumor resection was performed. Due to the aggressive and destructive growth with a high rate of recurrence and tendency of metastases, anaplastic meningiomas can be termed as malignant tumors. The extrinsic growth masks the tumor until they reach a size, which makes these tumors almost unresectable. In the best case scenarios, the five-year survival is about 50%. With the presented case, we would like to show the aggressive behavior of anaplastic meningiomas in a very illustrative way. Chemotherapy, radiotherapy, and surgery reach their limits in this tumor entity.
Transcriptional Regulation of Δ6‐Desaturase by Peroxisome Proliferative‐Activated Receptor δ Agonist in Human Pancreatic Cancer Cells: Role of MEK/ERK1/2 Pathway
Authors: Darabi Maryam , Byagowi Shima , Fayezi Shabnam , Darabi Masoud , Mirshahvaladi Shahab , Sahmani Mehdi
Published: October 2013

The Δ6‐desaturase (Δ6D), also known as fatty acid desaturase 2, is a regulatory enzyme in de novo fatty acid synthesis, which has been linked to obesity and diabetes. The aim of the present study was to investigate the effect of peroxisome proliferative‐activated receptor δ (PPARδ) agonist and MEK/ERK1/2‐dependent pathway on the expression of Δ6D in human pancreatic carcinoma cell line PANC‐1. PANC‐1 cells cultured in RPMI‐1640 were exposed to the commonly used ERK1/2 pathway inhibitor PD98059 and PPARδ agonist GW0742. Changes in mRNA and protein expression of Δ6D were then determined using real‐time RT‐PCR and Western blot, respectively. The expression of Δ6D (P < 0.01) increased following treatment with PPARδ agonist both at mRNA and protein levels, whereas no significant change was observed after treatment with MEK/ERK1/2 pathway inhibitor. It was also found that the increase in the expression of Δ6D in response to GW0742 was significantly inhibited by PD98059 (>40%, P < 0.05) or EGF receptor‐selective inhibitor AG1478 (>25%, P < 0.05) pretreatment. PPARδ and MEK/ERK1/2 signaling pathways affect differentially the expression of Δ6D in pancreatic cancer cells. Furthermore, there may be an inhibitory crosstalk between these two regulatory pathways on the mRNA expression of Δ6D and subsequently on Δ6D protein expression.
Nonlinear Analysis of Return Time Series Model by Oriented Percolation Dynamic System
Authors: Pei Anqi , Wang Jun
Published: October 2013

Fluctuation dynamics of financial price changes is developed and investigated by oriented percolation system; oriented percolation is percolation with a special direction along which the activity can only propagate one way but not the other. Then, nonlinear behaviors of distribution and leverage effect of return time series are studied for the proposed model and the real stock market by comparison. We also investigate the scaling behaviors of return intervals. And a scaling function of exponential parameter is introduced to analyze fluctuation behaviors of return intervals. The empirical research exhibits that, for proper parameters, the simulation data of the model can fit the real markets to a certain extent.
Improvement of Lifetime Using Transition Metal‐Incorporated SAPO‐34 Catalysts in Conversion of Dimethyl Ether to Light Olefins
Authors: Kim Hyo-Sub , Lee Su-Gyung , Kim Young-Ho , Lee Dong-Hee , Lee Jin-Bae , Park Chu-Sik
Published: October 2013

Transition metal (Mn, Fe, or Ni) incorporated SAPO‐34 (MeAPSO‐34)
nanocatalysts were synthesized using a hydrothermal method to improve the catalytic
lifetime in the conversion of dimethyl ether to light olefins (DTO). The structures of the
synthesized catalysts were characterized using several methods including XRD, SEM, BET,
29Si‐MAS NMR, and NH3‐TPD techniques. Although the structure
of the MeAPSO‐34 catalysts was similar to that of the SAPO‐34 catalyst, the amount of weak
acid sites in all MeAPSO‐34 catalysts was markedly increased and accompanied by differences
in crystallinity and structural arrangement. The amount of weak acid sites decreased in
the following order: NiAPSO‐34 > FeAPSO‐34 > MnAPSO‐34 > SAPO‐34
catalyst. The MeAPSO‐34 catalysts, when used in the DTO reaction, maintained DME
conversion above 90% for a longer time than the SAPO‐34 catalyst, while also maintaining
the total selectivity above 95% for light olefins. In addition, the NiAPSO‐34 catalyst showed
the longest catalytic lifetime; the lifetime was extended approximately 2‐fold relative to the
SAPO‐34 catalyst. Therefore, the increase in the catalytic lifetime is related to the amount
of weak acidic sites, and these sites are increased in number by incorporating transition metals into the SAPO‐34 catalyst.
Recurrent Vocal Fold Paralysis and Parsonage-Turner Syndrome
Authors: Pinto Marcus Vinicius , Joffily Lucia , Vincent Maurice Borges
Published: October 2013

Background. Parsonage-Turner syndrome, or neuralgic amyotrophy (NA), is an acute brachial plexus neuritis that typically presents with unilateral shoulder pain and amyotrophy but also can affect other peripheral nerves, including the recurrent laryngeal nerve. Idiopathic vocal fold paralysis (VFP) represents approximately 12% of the VFP cases and recurrence is extremely rare.Methods and Results. We report a man with isolated recurrent unilateral right VFP and a diagnosis of NA years before.Conclusions. We emphasize that shoulder pain and amyotrophy should be inquired in any patient suffering from inexplicable dysphonia, and Parsonage-Turner syndrome should be considered in the differential diagnosis of idiopathic VFP.
Long-Term Drug Survival of TNF Inhibitor Therapy in RA Patients: A Systematic Review of European National Drug Registers
Authors: Arora Anamika , Mahajan Anadi , Spurden Dean , Boyd Helen , Porter Duncan
Published: October 2013

Objective. The present systematic review of RA registry data was undertaken to analyse the time on treatment of licensed TNF inhibitors in patients with RA in Europe.Methods. English language European registry studies comparing TNF inhibitors were searched using MEDLINE, Embase, Cochrane, and WHO: ICTRP up to 16 April 2012 and proceedings of three selected conferences held between 2010 and 2012. Pooled analysis was performed to determine drug survival rates for each TNF inhibitor.Results. Sixteen studies met the inclusion criteria, of which 11 studies assessed biologic-naive patients and five studies included a mixed population of biologic-naive and biologic pretreated patients. The overall effectiveness of TNF inhibitors diminished with time, leading to decreased drug survival rates. Pooled drug survival rates after 60 months follow-up were 37% (infliximab), 48% (adalimumab), and 52% (etanercept). Further, in an observational study, when TNF inhibitors were used in combination with methotrexate, a longer drug survival was observed compared to TNF inhibitors alone.Conclusion. The findings of this systematic review indicated numerically lower drug discontinuation rates with etanercept than adalimumab, whereas infliximab had the highest rate. Further research is needed to understand the underlying mechanisms of treatment discontinuation with TNF inhibitors.
Secular, Spiritual, and Religious Existential Concerns of Women with Ovarian Cancer during Final Diagnostics and Start of Treatment
Authors: Seibaek Lene , Hounsgaard Lise , Hvidt Niels Christian
Published: October 2013

Introduction. This paper deals with secular, spiritual, and religious existential concerns during severe illness.Materials and Methods. Qualitative research interviews were made before and after surgery with women who underwent final diagnostics, surgery, and chemotherapy for ovarian cancer. By applying a phenomenological-hermeneutic text interpretation methodology the findings were systematically identified, placed into meaning structures, interpreted, and critically discussed.Results. The analysis offered insight into the complexity of challenges and personal development over time in being a woman with ovarian cancer during her first treatment period. Although the women experienced their health to be seriously threatened, they also felt hope, will, and courage. The diagnostic procedures and treatment had comprehensive impact on their lives. However, hope and spirituality were important resources of comfort and meaning.Conclusion. Hope and courage to face life represent significant personal resources that are created not only in the interplay between body and mind but also between patients and their healthcare professionals. The women dealt with this in a dialectical manner, so that hope and despair could be present simultaneously. In this process secular, spiritual, and religious existential meaning orientations assisted the women in creating new narratives and obtain new orientations in life.
Evaluation of Arterial Stiffness for Predicting Future Cardiovascular Events in Patients with ST Segment Elevation and Non‐ST Segment Elevation Myocardial Infarction
Authors: Akkus Oguz , Sahin Durmus Yildiray , Bozkurt Abdi , Nas Kamil , Ozcan Kazım Serhan , Illyés Miklós , Molnár Ferenc , Demir Serafettin , Tüfenk Mücahit , Acarturk Esmeray
Published: October 2013

Background. Arterial stiffness parameters in patients who experienced MACE after acute MI have not been studied sufficiently. We investigated arterial stiffness parameters in patients with ST segment elevation (STEMI) and non‐ST segment elevation myocardial infarction (NSTEMI). Methods. Ninety‐four patients with acute MI (45 STEMI and 49 NSTEMI) were included in the study. Arterial stiffness was assessed noninvasively by using TensioMed Arteriograph. Results. Arterial stiffness parameters were found to be higher in NSTEMI group but did not achieve statistical significance apart from pulse pressure (P = 0.007). There was no significant difference at MACE rates between two groups. Pulse pressure and heart rate were also significantly higher in MACE observed group. Aortic pulse wave velocity (PWV), aortic augmentation index (AI), systolic area index (SAI), heart rate, and pulse pressure were higher; ejection fraction, the return time (RT), diastolic reflex area (DRA), and diastolic area index (DAI) were significantly lower in patients with major cardiovascular events. However, PWV, heart rate, and ejection fraction were independent indicators at development of MACE. Conclusions. Parameters of arterial stiffness and MACE rates were similar in patients with STEMI and NSTEMI in one year followup. The independent prognostic indicator aortic PWV may be an easy and reliable method for determining the risk of future events in patients hospitalized with acute MI.
Remembering the Children: Implementation and Success of a Robust Method for Identifying and Testing Children of HIV Patients
Authors: Darlow Christopher , Tovey Peter , Wallis Fiona , Knowles Clare , Fairley Ian , Lacey Charles , Martin Fabiola
Published: October 2013

Background. Children of HIV patients are a historically neglected demographic by HIV services. It has been recommended by CHIVA that HIV services have a robust method of detecting and testing untested children. We note that no such method is either in widespread use or in the literature. Method. In December 2011, a one-page proforma to identify HIV untested children and a clear multidisciplinary pathway to test them were implemented. Twelve months later the uptake of the proforma and pathway, the numbers of patients and children identified for testing, and their outcomes were audited. Results. The proforma was completed in 192/203 (94.6%) eligible patients. Twenty-five (21.5%) of 118 identified offspring had not been tested. Ten (8.5%) of these were <18 years old. All were reported to be clinically well. Ten children were referred for testing, seven were tested immediately, and three were tested within 18 months of identification. All children were tested HIV negative. Discussion. We have identified a method of identification that is easy and robust and provides a user-friendly safety net to empower healthcare providers to identify and test children at risk. We recommend the implementation of such strategies nationwide to prevent death due to undiagnosed HIV in children.
On a Class of Self-Adjoint Compact Operators in Hilbert Spaces and Their Relations with Their Finite-Range Truncations
Authors: De la Sen M.
Published: October 2013

This paper investigates a class of self-adjoint compact operators in Hilbert spaces related to their truncated versions with finite-dimensional ranges. The comparisons are established in terms of worst-case norm errors of the composite operators generated from iterated computations. Some boundedness properties of the worst-case norms of the errors in their respective fixed points in which they exist are also given. The iterated sequences are expanded in separable Hilbert spaces through the use of numerable orthonormal bases.
Are Koreans Prepared for the Rapid Increase of the Single‐Household Elderly? Life Satisfaction and Depression of the Single‐Household Elderly in Korea
Authors: Won Mi-Ra , Choi Yun-Jung
Published: October 2013

Purpose. In Korea, it has been estimated that the number of the single‐household elderly increased 45% from 2005 to 2010. This research was conducted to provide empirical resources for development of a community mental health program by an explorative investigation on depression, coping mechanism, and life satisfaction of a single‐household elderly population. Design and Methods. This research applied a descriptive survey research design. Participants were 225 single‐household elderlies residing in Seoul, Korea. The geriatric depression scale and the satisfaction with life scale were used to check the level of depression and life satisfaction of the participants. Results. Results showed that 46.3 percent of the participants were categorized as having light‐to‐severe level of depression, and 80.5 percent of the participants responded that they were dissatisfied with their lives. This research demonstrated that the level of depression and life satisfaction of the Korean single‐household elderly is statistically significantly related to age and gender as well as coping resources and human resources. Implications. Current public health services in Korea for the single‐household elderly are still lacking and require active support, intervention, and research to provide effective programs and services. Case management, counseling, and various programs based on Korean culture including support from family members and community‐based assistance are recommended to help the vulnerable population.
Preclinical Activity Profile and Therapeutic Efficacy of the HSP90 Inhibitor Ganetespib in Triple-Negative Breast Cancer
Authors: Proia David A. , Zhang Chaohua , Sequeira Manuel , Jimenez John-Paul , He Suqin , Spector Neil , Shapiro Geoffrey I. , Tolaney Sara , Nagai Masazumi , Acquaviva Jaime , Smith Donald L. , Sang Jim , Bates Richard C. , El-Hariry Iman
Published: October 2013

Purpose: Treatment options for patients with triple-negative breast cancer (TNBC) are largely limited to systemic chemotherapies, which have shown disappointing efficacy in the metastatic setting. Here, we undertook a comprehensive evaluation of the activity of ganetespib, a potent inhibitor of HSP90, in this malignancy.

Experimental Design: The antitumor and antimetastatic activity of ganetespib was investigated using TNBC cell lines and xenograft models. Combinatorial drug analyses were performed with chemotherapeutic agents and concomitant effects on DNA damage and cell-cycle disruption were assessed in vitro; antitumor efficacy was assessed in vivo. Metabolic and objective tumor responses were evaluated in patients with metastatic TNBC undergoing ganetespib treatment.

Results: Ganetespib simultaneously deactivated multiple oncogenic pathways to potently reduce cell viability in TNBC cell lines, and suppressed lung metastases in experimental models. Ganetespib potentiated the cytotoxic activity of doxorubicin via enhanced DNA damage and mitotic arrest, conferring superior efficacy to the doxorubicin–cyclophosphamide regimen in TNBC xenografts. Ganetespib also promoted mitotic catastrophe and apoptosis in combination with taxanes in vitro, and these effects translated to significantly improved combinatorial activity in vivo. Marked tumor shrinkage of metastatic lung and lymphatic lesions were seen in patients on ganetespib monotherapy.

Conclusion: The preclinical activity profile and clinical evidence of tumor regression suggest that ganetespib offers considerable promise as a new therapeutic candidate to target TNBC. Clin Cancer Res; 20(2); 413–24. ©2013 AACR.
Breaking the Invulnerability of Cancer Stem Cells: Two-Step Strategy to Kill the Stem-like Cell Subpopulation of Multiple Myeloma
Authors: Morgenroth Agnieszka , Vogg Andreas T.J. , Zlatopolskiy Boris D. , Siluschek Monika , Oedekoven Caroline , Mottaghy Felix M.
Published: October 2013

In multiple myeloma, the presence of highly resistant cancer stem cells (CSC) that are responsible for tumor metastasis and relapse has been proven. Evidently, for achieving complete response, new therapeutic paradigms that effectively eradicate both, CSCs and bulk cancer populations, need to be developed. For achieving that goal, an innovative two-step treatment combining targeting of thymidine de novo synthesis pathway and a nanoirradiation by the Auger electron emitting thymidine analogue 123/125I-5-iodo-4′-thio-2′-deoxyuridine (123/125I-ITdU) could be a promising approach. The pretreatment with thymidylate synthase inhibitor 5-fluoro-2′-deoxyuridine (FdUrd, 1 μmol/L for 1 hour) efficiently induced proliferation and terminal differentiation of isolated myeloma stem-like cells. Moreover, FdUrd stimulation led to a decreased activity of a functional CSC marker, aldehyde dehydrogenase (ALDH). The metabolic conditioning by FdUrd emerged to be essential for enhanced incorporation of 125I-ITdU (incubation with 50 kBq/2 × 104 cells for 4 days) and, consequently, for the induction of irreparable DNA damage. 125I-ITdU showed a pronounced antimyeloma effect on isolated tumor stem-like cells. More than 85% of the treated cells were apoptotic, despite activation of DNA repair mechanisms. Most important, exposure of metabolically conditioned cells to 125I-ITdU resulted in a complete inhibition of clonogenic recovery. This is the first report showing that pretreatment with FdUrd sensitizes the stem-like cell compartment in multiple myeloma to apoptosis induced by 125I-ITdU–mediated nanoirradiation of DNA. Mol Cancer Ther; 13(1); 144–53. ©2013 AACR.
NO-Dependent Endothelial Dysfunction in Type II Diabetes Is Aggravated by Dyslipidemia and Hypertension, but Can Be Restored by Angiotensin-Converting Enzyme Inhibition and Weight Loss
Authors: Nevelsteen Ines , Van den Bergh An , Van der Mieren Gerry , Vanderper Annelies , Mubagwa Kanigula , Bult Hidde , Herijgers Paul
Published: October 2013

Aims: Insulin resistance, dyslipidemia and hypertension are independent mediators of endothelial dysfunction. It is incompletely defined whether dyslipidemia and hypertension in addition to diabetes mellitus type II (DMII), as seen in the metabolic syndrome (MS), worsen diabetes-induced endothelial dysfunction. Furthermore, it is unclear whether treatment influences endothelial dysfunction similarly in MS and DMII. Therefore, we studied vascular reactivity and the effect of in vivo treatment with angiotensin-converting enzyme inhibition (ACE-I) or hypocaloric diet in LDL receptor- and leptin-deficient (ob/ob), double knockout mice (DKO), featuring MS and in ob/ob mice with DMII. Methods and Results: Vascular reactivity was studied in isolated aortic ring segments. Maximum vasorelaxant response to acetylcholine (Ach) was more depressed in DKO than in ob/ob mice, whereas response to bradykinin (BK) was equally attenuated in both genotypes (52 ± 3 and 23 ± 9% reversal of preconstriction induced by 10-7M phenylephrine in DKO vs. 76 ± 3 and 23 ± 8% reversal of preconstriction in ob/ob mice, respectively). ACE-I and hypocaloric diet improved ACh-induced vasorelaxation significantly (89 ± 2 and 59 ± 2% reversal of preconstriction in DKO vs. 80 ± 3 and 84 ± 4% in ob/ob mice, respectively), but not the response to BK. Conclusion: These results indicate a differential impact of DMII and MS on endothelial function. ACE-I and hypocaloric diet improved ACh-, but not BK-induced vasorelaxation in these mouse models of DMII and MS.
Cupping for Chronic Nonspecific Neck Pain: A 2-Year Follow-Up
Authors: Lauche Romy , Cramer Holger , Langhorst Jost , Dobos Gustav
Published: October 2013

Background: Several trials have shown that cupping might be an effective treatment for chronic nonspecific neck pain, but little is known about the long-term effectiveness. This study aimed to investigate long-term effects of a short series of cupping; therefore additional follow-up measurements were conducted 2 years after completion of 3 studies. Patients and Methods: Participants from 3 randomized waitlist controlled trials on cupping for chronic nonspecific neck pain were followed 2 years after treatment. Outcome measures included neck pain intensity (100 mm Visual Analog Scale; VAS), functional disability (Neck Disability Index, NDI), and health-related quality of life (Short Form 36 Health Survey Questionnaire; SF-36). Results: 133 of 150 patients had received cupping treatment and were contacted; 82 of them (61.7%) returned the follow-up questionnaires. No effect was found for neck pain intensity, but for physical function (∆ NDI: -3.15; 95% CI: -5.89; -0.41; p = 0.025) and quality of life (∆ physical component summary: 2.97; 95% CI: 0.97; 4.97; p = 0.004; ∆ bodily pain: 14.53; 95 % CI: 9.67; 19.39; p < 0.001). Mean duration of cupping effect was 8.9 ± 8.7 months with 16 patients reporting that neck pain had not yet reached the level before cupping. The majority of the patients did not continue cupping therapy, mostly due to lack of providers, costs or loss of interest. Conclusions: A series of cupping treatments did not influence neck pain intensity on the longer term, however significant increases were found for physical function and quality of life in patients with chronic nonspecific neck pain. Due to the considerable drop-out rate conclusions are limited. There is evidence suggesting that cupping treatment might have sustainable effects in some patients. Further randomized controlled trials with long-term follow-up are urgently needed for conclusive judgment of long-term effectiveness.
Serum neutrophil gelatinase-associated lipocalin (NGAL) in patients with Shiga toxin mediated haemolytic uraemic syndrome (STEC-HUS)
Authors: Beneke Jan , Menne Jan , Vetter Frank , Schmidt Bernhard M. W. , Schiffer Mario , Haller Hermann , Kümpers Philipp , Kielstein Jan T. , Lukasz Alexander
Published: October 2013

Neutrophil gelatinase-associated lipocalin (NGAL) is an increasingly used biomarker for acute kidney injury (AKI). Its utility in adult patients with AKI caused by Shiga toxin producing Escherichia coli infection (STEC)-associated haemolytic-uraemic syndrome (HUS), remains unknown. We aimed to evaluate the prognostic value of serum NGAL admission levels for the need of renal replacement therapy (RRT) in STEC-HUS patients. Baseline serum NGAL was determined by ELISA in 39 patients with STEC O104:H4 infection cared for at Hannover Medical School during the outbreak in Germany through May-July 2011. Patients with HUS had significant higher NGAL levels than healthy controls (379 [248 – 540] vs 39.0 [37.5–45] ng/ml, p < 0.0001). During clinical course, 24 patients required RRT at a median of five days after admission. NGAL admission levels were higher in patients requiring RRT (476 (344–639) ng/ml) compared to patients not requiring RRT (257 (196–426) ng/ml; p < 0.001). Unadjusted and adjusted logistic regression analyses identified NGAL as an independent predictor for need of RRT. In a combined model, a joint NGAL/AKIN classification approach improved the predictive accuracy for need of RRT over either marker alone. The combined categorical cut-off point defined by NGAL ≥ 330 ng/ml and presence of AKI (AKIN ≥ I) on admission correctly identified 20 of 24 patients requiring RRT (odds ratio 20, sensitivity 83%, specificity 80%, negative predictive value 75%, positive predictive value 87%). NGAL may serve as an adjunctive tool to improve risk prediction in patients with STEC-HUS.
Anti-prothrombin (aPT) and anti-phosphatidylserine/prothrombin (aPS/PT) antibodies and the risk of thrombosis in the antiphospholipid syndrome
Authors: Sciascia Savino , Sanna Giovanni , Murru Veronica , Roccatello Dario , Khamashta Munther A. , Bertolaccini Maria Laura
Published: October 2013

Antibodies to prothrombin are detected by directly coating prothrombin on irradiated ELISA plates (aPT) or by using the phosphatidylserine/ prothrombin complex as antigen (aPS/PT). Although these antibodies have both been associated with antiphospholipid syndrome (APS) and a correlation between the two assays have been reported, it seems that aPT and aPS/PT belong to different populations of autoantibodies. It was our objective to systematically review the available evidence on aPT and aPS/PT antibodies and the risk of thrombosis in APS. Medline-reports published between 1988 and 2013 investigating aPT and aPS/PT as a risk factor for thrombosis were included. Whenever possible, antibody isotype(s) and site of thrombosis were analysed. This systematic review is based on available data from more than 7,000 patients and controls from 38 studies analysing aPT and 10 aPS/PT. Antibodies to prothrombin (both aPT and aPS/PT) increased the risk of thrombosis (odds ratio [OR] 2.3; 95% confidence interval [CI] 1.72–3.5). aPS/PT seemed to represent a stronger risk factor for thrombosis, both arterial and/or venous than aPT (OR 5.11; 95%CI 4.2–6.3 and OR 1.82; 95%CI 1.44–2.75, respectively). In conclusion, routine measurement of aPS/PT (but not aPT) might be useful in establishing the thrombotic risk of patients with previous thrombosis and/or systemic lupus erythematosus. Their inclusion as laboratory criteria for the APS should be indisputably further explored.
Validation of Noninvasive Indices of Global Systolic Function in Patients With Normal and Abnormal Loading Conditions
Authors: Yotti Raquel , Bermejo Javier , Benito Yolanda , Sanz-Ruiz Ricardo , Ripoll Cristina , Martínez-Legazpi Pablo , del Villar Candelas Pérez , Elízaga Jaime , González-Mansilla Ana , Barrio Alicia , Bañares Rafael , Fernández-Avilés Francisco
Published: October 2013

Background—

Noninvasive indices based on Doppler echocardiography are increasingly used in clinical cardiovascular research to evaluate left ventricular global systolic chamber function. Our objectives were to clinically validate ultrasound-based methods of global systolic chamber function to account for differences between patients in conditions of abnormal load, and to assess their sensitivity to load confounders.

Methods and Results—

Twenty-seven patients (8 dilated cardiomyopathy, 10 normal ejection fraction, and 9 end-stage liver disease) underwent simultaneous echocardiography and left heart catheterization with pressure-conductance instrumentation. The reference index, maximal elastance (
E
max
), was calculated from pressure–volume loop data obtained during acute inferior vena cava occlusion. A wide range of values were observed for left ventricular systolic chamber function (
E
max
: 2.8±1.0 mm Hg/mL), preload, and afterload. Among the noninvasive indices tested, the peak ejection intraventricular pressure difference showed the best correlation with
E
max
(
R
=0.75). A significant but weaker correlation with
E
max
was observed for ejection fraction (
R
=0.41), midwall fractional shortening (
R
=0.51), global circumferential strain (
R
=−0.53), and strain rate (
R
=−0.46). Longitudinal strain and strain rate failed to correlate with
E
max
, as did noninvasive single-beat estimations of this index. Principal component and multiple regression analyses demonstrated that peak ejection intraventricular pressure difference was less sensitive to load, whereas ejection fraction and longitudinal strain and strain rate were heavily influenced by afterload.

Conclusions—

Current ultrasound methods have limited accuracy to characterize global left ventricular systolic chamber function in a given patient. The Doppler-derived peak ejection intraventricular pressure difference should be preferred for this purpose because it best correlates with the reference index and is more robust in conditions of abnormal load.
Preventable Readmissions Within 30 Days of Ischemic Stroke Among Medicare Beneficiaries
Authors: Lichtman Judith H. , Leifheit-Limson Erica C. , Jones Sara B. , Wang Yun , Goldstein Larry B.
Published: October 2013

Background and Purpose—

The Centers for Medicare and Medicaid Services proposes to use 30-day hospital readmissions after ischemic stroke as part of the Hospital Inpatient Quality Reporting Program for payment determination beginning in 2016. The proportion of poststroke readmissions that is potentially preventable is unknown.

Methods—

Thirty-day readmissions for all Medicare fee-for-service beneficiaries aged ≥65 years discharged alive with a primary diagnosis of ischemic stroke (
International Classification of Diseases
,
Ninth Revision
, Clinical Modification 433, 434, 436) between December 2005 and November 2006 were analyzed. Preventable readmissions were identified based on 14 Prevention Quality Indicators developed for use with administrative data by the US Agency for Healthcare Research and Quality. National, hospital-level, and regional preventable readmission rates were estimated. Random-effects logistic regression was also used to determine patient-level factors associated with preventable readmissions.

Results—

Among 307 887 ischemic stroke discharges, 44 379 (14.4%) were readmitted within 30 days; 5322 (1.7% of all discharges) were the result of a preventable cause (eg, pneumonia), and 39 057 (12.7%) were for other reasons (eg, cancer). In multivariate analysis, older age and cardiovascular-related comorbid conditions were strong predictors of preventable readmissions. Preventable readmission rates were highest in the Southeast, Mid-Atlantic, and US territories and lowest in the Mountain and Pacific regions.

Conclusions—

On the basis of Agency for Healthcare Research and Quality Prevention Quality Indicators, we found that a small proportion of readmissions after ischemic stroke were classified as preventable. Although other causes of readmissions not reflected in the Agency for Healthcare Research and Quality measures could also be avoidable, hospital-level programs intended to reduce all-cause readmissions and costs should target high-risk patients.
Epeorus petersi, a new species of Heptageniidae (Ephemeroptera) from the Western Ghats of southern India
Authors: SIVARUBAN T. , BARATHY S. , ARUNACHALAM M. , VENKATARAMAN K. , SIVARAMAKRISHNAN K. G.
Published: October 2013

Heptageniidae is a family of mayflies (Ephemeroptera) distributed mainly in the Holarctic, Oriental and Afrotropical regions (Webb & McCafferty 2008). This family is Laurasian in origin and is a conspicuous component of the benthic community in the hill streams of the Western Ghats of southern India. This is a global hotspot of biodiversity endowed with a high degree of species endemism and is considered a significant reservoir of ancient lineages (Bossuyt et al. 2005).
Torture and terror post-9/11: The role of social work in responding to torture
Authors: Brooks Aloysia
Published: October 2013

Whilst terrorism is not a new global phenomenon, the fallout from the 9/11 terrorist attacks in the US remain extensive and far reaching, including the sanctioning of harsher security measures and the denigration of human rights and civil liberties. Of particular concern is the move towards torture being an accepted practice for those deemed ‘terror suspects’ or captured ‘enemy’ combatants in countries where the so called ‘war on terror’ is still being played out. This article argues that the social work response, particularly in relation to challenging pro-torture rhetoric, has been limited at best, and to effectively address the problem there must be an international response if social work is to adhere to its obligations under the IFSW Code of Ethics, and fulfil its role as a human rights profession.
Experimental approach for mixed-mode fatigue delamination crack growth with large-scale bridging in polymer composites
Authors: Holmes John W , Liu Liu , Sørensen Bent F , Wahlgren Søren
Published: October 2013

An experimental apparatus utilizing double cantilever beam specimens loaded with uneven bending moments was developed to study the mixed-mode fatigue crack growth in composites. The approach is suitable when large-scale bridging of cracks is present. To illustrate the testing method, cyclic growth of delaminations in a typical fibre-reinforced polymer composite was investigated under a constant cyclic loading amplitude. Pure mode I, mode II and mixed-mode crack growth conditions were examined. The results, analysed using a J-integral approach, show that the double cantilever beam loaded with uneven bending moments configuration provides a robust approach to investigate the fatigue crack growth of composites for pure mode and mixed-mode cracking. A steady-state crack growth regime was observed for mode I and mixed-mode loading. For mode II loading, steady-state was absent, and a progressively decreasing crack growth rate observed. In addition to details concerning the equipment, a general discussion of the development of cyclic bridging laws for delamination growth in the presence of large-scale bridging is provided.
Study of efficiency of different commercial carbon nanotubes on manufacturing of epoxy matrix composites
Authors: Prolongo SG , Melitón BG , Jiménez-Suárez A , Ureña A
Published: October 2013

The influence of geometry and structure of different commercial multi-walled carbon nanotubes (MWCNTs) have been analysed. MWCNTs have been characterized by transmission and high-resolution scanning electron microscopy, measurement of specific surface area by nitrogen isotherm and X-ray diffraction. The behaviour of carbon nanotube/epoxy composites has been studied by dynamic mechanical thermal analysis, differential scanning calorimetry, measurements of density and electrical conductivity. Composites manufactured at the same experimental conditions and with the same nanofiller content presented different thermal, mechanical and electrical properties. Despite using MWCNTs with similar aspect ratio, the presence of surface defects on the nanotube structure induces an important decrease in storage modulus and electrical conductivity of composites. The functionalization of MWCNTs leads to composites with lower electrical conductivity due to the breaking of sp2 carbon delocalization and also due to the insulating polymer film wrapping the nanotube. In contrast, resin reinforced with long MWCNTs present higher modulus and electrical conductivity than those filled with shorter nanotubes.
The Media-Entertainment Industry and the “War on Drugs” in Mexico
Authors: Mercille Julien
Published: October 2013

Since 2006, Mexico has militarized its “war on drugs,” backed by the United States. Examination of this drug war from a critical political economic angle suggests that the neoliberal reforms implemented in Mexico over the past several decades have increased the size of the drug industry and that drug war rhetoric facilitates the containment of popular opposition to neoliberal policies. U.S. popular culture has contributed to legitimizing the drug war and making it more acceptable to the U.S. public. An analysis of selected movies, television series, and a video game shows that the themes presented in these productions are very similar to those conveyed by U.S. government officials and mainstream analysts. Indeed, popular culture messages reflect elite views of U.S. foreign policy because the media-entertainment industry is itself part of the corporate establishment.

Desde 2006, México, con el apoyo de los Estados Unidos, ha militarizado su “guerra contra el narcotráfico.” Una crítica de esta guerra contra el narco de un punto de vista político-económico sugiere que las reformas neoliberales implementadas en México durante ya varias décadas han agrandado la industria de estupefacientes, y que la retórica de la guerra contra el narco facilita la contención de la oposición popular que se opone a la política neoliberal. Mientras tanto, en los Estados Unidos, la cultura popular ha contribuido a legitimar y hacer más aceptable la guerra contra el narco. Un análisis de películas y series de televisión seleccionadas, más un juego de video, muestra que los temas presentados en estas producciones son muy parecidos a los difundidos por oficiales del gobierno de Estados Unidos y analistas convencionales. De hecho, los mensajes de la cultura popular reflejan las perspectivas de la élite con respecto a la política exterior de los Estados Unidos porque los mismos medios de entretenimiento forman parte del establecimiento corporativo.
Intrastate peace agreements and the durability of peace
Authors: Badran Ramzi
Published: October 2013

The article debunks the conception that peace agreements are all equal. Distinct from the conventional monocausal assessment, I view the peace agreement as a cohesive whole and evaluate its strength in terms of its structural and procedural provisions. I use data on the length of intrastate peace episodes during the period from 1946 to 2010. My key finding is that the design quality of the peace agreement has a significant impact on the durability of peace. Agreements that are carefully designed to deal with all obstacles to cooperation have the strongest pacifying effect among armed conflict outcomes. The article sets forth ways to sharpen the performance of conflict management operations in war-torn countries.
Negotiating Gender through Fun and Play
Authors: van Bohemen Samira , van Zoonen Liesbet , Aupers Stef
Published: October 2013

The Red Hat Society (RHS) is a relatively new and international women’s network that offers “fun” and “friendship” specifically for women over fifty. Its members, the Red Hatters, are easily recognized in the streets by their red hats and otherwise purple attire, giving the RHS its unique flavor of leisure combined with expressive public performance. In this article, we use interviews and observations to study how the fun experiences aimed at by the RHS are articulated with negotiations of gender and age. Our analysis directed us toward a contradictory and multilayered expression of feminism and femininity entrenched in RHS performance. While some of the Red Hatters explicitly identified with feminism using RHS performance as a means to “undo” gender, others identified more with traditional femininity, using it to “do” gender instead. We introduce the concept of “radical femininity” to show how the Red Hatters continuously negotiate the volatile space between these two broad societal discourses that position women in contradictory ways. Furthermore, we show how Red Hatters draw upon fantasy as embodied in play to negotiate this space.
‘Cabined, cribbed, confined, bound in’ or ‘we are not a government poodle’: Structure and agency in museums and galleries
Authors: Gray Clive
Published: October 2013

Arguments within political science, public administration and public policy about how to both conceptualise and operationalise structure and agency in analysis have tended to operate at the level of ontology – and occasionally at the level of epistemology. This paper argues that development at the methodological level is required to make sense of the complexities of this debate. An analysis of how structure and agency can be applied to the museums policy sector is utilised to demonstrate the importance of linking methodology to epistemology and ontology, and to show the analytical consequences that arise from this.
Chronology and controls of donga (gully) formation in the upper Blood River catchment, KwaZulu-Natal, South Africa: Evidence for a climatic driver of erosion
Authors: Lyons Richard , Tooth Stephen , Duller Geoff AT
Published: October 2013

Dongas (gullies and badland-type terrain) are found extensively across interior South Africa, but the controls on their formation remain contested. Establishing the timing of donga formation is essential for developing a clearer understanding of the relative importance of natural (e.g. climatic) and human (e.g. overgrazing) controls. Here, we present optically stimulated luminescence (OSL) ages for colluvial sediments exposed in the sidewalls of dongas and for tributary fan sediments deposited downslope of dongas in the upper Blood River catchment, eastern South Africa. The tributary fan ages enable the timing of donga formation to be established, since fan sedimentation is a direct result of upslope donga erosion. The OSL ages indicate that net colluviation and intervening palaeosol formation occurred from prior to 22 ka until ~1.6 ka. From ~0.89 ka to present, there has been a shift to net erosion characterised by widespread donga formation and tributary fan sedimentation. Contemporary donga formation in interior South Africa has most commonly been attributed to changing land-use practices associated with European settlement from the second half of the 18th century onwards, but the OSL chronology indicates that dongas in the study area began forming significantly prior to European settlement. Instead, the initiation and main phase of donga formation encompasses periods of abrupt climatic changes associated with the ‘Mediaeval Climate Anomaly’ (ad ~900–1300) and the ‘Little Ice Age’ (ad ~1300–1800). The magnitude and abruptness of climatic changes during these periods appear to have destabilised hillslopes and initiated the shift from long-term net colluviation to net erosion by donga formation. The OSL-based approach to constraining the timing of donga formation adopted in this study has broader implications for assessment of the drivers of historical and contemporary donga (gully) formation elsewhere in South Africa and other drylands, and may help to inform management strategies for degrading lands.