bluuebunny/crossref_metadata_2025 huggingface dataset:
Survival of a highly toxic dose of caffeine
Authors: Bioh Gabriel , Gallagher Mark M , Prasad Usha
Published: February 2013

A 27-year-old woman with a history of depression and previous overdose presented within 60 min of ingestion of 50 g of caffeine powder. Initially alert but hypotensive and tachycardic, the patient developed a broad complex tachycardia followed by a seizure and multiple ventricular fibrillation (VF) arrests. Following multiple defibrillations for VF, eight cycles of cardiopulmonary resuscitation and treatment with amiodarone, lidocaine, magnesium and potassium supplementation, the patient went to the intensive care unit (ICU). While there, the patient had further VF and required haemofiltration for a profound metabolic acidaemia with cardiac rhythm instability. She developed a postcardiac arrest systemic inflammatory response syndrome with episodes of acute pulmonary oedema, profound vasoplegia, hypothermia and coagulopathy. After 5 days in the ICU, the patient was stable enough to be transferred to the ward, with a persistent sinus tachycardia, and was discharged 3 days later with cardiology and psychiatry follow-up.
Pilot study on the prevalence of abuse and mistreatment during clinical internship: a cross-sectional study among first year residents in Oman
Authors: Al-Shafaee Mohammed , Al-Kaabi Yousuf , Al-Farsi Yousuf , White Gillian , Al-Maniri Abdullah , Al-Sinawi Hamed , Al-Adawi Samir
Published: February 2013

Objective

To evaluate perceptions of being mistreated during internship among first year Oman Medical Specialty Board residents.

Design

A cross-sectional study.

Setting

Training centres for Oman Medical Specialty Board.

Participants

First year medical residents following completion of internship during the study period 2009–2010.

Method

A cross-sectional survey of first year medical residents.

Results

Of 58 residents (response rate 84%), 96.6% perceived that mistreatment exists. Among different types of mistreatment reported, verbal and academic abuses were the most common (87.9%), followed by sexual harassment (24.1%), then physical abuse (22.4%). Forty-four (75.9%) residents had advised at least one of their relatives not to join medical school.

Conclusions

Mistreatment of medical interns is an ethical issue challenging the quality of clinical training. Further research is needed to understand factors influencing mistreatment and to draw guidelines to limit such problems.
Usability of a computerised drug monitoring programme to detect adverse drug events and non-compliance in outpatient ambulatory care
Authors: Auger Claudine , Forster Alan J , Oake Natalie , Tamblyn Robyn
Published: February 2013

Objective

To assess the usability of a computerised drug monitoring programme for ambulatory patients receiving outpatient prescriptions.

Materials and methods

A prospective cohort of 200 patients received two automated calls after a new drug prescription (day 3 and day 17) to screen for unfilled prescriptions and medication problems. Usability was assessed objectively and subjectively with the coding of technical (eg, voice recognition problems) and respondent burden (eg, failing to follow instructions) problems observed during the calls, and with an interview 21 days after the prescription. Associations between personal factors, usability and call outcome were examined with logistic regression models.

Results

The automated calls successfully reached 70.0% of enrolled patients. Older age increased the likelihood of experiencing technical (OR 2.18, 95% CI 1.22 to 3.88) and respondent burden problems (OR 3.32, 95% CI 1.88 to 5.87), as well as unsuccessful calls (OR 2.16, 95% CI 1.19 to 3.91). Patients with higher education experienced less respondent burden problems (OR 0.44, 95% CI 0.21 to 0.91), but they were more prone to have unsuccessful calls (OR 2.65, 95% CI 1.07 to 6.56) and less likely to find them useful (OR 0.23 95% CI 0.08 to 0.68). Older adults perceived the calls as easy to use and useful, although they reported lower intention to use the automated calls in the future (OR 0.32, 95% CI 0.15 to 0.70).

Discussion

As reported in previous studies, we found that older adults tend to have more difficulty when interacting with automated calls. Evidence about the association between education and usability was mixed.

Conclusions

Our results highlight practical suggestions to improve the feasibility and usability of automated calls in primary care screening programmes.
The use of analgesia in mountain rescue casualties with moderate or severe pain
Authors: Ellerton John Alexander , Greene Mike , Paal Peter
Published: February 2013

Objectives

To assess the effectiveness of analgesia used in mountain rescue (MR) in casualties with moderate or severe pain. To determine if a verbal numeric pain score is practical in this environment. To describe the analgesic strategies used by MR.

Design

Prospective, descriptive study.

Setting

Fifty-one MR teams in England and Wales. The study period was 1 September 2008 to 31 August 2010.

Participants

92 MR casualties with a pain scoreof 4/10 or greater.

Main outcome

38% of casualties achieved a pain reduction of 50% or greater in their initial score at 15 min and 60.2% had achieved this at handover.

Results

The initial pain score was 8 (median), reducing to 5 at 15 min and 3 at handover. The mean pain reduction was 2.5±2.4 at 15 min and 3.9±2.5 at handover. 80 casualties (87%) were treated with an opioid and seven had two different opioids administered. Seven main strategies were identified in which the principal agent was entonox, intramuscular opioid, oral analgesia, fentanyl lozenge, intranasal or intravenous opioid. The choice of strategy varied with the skills of the casualty carer.

Conclusions

Pain should be assessed using a pain score. When possible, intravenous opioid is the gold standard to achieve early and continuing pain control in patients with moderate or severe pain. Entonox and oral analgesics, as sole agents, have limited use in moderate or severe pain. Intranasal opioid and fentanyl lozenge are effective, and appropriate in MR. Research priorities include bioavailability in different environmental conditions and patient's satisfaction with their pain management.
Crossover balloon technique for vertebral artery thrombus: a novel method
Authors: Huded Vikram , Ellajosyula Ratnavalli , de Souza Romnesh , Zafer Syed Moeed
Published: February 2013

A 54-year-old man presented with recurrent episodes of transient ischemic attacks and acute stroke secondary to a floating thrombus in the right vertebral artery (VA) with narrowing of the right VA. He was initially treated medically with anticoagulation, antiplatelets and statins but developed multiple fresh infarcts. He was then referred for endovascular treatment, which was performed in a novel way.
A Conversation with Andreas Acrivos
Authors: Acrivos Andreas , Shaqfeh Eric
Published: February 2013

For a video of this interview, please visit the Annual Reviews YouTube channel , or proceed to the full text of the article, which includes a transcript.
Asparagine synthetase: regulation by cell stress and involvement in tumor biology
Authors: Balasubramanian Mukundh N. , Butterworth Elizabeth A. , Kilberg Michael S.
Published: February 2013

Asparagine synthetase (ASNS) catalyzes the conversion of aspartate and glutamine to asparagine and glutamate in an ATP-dependent reaction. The enzyme is ubiquitous in its organ distribution in mammals, but basal expression is relatively low in tissues other than the exocrine pancreas. Human ASNS activity is highly regulated in response to cell stress, primarily by increased transcription from a single gene located on chromosome 7. Among the genomic elements that control ASNS transcription is the C/EBP-ATF response element (CARE) within the promoter. Protein limitation or an imbalanced dietary amino acid composition activate the ASNS gene through the amino acid response (AAR), a process that is replicated in cell culture through limitation for any single essential amino acid. Endoplasmic reticulum stress also increases ASNS transcription through the PERK-eIF2-ATF4 arm of the unfolded protein response (UPR). Both the AAR and UPR lead to increased synthesis of ATF4, which binds to the CARE and induces ASNS transcription. Elevated expression of ASNS protein is associated with resistance to asparaginase therapy in childhood acute lymphoblastic leukemia and may be a predictive factor in drug sensitivity for certain solid tumors as well. Activation of the GCN2-eIF2-ATF4 signaling pathway, leading to increased ASNS expression appears to be a component of solid tumor adaptation to nutrient deprivation and/or hypoxia. Identifying the roles of ASNS in fetal development, tissue differentiation, and tumor growth may reveal that ASNS function extends beyond asparagine biosynthesis.
Wide Effectiveness of a Sine Basis for Quantum-Mechanical Problems indDimensions
Authors: Hall Richard L. , Rodríguez Alexandra Lemus
Published: February 2013

It is shown that the spanning set forL2([0,1])provided by the eigenfunctions{2sin(nπx)}n=1∞of the particle in a box in quantum mechanics provides a very effective variational basis for more general problems. The basis is scaled to[a,b], whereaandbare then used as variational parameters. What is perhaps a natural basis for quantum systems confined to a spherical box inRdturns out to be appropriate also for problems that are softly confined byU-shaped potentials, including those with strong singularities atr=0. Specific examples are discussed in detail, along with some boundN-boson systems.
A Hybrid Algorithm of Traffic Accident Data Mining on Cause Analysis
Authors: Xi Jianfeng , Gao Zhenhai , Niu Shifeng , Ding Tongqiang , Ning Guobao
Published: February 2013

Road traffic accident databases provide the basis for road traffic accident analysis, the data inside which usually has a radial, multidimensional, and multilayered structure. Traditional data mining algorithms such as association rules, when applied alone, often yield uncertain and unreliable results. An improved association rule algorithm based on Particle Swarm Optimization (PSO) put forward by this paper can be used to analyze the correlation between accident attributes and causes. The new algorithm focuses on characteristics of the hyperstereo structure of road traffic accident data, and the association rules of accident causes can be calculated more accurately and in higher rates. A new concept of Association Entropy is also defined to help compare the importance between different accident attributes. T-test model and Delphi method were deployed to test and verify the accuracy of the improved algorithm, the result of which was a ten times faster speed for random traffic accident data sampling analyses on average. In the paper, the algorithms were tested on a sample database of more than twenty thousand items, each with 56 accident attributes. And the final result proves that the improved algorithm was accurate and stable.
A Minireview of the Natures of Radiation-Induced Point Defects in Pure and Doped Silica Glasses and Their Visible/Near-IR Absorption Bands, with Emphasis on Self-Trapped Holes and How They Can Be Controlled
Authors: Griscom David L.
Published: February 2013

The natures of most radiation-induced point defects in amorphous silicon dioxide (a-SiO2) are well known on the basis of 56 years of electron spin resonance (ESR) and optical studies of pure and doped silica glass in bulk, thin-film, and fiber-optic forms. Many of the radiation-induced defects intrinsic to pure and B-, Al-, Ge-, and P-doped silicas are at least briefly described here and references are provided to allow the reader to learn still more about these, as well as some of those defects not mentioned. The metastable self-trapped holes (STHs), intrinsic to both doped and undoped silicas, are argued here to be responsible for most transient red/near-IR optical absorption bands induced in low-OH silica-based optical fibers by ionizing radiations at ambient temperatures. However, accelerated testing of a-SiO2-based optical devices slated for space applications must take into account the highly supralinear dependence on ionizing-dose-rate of the initial STH creation rate, which if not recognized would lead to false negatives. Fortunately, however, it is possible to permanently reduce the numbers of environmentally or operationally created STHs by long-term preirradiation at relatively low dose rates. Finally, emphasis is placed on the importance and utility of rigorously derived fractal-kinetic formalisms that facilitate reliable extrapolation of radiation-induced optical attenuations in silica-based photonics recorded as functions of dose rate backward into time domains unreachable in practical laboratory times and forward into dose-rate regimes for which there are no present-day laboratory sources.
Preparation and Characterization of Nano-Cadmium Ferrite
Authors: Ismail S. M. , Labib Sh. , Attallah S. S.
Published: February 2013

Nano-hematite (α-Fe2O3) and nano-cadmium ferrite (CdFe2O4) are prepared using template-assisted sol-gel method. The prepared samples are analyzed using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and Mössbauer spectroscopy techniques for structural and microstructural studies. Nano-α-Fe2O3 with particle size ~60 nm is formed at 500°C, while nano-CdFe2O4 with smaller particle size (~40 nm) is formed at 600°C. It is found that with a simple sol-gel process we can prepare nano-CdFe2O4 with better conditions than other methods: pure phase at lower sintering temperature and time (economic point) and of course with a smaller particle size. So, based on the obtained experimental results, a proposed theoretical model is made to explain the link between the use of the sol-gel process and the formation of nano-CdFe2O4 as a pure phase at low temperature. This model is based on a simple magnetostatic interaction between the formed nuclei within the solution leading to the formation of the stable phase at low temperature.
Is the Simple Closure Technique Effective in the Treatment of Genital Fistulas?
Authors: Unlubilgin Eylem , İlhan Tolgay Tuyan , Sivaslioglu Ahmet Akin , Dolen Ismail
Published: February 2013

Aim. Genitourinary fistulas are bothersome clinical entities not only for the patient but also for the treating surgeon as well. A lot of surgical procedures have been proposed; however, most of the fistulas can be easily treated with plain surgical techniques, such as the simple surgical closure of the fistula tract. Material and Method. The study was carried out in the urogynecology department of Ankara Etlik Zübeyde Hanım Maternity Training and Research Hospital. The study included 12 cases with vesicovaginal fistulas and 15 cases with rectovaginal fistulas. Twenty-six patients underwent simple surgical closure technique. The age, the referral time to the hospital, the longest diameter of the fistula opening, the hospitalization time, the follow-up period and identifiable risk factors of the patients were evaluated. Results. Caeserean section was detected as primary risk factor for vesicovaginal fistulas and prolonged labor was detected as the most important risk factor for rectovaginal fistulas. In our study, we found that the simple closure technique cured 91% of vesicovaginal fistulas and 93% of rectovaginal fistulas. Conclusion. The simple closure technique has very high cure rates for both vesicovaginal and rectovaginal fistulas when the longest diameter of the fistula openings is ≤5 mm.
Existence of Mild Solutions for the Elastic Systems with Structural Damping in Banach Spaces
Authors: Fan Hongxia , Li Yongxiang , Chen Pengyu
Published: February 2013

This paper deals with the existence and uniqueness of mild solutions for a second order evolution equation initial value problem in a Banach space, which can model an elastic system with structural damping. The discussion is based on the operator semigroups theory and fixed point theorem. In addition, an example is presented to illustrate our theoretical results.
Study of Thorium-Plutonium Fuel for Possible Operating Cycle Extension in PWRs
Authors: Insulander Björk Klara , Lau Cheuk Wah , Nylén Henrik , Sandberg Urban
Published: February 2013

Computer simulations have been carried out to investigate the possibility of extending operating cycle length in the Pressurised Water Reactor Ringhals 3 by the use of thorium-plutonium oxide fuel. The calculations have been carried out using tools and methods that are normally employed for reload design and safety evaluation in Ringhals 3. The 3-batch reload scheme and the power level have been kept unchanged, and a normal uranium oxide fuel assembly designed for a 12-month operating cycle in this reactor is used as a reference. The use of plutonium as the fissile component reduces the worth of control rods and soluble boron, which makes it necessary to modify the control systems. The delayed neutron fraction is low compared with the reference, but simulations and qualitative assessments of relevant transients indicate that the reactor could still be operated safely. Differences in reactivity coefficients are mainly beneficial for the outcome of transient simulations for the thorium based fuel. A 50% extension of the current 12-month operating cycle length should be possible with thorium-plutonium mixed oxide fuel, given an upgrade of the control systems. More detailed simulations have to be carried out for some transients in order to confirm the qualitative reasoning presented.
Facial Localization of Malignant Chondroid Syringoma: A Rare Case Report
Authors: Tural Deniz , Selçukbiricik Fatih , Günver Feray , Karışmaz Abdülkadir , Serdengecti Süheyla
Published: February 2013

First described by Hirsch and Helwig in 1961, chondroid syringomas (CSs) are rare, benign tumors of the skin arising from the eccrine sweat glands with tumor differentiation in the epithelial and mesenchymal tissues. They most commonly occur in the head and neck, although they may be also found in the axilla, trunk, limbs, and genitalia. The incidence of CS is <0.01% of all primary skin tumors. Malingnant chondroid syringomas (MCS), which are also called malignant mixed tumors of the skin, are extremely uncommon. MCSs commonly involve the limbs and rarely head and neck. In this article, we present a case of malignant chondroid syringoma localized in the face at the left nasolabial region in the light of literature review.
Facial Edema Evaluation Using Digital Image Processing
Authors: Villafuerte-Nuñez A. E. , Téllez-Anguiano A. C. , Hernández-Díaz O. , Rodríguez-Vera R. , Gutiérrez-Gnecchi J. A. , Salazar-Martínez J. L.
Published: February 2013

The main objective of the facial edema evaluation is providing the needed information to determine the effectiveness of the anti-inflammatory drugs in development. This paper presents a system that measures the four main variables present in facial edemas: trismus, blush (coloration), temperature, and inflammation. Measurements are obtained by using image processing and the combination of different devices such as a projector, a PC, a digital camera, a thermographic camera, and a cephalostat. Data analysis and processing are performed using MATLAB. Facial inflammation is measured by comparing three-dimensional reconstructions of inflammatory variations using the fringe projection technique. Trismus is measured by converting pixels to centimeters in a digitally obtained image of an open mouth. Blushing changes are measured by obtaining and comparing the RGB histograms from facial edema images at different times. Finally, temperature changes are measured using a thermographic camera. Some tests using controlled measurements of every variable are presented in this paper. The results allow evaluating the measurement system before its use in a real test, using the pain model approved by the US Food and Drug Administration (FDA), which consists in extracting the third molar to generate the facial edema.
Fixed-Term Homotopy
Authors: Vazquez-Leal Hector , Khan Yasir , Filobello-Nino Uriel , Sarmiento-Reyes Arturo , Diaz-Sanchez Alejandro , Cisneros-Sinencio Luis-F.
Published: February 2013

A new tool for the solution of nonlinear differential equations is presented. The Fixed-Term Homotopy (FTH) delivers a high precision representation of the nonlinear differential equation using only a few linear algebraic terms. In addition to this tool, a procedure based on Laplace-Padé to deal with the truncate power series resulting from the FTH method is also proposed. In order to assess the benefits of this proposal, two nonlinear problems are solved and compared against other semianalytic methods. The obtained results show that FTH is a power tool capable of generating highly accurate solutions compared with other methods of literature.
Human Papillomavirus Load in Eyebrow Hair Follicles and Risk of Cutaneous Squamous Cell Carcinoma
Authors: Neale Rachel E. , Weissenborn Soenke , Abeni Damiano , Bavinck Jan Nico Bouwes , Euvrard Sylvie , Feltkamp Mariet C.W. , Green Adele C. , Harwood Catherine , de Koning Maurits , Naldi Luigi , Nindl Ingo , Pawlita Michael , Proby Charlotte , Quint Wim G. , Waterboer Tim , Wieland Ulrike , Pfister Herbert
Published: February 2013

Background: Beta-human papillomavirus (betaPV) may play a role in the development of cutaneous squamous cell carcinoma (SCC). However betaPV is highly prevalent, and it may only be people with a higher viral load who have increased risk of SCCs. We therefore examined the association between betaPV load and SCCs.

Methods: We recruited 448 immunocompetent cases with SCCs and 464 controls from Italy and Australia and 497 immunosuppressed organ transplant recipients (OTR; 179 cases and 318 controls) from Europe. We used reverse hybridization to genotype 25 betaPV types in eyebrow hair follicles and determined the viral load for eight selected types using quantitative PCR. We used logistic regression to assess associations between type-specific and cumulative viral load and SCCs.

Results: Australian and OTR participants in the highest cumulative load tertile were at significantly higher risk of SCCs than those in the lowest tertile. Those with more than four betaPV types in the high load tertile were at approximately three-fold increased risk of SCCs. In Australia, HPV23 and 36 loads were significantly associated with SCCs, with borderline associations for HPV5 and 38. In OTR, HPV8 and 38 loads were significantly associated and HPV20 and 36 were borderline. We found little evidence for an association between load and SCCs in Italy.

Conclusions: High viral load may be associated with risk of cutaneous SCCs, with total load seemingly more important than the load of any specific type.

Impact: Our findings lend weight to the hypothesis that HPV plays a role in skin carcinogenesis. Cancer Epidemiol Biomarkers Prev; 22(4); 719–27. ©2013 AACR.
First-in-Human Phase 0 Trial of Oral 5-Iodo-2-Pyrimidinone-2′-Deoxyribose in Patients with Advanced Malignancies
Authors: Kummar Shivaani , Anderson Larry , Hill Kimberly , Majerova Eva , Allen Deborah , Horneffer Yvonne , Ivy S. Percy , Rubinstein Larry , Harris Pamela , Doroshow James H. , Collins Jerry M.
Published: February 2013

Purpose: Iododeoxyuridine (IdUrd), a halogenated nucleoside analog, produced clinical responses when administered as a radiosensitizer via continuous intravenous (c.i.v.) infusion over the course of radiotherapy. We conducted a phase 0 trial of 5-iodo-2-pyrimidinone-2′-deoxyribose (IPdR), an oral prodrug of IdUrd, in patients with advanced malignancies to assess whether the oral route was a feasible alternative to c.i.v. infusion before embarking on large-scale clinical trials. Plasma concentrations of IPdR, IdUrd, and other metabolites were measured after a single oral dose of IPdR.

Experimental Design: Eligible patients had advanced refractory malignancies. A single oral dose of IPdR was administered per patient and patients were followed for 14 days for safety assessments; dose escalations were planned (150, 300, 600, 1,200, and 2,400 mg) with one patient per dose level and 6 patients at the highest dose level. Blood sampling was conducted over a 24-hour period for pharmacokinetic analysis.

Results: There were no drug-related adverse events. Plasma concentrations of IdUrd generally increased as the dose of IPdR escalated from 150 to 2,400 mg. All patients at the 2,400 mg dose achieved peak IdUrd levels of (mean ± SD) 4.0 μmol/L ± 1.02 μmol/L at 1.67 ± 1.21 hours after IPdR administration.

Conclusions: Adequate plasma levels of IdUrd were obtained to justify proceeding with a phase I trial of IPdR in combination with radiation. This trial shows the ability of a small, phase 0 study to provide critical information for decision-making regarding future development of a drug. Clin Cancer Res; 19(7); 1852–7. ©2013 AACR.
The Antimicrobial Peptide LL-37 Alters Human Osteoblast Ca2+ Handling and Induces Ca2+-Independent Apoptosis
Authors: Säll Johanna , Carlsson Martin , Gidlöf Olof , Holm Anders , Humlén Johan , Öhman Jenny , Svensson Daniel , Nilsson Bengt-Olof , Jönsson Daniel
Published: February 2013

The human antimicrobial peptide cathelicidin LL-37 has, besides its antimicrobial properties, also been shown to regulate apoptosis in a cell type-specific manner. Mechanisms involved in LL-37-regulated apoptotic signaling are not identified. Here, we show that LL-37 reduces the human osteoblast-like MG63 cell number and cell viability in the micromolar concentration range with an IC50 value of about 5 µM. Treatment with 4 µM LL-37 increased the number of annexin V-positive cells and stimulated activation of caspase 3 showing that LL-37 promotes apoptosis. Treatment with 4 µM LL-37 caused an acute and sustained rise in intracellular Ca2+ concentration assessed by laser-scanning confocal microscopy of Fluo-4-AM-loaded MG63 cells. LL-37 increased Ca2+ also in the presence of the respective L- and T-type voltage-sensitive Ca2+ channel blockers nifedipine and NiCl2. LL-37 had no effect on Ca2+ in cells incubated with Ca2+-free solution. LL-37 (4 and 8 µM) reduced the MG63 cell number both in the presence and absence of Ca2+ in the medium. In conclusion, LL-37 reduces the osteoblast cell number by promoting apoptosis, and furthermore, LL-37 stimulates Ca2+ inflow via a mechanism independent of voltage-sensitive Ca2+ channels. Interestingly, LL-37-induced lowering of the cell number seems to be mediated via a mechanism independent of Ca2+.
The Natural History of Depression up to 15 Years After Stroke
Authors: Ayerbe Luis , Ayis Salma , Crichton Siobhan , Wolfe Charles D.A. , Rudd Anthony G.
Published: February 2013

Background and Purpose—

Evidence on the natural history of depression after stroke is still insufficient to inform prognosis and treatment strategies. This study estimates the incidence, cumulative incidence, prevalence, time of onset, duration, and recurrence rate of depression up to 15 years after stroke.

Methods—

Data from patients registered in the South London Stroke Register between 1995 and 2009 were used (N=4022 at registration. Maximum number of participants for these analyses n=1233). Depression was assessed in all patients with the Hospital Anxiety and Depression Scale (scores >7=depression) 3 months after stroke, 1 year after stroke, and annually thereafter up to 15 years after stroke. Inverse probability weighting was used to calculate the estimates accounting for missing data.

Results—

The poststroke incidence of depression ranged from 7% to 21% in the 15 years after a stroke, with cumulative incidence of 55% and prevalence ranging from 29% to 39%. Most episodes of depression started within a year of stroke, with 33% of the cases starting in the 3 months after a stroke, and none from year 10 onward. Fifty percent of the patients with depression at 3 months had recovered 1 year after stroke. The proportion of recurrent episodes of depression after stroke increased gradually from 38% in year 2 to 100% in years 14 and 15.

Conclusions—

The natural history of depression after stroke is dynamic. Depression affects most of the stroke patients with episodes that have a short duration but a high risk of recurrence in the long term.
Sextus Empiricus on Xenophanes’ Scepticism
Authors: Tor Shaul
Published: February 2013

Sextus’ interpretation of Xenophanes’ scepticism in M 7.49–52 is often cited but has never been subject to detailed analysis. Such analysis reveals that Sextus’ interpretation raises far more complex problems than has been recognised. Scholars invariably assume one of two ways of construing his account of Xenophanes B34, without observing that the choice between these two alternatives poses an interpretive dilemma. Some scholars take it that Sextus ascribes to Xenophanes (i) the view that one may have knowledge without knowing that one has knowledge. Others take it that he ascribes to Xenophanes (ii) the view that one may have true belief without knowing that one has true belief. A close examination of Sextus’ paraphrase exposes a crucial but overlooked complication. Sextus elides Xenophanes’ pivotal distinction between knowing “the clear and certain” (to saphes) and believing “what has been fulfilled” (tetelesmenon). He eliminates altogether tetelesmenon from his analysis of B34, and expands the role of to saphes. I demonstrate that, as a result, Xenophanes B34, as interpreted by Sextus, does not consistently and straightforwardly express either view (i) or view (ii). Sextus, I argue, in fact develops a fundamentally incoherent interpretation of Xenophanes B34. On Sextus’ interpretation, Xenophanes justifies the proposition “No human knows” by arguing that, even if a human does, in fact, know, he does not know that he knows. Finally, I argue that Sextus’ incoherent account reflects not unthinking negligence, but a sophisticated if ultimately doomed attempt to interpret the logical structure of Xenophanes B34 in line with later models of second-order scepticism.
Toward a Process-Based Approach of Conceptualizing Change Readiness
Authors: Stevens Gregory W.
Published: February 2013

Establishing change readiness may be one of the key factors in determining whether a given change intervention will ultimately be successful or not. Unfortunately, there is a good deal of conceptual confusion in the literature surrounding the term, illustrated by the sheer number of terms that are used to capture the construct (e.g., openness, receptivity, commitment, attitudes toward change) and the varying theoretical foundations that have been proposed. To arrive at a more conceptually sound notion of change readiness, the current article advocates moving beyond state-based conceptualizations toward a process model of change readiness. This process model has the advantage of serving as a framework against which to synthesize extant theorizing on change readiness, incorporating the influences of context and environment over time on an individual’s cognitive and affective evaluations and subsequent positive and proactive responses to change, and capturing readiness as a recursive and multidimensional process.
Drug Generations in the 2000s
Authors: Golub Andrew , Brownstein Henry H.
Published: February 2013

Much empirical evidence indicates that the popularity of various drugs tends to increase and wane over time producing episodic epidemics of particular drugs. These epidemics mostly affect persons reaching their late teens at the time of the epidemic resulting in distinct drug generations. This article examines the drug generations present in the 2000s among arrestees in the 10 locations served by the Arrestee Drug Abuse Monitoring–II program. At all 10 locations, our findings show that crack use is still common among older arrestees but not among arrestees born more recently. Marijuana is the drug most common among younger arrestees. The article also examines trends in heroin, methamphetamine, and powder cocaine use among arrestees at the few locations where their use was substantial.
You Are Not Alone: Relatedness Reduces Adverse Effects of State Orientation on Well-Being Under Stress
Authors: Chatterjee Monischa B. , Baumann Nicola , Osborne Danny
Published: February 2013

A low ability to self-regulate emotions (state orientation) is associated with reduced well-being—especially under stress. Until now, research has approached this topic from an asocial perspective that views the self as devoid from relatedness concerns. However, people are social creatures who benefit from their relationships with others. As such, we expected that personally valuing (Study 1) and experimentally priming (Study 2) a sense of relatedness with others would act as a buffer against stress-related impairments in state-oriented individuals. In Study 1, high (vs. low) benevolence values removed the adverse effect of state orientation on well-being found under stressful life circumstances. In Study 2, focusing on similarities (vs. differences) while comparing oneself with a friend removed the adverse effect of state orientation on recovery from a negative mood induction. Our findings suggest that individuals with low self-regulatory competencies may profit from valuing and directing their attention toward their relatedness with others.
The Italian Version of the Strengths and Difficulties Questionnaire (SDQ)—Teacher
Authors: Tobia Valentina , Gabriele Maria Antonietta , Marzocchi Gian Marco
Published: February 2013

The Strengths and Difficulties Questionnaire (SDQ) is an instrument developed by Goodman for screening child and adolescent psychopathology. The aim of this study is to contribute to the analysis and validation of the internal structure of the Italian SDQ teacher version (SDQ-T). The SDQ-T was completed by 301 teachers, evaluating 3,302 children aged 3 to 15 years. Exploratory factor analysis (EFA) performed on a portion of the sample ( n = 1,000) led to five interpretable factors, partially different from the original structure: Items 2 and 10 loaded on the Conduct Problems scale instead of that on the Hyperactivity/Inattention scale. Confirmatory factor analyses (CFAs) were performed to compare three different latent structures: the original five-factor structure; a second-order model recently proposed by Goodman, Lamping, and Ploubidis; and structure obtained with the EFA. The latter one showed the best fit. Significant differences by gender and school grade were found. The Italian SDQ-T’s internal structure differed in part from the original instrument; possible causes are discussed.
Forest Grove v. T.A. Rejoinder to Zirkel
Authors: Wright Peter W. D. , Hale James B. , Backenson Erica M. , Eusebio Eleazar C. , Dixon Shauna G.
Published: February 2013

In this issue, Professor Perry Zirkel argues that the points presented in the Dixon, Eusebio, Turton, Wright, and Hale treatise of the Forest Grove School District v. T.A. Supreme Court case confuses “legal requirements with professional norms.” Although we appreciate Zirkel’s acknowledgment that our position reflects the professional norm—that comprehensive evaluation of psychological processes is critical for identifying children with learning and other disabilities—this position does not equate with “confusion” regarding the Individuals with Disabilities Education Improvement Act statutory or regulatory requirements, or legal precedents, presented in Dixon et al. On the contrary, Dixon et al. specifically address all three requirements in their article, suggesting Zirkel’s rebuttal is not supported. The resultant effects of Zirkel’s arguments on public opinion, professional conduct, and individual children served by the law will be elucidated in this rebuttal.
Rethinking International Migration of Human Capital and Brain Circulation
Authors: Blachford Dongyan Ru , Zhang Bailing
Published: February 2013

This article examines the dynamics of brain circulation through a historical review of the debates over international migration of human capital and a case study on Chinese-Canadian academics. Interviews with 22 Chinese-Canadian professors who originally came from China provide rich data regarding the possibilities and problems of the contemporary global mobility. The findings indicate that brain circulation is possible in the case of Chinese-Canadian academics but that certain conditions and factors, especially some disparity issues associated with international migration of human capital, have prevented a more effective brain circulation from taking place. This article argues that addressing these disparity issues will be an indispensable step toward fostering an effective global human capital circulation and knowledge exchange.
Factors Associated With Advance Care Planning Discussions by Area Agency on Aging Care Managers
Authors: Hazelett Susan , Baughman Kristin R. , Palmisano Barbara R. , Sanders Margaret , Ludwick Ruth E.
Published: February 2013

Background:

Initiating advance care planning (ACP) discussions in the home may prevent avoidable hospitalizations by elucidating goals of care. Area agencies on aging care managers (AAACMs) work in the home with high-risk consumers.

Purpose:

To determine which AAACM characteristics contribute to an increased frequency of ACP discussions.

Method:

Cross-sectional investigator-generated surveys administered to AAACMs at 3 AAAs in Ohio. Results: Of 289 AAACMs, 182 (63%) responded. The more experience and comfort AAACMs felt with ACP discussions, the more likely they were to initiate ACP discussions.

Discussion:

It may be necessary to build interactive educational experiences where, for example, AAACMs are asked to fill out their own advance directives and/or facilitate others in ACP discussions to improve experience and comfort with ACP discussions.
Deciding if Home Care Is Right for Me
Authors: Patterson Erin , Hart Corinne , Bishop Susan E. , Purdy Nancy
Published: February 2013

As the location of health care delivery continues to shift from inpatient settings into the community understanding the experience of the home care workforce is important. Challenges related to recruitment and retention of nurses in home care has resulted in agencies hiring new graduate nurses. While Extensive research exists exploring experiences of new graduates in hospital settings, experiences of new graduates in home care are not well understood. Given the contextual differences between hospital and home care, research exploring new graduate nurses’ experiences in the home care sector is warranted. A phenomenological approach was used. “Deciding if home care is right for me” emerged as a way of understanding new graduate nurses’ experiences in home care.
Effects of antihypertensive therapy on glucose, insulin metabolism, left ventricular diastolic dysfunction and renin system in overweight and obese hypertensives
Authors: De Rosa Maria Leonarda , Musella Francesca , Ilardi Federica , D’Amore Carmen , Luciano Rossella , Maresca Fabio
Published: February 2013

Background:

We attempted to test the hypothesis that the direct renin inhibitor aliskiren can improve diastolic dysfunction, glucose, and insulin metabolism (GIM) in overweight and obese hypertensive patients.

Methods and results:

Seventy-eight hypertensive patients were divided into two groups: 38 treated with aliskiren for six months, and 40 treated without aliskiren but with only traditional anti-hypertensive therapy, as controls. Doppler mitral flow velocity patterns were assessed before and after aliskiren during a six-month period. GIM (three-hour intravenous glucose tolerance test) was measured after four to six weeks of washout and six months of treatment. The mitral E/A ratio increased from 0.65 ± 0.11 to 0.75 ± 0.19. None of the indexes changed in the control group. In the control group, GIM parameters, fasting glucose levels (5.3 ± 0.9 to 6.0 ± 1.5 mmol/l; p = 0.003), fasting insulin levels (121 ± 121 to 189 ± 228 pmol/l; p = 0.03), and most other relevant metabolic measures ( p < 0.05 for all) significantly worsened. Aliskiren did not affect GIM. In the control group LVM/height was not affected (119 ± 12 to 120 ± 17 g/m; p = 0.8), whereas aliskiren significantly reduced LVM/height (120 ± 13 to 111 ± 19 g/m; p = 0.04).

Conclusions:

Optimal target BP was achieved in the group as a whole and in both obese patient groups, while benefits to cardiac structure were of a smaller magnitude. In high-risk, overweight/obese patients with hypertension, traditional therapy provides significantly greater BP- versus aliskiren-lowering throughout the 24-hour dosing interval. Therefore in obese, hypertensive individuals, adequate and similar blood pressure control was achieved with aliskiren; however, the aliskiren group and not the control group was associated with a more favorable GIM profile and led to a significant regression of LVM; overall aliskiren-based treatment offers sustained control of PRA.
Agenda Control in the 2008 Presidential Debates
Authors: Boydstun Amber E. , Glazier Rebecca A. , Phillips Claire
Published: February 2013

Research indicates that, when engaging their opponents, strategic candidates will draw (and redraw) lines of conflict, pulling attention to their advantaged topics. But do these expectations hold up in debates, where candidates are at the mercy of those asking the questions? And do strategic debate behaviors matter? This study draws on past literature to hypothesize the specific types of agenda-control behaviors we should see in debates. These hypotheses are tested in the 2008 presidential debates, using quantitative content analysis to examine candidate agenda setting, issue framing, and tone. The results show that both Obama and McCain used all three means of agenda control to continually displace the line of conflict in their favor.  These findings offer empirical support for theories of strategic agenda control and heighten our understanding of agenda setting, framing, and tone as agenda-control mechanisms.  Additionally, media and public opinion data suggest these debate agenda-control behaviors had real effects during the 2008 election.
A Pilot Study Analyzing Grocery Purchases of Families With Head Start Preschoolers
Authors: Winston Courtney P. , Sharma Shreela V.
Published: February 2013

This study describes the foods and beverages available in the homes of low-income, minority preschoolers. In all, 42 families who represented 43 preschoolers from 2 Head Start centers submitted grocery receipts over a 6-week period in Fall 2008. Descriptive statistics were used to estimate the distribution of purchases of various foods for the families, and correlations were used to associate purchases between food groups. Results showed that a majority of families purchased animal proteins, desserts/chips, and sugar-sweetened beverages at least once during the study. Conversely, less than one third of families purchased green leafy vegetables and water. Purchases of vegetarian proteins were moderately associated with purchases of other plant-based foods. Results indicate that a large percentage of the participating preschoolers reside in homes where high-sugar, high-fat foods and beverages are readily available. These preliminary findings, which were obtained using an objective approach, provide important insight into consumer purchasing trends among low-income families.
Continuing clozapine with granulocyte colony-stimulating factor in patients with neutropenia
Authors: Khan Al Aditya , Harvey Jake , Sengupta Samrat
Published: February 2013

Background:

The current guidelines dictate that clozapine should be stopped following the emergence of neutropenia. Various alternative approaches have been tried in the past, among them one rarely used alternative being to continue treatment with clozapine with coprescription of granulocyte colony-stimulating factor (G-CSF).

Aim and method:

In this case series we aim to describe the treatment and progress of a number of patients in a secure psychiatric hospital in the UK. These patients were restarted on clozapine in combination with G-CSF, in spite of previous neutropenia associated with clozapine treatment.

Discussion and conclusion:

We hope that this case series will raise the profile of a potentially effective alternative to discontinuing clozapine after neutropenia.
Discovery of novel biomarkers and phenotypes by semantic technologies
Authors: Trugenberger Carlo A , Wälti Christoph , Peregrim David , Sharp Mark E , Bureeva Svetlana
Published: February 2013

Background

Biomarkers and target-specific phenotypes are important to targeted drug design and individualized medicine, thus constituting an important aspect of modern pharmaceutical research and development. More and more, the discovery of relevant biomarkers is aided by in silico techniques based on applying data mining and computational chemistry on large molecular databases. However, there is an even larger source of valuable information available that can potentially be tapped for such discoveries: repositories constituted by research documents.

Results

This paper reports on a pilot experiment to discover potential novel biomarkers and phenotypes for diabetes and obesity by self-organized text mining of about 120,000 PubMed abstracts, public clinical trial summaries, and internal Merck research documents. These documents were directly analyzed by the InfoCodex semantic engine, without prior human manipulations such as parsing. Recall and precision against established, but different benchmarks lie in ranges up to 30% and 50% respectively. Retrieval of known entities missed by other traditional approaches could be demonstrated. Finally, the InfoCodex semantic engine was shown to discover new diabetes and obesity biomarkers and phenotypes. Amongst these were many interesting candidates with a high potential, although noticeable noise (uninteresting or obvious terms) was generated.

Conclusions

The reported approach of employing autonomous self-organising semantic engines to aid biomarker discovery, supplemented by appropriate manual curation processes, shows promise and has potential to impact, conservatively, a faster alternative to vocabulary processes dependent on humans having to read and analyze all the texts. More optimistically, it could impact pharmaceutical research, for example to shorten time-to-market of novel drugs, or speed up early recognition of dead ends and adverse reactions.