bluuebunny/crossref_metadata_2025 huggingface dataset:
High platelet reactivity – the challenge of prolonged anticoagulation therapy after ACSI
Authors: Brouwer Marc A. , Verheugt Freek W. A. , Focks Jeroen
Published: February 2013

Despite dual antiplatelet therapy (DAPT), one-year event rates after acute coronary syndrome (ACS) vary from 9–12%. The development of novel oral anticoagulants (NOAC) without a need for monitoring has initiated renewed interest for prolonged adjunctive anticoagulation. Importantly, the cornerstone of treatment after ACS consists of long-term DAPT. In that context, the NOACs have only been tested as adjunctive therapy. Of all new agents, only rivaroxaban –in a substantially lower dose than used for atrial fibrillation– has been demonstrated to improve outcome, albeit at the cost of bleeding. In selected cases, adjunctive therapy with dose-adjusted vitamin-K antagonists (international normalized ratio [INR] 2.0–3.0) can be considered as well. These two strategies of prolonged anticoagulation can be considered in case of ‘high platelet reactivity’, i.e. in patients at high risk of recurrent thrombotic events despite DAPT. Both during admission and after discharge for ACS, the use of NOACs in doses indicated for atrial fibrillation is strictly contra-indicated in patients on DAPT. In case of post-discharge anticoagulation therapy for atrial fibrillation, patients should preferably receive vitamin-K antagonists (INR 2.0–3.0), with discontinuation of one antiplatelet agent as soon as clinically justifiable. Importantly, the impact of prolonged anticoagulation (low-dose rivaroxaban, vitamin-K antagonists) as adjunctive to DAPT after ACS has not been addressed with the most potent antiplatelet agents (prasugrel, ticagrelor) and merits further study. Despite the potential indication of prolonged oral anticoagulation as adjunctive treatment, it remains to be established whether anticoagulation therapy could also be an alternative for either aspirin or thienopyridine treatment in selected ACS patients on DAPT.
Cardioprotective Effect of β-Adrenoceptor Blockade in Patients With Breast Cancer Undergoing Chemotherapy
Authors: Seicean Sinziana , Seicean Andreea , Alan Nima , Plana Juan Carlos , Budd G. Thomas , Marwick Thomas H.
Published: February 2013

Background—

Chemotherapy with trastuzumab and anthracycline is associated with incident heart failure (HF) in patients with breast cancer. We hypothesized that continuous incidental use of β-blocker agents (BB) was protective against HF in patients without established structural heart disease who were receiving trastuzumab and anthracycline.

Methods and Results—

We identified 920 consecutive patients with breast cancer (age 52.3±11.0 years) with normal ejection fraction before receiving trastuzumab and anthracycline therapy at our institution between 2005 and 2010. Using a propensity score and a greedy 5 to 1 digit-matching algorithm, 106 of these patients on continuous BB during cancer treatment were matched with 212 patients from the same pool with similar characteristics but not on continuous BB. During a median follow-up of 3.2±2.0 years, 32 incident HF admissions were identified in these 318 patients with breast cancer, whereas 28 cancer-related (noncardiac) deaths occurred before any incident HF. Cumulative incidence regression models and cause-specific hazards of new HF events were estimated from competing risk Cox models of time-dependent covariates. Although trastuzumab therapy showed significant association with incident HF, independent of anthracycline-related cardiotoxicity (hazard ratio, 9.0; 95% confidence interval, 3.0–27.0;
P
<0.0001), continuous use of BB was associated with lower risk of new HF events (hazard ratio, 0.2; 95% confidence interval, 0.1–0.5;
P
=0.003).

Conclusions—

Coincidental, continuous use of BB is associated with lower incidence of HF in patients with breast cancer and normal baseline ejection fraction in a competing risk framework, and after matching for demographics, clinical, and cancer-related treatment characteristics. Prospective randomized clinical trials to validate these findings are warranted.
Inactivation of Serum Response Factor Contributes To Decrease Vascular Muscular Tone and Arterial Stiffness in Mice
Authors: Galmiche Guillaume , Labat Carlos , Mericskay Mathias , Aissa Karima Ait , Blanc Jocelyne , Retailleau Kevin , Bourhim Mustapha , Coletti Dario , Loufrani Laurent , Gao-Li Jacqueline , Feil Robert , Challande Pascal , Henrion Daniel , Decaux Jean-François , Regnault Véronique , Lacolley Patrick , Li Zhenlin
Published: February 2013

Rationale:

Vascular smooth muscle (SM) cell phenotypic modulation plays an important role in arterial stiffening associated with aging. Serum response factor (SRF) is a major transcription factor regulating SM genes involved in maintenance of the contractile state of vascular SM cells.

Objective:

We investigated whether SRF and its target genes regulate intrinsic SM tone and thereby arterial stiffness.

Methods and Results:

The SRF gene was inactivated SM-specific knockout of SRF (SRF
SMKO
) specifically in vascular SM cells by injection of tamoxifen into adult transgenic mice. Fifteen days later, arterial pressure and carotid thickness were lower in SRF
SMKO
than in control mice. The carotid distensibility/pressure and elastic modulus/wall stress curves showed a greater arterial elasticity in SRF
SMKO
without modification in collagen/elastin ratio. In SRF
SMKO
, vasodilation was decreased in aorta and carotid arteries, whereas a decrease in contractile response was found in mesenteric arteries. By contrast, in mice with inducible SRF overexpression, the in vitro contractile response was significantly increased in all arteries. Without endothelium, the contraction was reduced in SRF
SMKO
compared with control aortic rings owing to impairment of the NO pathway. Contractile components (SM-actin and myosin light chain), regulators of the contractile response (myosin light chain kinase, myosin phosphatase target subunit 1, and protein kinase C–potentiated myosin phosphatase inhibitor) and integrins were reduced in SRF
SMKO
.

Conclusions:

SRF controls vasoconstriction in mesenteric arteries via vascular SM cell phenotypic modulation linked to changes in contractile protein gene expression. SRF-related decreases in vasomotor tone and cell-matrix attachment increase arterial elasticity in large arteries.
Surgical Outcome of Discrete Subaortic Stenosis in Adults
Authors: van der Linde Denise , Roos-Hesselink Jolien W. , Rizopoulos Dimitris , Heuvelman Helena J. , Budts Werner , van Dijk Arie P.J. , Witsenburg Maarten , Yap Sing C. , Oxenius Angela , Silversides Candice K. , Oechslin Erwin N. , Bogers Ad J.J.C. , Takkenberg Johanna J.M.
Published: February 2013

Background—

Discrete subaortic stenosis is notable for its unpredictable hemodynamic progression in childhood and high reoperation rate; however, data about adulthood are scarce.

Methods and Results—

Adult patients who previously underwent surgery for discrete subaortic stenosis were included in this retrospective multicenter cohort study. Mixed-effects and joint models were used to assess the postoperative progression of discrete subaortic stenosis and aortic regurgitation, as well as reoperation. A total of 313 patients at 4 centers were included (age at baseline, 20.2 years [25th–75th percentile, 18.4–31.0 years]; 52% male). Median follow-up duration was 12.9 years (25th–75th percentile, 6.2–20.1 years), yielding 5617 patient-years. The peak instantaneous left ventricular outflow tract gradient decreased from 75.7±28.0 mm Hg preoperatively to 15.1±14.1 mm Hg postoperatively (
P
<0.001) and thereafter increased over time at a rate of 1.31±0.16 mm Hg/y (
P
=0.001). Mild aortic regurgitation was present in 68% but generally did not progress over time (
P
=0.76). A preoperative left ventricular outflow tract gradient ≥80 mm Hg was a predictor for progression to moderate aortic regurgitation postoperatively. Eighty patients required at least 1 reoperation (1.8% per patient-year). Predictors for reoperation included female sex (hazard ratio, 1.53; 95% confidence interval, 1.02–2.30) and left ventricular outflow tract gradient progression (hazard ratio, 1.45; 95% confidence interval, 1.31–1.62). Additional myectomy did not reduce the risk for reoperation (
P
=0.92) but significantly increased the risk of a complete heart block requiring pacemaker implantation (8.1% versus 1.7%;
P
=0.005).

Conclusions—

Survival is excellent after surgery for discrete subaortic stenosis; however, reoperation for recurrent discrete subaortic stenosis is not uncommon. Over time, the left ventricular outflow tract gradient slowly increases and mild aortic regurgitation is common, although generally nonprogressive over time. Myectomy does not show additional advantages, and because it is associated with an increased risk of complete heart block, it should not be performed routinely.
Prosperity with the Help of “Villains,” 1776-1799
Authors: Yoon Wook
Published: February 2013

The late Qianlong period (ca. 1776-1795) has mostly been seen as the time when
the Qing empire went from its pinnacle into its decline as the bureaucracy
became bogged down in corruption. Heshen has come to epitomize late Qing
venality and mismanagement. This article argues that, in reality, the Qianlong
emperor employed Heshen and his associates in order to overcome the political
crisis that marred the middle years of his reign. A balance of power was
established whereby the cliques respectively represented by Akedun and Liu
Tongxun and by Heshen held each other in check. It is also shown that the wealth
that Heshen is alleged to have accumulated through his corrupt activities was
far less than commonly believed, and that Heshen could not significantly abuse
his political authority until about the time of Qianlong’s abdication,
four years before his own demise.  Les dernières
années du règne de l’empereur Qianlong (de 1776 environ
à 1795) sont la plupart du temps considérées comme celles
où l’empire des Qing a entamé son déclin
après avoir connu son apogée et où la bureaucratie a
été engloutie par la corruption. Heshen en est venu à
symboliser la vénalité et la mauvaise gestion de la fin des Qing.
Cet article montre au contraire que Qianlong a recouru à Heshen et
à son groupe dans l’espoir de surmonter la crise politique qui
ébranlait le milieu de son règne. En se neutralisant mutuellement,
les cliques représentées par Akedun et Liu Tongxun, d’une
part, et Heshen, de l’autre, ont préservé
l’équilibre au sein du pouvoir. Il est également
démontré que la richesse accumulée par les pratiques
corrompues de Heshen était bien moindre qu’on ne le croit
usuellement, et que Heshen n’a pu abuser de son autorité politique
de façon significative avant l’abdication de Qianlong,
précédant de quatre années sa propre chute.
Predictors of Blood Pressure Reduction With Nocturnal Continuous Positive Airway Pressure Therapy in Patients With Obstructive Sleep Apnea and Prehypertension
Authors: Yorgun Hikmet , Kabakçı Giray , Canpolat Uğur , Kırmızıgül Engin , Şahiner Levent , Ateş Ahmet Hakan , Şendur Mehmet Ali , Kaya Ergün Barış , Demir Ahmet Uğur , Aytemir Kudret , Tokgözoğlu Lale , Oto Ali
Published: February 2013

Previous studies showed that treatment of obstructive sleep apnea syndrome (OSAS) with continuous positive airway pressure (CPAP) significantly reduced the blood pressure (BP) in hypertensive patients. We investigated the predictors of BP change in normotensive patients with OSAS who underwent CPAP. A total of 24 patients with OSAS (19 male; age: 48.7 ± 10.4 years) were enrolled. The 24-hour mean BP (24 hMBP), subjective sleepiness, fasting venous blood samples, and anthropometric measurements were assessed at baseline, 6th week and 12th week of CPAP treatment. The 24 hMBP fell at 12 weeks from 89.2 ± 8.4 to 82.9 ± 7.3 mm Hg ( P < .0001) irrespective of the severity of disease. Also, both daytime and nighttime BP showed significant reduction after CPAP. Male gender, Epworth sleepiness scale, body mass index, smoking, alcohol use, and baseline 24 hMPB were the independent predictors of a fall in 24 hMBP. The CPAP therapy may provide benefit even in the absence of overt hypertension by reducing both daytime and nighttime BP.
Supporting Interruption Management and Multimodal Interface Design
Authors: Lu Sara A. , Wickens Christopher D. , Prinet Julie C. , Hutchins Shaun D. , Sarter Nadine , Sebok Angelia
Published: February 2013

Objective:

The aim of this study was to integrate empirical data showing the effects of interrupting task modality on the performance of an ongoing visual-manual task and the interrupting task itself. The goal is to support interruption management and the design of multimodal interfaces.

Background:

Multimodal interfaces have been proposed as a promising means to support interruption management. To ensure the effectiveness of this approach, their design needs to be based on an analysis of empirical data concerning the effectiveness of individual and redundant channels of information presentation.

Method:

Three meta-analyses were conducted to contrast performance on an ongoing visual task and interrupting tasks as a function of interrupting task modality (auditory vs. tactile, auditory vs. visual, and single modality vs. redundant auditory-visual). In total, 68 studies were included and six moderator variables were considered.

Results:

The main findings from the meta-analyses are that response times are faster for tactile interrupting tasks in case of low-urgency messages. Accuracy is higher with tactile interrupting tasks for low-complexity signals but higher with auditory interrupting tasks for high-complexity signals. Redundant auditory-visual combinations are preferable for communication tasks during high workload and with a small visual angle of separation.

Conclusion:

The three meta-analyses contribute to the knowledge base in multimodal information processing and design. They highlight the importance of moderator variables in predicting the effects of interruption task modality on ongoing and interrupting task performance.

Applications:

The findings from this research will help inform the design of multimodal interfaces in data-rich, event-driven domains.
Microwave foaming of starch-based materials (I) dielectric performance
Authors: Peng Xi , Song Jim , Nesbitt Alan , Day Richard
Published: February 2013

Extruded pellets from starch-based materials have been heated and foamed under microwave radiation. The foaming mechanisms and effects of some additives on the dielectric properties of the materials have been investigated using a microwave calorimeter. A rapid increase in dielectric loss factor (ɛ″) has been found for all the tested materials foamable under microwave heating and the onset of the ɛ″ increase is considered to be correlated to glass transition. It has been found that extruded starch materials can be foamed at 15℃/min but the expansion level reduced compared with that of the same material foamed at higher heating rate. The incorporation of organic additives in starch-based materials generally led to significant decrease of their microwave foamability when glycerol and polyvinyl alcohol are used as the additives in the extruded pellets.
The influence of plant natural fibers on swelling behavior of polymer hydrogels
Authors: Laftah Waham Ashaier , Hashim Shahrir
Published: February 2013

Central composite design method was used to design and optimize the best content of initiator, cross-linker, neutralizer and plant natural fibers of cotton and oil empty fruit bunch. The effect of buffer and saline solution on plant natural fiber based polymer hydrogel composites was investigated. The influences of plant natural fiber content and swelling behavior of polymer hydrogels were studied. Natural fibers had positive effect on polymer hydrogels in terms of absorption capacity and swelling rate. Polymer hydrogel composite of natural fiber with higher cellulose content had better swelling properties than that of less cellulose content and plain hydrogels. Polymer hydrogel composite base of high cellulose fiber content is less affected by the pH and ion concentration of the external solutions.
Material and structural response of polymer-matrix fibre-reinforced composites: Part B
Authors: Pinho ST , Vyas GM , Robinson P
Published: February 2013

This article showcases the authors’ predictions for Part B of the second World Wide Failure Exercise. Predictions are made using the failure criteria published in the submission for Part A. In several cases, the original predictions are found to match the experimental data well and no revisions are made. A novel constitutive model for unidirectional composite materials is used to improve predictions for cases involving multidirectional laminates.
Composite varistors based on epoxy resin/La0.8Sr0.2MnO3
Authors: Yang Xinsheng , Kim Hern , Yang Liqin , Cheng Cuihua , Zhao Yong
Published: February 2013

Polymer/perovskite manganese oxide (epoxy resin/La0.8Sr0.2MnO3) composites are prepared using bonded method. There is no reaction between La0.8Sr0.2MnO3 and the polymer. The nonlinear current–voltage property is significantly affected by the content of polymer. The resistivity and nonlinear coefficient increase with the increase of polymer content. The resistivity of the composites is 5–9 orders of magnitude higher than that of the sintering ceramics. The nonlinear electrical behavior is an intrinsic property. Compared with conventional sintered ceramic varistors, the polymer/manganese oxide composite varistors have greater nonlinear coefficient above 45.
Educators’ Insights in Using Chronicle Diabetes
Authors: Wang Jing , Siminerio Linda M.
Published: February 2013

Purpose

Diabetes educators lack data systems to monitor diabetes self-management education processes and programs. The purpose of the study is to explore diabetes educator’s insights in using a diabetes education data management program: the Chronicle Diabetes system.

Methods

We conducted 1 focus group with 8 diabetes educators who use the Chronicle system in western Pennsylvania. The focus group was audiotaped and transcribed verbatim. Themes were categorized according to system facilitators and barriers in using Chronicle.

Results

Educators report 4 system facilitators and 4 barrier features. System facilitators include (1) ability to extract data from Chronicle for education program recognition, (2) central location for collecting and documenting all patient and education data, (3) capability to monitor behavioral goal setting and clinical outcomes, and (4) use of a patient snapshot report that automatically summarizes behavioral goal setting and an education plan. Barriers reported are (1) initially time-consuming for data entry, (2) Health Insurance Portability and Accountability Act privacy concerns for e-mailing or downloading report, (3) need for special features (eg, ability to attach a food diary), and (4) need to enhance existing features to standardize goal-setting process and incorporate psychosocial content.

Conclusions

Educators favor capabilities for documenting program requirements, goal setting, and patient summaries. Barriers that need to be overcome are the amount of time needed for data entry, privacy, and special features. Diabetes educators conclude that a data management system such as Chronicle facilitates the education process and affords ease in documentation of meeting diabetes self-management education standards and recognition requirements.
Challenges of Diabetes Management in Immigrant Korean Americans
Authors: Nam Soohyun , Song Hee-Jung , Park So-Youn , Song Youngshin
Published: February 2013

Purpose

To examine challenges in diabetes self-management among Korean Americans to guide clinicians in providing culturally appropriate and population-targeted diabetes care.

Methods

Five focus groups with 23 Korean Americans with type 2 diabetes, 30 to 75 years of age, were conducted. Open-ended questions were presented focusing on previous experiences in living with diabetes; digital recordings were transcribed verbatim; transcripts were coded and themes were identified.

Results

Most participants were reluctant to disclose diabetes because of social stigma and said that they did not know much about diabetes and its complications. Diabetes self-management is not always a top priority for Korean Americans over other family obligations or financial stability in their busy immigration lives. Many Korean Americans experience conflicts with family members in managing diabetes or would not request support from family members for their diabetes care. Traditional women’s roles and demanding immigration life seem to leave women particularly vulnerable to a lack of self-care. Lack of English proficiency limits access to mainstream health care.

Conclusions

Providing diabetes education at the community level is important to raise public awareness of diabetes and to eliminate social stigma. To facilitate family support for individuals with type 2 diabetes, it is appropriate to include the entire family in diabetes educational programs and to promote individual family members’ health in the context of maintaining their role within the family. Future efforts should be made with full implementation of language services in various clinical encounters and diabetes education.
Pretreatment Interleukin‐6 Serum Levels Are Associated with Patient Survival for Oral Cavity Squamous Cell Carcinoma
Authors: Chang Kai‐Ping , Kao Huang‐Kai , Wu Chih‐Ching , Fang Ku‐Hao , Chang Yu‐Liang , Huang Yu‐Chen , Liu Shiau‐Chin , Cheng Ming‐Huei
Published: February 2013

Objective

This study aims to determine the role of serum interleukin‐6 concentration for oral cavity squamous cell carcinomas.

Study Design

Cohort study.

Setting

Tertiary referral center.

Methods

Two hundred thirty‐seven untreated patients, 125 healthy individuals, and 104 individuals with oral premalignant lesions were enrolled. Interleukin‐6 serum concentrations were measured by enzyme‐linked immunosorbent assay.

Results

Serum concentrations of interleukin‐6 were significantly higher in patients compared with the levels in healthy individuals and the subjects with oral premalignant lesions. Serum interleukin‐6 levels were significantly higher in patients with higher pT status (from pT1 to pT4, median values in pg/mL = 0, 0, 1.3, and 5.0, respectively, with P <. 001), higher pathological stages (from stage I to IV, median values = 0, 0, 1.3, and 3.6, respectively, with P <. 001), positive bone invasion (5.0 vs 0, 1.4 vs 0; P <. 001), and higher tumor depths (1.4 vs 0; P =. 005). Patients with higher pretreatment levels of interleukin‐6 (>1.35 pg/mL, median level) had worse prognoses for 5‐year overall survival and disease‐specific survival despite treatment (75.7% vs 54.9% and 79.1% vs 59.8%; P =. 001 and. 003, respectively). Multivariate logistic regression analyses also indicated that higher interleukin‐6 serum levels were an independent prognostic factor for overall survival and disease‐free survival (adjusted hazard ratio = 2.417 and 2.364; P =. 009 and. 017, respectively).

Conclusion

Our study revealed that serum interleukin‐6 levels were associated with increased tumor burden and aggressiveness of oral cavity squamous cell carcinomas and may be useful as a prognostic indicator after treatment.
A randomized controlled trial of a mixed Kinesio taping–compression technique on venous symptoms, pain, peripheral venous flow, clinical severity and overall health status in postmenopausal women with chronic venous insufficiency
Authors: Aguilar-Ferrándiz Mª Encarnación , Castro-Sánchez Adelaida María , Matarán-Peñarrocha Guillermo A , Guisado-Barrilao Rafael , García-Ríos Mª Carmen , Moreno-Lorenzo Carmen
Published: February 2013

Objectives:

To investigate the effect of a mixed Kinesio taping treatment in women with chronic venous insufficiency.

Design:

A double-blinded randomized clinical trial.

Setting:

Clinical setting.

Participants:

One hundred and twenty postmenopausal women with mild–moderate chronic venous insufficiency were randomly assigned to an experimental group receiving standardized Kinesio taping treatment for gastrocnemius muscle enhancement and ankle functional correction, or to a placebo control group for simulated Kinesio taping.

Main outcomes variables:

Venous symptoms, pain, photoplethysmographic measurements, bioelectrical impedance, temperature, severity and overall health were recorded at baseline and after four weeks of treatment.

Results:

The 2 × 2 mixed model ANCOVA with repeated measurements showed statistically significant group * time interaction for heaviness ( F = 22.99, p = 0.002), claudication ( F = 8.57, p = 0.004), swelling ( F = 22.58, p = 0.001), muscle cramps ( F = 7.14, p = 0.008), venous refill time (right: F = 9.45, p = 0.023; left: F = 14.86, p = 0.001), venous pump function (right: F = 35.55, p = 0.004; left: F = 17.39 p = 0.001), extracellular water (right: F = 35.55, p = 0.004; left: F = 23.84, p = 0.001), severity ( F = 18.47, p = 0.001), physical function ( F = 9.15, p = 0.003) and body pain ( F = 3.36, p = 0.043). Both groups reported significant reduction in pain.

Conclusion:

Mixed Kinesio taping-compression therapy improves symptoms, peripheral venous flow and severity and slightly increases overall health status in females with mild chronic venous insufficiency. Kinesio taping may have a placebo effect on pain.
Repeatability of the timed 25-foot walk test for individuals with multiple sclerosis
Authors: Larson Rebecca D , Larson Daniel J , Baumgartner Ted B , White Lesley J
Published: February 2013

Objective:

The purpose of this study was to determine if there is a practice effect present in the timed 25-foot walk in ambulatory individuals with multiple sclerosis.

Design:

Thirty six people (30 women and 6 men) diagnosed with relapsing remitting multiple sclerosis participated in two testing sessions, one week apart. Each participant performed two sequential trials of the timed 25-foot walk test per session and the walk performance was measured with a laser timing system.

Results:

We observed improvements in walking speed between the two trials of session one (trial one: 6.42 (0.09) vs. trail two: 5.97 (0.08) seconds, p < 0.001). Within session two, performance remained stable (trial three: 5.71 (0.07) vs. trial four: 5.63 (0.07) seconds, p > 0.05). We also observed a significant improvement in walking speed when averages of the two trials were compared across sessions (session 1: 6.19 (0.09) vs. session 2: 5.67 (0.07) seconds, p < 0.01).

Conclusions:

Based on our results, familiarization of the timed 25-foot walk test improves stability of walk performance scores in ambulatory individuals with relapsing remitting multiple sclerosis.
What effect does a structured home-based exercise programme have on people with Huntington’s disease? A randomized, controlled pilot study
Authors: Khalil Hanan , Quinn Lori , van Deursen Robert , Dawes Helen , Playle Rebecca , Rosser Anne , Busse Monica
Published: February 2013

Objective:

The aim of this study was to explore feasibility, safety and outcome of an exercise intervention in people with Huntington’s disease.

Design:

A randomized controlled pilot trial.

Setting:

A home-based exercise programme.

Subjects:

A total of 25 subjects with early to mid-stage Huntington’s disease.

Intervention:

Subjects were randomly allocated to either an exercise intervention ( n = 13) or a control group ( n = 12). Subjects in the exercise intervention group were asked to perform exercises at home three times a week for eight weeks using an exercise DVD, specifically developed for this purpose. The control group received their usual care.

Measures:

Adherence in the intervention group was calculated from exercise diaries. Measures of gait, balance, function, level of physical activity and quality of life were evaluated. Analysis of covariance was used to compare follow-up scores across groups after adjustment for chance baseline differences. Effect sizes were calculated.

Results:

Eleven participants from the intervention and ten from the control group completed the study. Mean adherence was 29.4 SD 1.8 for the 32 prescribed sessions. There were no related adverse events. Differences between groups were observed in gait speed, balance, function and level of physical activity, but not quality of life as measured by the SF36. Effect sizes were large (>0.8) for the majority of the outcomes.

Conclusions:

Short-term structured home exercise programmes are feasible, beneficial and safe for people with early to mid-stage of Huntington’s disease. Our findings support the implementation of a larger trial of longer-term home exercise.
Antidepressants for depression in Parkinson’s disease: systematic review and meta-analysis
Authors: Rocha Fábio L , Murad Melissa GR , Stumpf Bárbara P , Hara Cláudia , Fuzikawa Cíntia
Published: February 2013

Depression is common in Parkinson’s disease (PD) and is associated with several poor outcomes. However the literature regarding treatment with antidepressants in this population is controversial. The aim of this paper was to systematically review all randomized controlled trials that studied the efficacy of antidepressants for depression in PD (dPD). Studies were retrieved from PubMed (1966–July 2012), Cochrane Library (–July 2012, issue 7), Embase (1980–July 2012), PsycINFO (1980–July 2012), Lilacs (1982–July 2012), secondary references, clinical trials registries and a thesis database. Only double-blind, randomized controlled trials in which an antidepressant was given as the main treatment and compared with placebo and/or another antidepressant were included. Out of the 1438 studies retrieved, only six could be included. Taking into account the five placebo-controlled trials, the overall risk ratio (RR) for response was 1.36 (0.98, 1.87), indicating no statistically significant superiority of antidepressants over placebo. However, in the sensitivity analysis, the RR for response was 1.41 (1.01, 1.96) and 1.48 (1.05, 2.10) after exclusion of one study with questionable results, and when only studies with low risk of bias were considered, respectively. No specific antidepressant class was superior to placebo. In general antidepressant medications were well tolerated. The results suggest antidepressants may be efficacious in the treatment of dPD. However, the results were unstable. In fact, the small number of trials and methodological drawbacks preclude definitive conclusions about their efficacy and tolerability in dPD.
Toward a really temporalized theory of event: A Luhmannian critique and reconstruction of Sewell’s logics of history
Authors: Tang Chih-Chieh
Published: February 2013

In recent discussions about event as the foundation of historical research, it is William H Sewell Jr who has developed the most comprehensive version. However, Sewell’s theory of the event is not adequately articulated and is even one-sidedly dominated by his theory of structure. He did not take the problem of self-reference (and therefore circular causality) seriously enough, with the consequence that his emphasis on eventful temporality and contingency could not be carried through to the end. This article attempts to overcome such shortcomings by introducing Niklas Luhmann’s insights, which take a fully temporalized concept of event as departure, in order to build an adequate theory of event that complements the idea of eventful temporality.
Strengthening Infrastructure and Implementing Functions to Support Collaborative Community Problem Solving
Authors: Julian David A. , Ross Melissa
Published: February 2013

The purpose of this article is to explore infrastructure and functions to serve as a foundation for collaborative community problem solving. The literature reviewed in this article focuses on problem solving in the health, education, and social services arenas. However, the recommendations and perspectives would appear to apply to collaborative community problem solving focused on any complex social issue. It is imperative that as local, state, and national policies and practices evolve supporting collaborative efforts to address a variety of issues, planners be prepared to facilitate community dialogue designed to build strong partnerships at the local level.
Navigating the Changing Landscape of Retirement
Authors: Augelli Chris
Published: February 2013

Recent studies show that Americans are less confident than ever in their ability to achieve financial security in retirement. According to the Employee Benefit Research Institute, just 14% of survey respondents think they will have enough money to live comfortably in retirement. This article describes the challenges Americans face in saving for retirement and the steps plan sponsors and employees should take to achieve financial security in retirement.
Flexural and impact studies on stitched self-reinforced polypropylene composites
Authors: Nanthagopal V , Senthilram T , Dev VR Giri
Published: February 2013

Self-reinforced composite (SRC) has gained significant interest due to its lightweight and good recyclability. In the present work, SRCs were prepared from woven polypropylene tapes. The woven tapes were further stitched by lock stitch and its effects on flexural and impact properties of the composites were studied. Flexural and impact results show that stitching parameters such as stitches per inch, sewing yarn count and the direction of stitching have a significant effect on the improvement of mechanical properties compared with the control sample (unstitched sample) without stitching. The morphological studies were carried out using optical microscopy and failure mechanism was analysed.
Perinatal mental health services: what are they and why do we need them?
Authors: Galbally Megan , Blankley Gaynor , Power Josephine , Snellen Martien
Published: February 2013

Objective:

To review the evidence for perinatal mental health as a sub-specialist area of mental health and describe the development of a service model.

Conclusions:

Perinatal mental health is emerging as a sub-specialist area of mental health with specific knowledge and expertise in assessment, diagnosis and treatment. It requires services to ensure that women and infants receive optimal care across pregnancy and the postpartum.
Multiple KRAS Mutations in Pancreatic Adenocarcinoma
Authors: Visani Michela , de Biase Dario , Baccarini Paola , Fabbri Carlo , Polifemo Anna Maria , Zanini Nicola , Pession Annalisa , Tallini Giovanni
Published: February 2013

KRAS is one of the most common genes mutated in pancreatic adenocarcinoma. Multiple KRAS mutations may be detected within the same pancreatic adenocarcinoma, but it is usually unclear whether the different mutations represent biologically irrelevant molecular events or whether they indicate the coexistence of distinct sizable neoplastic clones within a given tumor. We identified a case of pancreatic adenocarcinoma with 5 different mutations in the KRAS gene and have been able to characterize the allelic distribution of the KRAS mutations and the size of the neoplastic clones using allele-specific locked nucleic acid polymerase chain reaction and next-generation sequencing (454 GS-Junior). The results indicate that the tumor is composed of 5 distinct cell populations: one is KRAS G12V mutated (~38% of neoplastic cells), the second is KRAS G12V in one allele and KRAS G12D in the other (~32%), the third is KRAS G12V in one allele and KRAS G12R in the other (~24%), and the fourth is KRAS G12V in one allele and KRAS G12C in the other (~6%). The fifth clone, representing a minority of neoplastic cells, has a KRAS Q61H mutation in addition to one of the above alterations. Microsatellite analysis identified mutation of the NR21 marker out of the 13 tested, indicating that the tumor has a defect in maintaining DNA integrity different from loss of conventional DNA mismatch repair. These results are consistent with the successive selection of divergent populations of tumor cells and underscore the relevance of nucleotide instability in pancreatic adenocarcinoma.
Hydrolysis of chickpea proteins with Flavourzyme immobilized on glyoxyl-agarose gels improves functional properties
Authors: del Mar Yust María , del Carmen Millán-Linares María , Alcaide-Hidalgo Juan María , Millán Francisco , Pedroche Justo
Published: February 2013

Chickpea protein isolate was hydrolyzed using Flavourzyme immobilized on glyoxyl-agarose beads by multipoint covalent attachment. This Flavourzyme-glyoxyl derivative, produced after 1 h of immobilization at 4 °C followed by 5.5 h at room temperature, presented approximately 51% of the endoprotease activity of Flavourzyme but was around 700 times more stable than soluble enzyme. Chickpea protein hydrolysates ranging from 1% to 10% degree of hydrolysis were produced and their chemical composition was very close to that of protein isolate used as starting material. Solubility, oil absorption, emulsifying activity and stability, and foaming capacity and stability were determined. All protein hydrolysates showed higher solubility than intact proteins, especially at pHs near isoelectric point of native chickpea proteins. Moreover, all hydrolysates had better functional properties, except emulsifying activity, than the original protein isolate.
Retention in mental health care of Portuguese-speaking patients
Authors: Gonçalves Marta , Cook Benjamin , Mulvaney-Day Norah , Alegría Margarita , Kinrys Gustavo
Published: February 2013

We compared service outcomes of dedicated language and cultural competency services in adequacy of care, ER, and inpatient care among Portuguese-speaking patients in ethnic- and non-ethnic-specific behavioral health clinics. We assessed adequacy of mental health care, and use of inpatient emergency department among Portuguese-speaking patients, comparing individuals receiving care from a culturally and linguistically competent mental health care setting (the Portuguese Mental Health Program [PMHP]) with usual mental health care in a community health care system in the USA. Propensity score matching was used to balance patients in treatment and control groups on gender, marital status, age, diagnosis of mental disorder, and insurance status. We used de-identified, longitudinal, administrative data of 854 Portuguese-speaking patients receiving care from the PMHP and 541 Portuguese-speaking patients receiving usual care from 2005–2008. Adequate treatment was defined as receipt of at least eight outpatient psychotherapy visits, or at least four outpatient visits of which one was a psychopharmacological visit. PMHP patients were more likely to receive adequate care. No differences were found in rates of ER use or inpatient mental health care. The present study suggests increased quality of care for patients that have contact with a clinic that dedicates resources specifically to a minority/immigrant group. Advantages of this setting include greater linguistic and cultural concordance among providers and patients. Further research is warranted to better understand the mechanisms by which culturally appropriate mental health care settings benefit minority/immigrant patients.
Photometric characterisation of small sources with high dynamic range illuminance mapping
Authors: Bellia L , Spada G
Published: February 2013

In this paper a system for obtaining the luminous intensity distribution of a small light source, based on high dynamic range imaging, is described. The system uses a dark room, a lambertian screen and a video-luminance-meter mounted on a workbench. The luminous intensity distribution of the light source is derived from the illuminance map on the screen by applying the photometric inverse law. The geometry of the system is presented and the measurements’ uncertainties are estimated. Finally, an application to a LED source is presented.
A Movement Returning Home? Occupy Wall Street After the Evictions
Authors: Crane Nicholas Jon , Ashutosh Ishan
Published: February 2013

This article investigates the possible geographies generated in Occupy Wall Street’s emergence and subsequent evictions from multiple sites of occupation. As Occupy Wall Street (OWS) moves into other spaces, most notably the home, we counter the application of a priori analytics of traditional social movement studies, through which OWS would be seen as unified (with leaders, corresponding constituencies, and clearly crafted demands). Instead, we argue for a relational conception of spaces of politics, and emphasize the indeterminate multiplicity that we believe is crucial for ensuring continued critique and agitation. The argument is advanced, first, by considering the theoretical disjuncture between OWS and social movements, and second, by turning to OWS’s geographies of movement and settlement. We conclude by suggesting that, when OWS goes home, it does not retreat from politics. From a relational perspective, the home is itself a space of politics and not a secure, enclosed site to which one returns when the political is left behind.
Democratic deliberations in the Finnish elementary classroom: The dilemmas of deliberations and the teacher’s role in an action research project
Authors: Tammi Tuure
Published: February 2013

Finnish youth are found to be, despite their broad knowledge, uninterested in politics and in societal participation. As a remedy, international studies suggest enabling democratic experiences in schools. This article discusses an action research project aimed at developing deliberation-based democratic practice in an elementary classroom. Results suggest that the formal deliberative-democratic practice opens up a way for pupils to productively express themselves, challenge the prevailing structures, make sense of social reality and, thus, practise skills and motivations needed in democratic citizenship. However, the teacher is argued to be in constant struggle between deliberative-democratic stance and control orientation. This tension exists in the teacher’s actions and thinking and in his reflections about the contrast between the classroom practice and the overall school ethos. Therefore, this article suggests using the understanding of this tension in scrutinizing projects aiming at pupil participation and involvement.
Adult Protective Services Workers Assess the Effectiveness of Mandatory Reporting of Elder Maltreatment in Michigan
Authors: Sengstock Mary C. , Marshall Brenda I.
Published: February 2013

Mandatory reporting is the method by which most states deal with the problem of elder abuse. However, the effectiveness of this approach has been the topic of little research. In this study, we report on a series of qualitative interviews with workers involved in the mandatory reporting process in the State of Michigan. The workers were involved either as mandated reporters or as representatives of the state who receive the reports (Adult Protective Services workers). Numerous problems were identified, including inadequate staffing in the state agency responsible for receiving reports of elderly abuse, lack of a standardized mechanism for submitting reports, poor training in a variety of areas for both reporters and APS workers, inadequate communication and coordination among agencies involved in the process, confidentiality concerns at all levels, inability of agencies to identify persons responsible for previous abuse of the elderly, and lack of involvement of knowledgeable workers in the establishment and administration of the law. Workers were also concerned that the needs of the elderly received little attention from officials at all levels (courts, prosecutors, and state government), most of whom were perceived to consider the needs of the children to be primary. On the positive side, workers in both types of agencies appeared highly committed to their clients and went considerably out of their way to be of assistance.
The pain of chronic pancreatitis: a persistent clinical challenge
Authors: Goulden Michael R
Published: February 2013

The pain of chronic pancreatitis represents a major challenge to those working in the field, including pain specialists, gastroenterologists and surgeons. This article describes the different aetiologies of chronic pancreatitis and lists the models for the pathogenesis of pain, including novel ideas such as the role of the immune system in the modulation of pain. The patient profile in chronic pancreatitis is discussed along with the social impact of the disease in relation to alcohol misuse.

The range of treatment strategies including medical, endoscopic and surgical approaches are evaluated. Common analgesic regimes and their limitations are reviewed.

The pain of chronic pancreatitis remains refractory to effective treatment in many cases and further study and understanding of the underlying pathophysiology are required.
The secreted lymphangiogenic factor CCBE1 is essential for fetal liver erythropoiesis
Authors: Zou Zhiying , Enis David R. , Bui Hung , Khandros Eugene , Kumar Vinayak , Jakus Zoltan , Thom Christopher , Yang Yiqing , Dhillon Veerpal , Chen Mei , Lu MinMin , Weiss Mitchell J. , Kahn Mark L.
Published: February 2013

Key Points

The secreted lymphangiogenic protein CCBE1 is essential for fetal but not postnatal erythropoiesis. Loss of CCBE1 impairs erythroblastic island formation and function.
Impact of joint contractures on functioning and social participation in older individuals – development of a standard set (JointConFunctionSet): study protocol
Authors: Müller Martin , Fischer Uli , Bartoszek Gabriele , Grill Eva , Meyer Gabriele
Published: February 2013

Background

Joint contractures are frequent in older individuals in geriatric care settings. Even though they are used as indicator of quality of care, there is neither a common standard to describe functioning and disability in patients nor an established standardized assessment to describe and quantify the impact of joint contractures on patients’ functioning. Thus, the aim of our study is (1) to develop a standard set for the assessment of the impact of joint contractures on functioning and social participation in older individuals and (2) to develop and validate a standardized assessment instrument for describing and quantifying the impact of joint contractures on the individuals’ functioning.

Methods

The standard set for joint contractures integrate the perspectives of all potentially relevant user groups, from the affected individuals to clinicians and researchers. The development of this set follows the methodology to develop an International Classification of Functioning Disability and Health (ICF) Core Set and involves a formal decision-making and consensus process. Evidence from four preparatory studies will be integrated including qualitative interviews with patients, a systematic review of the literature, a survey with health professionals, and a cross sectional study with patients affected by joint contractures. The assessment instrument will be developed using item-response-theory models. The instrument will be validated.

Discussion

The standard set for joint contractures will provide a list of aspects of functioning and health most relevant for older individuals in geriatric care settings with joint contractures. This list will describe body functions, body structures, activities and participation and related environmental factors. This standard set will define what aspects of functioning should be assessed in individuals with joint contractures and will be the basis of the new assessment instrument to evaluate the impact of joint contractures on functioning and social participation.