bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal Responses to Long-Term Carotid Baroreflex Activation Therapy in Patients With Drug-Resistant Hypertension
Authors: Alnima Teba , de Leeuw Peter W. , Tan Frans E.S. , Kroon Abraham A. ,   for the Rheos Pivotal Trial Investigators
Published: April 2013

Carotid baroreflex activation has been demonstrated to provide enduring reductions in arterial blood pressure. The aim of this study was to investigate the effect of long-term therapy on renal function. A total of 322 patients were enrolled in the Rheos Pivotal Trial. Group 1 consisted of 236 patients who started baroreflex activation therapy 1 month after device implantation, whereas in the 86 patients from group 2 the device was activated 6 months later. Serum creatinine and urine albumin/creatinine ratio were collected at screening (before device activation), and at months 6 and 12. Multilevel statistical analyses were adjusted for various covariables. Serum creatinine increased from 78 to 84 μmol/L, and glomerular filtration rate decreased from 92 to 87 mL/min per 1.73 m
2
in group 1 at month 6 (
P
<0.05). These values did not change any further after 12 months of therapy. Patients with highest glomerular filtration rate showed the greatest decrease in glomerular filtration. Group 2 showed the same trends as group 1 even before device activation at month 6. Systolic blood pressure reduction seemed to be significantly related to the change in glomerular filtration rate in both groups. Albumin/creatinine ratio did not change in both groups during follow-up. In conclusion, baroreflex activation therapy in hypertensive patients is associated with an initial mild decrease in glomerular filtration rate, which may be considered as a normal hemodynamic response to the drop in blood pressure. Long-term treatment does not result in further decrease in renal function, indicating baroreflex activation as a safe and effective therapy.
Sweatshops in the silk industry of the Bursa region and the workers’ strikes in 1910
Authors: Çelik Birten
Published: April 2013

Based on archival material including silk workers’ letters and telegraphs sent to the state authorities, including the sultan, and to the newspapers, as well as official correspondence between the local authorities in Bursa and the government, the article examines the strikes which occurred in the silk industry in Bursa and Bilecik in 1910. The silk factory workers, mostly female, wanted a decrease in working hours, an increase in their wages and exemption from paying the temettü vergisi (the profit tax). These demands were accepted neither by the factory owners nor by the government and in consequence the workers went on strike in August 1910. The strike, however, was unsuccessful.
Korea’s Experience of Peaceful Settlement of WTO Disputes Some Lessons for Asia
Authors: Choi Won-Mog
Published: April 2013

Abstract

Without the means of DSP, a rules-based system of WTO would be less effective because the rules could not be enforced. In order to receive benefits of depoliticization of trade disputes, the DSP must function as an alternative that is readily available to decision makers. After a trial and error process, Korea learned this lesson and moved to a policy of practical legalism.

To actively pursue this policy, Korea unified governmental agencies related to the DSP function into a single organization and it has fully implemented DSB recommendations. Despite this general trend, a warning signal of possible non-compliance with DSB recommendations has been seen from the recent political atmosphere in Korea.

All of these experiences and lessons of Korea deserve to be learned by other Asian countries. How to enhance legal capacity of in-house counsels and how to establish a system that connects the growing demands of private parties to the DSP are remaining tasks for Asia to undertake.
Korea and TWAIL: Does She Fit into the Picture?
Authors: Park Pae Keun
Published: April 2013

Abstract

The historical experiences of Korea around the 19th century do not seem to fit well into the theoretical perspective of TWAIL. It was not Europeans who colonized Korea. Cultural differences cannot explain the Korean experience of exclusion and marginalization as they were brought about by Japan and China who belong to the same cultural sphere as Korea. The cause of imperialism and colonialism may not be confined only to cultural differences. It is not only Europeans who were imperialist and colonialist. Even though it is an undeniable fact that imperialism and colonialism were largely exerted by Westerners, imperialism and colonialism are not solely racial problems. These facts, together with many other facts about Korea, suggest the necessity of a revision of some of the assertions of TWAIL.
Three new species of Rhyacophila (Trichoptera: Rhyacophilidae) from Taiwan and Nepal
Authors: KISS OTTÓ
Published: April 2013

Three new species of the Rhyacophila scissa Group in the genus Rhyacophila (Trichoptera, Rhyacophilidae), i.e., Rhya-cophila matanyii n. sp. from Taiwan (Republic of China), Rhyacophila steinmanni n. sp. and Rhyacophila kisszoltani n. sp. from Nepal are described and illustrated with drawings of the genitalia.
A hypokalaemic woman with nephrocalcinosis: rebirth of old knowledge
Authors: Chiang Wen-Fang , Yan Ming-Tso , Wu Tsung-Jui , Lin Shih-Hua
Published: April 2013

The coexistence of hypokalaemia and nephrocalcinosis poses a challenge in rapid diagnosis and appropriate management. We describe a 38-year-old woman who presented with thirst, intermittent carpopedal spasm, paresthaesia of both hands and progressive weakness of lower extremities for two years. She had a history of chronic hypokalaemia of unknown cause with intermittent potassium supplementation for 7-8 y and bilateral nephrocalcinosis notable for one year. She denied vomiting, diarrhoea or use of laxatives, alcohol or diuretics. Her blood pressure was normal. Laboratory investigations showed hypokalaemia (2.7 mmol/L) and metabolic alkalosis (HCO3− 32.6 mmol/L, pH 7.46). Two random urine samples both showed a consistently high urine K+ excretion but with excretion rates of Na+, Cl− and divalent cations which were high in one sample but not the other. Ingestion of furosemide 120 mg daily for body image for 7-8 y was uncovered. With furosemide cessation and potassium supplementation, her hypokalaemia with neuromuscular symptoms was corrected but nephrocalcinosis persisted. Surreptitious use of diuretics for various purposes should be kept in mind as an important cause of hypokalaemia and/or nephrocalcinosis. Measurement of electrolyte concentrations in at least two random urine samples is warranted to distinguish it from true renal tubular disorders and extrarenal causes.
CEO Tenure and R&D Investment
Authors: Chen Hsiang-Lan
Published: April 2013

This study examines the curvilinear CEO tenure–R&D investment relationship and the moderating influence of board capital on this relationship, thus making two major contributions. First, the finding of an inverted-U CEO tenure–R&D investment relationship enriches our understanding of how the CEO life cycle affects corporate investment decisions, particularly R&D. Second, the evidence of positive moderating effects of board human and social capital suggests that boards affect managerial choices through their human and social capital, thereby providing insight into how boards influence CEOs’ decision-making capabilities and, consequently, their R&D investment decisions. One important implication is that to encourage CEOs to invest in R&D, shareholders in the electronics industry and firms competing in innovation through R&D spending may consider appointing more directors with greater human and social capital to the Board because they will provide CEOs with ongoing advice and essential resources for R&D. The implications for strategy consultants are also discussed.
Indigenous Peoples and Modernity
Authors: Kowalczyk Anna Maria
Published: April 2013

The twenty-first century has ushered in a new era for the numerous social and political movements of Mapuche indigenous groups in Chile. Apart from distancing themselves from state institutionality and demanding autonomy, they have tended to reject alliances with the traditional left, considering it alien to indigenous subjectivities. Study of these various “new wave” movements paying particular attention to the relationship between indigenous and modern subjectivities suggests that, while the historical memory of Mapuche social and political organization may contribute to the creation of a powerful progressive social movement, the highly modernized Mapuche indigenous cultures are also quite compatible with an indigenous brand of neoliberalism.

El siglo veintiuno dio paso a una nueva era para los numerosos movimientos sociales y políticos de grupos indígenas mapuches en Chile. Aparte de distanciarse de la institucionalidad estatal y exigir autonomía, también solían rechazar una alianza con la izquierda tradicional, considerándola ajena a las subjetividades indígenas. Un estudio de la relación entre subjetividades indígenas y modernas sugiere que, mientras la memoria histórica de organización social y política mapuche podría contribuir a la creación de un poderoso movimiento progresista social, las modernizadas culturas indígenas mapuches son también altamente compatibles con una marca indígena de neoliberalismo.
Knockdown of DEPTOR inhibits cell proliferation and increases chemosensitivity to melphalan in human multiple myeloma RPMI-8226 cells via inhibiting PI3K/AKT activity
Authors: Zhang Hao-Ran , Chen Jun-Min , Zeng Zhi-Yong , Que Wen-Zhong
Published: April 2013

Objective

The present study determined the role of DEP domain containing mTOR-interacting protein (DEPTOR) in the proliferation, apoptosis and chemosensitivity of RPMI-8226 multiple myeloma cells, using small hairpin RNA (shRNA) to knock down DEPTOR gene expression in vitro.

Methods

DEPTOR mRNA and protein levels in RPMI-8226 cells treated with DEPTOR-specific shRNA were evaluated by reverse transcription–polymerase chain reaction and Western blotting. Expression of apoptosis-associated proteins (including cleaved caspase-3 and cleaved poly-ADP ribose polymerase [PARP]) and activation of the phosphatidylinositol 3-kinase (PI3K)/v-akt murine thymoma viral oncogene homologue 1 (AKT) signalling pathway were detected by Western blotting.

Results

Transfection of DEPTOR-specific shRNA successfully knocked down DEPTOR gene expression in transfected RPMI-8226 cells. These transfected cells, together with control RPMI-8226 cells, were treated with 20 µmol/l melphalan for 24 h. Knockdown of DEPTOR exacerbated melphalan-induced growth inhibition and apoptosis, increased levels of cleaved caspase-3 and cleaved PARP, and reduced levels of phosphor-AKT.

Conclusion

Downregulation of DEPTOR inhibited proliferation and increased chemosensitivity to melphalan in human multiple myeloma RPMI-8226 cells via inhibiting the PI3K/AKT pathway.
Weight Disparities Between Female Same-Sex Romantic Partners and Weight Concerns
Authors: Markey Charlotte N. , Markey Patrick M.
Published: April 2013

In the current study, we investigated the relevance of women’s own and their romantic partners’ weight status to the development of weight concerns. Seventy-two female same-sex couples ( n = 144 women) completed the Weight Concerns Scale and a researcher measured their height and weight to compute body mass index as a measure of weight status. Using the Actor–Partner Interdependence Model, which accounts for the dependency in these data, analyses revealed a significant link between women’s own weight status, their weight concerns, and their partners’ weight status and their weight concerns. Further, an interaction indicated that women who were heavier and who had thinner female partners were most at risk of experiencing weight concerns. These findings are discussed as evidence for the importance of partner comparisons in the context of romantic relationships and should inform research examining links between romantic relationships and health, particularly among sexual minority couples. Clinical implications of our research include the potential role of couples’ therapy in treating not only relationship problems but also potential health challenges.
Midterm Results of Comprehensive Surgical Reconstruction Including Sulcus-Deepening Trochleoplasty in Recurrent Patellar Dislocations With High-Grade Trochlear Dysplasia
Authors: Ntagiopoulos Panagiotis G. , Byn Pieter , Dejour David
Published: April 2013

Background:

Trochlear dysplasia is one of the most consistent anatomic factors that can lead to recurrent patellar dislocations. Various trochleoplasty procedures have been described to treat patellar dislocations in high-grade dysplasia by creating a new congruent trochlea.

Purpose:

To present the midterm efficacy and outcome of the sulcus-deepening trochleoplasty procedure in patients with recurrent patellar dislocations due to high-grade trochlear dysplasia. The clinical evaluation results, the amount of radiological correction, and the prevalence of arthritis were recorded.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 27 skeletally mature patients (31 knees) with recurrent patellar dislocations due to high-grade trochlear dysplasia without any previous surgery were retrospectively included from September 1993 to September 2006. All patients underwent sulcus-deepening trochleoplasty combined with a bony and/or soft tissue procedure according to concomitant etiological factors to patellar dislocations: medial patellofemoral ligament reconstruction (16.1%), vastus medialis obliquus plasty (83.8%), tibial tuberosity distalization (51.6%), tibial tuberosity medialization (67.7%), and lateral retinaculum release (67.6%). Mean follow-up was 7 years (range, 2-9 years).

Results:

The mean sulcus angle decreased significantly ( P < .01) from 152° ± 16° preoperatively to 141° ± 9° postoperatively, tibial tuberosity–trochlear groove distance decreased significantly ( P < .001) from 19 ± 4 mm to 12 ± 5 mm, and patellar tilt decreased significantly ( P < .001) from 37° ± 7° to 15° ± 8°. No recurrence was observed, and there was no case of stiffness. Apprehension signs remained positive in 19.3% of the cases, patellar tracking was normal in all cases, and the lateral patellar glide test finding was negative in 96.8%. The mean preoperative International Knee Documentation Committee (IKDC) score was 51 (range, 25-80), and the mean postoperative IKDC score was 82 (range, 40-100) ( P < .001), while the mean Kujala score improved from a preoperative 59 (range, 28-81) to 87 (range, 49-100) postoperatively ( P < .001). There was no radiographic evidence of patellofemoral arthritis at the latest follow-up.

Conclusion:

Sulcus-deepening trochleoplasty is a valid option for the primary surgical treatment of carefully selected patients with recurrent patellar dislocations with high-grade trochlear dysplasia type B and D. Concomitant etiological factors must be cautiously corrected in an associated procedure. Midterm follow-up showed satisfactory restoration of patellar stability and improvement of knee scores with no complication of subsequent arthritis.
Exploring the Quality of Life of Younger Residents Living in Long-Term Care Facilities
Authors: Hay Kara , Chaudhury Habib
Published: April 2013

The purpose of this qualitative study was to explore the characteristics of “quality of life” of younger residents in long-term care facilities. This multimethod study employed in-depth interviews with younger residents, focus groups with staff members and interviews with management team members at two care facilities in British Columbia, Canada. Data analysis revealed three themes: (a) a new chapter in life, (b) experiencing quality of life, and (c) nature of social life. These themes highlight the characteristics of younger residents’ quality of life and provide insights into the salient contributing factors. Findings of this study are useful in better understanding aspects of younger residents’ quality of life and their psychosocial needs and consequently can guide decision making to provide an appropriate care environment for this population segment in long-term care settings.
Exposure to mercury among dental health workers in Turkey
Authors: Yılmaz Hınç , Tutkun Engin , Demiralp Kemal Ö , Yılmaz Fatma M , Aliyev Vugar , Söylemezoğlu Tülin
Published: April 2013

Purpose:

To investigate the current status of exposure to mercury (Hg) among dental health workers in Turkey.

Methods:

A total of 115 persons working in the same hospital were included in the study and were divided into three groups. Group 1 consisted of 67 dentists; group 2 consisted of 21 dental personnel who work with amalgam, and group 3 consisted of 27 control subjects who work in the same hospital but are non-dental personnel. The number of amalgam fillings that have been made by the dentists and the number of own fillings of the subjects were recorded.

Results:

Plasma Hg levels were found to be 3.76 ± 1.84, 3.54 ± 1.83, and 2.69 ± 0.97 µg/L in groups 1, 2, and 3, respectively. Hg concentrations in group 1 were significantly higher than the control group. There was no significant difference between groups 1 and 2. The number of amalgam fillings made by the dentists in the previous year correlated significantly with plasma Hg levels ( r = 0.378, p < 0.01). There was no significant correlation between the own amalgam fillings in the teeth of the subjects and Hg levels.

Conclusion:

Preventive measures for protection from exposure to Hg are necessary for occupational health in dentistry and proper industrial hygiene rules should be emphasized to avoid contamination during work.
Genotoxic and antigenotoxic potentials of two Usnea species
Authors: Ceker Selcuk , Orhan Furkan , Kizil Hamit Emre , Alpsoy Lokman , Gulluce Medine , Aslan Ali , Agar Guleray
Published: April 2013

For ages, lichens have long been investigated popularly for biological roles, mainly antitumor, antimicrobial and antioxidant activities. Many positive results were obtained in these previous research. Thus, in this study, we aimed to determine whether extracts of Usnea articulata (UAE) and Usnea filipendula (UFE) possessing a protection against aflatoxin B1 (AFB1)-induced genotoxic and oxidative damage. The results of our studies showed that 5 μM concentrations of AFB1 increased the frequencies of sister chromatid exchange (SCE) and the level of malondialdehyde (MDA) and decreased the activities of superoxide dismutase (SOD), glutathione (GSH) and glutathione peroxidase (GPx). However, when 5, 10 and 20 µg/mL concentrations of UAE and UFE was added to AFB1, the frequencies of SCE and MDA level were decreased and SOD, GSH and GPx level were increased. The Ames ( Salmonella typhimurium TA1535, TA1537) and WP2 ( Escherichia coli) test systems carried out evinced that UAE and UFE possess any mutagenicity, but have antimutagenic effects. Consequently, the results of this experiment have clearly shown that UAE and UFE have strong antioxidative and antigenotoxic effects that are associated with its antioxidant nature. A detailed study can be performed to determine the antioxidant properties of each compound that will extend the use of lichen extracts in food and pharmacy industries.
Barriers to Mental Health Care Utilization in Parkinson’s Disease
Authors: Dobkin Roseanne D. , Rubino Jade Tiu , Friedman Jill , Allen Lesley A. , Gara Michael A. , Menza Matthew
Published: April 2013

Background:

Parkinson’s disease (PD) is frequently complicated by co-occurring psychiatric problems such as depression and anxiety that negatively affect the course and management of the illness. Yet, in most cases, these psychiatric comorbidities are neither recognized nor treated to remission. The primary purpose of this study was to identify and describe barriers to mental health care utilization for people with PD. Secondary objectives included the assessment of attitudes and preferences regarding the need for mental health services in the PD community and the acceptability of telehealth interventions as a method for improving access and quality of care.

Methods:

A total of 769 people with PD completed an anonymous cross-sectional questionnaire assessing barriers to mental health care utilization in this medical population. Respondents were drawn from a national sample.

Results:

Commonly endorsed barriers to mental health care utilization in PD reflect the patients’ incomplete understanding of mental health problems, access issues, and illness-specific concerns, as well as the inadequate screening and detection of psychiatric complications by medical providers and the need for more effective treatments in this medical population. Several demographic, medical, and psychiatric variables also influenced the likelihood of accessing mental health care. Interest in telehealth approaches to mental health treatment was high and, in several instances, correlated with perceived barriers to mental health care utilization.

Conclusions:

People with PD may encounter a multitude of barriers that impede their pursuit of mental health care. Clinical implications are discussed and further research is needed to replicate and extend these findings.
Novel sulfonated poly(ether ether ketone)/ polybenzimidazole blends for proton exchange membranes
Authors: Feng Pengju , Liu Zhuang , Liu Siyuan , Li Xiaobai , Hu Wei , Jiang Zhenhua , Liu Baijun
Published: April 2013

A novel soluble polybenzimidazole with a pendant phenyl group (Ph-PBI) was successfully synthesized based on 4,4′-(1,4-phenylenedioxy-2-phenyl) dibenzoic acid and diaminobenzidine. A phenylated sulfonated poly(ether ether ketone) (Ph-SPEEK) with a similar chemical structure to Ph-PBI was selected as matrix. Ph-SPEEK/Ph-PBI membranes were produced by a solution method. The obtained blend membranes exhibited much higher thermal stability as well as oxidative stability and lower water uptake than the pristine Ph-SPEEK membrane. The proton conductivity of the blend membranes could be in the range of 0.0374–0.1456 S cm−1 at 100°C. As a result, the blend membranes also showed improved mechanical properties that may be related with the acid–base interactions between the two components.
Modification of dicyandiamide-cured epoxy resin with different molecular weights of polyethylene glycol and its effect on epoxy/glass prepreg characteristics
Authors: Mahnam Navid , Beheshty Mohammad Hosain , Barmar Mohammad , Shervin Mahdieh
Published: April 2013

Epoxy resins are widely used in the manufacture of structural composites; however, the inherent brittleness of epoxy matrices has restricted their applications. In this work, a diglycidyl ether of bisphenol-A epoxy resin cured by dicyandiamide (DICY) was modified by adding polyethylene glycol (PEG) with molecular weights of 2000 and 4000 g/mol in amounts of 10, 20, and 30 phr. The effect of these PEGs on the mechanical properties and fracture toughness of epoxy resin was studied. Toughness (the area under the stress–strain curve) increased approximately four- and eightfold upon the addition of 20 and 30 phr of the PEGs, respectively. Results of this study also showed a 73% increase in fracture toughness (KIC) and increases in 300% and 425% in fracture energy (GIC) following the addition of 30 phr of PEGs 2000 and 4000, respectively. Subsequently, prepregs having 50 wt% resin content were prepared. Then relevant prepreg tests such as rheology, resin flow, and lap shear strength were performed. Increasing the PEGs continuously improved resin flow. Scanning electron micrographs (SEMs) of unmodified samples and some PEG-modified samples were examined. SEM showed homogeneous blends with no phase separation occurring.
Optimisation of wheelset maintenance using whole-system cost modelling
Authors: Bevan Adam , Molyneux-Berry Paul , Mills Steve , Rhodes Andy , Ling Daniel
Published: April 2013

The maintenance and renewal activities of wheelsets account for a large proportion of the whole-life costs for railway rolling stock. These activities are influenced by a large number of factors including depot constraints, wheel surface damage, fleet availability and vehicle design. If these factors are not managed efficiently it can have significant implications on a vehicle’s service provision, track damage, environmental and whole-life costs. Therefore, the development of an effective wheelset management tool will support the optimisation of maintenance and renewal regimes, thereby increasing wheelset life and reducing costs. Further development of the Vehicle Track Interaction Strategic Model has enhanced the rolling stock modelling capabilities of the tool through the development of the Wheelset Management Model (WMM). This model aims to assist in the strategic planning of wheelset maintenance and renewal activities and thereby allowing users to examine the benefits and cost impact of a range of different scenarios to optimise wheelset management strategies. This paper describes the capabilities of the WMM and illustrates how the model can be used to optimise a fleet’s maintenance strategy through the application of a realistic industry case study. The implications of different wheelset maintenance regimes on wheelset life and costs were examined. Finally, the paper presents how the tools can be used to investigate whole-system costs and demonstrate the impact of wheelset maintenance on track costs.
Off-Road and Spaced-Out in the City
Authors: O’Doherty Damian P.
Published: April 2013

The article reports on the methods and findings of an urban experiment/intervention that deployed mathematic formulae to design a series of random walks through the city of Manchester. In developing these methods, the letters of the words “order” and “disorder” were inscribed into an A-Z map of the city to provide the outline for these walks. This quest to seek alternative modes of conduct in the everyday life of the city attempts to find access to what Massumi has identified as the transitional qualities of a body-in-motion. In this systematic derangement of the senses, the city gives way to a proliferation of decontexualized objects and fragments that stimulate alternative forms of narrative and possible new political imaginaries. Folding the city in these ways brings into relief a number of important spatial features of Manchester that converge around the concept proposed here as “the interruption of topology.” This interruption demands a certain textual innovation that displaces the performative rituals of the academic article while improvising its own “mythologization” of the city.
Beyond compliance and resistance: Polish Catholic nuns negotiating femininity
Authors: Trzebiatowska Marta
Published: April 2013

This article examines the production of consecrated femininity in contemporary Polish convents. Drawing on qualitative data from 35 interviews in five religious communities the article explores the type of female agency which transforms the dominant model of Polish femininity instead of resisting it. Following Lois McNay’s (2000) concept of narrative identity, the article argues that female agency does not necessarily emerge out of subversion of the male-dominated Polish Catholic Church. Rather than simply being placed within discursive structures, Catholic nuns reflexively alter them by using a mixture of gender ideology and spiritually driven gender work in order to produce coherent and socially meaningful narratives of consecrated femininity.
A novel method for calculating prevalence of multiple sclerosis in Australia
Authors: Palmer Andrew J , Hitchens Peta L , Simpson Steve , O’Leary Beth , Colman Sam , Taylor Bruce V
Published: April 2013

Objectives:

The purpose of this study was to determine the prevalence of multiple sclerosis (MS) in Australia in 2010 using a novel method based on Australia-wide prescription data for MS-specific disease modifying agents. The results obtained were validated against two other prevalence estimates.

Methods:

We obtained the total number of scripts for medications that were used exclusively for the treatment of MS written in Australia for the period January–December 2010. The percentage of MS patients using medications (42–55%) was taken from state-specific surveys of MS Society clients. To estimate prevalence we divided the annual number of scripts dispensed by 12 and adjusted for penetration of medications by state.

Results:

The prevalence of MS in Australia in 2010 calculated using the prescription method was 21,283 people (95.5/100,000). This compared to 21,200 people (95.2/100,000) obtained from the Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers (SDAC) survey of 2009 and 20,471 people (91.9/100,000) using MS Society client numbers. Prevalence increased with increasing latitude, with the prevalence for Tasmania over seven times that of the Northern Territory. Results were sensitive to the percentage of people with MS being treated.

Conclusions:

Calculation of prevalence of MS using nation-wide prescription data is a novel method that generates results similar to other potentially more resource-intensive methods.
Antimicrobial Stewardship Through Telemedicine in a Community Hospital in Southern Brazil
Authors: Santos Rodrigo Pires Dos , Deutschendor Caroline , Carvalho Otavio Fontoura , Timm Robert , Sparenberg Adolfo
Published: April 2013

We developed an antimicrobial stewardship programme, based on telemedicine, for a remote community hospital in southern Brazil. Expertise in infectious diseases was provided from a 250-bed tertiary hospital for cardiology patients located 575 km away. At the community hospital, antimicrobial prescriptions were completed via a secure web site. A written reply was sent back to the prescriber by email and SMS text message. During a 4-month study period there were 81 prescriptions for 76 patients. Most antimicrobial prescriptions (67%) were for respiratory infections. Ampicillin was prescribed in 44% of cases ( n = 56), gentamicin in 18% of cases ( n = 23) and azithromycin in 18% of cases ( n = 23). Two infectious diseases specialists independently reviewed each antimicrobial prescription. A total of 41 prescriptions (55%) were considered inappropriate. The median time to obtain a second opinion via the web site was 22 min (interquartile range 12–55). Overall compliance with the recommendations of the infectious diseases specialist was 100% (81 out of 81 requests). Telemedicine appears to have a useful potential role in antimicrobial stewardship programmes.
Teleconsulting for Minor Head Injury: The Piedmont Experience
Authors: Migliaretti Giuseppe , Ciaramitaro Palma , Berchialla Paola , Scarinzi Cecilia , Andrini Rita , Orlando Anna , Faccani Giuliano
Published: April 2013

We evaluated the benefits of teleconsulting for patients hospitalised with minor head injuries in centres without neurosurgery. In the Piedmont region, 1462 consultation requests were received at specialist centres in 2009, relating to 519 patients with a minor head injury diagnosis (ICD 850–854). These were compared with the details of 1895 patients admitted with the same diagnosis during 2009, but for whom no consultations were requested. The mortality risk in the two groups was estimated using logistic regression, after adjusting for the principal confounding factors (sex, age, seriousness of the patient's injury at diagnosis, referral centre). The estimated risk of death for patients for whom no consultation was requested was an odds ratio of 1.32 (95% CI 1.08 to 1.74) compared to those who received a teleconsultation. However, after adjusting for the confounding factors, the risk was not significant (odds ratio = 1.25, 95% CI 0.83 to 1.91). A stratified analysis identified a significant effect for elderly people, aged over 70 years, in whom the odds ratio was 1.14 (95% CI 1.04 to 1.82). The results confirm the benefits of telemedicine, in particular for elderly patients, when teleconsultation is requested in the case of minor head injury.
Relation between Telecare Implementation and Number of Treatment Days in a Japanese Town
Authors: Akematsu Yuji , Tsuji Masatsugu
Published: April 2013

We analysed data on the medical expenditure of 199 telecare users in Nishiaizu Town, Fukushima Prefecture, which has one of the oldest ongoing telecare implementations in Japan. As controls, 450 out of 3528 non-users residents covered by National Health Insurance were randomly selected in the same age and sex ratios as the telecare users. An analysis by the Generalized Method of Moments (GMM) was conducted in order to examine causality, i.e. that telecare use reduces the number of treatment days. To reduce sample selection bias, the presence of chronic diseases, age and education were added as control variables in the estimation. The results show that the treatment days of those who had chronic diseases were greater than those who did not have chronic diseases by 8.7 days per year ( P < 0.10), and they were increased by 5.6 days ( P < 0.01) according to their age. Finally, telecare use decreased treatment days by 3.1 days ( P < 0.05).
The Contribution of Teledermatoscopy to the Diagnosis and Management of Non-Melanocytic Skin Tumours
Authors: Şenel Engin , Baba Mete , Durdu Murat
Published: April 2013

We examined the contribution of dermatoscopy to the reliability of the diagnosis and management of non-melanocytic skin tumours using store-and-forward teledermatology. A total of 150 patients with non-melanocytic skin tumours were enrolled into the study. The reliability of the diagnoses and management plans was measured by comparing teledermatology with face-to-face examination; the effect of adding dermatoscopy images was also analysed. The accuracy of the diagnoses was measured by comparing teledermatology with histology; the effect of adding dermatoscopy images was also analysed. Diagnostic reliability (kappa) for teledermatology without dermatoscopy was 0.75 and 0.77 for two different dermatologists, A and B. The reliability increased significantly when dermatoscopy was added, to 0.86 and 0.88 respectively ( P < 0.05). The reliability of management plans without dermatoscopy was 0.67 and 0.70, but it did not increase significantly when dermatoscopy was added. The accuracy of the diagnoses was significantly increased by the addition of dermatoscopic images, from 85% to 94% for dermatologist A and from 88% to 95% for dermatologist B. Teledermatology is a reliable technique for the diagnosis and management of non-melanocytic skin tumours and the addition of dermatoscopic images increases the reliability and the accuracy of teledermatology.
A Critical Review of the Use of Telephone Tests to Identify Cognitive Impairment in Epidemiology and Clinical Research
Authors: Herr Marie , Ankri Joël
Published: April 2013

We reviewed the use of telephone tests to identify cognitive impairment. We searched PubMed for epidemiological studies and clinical trials reporting the use of telephone tests to identify cognitive impairment. Validation studies and papers published more than 10 years ago were excluded. A total of 132 abstracts were identified, from which 19 epidemiological studies and four clinical trials were selected. Telephone tests were found to reduce selection bias in epidemiology by including people over large areas and facilitating follow-up in longitudinal studies. The most widely used tests were the Telephone Interview for Cognitive Status (TICS) and its modified version, the TICSm. Interviewing a proxy was included in most of the studies to compensate for the unavailability of some participants because of deafness, disease or death. In the epidemiological studies, results of telephone tests were seldom confirmed by a medical examination. Telephone screening for cognitive impairment to identify individuals eligible for clinical trials is impeded by low efficiency and lack of sensitivity for separating early pathological cognitive impairment from dementia and normal ageing.
Assessment feedback only on demand: Supporting the few not supplying the many
Authors: Jones Ollie , Gorra Andrea
Published: April 2013

There are many pressures on academics to ‘satisfy’ students’ needs for feedback, not least the inclusion of questions about feedback. Many have commentated on the lack of student engagement with summative feedback while most believe that feedback is necessary to improve individual student performance. Several have looked at a range of reasons why students do not collect their feedback, but investigated in this article is how many students collected summative feedback and why they did so. This article outlines an action research–based intervention that involved offering feedback ‘on demand’ to undergraduate students and utilised access statistics data from the virtual learning environment to identify the actual rate of feedback collection by students. Investigated is whether or not there is a discernible preference for seeking feedback where there is a difference between the expected grade and the actual grade. Student survey and the virtual learning environment access data were used to indicate whether students are satisfied with a few short comments and a marking grid, if the mark is similar to their expectations. The resource efficiency and effectiveness for academic staff in terms of providing detailed individual feedback to all students are discussed.
Is tenofovir/emtricitabine teratogenic?
Authors: Jibril Murtala , Egunsola Oluwaseun
Published: April 2013

The Truvada® (tenofovir/emtricitabine) and nevirapine combination is increasingly being prescribed for prevention of mother-to-child HIV transmission. There is presently no documented evidence of teratogenicity of either tenofovir/emtricitabine or nevirapine. We report two cases of spina bifida in infants of mothers on this drug combination.
Balancing Trust and Anxiety in a Culture of Fear
Authors: Cahir Jayde
Published: April 2013

To date, there is no empirical research on the risk perceptions of Sydneysiders following the Cronulla riots nor are there any connections made between risk perceptions and ontological security in the mobile communication literature. This article addresses this gap by exploring the risk perceptions of individuals in the wake of these riots, specifically, their reactions to the new surveillance measures and policing of text messaging. This qualitative study uses empirical data collected from 30 one-on-one interviews conducted 12 to 16 months after the riots. To provide a theoretical framework for these risk perceptions Anthony Giddens’ notion of ontological security, the inner balance between trust and anxiety is used. The data analysis shows that while individuals risk perceptions are complex and contradictory, they use a range of methods to create a balance between trust and anxiety. This article argues that to manage fear in a present or perceived threat, individuals are disposed to mediate any actual or perceived risks by bracketing out anxieties to manage their everyday lives.
Passing the Dinner Table Test
Authors: Allen Chris
Published: April 2013

Through establishing the All Party Parliamentary Group on Islamophobia and Cross-Government Working Group on Anti-Muslim Hatred, the Coalition government has afforded significance to Islamophobia. Focusing on definition, evidence, and politics, this article considers British governmental policy approaches to tackling Islamophobia over the past 15 years. Tracing religiously based discrimination from the 1980s to the publication of the Runnymede Trust’s 1997 groundbreaking report into Islamophobia, this article explores how the New Labour government sought primarily to address Islamophobia through a broadening of the equalities framework. Against a backdrop of 9/11 and 7/7, a concurrent security and antiterror agenda had detrimental impacts. Under the Coalition, there has been a marked change. Considering recent developments and initiatives, the Coalition has seemingly rejected Islamophobia as an issue of equalities preferring approaches more akin to tackling Anti-Semitism. In conclusion, definition, evidence, and politics are revisited to offer a prospective for future British governmental policy.
Not All Avoidance Help Seekers Are Created Equal
Authors: White Marie C. , Bembenutty Héfer
Published: April 2013

This study examined 86 teacher candidates’ use of help seeking strategies and beliefs for preparing to pass a state certification examination. Using cluster analysis, we identified three different kinds of help seekers among the participants. One of the clusters represented teacher candidates for whom help seeking was an important and adaptive self-regulatory strategy and essential to their successful academic performance. The other two clusters represented the group of teacher candidates who had help-avoidance tendencies, but they were different in that for one group, seeking help implied inadequate use and maladaptive self-regulatory strategies while for the other, coping and adaptive self-regulatory strategies were utilized to ask for help when needed. The results revealed that students’ tendencies for help seeking vary according to their teacher’s self-efficacy beliefs, and use of self-regulatory strategies, such as delay of gratification. These findings suggested that help seeking is indeed a self-regulatory learning strategy used by learners to pursue valuable academic goals, and that differences do exist in approaches to help avoidance.
Reperfusion of cerebral artery thrombosis by the GPIb–VWF blockade with the Nanobody ALX-0081 reduces brain infarct size in guinea pigs
Authors: Momi Stefania , Tantucci Michela , Van Roy Maarten , Ulrichts Hans , Ricci Giovanni , Gresele Paolo
Published: April 2013

Key Points

Blockade of VWF-A1 by ALX-0081 induces reperfusion of a thrombus-occluded middle cerebral artery without provoking cerebral bleeding. The interaction between GPIb and VWF is not only essential for platelet adhesion but also for initial thrombus stabilization.
A Sleeping Beauty screen reveals NF-kB activation in CLL mouse model
Authors: Zanesi Nicola , Balatti Veronica , Riordan Jesse , Burch Aaron , Rizzotto Lara , Palamarchuk Alexey , Cascione Luciano , Lagana Alessandro , Dupuy Adam J. , Croce Carlo M. , Pekarsky Yuri
Published: April 2013

Key Points

Tcl1 cooperates with the NF-kB pathway in the pathogenesis of the aggressive form of CLL.
Persistent unsealed internal limiting membrane after Nd:YAG laser treatment for valsalva retinopathy
Authors: Zou Ming , Gao Sheng , Zhang Junjun , Zhang Meixia
Published: April 2013

Background

To report a long-term complication of unsealed and un-reattached internal limiting membrane in Valsalva retinopathy after neodymium-doped yttrium–aluminium–garnet (Nd:YAG) laser membranotomy.

Case presentation

A 41-year-old man presenting with a massive premacular hemorrhage due to Valsalva retinopathy underwent Nd:YAG laser membranotomy. During follow-up, best-corrected visual acuity, retinal alteration and optical coherence tomography (OCT) outcomes were documented. One month after membranotomy, his visual acuity improved to 20/20 and the hemorrhage resolved completely. At an 8-month follow-up visit, the fundus showed progressive wrinkling of the internal limiting membrane with the laser perforation located in the center. OCT showed a persistent unsealed and un-reattached internal limiting membrane.

Conclusions

Not all patients with Valslava retinopathy with premacular hemorrhage are appropriate candidates for laser membranotomy, especially patients with sub- internal limiting membrane hemorrhage. The key point for observation is the interface between internal limiting membrane and retinal surface. The long-term consequences of unsealed internal limiting membrane after Nd:YAG laser membranotomy require further understanding.
Geographic patterns of hepatocellular carcinoma mortality with exposure to iron in groundwater in Taiwanese population: An ecological study
Authors: Shyu Horng-Jeng , Lung Chia-Chi , Ho Chien-Chang , Sun Yi-Hua Iris , Ko Pei-Chieh , Huang Jing-Yang , Pan Chia-Chen , Chiang Yi-Chen , Chen Shih-Chang , Liaw Yung-Po
Published: April 2013

Background

Many studies have examined the risk factors for HCC (including hepatitis B virus, hepatitis C virus, aflatoxin, retinol, cigarette smoking, and alcohol consumption). However, data from previous studies on the association between iron exposure, land subsidence, and HCC mortality/incidence were limited, especially in Taiwanese population. We aimed to explore the geographical distribution of HCC mortality rates by township-specific data and to evaluate the association between HCC mortality, land subsidence, and iron levels in groundwater in Taiwan.

Methods

We conducted an ecological study and calculated the HCC age-standardized mortality/incidence rates according to death certificates issued in Taiwan from 1992 to 2001 and incidence data from 1995–1998. The land subsidence dataset before 2005 and iron concentrations in groundwater in 1989 are also involved in this study. Both geographical information systems and Pearson correlation coefficients were used to analyze the relationship between HCC mortality rates, land subsidence, and iron concentrations in groundwater.

Results

Township-specific HCC mortality rates are higher in southwestern coastal townships where serious land subsidence and higher township-specific concentrations of iron in groundwater are present. The Pearson correlation coefficients of iron concentrations in groundwater and ASRs of HCC were 0.286 (P = 0.004) in males and 0.192 (P = 0.058) in females for mortality data; the coefficients were 0.375 (P < 0.001) in males and 0.210 (P = 0.038) in females for incidence data.

Conclusions

This study showed that HCC mortality is clustered in southwestern Taiwan and the association with the iron levels in groundwater in Taiwanese population warrant further investigation.
Repair of a chondral defect using a cell free scaffold in a young patient - a case report of successful scaffold transformation and colonisation
Authors: Schüettler Karl F , Struewer Johannes , Rominger Marga B , Rexin Peter , Efe Turgay
Published: April 2013

Background

Chondral defects of the articular surface are a common condition that can lead to osteoarthritis if not treated. Therapy of this condition is a topic of constant debate and a variety of chondral repair strategies are currently used. One strategy involves implantation of a cell-free matrix of type I collagen (COL1), to provide a scaffold for chondrocyte migration and proliferation and extracellular matrix production. Although several studies have suggested that chondrocytes can move, to the best of our knowledge there is still no proof of chondrocyte occurrence in a former cell-free scaffold for articular cartilage repair in humans.

Case presentation

An 18-year-old male patient underwent arthroscopic surgery of the knee for patellar instability and a chondral defect of the femoral condyle. Clinical outcome scores were recorded pre-operatively, after 6 weeks and after 6, 12, 24 and 36 months. MRI was recorded after 6 weeks and after 6, 12, 24 and 36 months postoperatively. At 42 months after implantation of a cell-free type I collagen matrix and reconstruction of the medial patellofemoral ligament, the patient was again treated arthroscopically for a tear of the medial meniscus of the same knee. A biopsy of the previous chondral defect was taken during arthroscopy for histological examination.

Conclusion

In addition to good clinical and radiological results reported for cell-free scaffolds for cartilage repair in several other studies, transformation of the scaffold could be observed during re-arthroscopy for the meniscal tear. Histological examination of the specimen revealed articular cartilage with vital chondrocytes and a strong staining reaction for type II collagen (COL II), but no reaction for type I collagen staining. This might indicate a complete transformation of the scaffold and supports the theory that cell free scaffolds could support cell migration. Although the cell source remains unclear, migrating chondrocytes from the periphery remain a possibility.