bluuebunny/crossref_metadata_2025 huggingface dataset:
The oral mucosal surface and blood vessels
Authors: Naumova Ella A. , Dierkes Tobias , Sprang Jürgen , Arnold Wolfgang H.
Published: March 2013

Introduction

Detailed information about the size of the oral mucosa is scarce in the literature, and those studies that do exist do not take into account the size of the tongue or the enlargement of the surface by the papillae. Because of the various functions of the oral mucosa in the maintenance of oral health, knowledge of its true size may provide a better understanding of the physiology of the oral cavity and some oral diseases and direct future therapeutic strategies. The aim of this study was to determine the total size of the oral mucosa.

Methods

Five human adult cadaver heads were cut in the median sagittal plane, and the total area of the oral surface was determined using silicon casts. The surface of the tongue was measured with quantitative profilometry. Photographs of oral blood vessels were taken in different areas of the oral mucosa of adult test subjects using intravital microscopy, and the pictures were compared with vessel casts of the oral mucosal capillaries of a maccaca fasciculrais monkey, which was studied using a scanning electron microscope.

Results

The results showed that the dorsal side of the tongue comprises a large proportion of the total oral mucosal surface. The surface area of the epithelium increases moving from anterior to posterior on the tongue, and the number of underlying blood vessels increases proportionally.

Conclusions

It can be concluded that the back of the tongue plays an important role in the oral resorption of drugs. Clinical relevance: The results may be of relevance for the delivery and development of oral drug application.
Clostridium difficile in faeces from healthy dogs and dogs with diarrhea
Authors: Wetterwik Karl-Johan , Trowald-Wigh Gunilla , Fernström Lise-Lotte , Krovacek Karel
Published: March 2013

Background

This study was conducted to evaluate the faecal occurrence and characterization of Clostridium difficile in clinically healthy dogs (N = 50) and in dogs with diarrhea (N = 20) in the Stockholm-Uppsala region of Sweden.

Findings

Clostridium difficile was isolated from 2/50 healthy dogs and from 2/20 diarrheic dogs. Isolates from healthy dogs were negative for toxin A and B and for the tcdA and tcdB genes. Both isolates from diarrheic dogs were positive for toxin B and for the tcdA and tcdB genes. The C. difficile isolates from healthy dogs had PCR ribotype 009 (SE-type 6) and 010 (SE-type 3) whereas both isolates from dogs with diarrhoea had the toxigenic ribotype 014 (SE-type 21). One of the isolates from healthy dogs was initially resistant to metronidazole.

Conclusions

This study revealed presence of toxigenic C. difficile in faecal samples of diarrheic dogs and low number of non- toxigenic isolates in healthy dogs from Uppsala-Stockholm region in Sweden. However, more comprehensive studies are warranted to investigate the role of C. difficile in gastrointestinal disease in dogs.
Synaptosomal-associated protein 25 mutation induces immaturity of the dentate granule cells of adult mice
Authors: Ohira Koji , Kobayashi Katsunori , Toyama Keiko , Nakamura Hironori K , Shoji Hirotaka , Takao Keizo , Takeuchi Rika , Yamaguchi Shun , Kataoka Masakazu , Otsuka Shintaro , Takahashi Masami , Miyakawa Tsuyoshi
Published: March 2013

Background

Synaptosomal-associated protein, 25 kDa (SNAP-25) regulates the exocytosis of neurotransmitters. Growing evidence suggests that SNAP-25 is involved in neuropsychiatric disorders, such as schizophrenia, attention-deficit/hyperactivity disorder, and epilepsy. Recently, increases in anxiety-related behaviors and epilepsy have been observed in SNAP-25 knock-in (KI) mice, which have a single amino acid substitution of Ala for Ser187. However, the molecular and cellular mechanisms underlying the abnormalities in this mutant remain unknown.

Results

In this study, we found that a significant number of dentate gyrus (DG) granule cells was histologically and electrophysiologically similar to immature DG neurons in the dentate gyrus of the adult mutants, a phenomenon termed the “immature DG” (iDG). SNAP-25 KI mice and other mice possessing the iDG phenotype, i.e., alpha-calcium/calmodulin-dependent protein kinase II heterozygous mice, Schnurri-2 knockout mice, and mice treated with the antidepressant fluoxetine, showed similar molecular expression patterns, with over 100 genes similarly altered. A working memory deficit was also identified in mutant mice during a spontaneous forced alternation task using a modified T-maze, a behavioral task known to be dependent on hippocampal function. Chronic treatments with the antiepileptic drug valproate abolished the iDG phenotype and the working memory deficit in mutants.

Conclusions

These findings suggest that the substitution of Ala for Ser187 in SNAP-25 induces the iDG phenotype, which can also be caused by epilepsy, and led to a severe working memory deficit. In addition, the iDG phenotype in adulthood is likely an endophenotype for at least a part of some common psychiatric disorders.
Gait parameters associated with hallux valgus: a systematic review
Authors: Nix Sheree E , Vicenzino Bill T , Collins Natalie J , Smith Michelle D
Published: March 2013

Background

Hallux valgus (HV) has been linked to functional disability and increased falls risk in older adults. However, specific gait alterations in individuals with HV are unclear. This systematic review investigated gait parameters associated with HV in otherwise healthy adults.

Methods

Electronic databases (Medline, Embase, CINAHL) were searched to October 2011, including cross‐sectional studies with clearly defined HV and non‐HV comparison groups. Two investigators independently rated studies for methodological quality. Effect sizes (95% confidence intervals (CI)) were calculated as standardized mean differences (SMD) for continuous data and risk ratios (RR) for dichotomous data.

Results

Nine studies included a total of 589 participants. Three plantar pressure studies reported increased hallux loading (SMD 0.56 to 1.78) and medial forefoot loading (SMD 0.62 to 1.21), while one study found reduced first metatarsal loading (SMD −0.61, CI −1.19 to −0.03) in HV participants. HV participants demonstrated less ankle and rearfoot motion during terminal stance (SMD −0.81 to −0.63) and increased intrinsic muscle activity (RR 1.6, 1.1 to 2.2). Most studies reported no differences in spatio‐temporal parameters; however, one study found reduced speed (SMD −0.73, ‐1.25 to −0.20), step length (SMD −0.66 to −0.59) and less stable gait patterns (SMD −0.86 to −0.78) in older adults with HV.

Conclusions

HV impacts on particular gait parameters, and further understanding of potentially modifiable factors is important for prevention and management of HV. Cause and effect relationships cannot be inferred from cross‐sectional studies, thus prospective studies are warranted to elucidate the relationship between HV and functional disability.
Artificial neuro fuzzy logic system for detecting human emotions
Authors: Malkawi Mohammad , Murad Omayya
Published: March 2013

This paper presents an adaptive neuro/fuzzy system which can be trained to detect the current human emotions from a set of measured responses. Six models are built using different types of input/output membership functions and trained by different kinds of input arrays. The models are compared based on their ability to train with lowest error values. Many factors impact the error values such as input/output membership functions, the training data arrays, and the number of epochs required to train the model. ANFIS editor in MATLAB is used to build the models.
Trends in End-of-Life Decision Making in Patients With and Without Cancer
Authors: Pardon Koen , Chambaere Kenneth , Pasman H. Roeline W. , Deschepper Reginald , Rietjens Judith , Deliens Luc
Published: March 2013

Purpose

Because of cancer's high symptom burden and specific disease course, patients with cancer are more likely than other patients to face end-of-life decisions that have possible or certain life-shortening effects (ELDs). This study examines the incidence of ELDs in patients with cancer compared with patients without cancer and the trends in ELD incidence from 1998-2007.

Patients and Methods

A nationwide death certificate study in Flanders, Belgium, was conducted in 2007, analogous to one completed in 1998. Physicians who had signed selected death certificates (n = 6,927) were sent a questionnaire.

Results

The response rate was 58.4%. Nonsudden deaths were studied. Intensified symptom alleviation occurred more in patients with cancer than in those without (53.8% v 31.7%; P < .001) as did euthanasia (6.8% v 0.9%; P < .001). There was no difference between groups in nontreatment decisions and life-ending acts without patient's explicit request. Patients with cancer were less involved in the end-of-life decision-making process than patients without cancer (69.7% v 83.5%; P = .001). From 1998 to 2007, ELD incidence has increased in patients with cancer (+6.7%) and even more in patients without cancer (+14.9%) because of an increase in intensified symptom alleviation. In patients with cancer, euthanasia rates increased strongly and life-ending acts without the patient's explicit request decreased.

Conclusion

The higher ELD incidence in patients with cancer compared with those without is probably related to differences in disease trajectories and access to end-of-life care. During the period from 1998 to 2007, when euthanasia was legalized and palliative care intensified, overall ELDs increased, including those as a result of symptom alleviation and euthanasia, with a decrease in life-ending acts without explicit request.
MNADK, a novel liver-enriched mitochondrion-localized NAD kinase
Authors: Zhang Ren
Published: March 2013

NADP+ and its reducing equivalent NADPH are essential for counteracting oxidative damage. Mitochondria are the major source of oxidative stress, since the majority of superoxide is generated from the mitochondrial respiratory chain. Because NADP+ cannot pass through the mitochondrial membrane, NADP+ generation within mitochondria is critical. However, only a single human NAD kinase (NADK) has been identified, and it is localized to the cytosol. Therefore, sources of mitochondrial NADP+ and mechanisms for maintaining its redox balance remain largely unknown. Here, we show that the uncharacterized human gene C5ORF33, named MNADK (mouse homologue 1110020G09Rik), encodes a novel mitochondrion-localized NAD kinase. In mice MNADK is mostly expressed in the liver, and also abundant in brown fat, heart, muscle and kidney, all being mitochondrion-rich. Indeed, MNADK is localized to mitochondria in Hep G2 cells, a human liver cell line, as demonstrated by fluorescence imaging. Having a conserved NAD kinase domain, a recombinant MNADK showed NAD kinase activity, confirmed by mass spectrometry analysis. Consistent with a role of NADP+ as a coenzyme in anabolic reactions, such as lipid synthesis, MNADK is nutritionally regulated in mice. Fasting increased MNADK levels in liver and fat, and obesity dramatically reduced its level in fat. MNADK expression was suppressed in human liver tumors. Identification of MNADK immediately suggests a model in which NADK and MNADK are responsible for de novo synthesis of NADP+ in cytosol and mitochondria, respectively, and therefore provides novel insights into understanding the sources and mechanisms of mitochondrial NADP+ and NADH production in human cells.
MAPK1 is required for establishing the pattern of cell proliferation and for cell survival during lens development
Authors: Upadhya Dinesh , Ogata Masato , Reneker Lixing W.
Published: March 2013

The mitogen-activated protein kinases (MAPKs; also known as ERKs) are key intracellular signaling molecules that are ubiquitously expressed in tissues and were assumed to be functionally equivalent. Here, we use the mouse lens as a model system to investigate whether MAPK1 plays a specific role during development. MAPK3 is known to be dispensable for lens development. We demonstrate that, although MAPK1 is uniformly expressed in the lens epithelium, its deletion significantly reduces cell proliferation in the peripheral region, an area referred to as the lens germinative zone in which most active cell division occurs during normal lens development. By contrast, cell proliferation in the central region is minimally affected by MAPK1 deletion. Cell cycle regulators, including cyclin D1 and survivin, are downregulated in the germinative zone of the MAPK1-deficient lens. Interestingly, loss of MAPK1 subsequently induces upregulation of phosphorylated MAPK3 (pMAPK3) levels in the lens epithelium; however, this increase in pMAPK3 is not sufficient to restore cell proliferation in the germinative zone. Additionally, MAPK1 plays an essential role in epithelial cell survival but is dispensable for fiber cell differentiation during lens development. Our data indicate that MAPK1/3 control cell proliferation in the lens epithelium in a spatially defined manner; MAPK1 plays a unique role in establishing the highly mitotic zone in the peripheral region, whereas the two MAPKs share a redundant role in controlling cell proliferation in the central region of the lens epithelium.
Conserved non-coding elements and cis regulation: actions speak louder than words
Authors: Nelson Andrew C. , Wardle Fiona C.
Published: March 2013

It is a truth (almost) universally acknowledged that conserved non-coding genomic sequences function in the cis regulation of neighbouring genes. But is this a misconception? The literature is strewn with examples of conserved non-coding sequences being able to drive reporter expression, but the extent to which such sequences are actually used endogenously in vivo is only now being rigorously explored using unbiased genome-scale approaches. Here, we review the emerging picture, examining the extent to which conserved non-coding sequences equivalently regulate gene expression in different species, or at different developmental stages, and how genomics approaches are revealing the relationship between sequence conservation and functional use of cis-regulatory elements.
CLIPR-59: a protein essential for neuromuscular junction stability during mouse late embryonic development
Authors: Couesnon Aurélie , Offner Nicolas , Bernard Véronique , Chaverot Nathalie , Backer Stéphanie , Dimitrov Ariane , Perez Franck , Molgó Jordi , Bloch-Gallego Evelyne
Published: March 2013

CLIPR-59 is a new member of the cytoplasmic linker proteins (CLIP) family mainly localized to the trans-Golgi network. We show here that Clipr-59 expression in mice is restricted to specific pools of neurons, in particular motoneurons (MNs), and progressively increases from embryonic day 12.5 (E12.5) until the first postnatal days. We generated a Clipr-59 knockout mouse model that presents perinatal lethality due to respiratory defects. Physiological experiments revealed that this altered innervation prevents the normal nerve-elicited contraction of the mutant diaphragm that is reduced both in amplitude and fatigue-resistance at E18.5, despite unaffected functional muscular contractility. Innervation of the mutant diaphragm is not altered until E15.5, but is then partially lost in the most distal parts of the muscle. Ultrastructural observations of neuromuscular junctions (NMJs) in the distal region of the diaphragm reveal a normal organization, but a lower density of nerve terminals capped by terminal Schwann cells in E18.5 mutant when compared with control embryos. Similar defects in NMJ stability, with a hierarchy of severity along the caudo-rostral axis, are also observed in other muscles innervated by facial and spinal MNs in Clipr-59 mutant mice. Clipr-59 deficiency therefore affects axon maintenance but not axon guidance toward muscle targets. Thus, CLIPR-59 is involved in the stabilization of specific motor axons at the NMJ during mouse late embryogenesis and its role is crucial for mouse perinatal development.
Enrolados na sacola plástica
Authors: Rodrigues Antonio Carlos , De Morais Kelly
Published: March 2013

Os donos da Pão Delícia, panificadora tradicional de Belo Horizonte, precisam decidir como irão se adaptar à Lei Municipal n. 9.529, que exige que as sacolas plásticas sejam substituídas por versões ecológicas. O meio ambiente agradece, mas quem vai pagar essa conta?DOI: 10.12660/gvcasosv2n1c2 http://dx.doi.org/10.12660/gvcasosv2n1c2
Uma fronteira para Alexandre?
Authors: Da Silva Maria Tereza Gomes , Silva Rodrigo Cunha , Casado Tania
Published: March 2013

Alexandre Barros, 41 anos, recebeu uma tentadora oferta de um headhunter. Vale a pena aceitar, considerando que ainda não completou um ano em sua atual empresa e já mudou muitas vezes de emprego ao longo de sua carreira?DOI: 10.12660/gvcasosv2n1c4http://dx.doi.org/10.12660/gvcasosv2n1c4
A Internacionalização da marca Melissa
Authors: De Almeida Moraes Sylvia Therezinha , Senra Melissa , Da Rocha Angela
Published: March 2013

Apesar de os avanços obtidos pela Melissa terem sido significativos, o gerente de operações da empresa achou necessário rever as ações de marketing da marca para  aumentar a sua diferenciação e exposição no mercado. A nova estratégia adotada pela Melissa trouxe bons resultados, já que os imitadores chineses apresentaram pouco sucesso em se apropriar do brand equity da marca. DOI: 10.12660/gvcasosv2n1c6http://dx.doi.org/10.12660/gvcasosv2n1c6
Sucos do bem: o desafio de crescer com a fruta na caixinha (Notas de ensino)
Authors: Ferreira Daniela Abrantes , Ferreira Lucelena Abrantes , Mayer Verônica Feder
Published: March 2013

DOI: 10.12660/gvcasosv2n1n1http://dx.doi.org/10.12660/gvcasosv2n1n1
Seguir carreira (ou não) em uma empresa familiar (Notas de ensino)
Authors: Hehn Elisa Bornhausen Cunha , Lohn Deise , Pereira Daniela Cardoso , Mignoni Alissane , Marinho Sidnei Vieira
Published: March 2013

DOI: 10.12660/gvcasosv2n1n3http://dx.doi.org/10.12660/gvcasosv2n1n3
Uma fronteira para Alexandre? (Notas de ensino)
Authors: Gomes Maria Tereza , Silva Rodrigo Cunha , Casado Tania
Published: March 2013

DOI: 10.12660/gvcasosv2n1n4http://dx.doi.org/10.12660/gvcasosv2n1n4
A resposta da geração Y na estratégia de crescimento organizacional
Authors: Berteli Michele Otobelli , Lain Gabriela Cristina , Bacichetto Vinícius de Vargas , Roesch Sylvia Maria Azevedo , Olea Pelayo Munhoz
Published: March 2013

Os sócios da empresa Treviso, especializada em softwares para gestão, planejavam melhorar e formalizar a relação com os funcionários. Quando implantado o novo modelo, cerca de 20% dos empregados se demitiu. A Treviso começou a passar por dificuldades financeiras, descontentamento de clientes e problemas de gestão com funcionários da geração Y. A empresa precisa descobrir como enfrentar esse desafio inesperado.  DOI: 10.12660/gvcasosv2n2c10http://dx.doi.org/10.12660/gvcasosv2n2c10
A resposta da geração Y na estratégia de crescimento organizacional (Notas de ensino)
Authors: Berteli Michele Otobelli , Lain Gabriela Cristina , Bacichetto Vinícius de Vargas , Roesch Sylvia Maria Azevedo , Olea Pelayo Munhoz
Published: March 2013

DOI: 10.12660/gvcasosv2n2n10http://dx.doi.org/10.12660/gvcasosv2n2n10
Sobral and its hard earned success in the international costume jewelry market (Notas de ensino)
Authors: Viana Mila , Carneiro Jorge , Garrido Marcos , Peixoto Tania
Published: March 2013

DOI: 10.12660/gvcasosv2n2n11http://dx.doi.org/10.12660/gvcasosv2n2n11
Positive or negative allosteric modulation of metabotropic glutamate receptor 5 (mGluR5) does not alter expression of behavioral sensitization to methamphetamine
Authors: Kufahl Peter R , Nemirovsky Natali E , Watterson Lucas R , Zautra Nicholas , Olive M Foster
Published: March 2013

We investigated the role of metabotropic glutamate receptor type 5 (mGluR5) in methamphetamine-induced behavioral sensitization. The mGluR5 positive allosteric modulator (3-cyano-N-(1,3-diphenyl-1H-pyrazol-5-yl) benzamide (CDPPB) and negative allosteric modulator fenobam were tested in separate experiments. Sprague-Dawley rats were repeatedly injected with 1 mg/kg methamphetamine or saline, and then given a locomotor challenge test using a dose of 0.5 mg/kg methamphetamine. Prior to the challenge test session, rats were injected with CDPPB, fenobam, or a vehicle.  Doses from previous studies showed reduced drug-conditioned behavior; however in this study neither CDPPB nor fenobam pretreatment resulted in an altered expression of behavioral sensitization, indicating a lack of mGluR5 involvement in sensitized methamphetamine-induced locomotion. Additionally, the high dose (30 mg/kg) of fenobam resulted in decreased methamphetamine-induced locomotion in rats regardless of drug exposure history, which suggests evidence of nonspecific behavioral inhibition.
Modellbasierte Regelungsansätze für überaktuierte planetare Rover und robotische Elektromobile
Authors: Krenn Rainer , Köppern Johannes , Bünte Tilman , Brembeck Jonathan , Gibbesch Andreas , Bals Johann
Published: March 2013

Der Beitrag beschreibt modellbasierte Regelungsstrategien für planetare Rover und innovative Elektromobile. Trotz prinzipiell gleichen Aufbaus ihrer Fahrwerke werden doch unterschiedliche Reglerlösungen bevorzugt, deren Bandbreite in diesem Beitrag vorgestellt wird. Beide Systeme sind überaktuierte robotische Fahrzeuge, deren Regler die jeweils unabhängig ansteuerbaren Rad- und Lenkantriebe koordinieren. Im Fall des planetaren Rovers wird ein Fahrzeugmodell mit Rad-Sand-Kontaktdynamik verwendet, das innerhalb eines modellprädiktiven Reglers (MPC) zum Einsatz kommt. Für das wesentlich dynamischere Straßenfahrzeug wird der MPC-Ansatz erweitert. Zur Reduzierung der Steuerungsdimension wird ein invertiertes Modell der Fahrdynamik eingeführt und das Optimierungsproblem auf das Bestimmen von Hilfsgrößen für die verbleibenden Freiheitsgrade reduziert.
Comparison between 3D Digital and Optical Microscopes for the Surface Measurement by Computer Vision
Authors: Bogrekci Ismail , Durakbasa M. Numan , Demircioglu Pinar
Published: March 2013

In this study, 3D digital and optical microscopes were used. The aim of this study is to compare surface roughness measurement by employing the image processing methods such as line scanning, speckle and fast fourier transform with three different samples machined by different manufacturing processes. The surface roughness results from processed images were obtained using different image analysis techniques such as Dark-light technique developed by the authors. The values calculated with the proposed method were compared with the roughness values obtained from 3D digital and optical microscopes.
Sedentary Risk Factors across Genders and Job Roles within a University Campus Workplace: Preliminary Study
Authors: Alkhatib Ahmad
Published: March 2013

Sedentary Risk Factors across Genders and Job Roles within a University Campus Workplace: Preliminary Study: Ahmad ALKHATIB. Department of Life and Sport Science, School of Science, University of Greenwich, UKï¿½

Background

University campus administrators, predominantly females, are considered more sedentary than academics, which may lead to higher prevalence of associated health risks. Objectives: The aim of this study was to investigate whether sedentary job role and gender are reflected by sedentary risk factors within a university campus.

Methods

Following institutional ethical approval, 80 UK university campus employees were recruited, and 34 of them (age 47.8 ï¿½ 11.9 years, height 169 ï¿½ 1.0 cm, body mass 72.0 ï¿½ 14.1 kg) were measured for their systolic (SBP) and diastolic blood pressure (DBP), blood glucose (Glu), total serum blood cholesterol (Cho), dominant (DHG) and nondominant handgrip strength (NHG), body fat percentage (Fat%), trunk flexibility (Flex), peak cardiorespiratory capacity (V . O2max), and answered a physical activity questionnaire (IPAQ). The data were analyzed using two‐way ANOVA with job role and gender as independent factors, and each measured risk as a dependent factor.

Results

Gender had significant effects (p<0.05), and males demonstrated higher Glu, SBP, DBP and BMI than females (p<0.05). Females had higher Flex and Fat%, and lower DHG and NHG (p<0.05). Job role neither affected measured risk factors nor interacted with gender. However, both groups demonstrated high BMI, Fat% and Glu values, with these risk factors being above the recommended healthy thresholds. IPAQ hours correlated positively with Glu (p<0.05) but with none of the remaining tests. Conclusions: Sedentary risk factors are prevalent within university employees irrespective of job role but not irrespective of gender. The results may provide a baseline for initiating tailored organizational targeted policies aimed at reducing sedentary risk factors associated with the university workplace.
Radiographic Progression of Silicosis among Japanese Tunnel Workers in Kochi
Authors: Dumavibhat Narongpon , Matsui Tomomi , Hoshino Eri , Rattanasiri Sasivimol , Muntham Dittapol , Hirota Ryoji , Eitoku Masamitsu , Imanaka Momo , Muzembo Basilua Andre , Ngatu Nlandu Roger , Kondo Shinichi , Hamada Norihiko , Suganuma Narufumi
Published: March 2013

Radiographic Progression of Silicosis among Japanese Tunnel Workers in Kochi: Narongpon DUMAVIBHAT, et al. Department of Environmental Medicine, Kochi Medical School, Kochi University, Japan—

Objective

The aim of our study was to investigate the natural course of silicosis in terms of radiographic progression among Japanese tunnel workers.

Methods

Tunnel workers with silicosis were included in our study between January 2008 and June 2011. We retrospectively assessed workers' radiographs from their first through last visits to see whether there was progression. All films were interpreted by two physicians, who had been specially trained in using the ILO (2000) International Classification of Radiographs of Pneumoconioses (ILO/ICRP). We classified the radiographic findings according to the ILO/ICRP. Survival analysis was performed and then presented as time to progression. Subgroup analysis among the progressed group was performed to demonstrate duration of progression.

Results

A total of 65 patients, who were no longer exposed to silica for the duration of the study, were included. The mean age at the first visit was 58.60 ± 7.10 years. The incidence rate of progression was 42 per 1,000 person‐years with a median time to progression of 17 years. Progression was demonstrated among 33 cases (51%). The mean durations of progression from category 1 to category 4 and category 2 to category 4 were 14.55 and 10.65 years, respectively. Most patients (86%) had radiographic change from category 1 or 2 directly to category 4.

Conclusion

Silicosis progressed at a relatively high rate among tunnel workers without further silica exposure. The high probability of progression directly from category 1 to category 4 may lead to further investigation for the improvement of disease prevention.
Time and Risk Preferences and the Use of Asthma Controller Medication
Authors: Brandt Sylvia , Dickinson Brenton
Published: March 2013

OBJECTIVES:

We investigated the role of risk tolerance, time preference, and asthma-specific attitudes in adherence to asthma control medications.

METHODS:

Students with persistent asthma completed an online survey on asthma beliefs, risk tolerance, and time preference (n = 47). The time preference questions measure the degree to which the individual discounts future outcomes and essentially prefers immediate gratification to delayed gratification. The risk tolerance questions indicate the individual’s dislike of uncertainty about outcomes. We analyzed the relationship between the independent and dependent variables.

RESULTS:

Feelings of embarrassment and concern about medication, as well as risk tolerance and time preference, were found to be significant predictors of adherence to control medication in the logistic regression. Analysis of probabilities associated with different profiles shows that at high rates of risk tolerance and discounting of future outcomes, the probability of adherence is near 0 regardless of asthma-specific attitudes. Asthma attitudes have a statistically significant effect for individuals with low rates of risk tolerance and time preference.

CONCLUSIONS:

The risk tolerance and time preferences of the target group should be considered when designing an asthma-intervention program. Individuals who strongly prefer immediate gratification over future benefits and are willing to tolerate uncertain outcomes are unlikely to adhere to controller medication, regardless of their asthma attitudes. In contrast, efforts to affect relevant attitudes will be most fruitful for individuals with low rates of risk tolerance and time preference. However, as we cannot extrapolate these results to a larger population, we must view them with caution.
Neonatal Endogenous Endophthalmitis: A Report of Six Cases
Authors: Basu Sriparna , Kumar Ashok , Kapoor Kanika , Bagri Narendra Kumar , Chandra Abhishek
Published: March 2013

Endogenous endophthalmitis is a rare but potentially blinding complication of neonatal sepsis. Early diagnosis and aggressive treatment are essential to avoid vision loss. Therapeutic options include systemic and intravitreal antibiotics, as well as vitrectomy in selected cases. We report a series of 6 premature very low birth weight neonates who developed endogenous endophthalmitis in our NICU over the past 3 years. Endophthalmitis was part of early-onset sepsis in 2 newborns, both of whom died, and late-onset sepsis in 4 newborns, of which 1 infant died. None of the neonates had any history of previous trauma or intervention to the eye. Maternal screening for congenital infections, including HIV, was negative in all. Causative organisms included Klebsiella pneumoniae (2 cases), Pseudomonas aeruginosa (2 cases), Methicillin-resistant Staphylococcus aureus (1 case), and Candida albicans (1 case). All bacterial isolates showed resistance to first-line antibiotics. Of the 3 survivors, 2 infants had normal vision in the affected eye, and 1 developed phthisis bulbi after corneal perforation and required enucleation. This report draws attention to the emergence of endophthalmitis as a complication of neonatal sepsis in places where, although survival of very low birth weight newborns has increased significantly due to improved care, the burden of infection continues to be high. We emphasize the importance of daily examination of eyes as a part of routine clinical care in septic newborns for early diagnosis of endophthalmitis and prompt intervention in consultation with an ophthalmologist to optimize the outcome.
US Outbreak of Human Salmonella Infections Associated With Aquatic Frogs, 2008–2011
Authors: Mettee Zarecki Shauna L. , Bennett Sarah D. , Hall Julia , Yaeger Jill , Lujan Kate , MPH RN , Adams-Cameron Marguerite , Winpisinger Quinn Kim , Brenden Rita , Biggerstaff Gwen , Hill Vincent R. , Sholtes Kari , Garrett Nancy Marie , Lafon Patti C. , Barton Behravesh Casey , Sodha Samir V. ,   on behalf of the Salmonella Typhimurium Outbreak Investigation Team
Published: March 2013

OBJECTIVE:

Although amphibians are known Salmonella carriers, no such outbreaks have been reported. We investigated a nationwide outbreak of human Salmonella Typhimurium infections occurring predominantly among children from 2008 to 2011.

METHODS:

We conducted a matched case-control study. Cases were defined as persons with Salmonella Typhimurium infection yielding an isolate indistinguishable from the outbreak strain. Controls were persons with recent infection with Salmonella strains other than the outbreak strain and matched to cases by age and geography. Environmental samples were obtained from patients’ homes; traceback investigations were conducted.

RESULTS:

We identified 376 cases from 44 states from January 1, 2008, to December 31, 2011; 29% (56/193) of patients were hospitalized and none died. Median patient age was 5 years (range <1–86 years); 69% were children <10 years old (253/367). Among 114 patients interviewed, 69 (61%) reported frog exposure. Of patients who knew frog type, 79% (44/56) reported African dwarf frogs (ADF), a type of aquatic frog. Among 18 cases and 29 controls, illness was significantly associated with frog exposure (67% cases versus 3% controls, matched odds ratio 12.4, 95% confidence interval 1.9–infinity). Environmental samples from aquariums containing ADFs in 8 patients’ homes, 2 ADF distributors, and a day care center yielded isolates indistinguishable from the outbreak strain. Traceback investigations of ADFs from patient purchases converged to a common ADF breeding facility. Environmental samples from the breeding facility yielded the outbreak strain.

CONCLUSIONS:

ADFs were the source of this nationwide pediatric predominant outbreak. Pediatricians should routinely inquire about pet ownership and advise families about illness risks associated with animals.
Development of Heart and Respiratory Rate Percentile Curves for Hospitalized Children
Authors: Bonafide Christopher P. , Brady Patrick W. , Keren Ron , Conway Patrick H. , Marsolo Keith , Daymont Carrie
Published: March 2013

OBJECTIVE:

To develop and validate heart and respiratory rate percentile curves for hospitalized children and compare their vital sign distributions to textbook reference ranges and pediatric early warning score (EWS) parameters.

METHODS:

For this cross-sectional study, we used 6 months of nurse-documented heart and respiratory rates from the electronic records of 14 014 children on general medical and surgical wards at 2 tertiary-care children’s hospitals. We developed percentile curves using generalized additive models for location, scale, and shape with 67% of the patients and validated the curves with the remaining 33%. We then determined the proportion of observations that deviated from textbook reference ranges and EWS parameters.

RESULTS:

We used 116 383 heart rate and 116 383 respiratory rate values to develop and validate the percentile curves. Up to 54% of heart rate observations and up to 40% of respiratory rate observations in our sample were outside textbook reference ranges. Up to 38% of heart rate observations and up to 30% of respiratory rate observations in our sample would have resulted in increased EWSs.

CONCLUSIONS:

A high proportion of vital signs among hospitalized children would be considered out of range according to existing reference ranges and pediatric EWSs. The percentiles we derived may serve as useful references for clinicians and could be used to inform the development of evidence-based vital sign parameters for physiologic monitor alarms, inpatient electronic health record vital sign alerts, medical emergency team calling criteria, and EWSs.
Evidence of Small-Fiber Polyneuropathy in Unexplained, Juvenile-Onset, Widespread Pain Syndromes
Authors: Oaklander Anne Louise , Klein Max M.
Published: March 2013

OBJECTIVE:

We tested the hypothesis that acquired small-fiber polyneuropathy (SFPN), previously uncharacterized in children, contributes to unexplained pediatric widespread pain syndromes.

METHODS:

Forty-one consecutive patients evaluated for unexplained widespread pain beginning before age 21 had medical records comprehensively analyzed regarding objective diagnostic testing for SFPN (neurodiagnostic skin biopsy, nerve biopsy, and autonomic function testing), plus histories, symptoms, signs, other tests, and treatments. Healthy, demographically matched volunteers provided normal controls for SFPN tests.

RESULTS:

Age at illness onset averaged 12.3 ± 5.7 years; 73% among this poly-ethnic sample were female (P = .001). Sixty-eight percent were chronically disabled, and 68% had hospitalizations. Objective testing diagnosed definite SFPN in 59%, probable SFPN in 17%, and possible SFPN in 22%. Only 1 of 41 had entirely normal SFPN test results. Ninety-eight percent of patients had other somatic complaints consistent with SFPN dysautonomia (90% cardiovascular, 82% gastrointestinal, and 34% urologic), 83% reported chronic fatigue, and 63% had chronic headache. Neurologic examinations identified reduced sensation in 68% and vasomotor abnormalities in 55%, including 23% with erythromelalgia. Exhaustive investigations for SFPN causality identified only history of autoimmune illnesses in 33% and serologic markers of disordered immunity in 89%. Treatment with corticosteroids and/or intravenous immune globulin objectively and subjectively benefited 80% of patients (12/15).

CONCLUSIONS:

More than half among a large series of patients with childhood-onset, unexplained chronic widespread pain met rigorous, multitest, diagnostic criteria for SFPN, which extends the age range of acquired SFPN into early childhood. Some cases appeared immune-mediated and improved with immunomodulatory therapies.
Sentinel Injuries in Infants Evaluated for Child Physical Abuse
Authors: Sheets Lynn K. , Leach Matthew E. , Koszewski Ian J. , Lessmeier Ashley M. , Nugent Melodee , Simpson Pippa
Published: March 2013

OBJECTIVE:

Relatively minor abusive injuries can precede severe physical abuse in infants. Our objective was to determine how often abused infants have a previous history of “sentinel” injuries, compared with infants who were not abused.

METHODS:

Case-control, retrospective study of 401, <12-month-old infants evaluated for abuse in a hospital-based setting and found to have definite, intermediate concern for, or no abuse after evaluation by the hospital-based Child Protection Team. A sentinel injury was defined as a previous injury reported in the medical history that was suspicious for abuse because the infant could not cruise, or the explanation was implausible.

RESULTS:

Of the 200 definitely abused infants, 27.5% had a previous sentinel injury compared with 8% of the 100 infants with intermediate concern for abuse (odds ratio: 4.4, 95% confidence interval: 2.0–9.6; P < .001). None of the 101 nonabused infants (controls) had a previous sentinel injury (P < .001). The type of sentinel injury in the definitely abused cohort was bruising (80%), intraoral injury (11%), and other injury (7%). Sentinel injuries occurred in early infancy: 66% at <3 months of age and 95% at or before the age of 7 months. Medical providers were reportedly aware of the sentinel injury in 41.9% of cases.

CONCLUSIONS:

Previous sentinel injuries are common in infants with severe physical abuse and rare in infants evaluated for abuse and found to not be abused. Detection of sentinel injuries with appropriate interventions could prevent many cases of abuse.
Comparison of seven estimated glomerular filtration rate equations in kidney patients
Authors: Kovács Ferenc , Sárváry Enikő , Remport Ádám
Published: March 2013

Introduction: The degree of glomerular filtration rate determines the stages of chronic renal disease and, therefore, knowledge on its estimation is essential. Aims: Two standardized creatinine based estimated glomerular filtration rate equations and five equations based on the immunoturbidimetric determination of cystatin C were compared. Methods: The distribution of the analytes and the equations, their relations, as well as the differences among the estimated glomerular filtration rates and their chronic kidney disease stages assignments were studied. Results: The equations based on cystatin C classified more patient into stage 1, while the creatinine based ones more into stages 2, 3 and 4. The equations published as Grubb1, Grubb2 and Larsson classified more patients while the equations created by Tan and Sjöström classified fewer into stage 5 compared to the creatinine based equations. The equations of Grubb1 and Grubb2 resulted in the most similar stage assignment. The occurence of stages between 3 and 5 was the lowest using the equation of Sjöström. Conclusions: The different equations for the estimation of glomerular filtration rate modify significantly the chronic kidney disease stage assignment which may have an influence on the treatment and outcome measures of the patients. Orv. Hetil., 2013, 154, 415–425.
Listening to patients’ voices: Linguistic indicators related to diabetes self-management
Authors: Connor Ulla , Antón Marta , Goering Elizabeth , Lauten Kathryn , Roach Paris , Balunda Stephanie , Hayat Amir
Published: March 2013

A great deal of research in health care has examined a wide range of variables to better understand the degree to which patients follow the advice of medical professionals in managing their health, known as adherence. This paper explains the development of the linguistic systems to describe and evaluate two psychosocial constructs (i.e. control orientation and agency) that have been found to be related to adherence in previous research for subjects with diabetes (Trento et al. 2007; Wangberg 2007; O’Hea et al. 2009). The present data came from 43 semi-structured in-depth interviews of subjects with Type 2 diabetes. One-on-one interviews with open-ended questions elicited subjects’ ‘stories’ about living with diabetes, and the transcribed interviews were analyzed to develop the linguistic systems of control orientation and agency. The resultant systems were applied to the 43 interviews by raters with high inter-rater reliability. The results showed demarcations of clearly identified codings of patient types. The paper presents the linguistic coding systems developed in the study, the results of their application to the patient interview data, and recommendations for improved communication with patients.
Discourse and policy making on consumer protection in the areas of mobile telecommunication and tanning
Authors: Schweikardt Christoph , Gross Dominik , Rosentreter Michael
Published: March 2013

Perceived health risks from electromagnetic fields in mobile telecommunication and from UV radiation in tanning have become regulation issues in Germany during the last decade. Health risk messages from government expert bodies and the main stakeholders in these areas as well as subsequent consumer protection policy making are investigated. Publications and websites of government expert bodies and the main stakeholders as well as debates in Federal Parliament were analysed to compare argumentation patterns and parliamentary decision-making processes. In both areas, the public received competing health risk messages from the industries and their critics. As a government expert body, the Federal Office for Radiation Protection (BfS) held the view that alleged health risks from electromagnetic telecommunication were not proven, and propagated the precautionary principle. This opinion did not endanger the agreement of 2001 between the government and mobile telecommunication operators. After the failure to obtain voluntary commitment from the tanning industry, by contrast, the BfS recommended stricter consumer protection legislation, which was subsequently implemented. The BfS was in a key position to demand the prerogative of interpretation concerning mutually excluding health risk messages and to provide the argumentation which led the way to non-ionic radiation health protection measures.
Supportive interchanges and face-work as ‘protective talk’ in an online self-harm support forum
Authors: Sharkey Siobhan , Smithson Janet , Hewis Elaine , Jones Ray , Emmens Tobit , Ford Tamsin , Owens Christabel
Published: March 2013

Within a context of concern about inappropriate advice-giving online, we examined how young people who self-harm behave online, and how professionals might engage with them. We use Discourse Analysis to focus on participant interactions (posts) from a forum's crisis/support rooms, and highlight the prevalence of disclaimers, hedges, questions and tags in the young people's online interactions. We use the concept of facework as a framework to help understand interactions in the forum SharpTalk. The findings demonstrate the use of a range of mitigation devices, and suggest that the young people orientate to a ‘protective’ line in their supportive interactions. These findings echo Goffman's (1967) ‘supportive interchanges’ in that the young people's online interactions may help to preserve face, in an emotionally complex setting, whose vulnerable members also need ‘protective’ and sensitive support. Taking this ‘line’ may enable members to create a more open and trusting context for support, and to remain in a forum which they find both helpful and challenging. In light of concerns about online support, the findings provide a new perspective on online peer-support for young people who self-harm.
Negotiating roles in pharmacy practice: Interactions across linguistic and cultural barriers
Authors: Stevenson Fiona , McNulty Grant , Leontowitsch Miranda
Published: March 2013

There has been relatively little discussion of the effects of cultural and linguistic differences on communication in consultations. Moreover, communication in community pharmacy is largely under-researched. This study explores interactions between pharmacists, pharmacy assistants and patients conducted across cultural and linguistic barriers. We drew on a data set collected in a pharmacy in London. The data consisted of 12 video recorded consultations in which patients spoke in Sylheti (a dialect of Bengali), the pharmacists spoke in English and pharmacy assistants used both languages. These data were supplemented with focus groups. Despite the fact that the pharmacy assistant was the only person able to follow all the interactions, pharmacists worked to fulfil their legal and professional duties. It could be argued that the very existence of cultural and linguistic barriers prompted the pharmacists to engage to ensure that the patient understood how to use their medicine. There was no acknowledgement that the pharmacy assistants were fulfilling an additional role. It is likely that explicit negotiation of a flexible and adaptive communicative model would lead to a more satisfying encounter for all participants.
Eficiência agronômica de estirpes de rizóbio em feijão-caupi cultivado na região da Pré-Amazônia Maranhense
Authors: Gualter Régia Maria Reis , Boddey Robert Michael , Rumjanek Norma Gouvêa , Freitas Antônio Carlos Reis de , Xavier Gustavo Ribeiro
Published: March 2013

O objetivo deste trabalho foi avaliar a eficiência agronômica de estirpes de rizóbio para inoculação emcampo,dacultivarBRS Guaribadefeijão-caupi.Os experimentosforamrealizadosemduasáreasemSanta Luzia do Paruá, MA, na região de Pré-Amazônia, em 2009. Foram testadas as estirpes de Bradyrhizobium BR 3299, BR 3262, e INPA 03-11B, um controle absoluto e um tratamento nitrogenado (80 kg ha-1 de N). As avaliações foram realizadas aos 30 e 50 dias após a emergência (DAE) das plantas. Aos 65 DAE, foi avaliada a produtividade de grãos. Foram avaliados número e massa de matéria seca de nódulos, massa de matéria seca da parte aérea, eficiência relativa e acúmulo de N na parte aérea. As estirpes proporcionaram maior número e massa de matéria seca de nódulos, bem como maior produtividade em comparação ao controle absoluto, sem inoculação e sem ureia, nas duas áreas. Para massa de matéria seca da parte aérea, eficiência relativa e acúmulo de N na parte aérea, a estirpe BR 3299 diferiu significativamente do controle absoluto, aos 30 DAE, em uma das propriedades. O feijão-caupi responde positivamente à inoculação com as estirpes, especialmentea BR 3299.