bluuebunny/crossref_metadata_2025 huggingface dataset:
Linguistic Representations of Motion Do Not Depend on the Visual Motion System
Authors: Pavan Andrea , Baggio Giosuè
Published: January 2013

Embodied semantics proposes that constructing the meaning of motion verb phrases relies on representations of motion in sensory cortex. However, the data reported by earlier studies as evidence for this claim are also explained by a symbolic-semantics view proposing interactions between dissociable systems. In the experiments reported here, participants were visually adapted to real and implied leftward or rightward motion, which produced a motion aftereffect opposite to the direction of the adapting stimulus. Participants then decided whether a directionally ambiguous or a leftward- or rightward-directional verb phrase implied leftward or rightward motion. Because the visual system is engaged in the motion aftereffect, embodied semantics predicts that responses in the motion-aftereffect direction (opposite to the direction of the adapting stimulus) are facilitated, whereas symbolic semantics predicts response facilitation in the direction of the adapting stimulus (opposite to the direction of the motion aftereffect). We found response facilitation in the direction of real- and implied-motion adapting stimuli in ambiguous and directional verb phrases. These results suggest that visual and linguistic representations of motion can be dissociated.
Information content of zero pollen counts in Holocene profiles
Authors: Walanus Adam , Nalepka Dorota
Published: January 2013

Percentage-based pollen diagrams display the relative proportions of various taxa in relation to a stated pollen sum. A zero count for a given palynological taxon, as recorded for a given sample, does not mean that the taxon was absent at the time and place represented by the sample, but only that the concentration of palynomorphs is, at most, below the detection limit of the method. Here we apply the statistical concept of the confidence interval to approach this problem. In general, observing zero counts, one can state that there is a 95% probability that the true average for the given sample is simply below 3.0. However, if the sample has a neighboring non-zero sample, the best-fit value for the expected number of counts is 0.6–0.7, as estimated in the statistical analysis of a data base of 39 pollen diagrams from the Carpathian mountains, with a combined total of 4304 pollen curves. We suggest applying the confidence intervals (for a zero as well any positive number of counts) in drawing pollen diagrams, in order to clearly indicate the measurement uncertainties connected with pollen counting.
Quality care for persons experiencing dementia
Authors: Sellevold Gerd S , Egede-Nissen Veslemøy , Jakobsen Rita , Sørlie Venke
Published: January 2013

The degree of success in creating quality care for people suffering from dementia is limited despite extensive research. This article describes healthcare providers’ experience with the ethical challenges and possibilities in the relationship with patients suffering from dementia and its impact on quality care. The material is based on qualitative, in-depth individual narrative interviews with 12 professional healthcare providers from two different nursing homes. The transcribed interview texts were subjected to a phenomenological–hermeneutical interpretation. To provide quality care to patients with dementia, the healthcare providers emphasized the importance of sensing and understanding the patients’ emotional and bodily expressions through sentient attentiveness and recognition of the patient as a person. They also described reciprocity of expressions in the relationship where the patient recognized them both as persons and healthcare providers. The analyses of the findings are, inter alia, discussed in light of Løgstrup’s relational philosophy of ethics.
Bioethics education of nursing curriculum in Korea
Authors: Choe Kwisoon , Kang Youngmi , Lee Woon-Yong
Published: January 2013

The aim of this study is to examine the current profile of bioethics education in the nursing curriculum as perceived by nursing students and faculty in Korea. A convenience sampling method was used for recruiting 1223 undergraduate nursing students and 140 nursing faculty in Korea. Experience of Bioethics Education, Quality of Bioethics Education, and Demand for Bioethics Education Scales were developed. The Experience of Bioethics Education Scale showed that the nursing curriculum in Korea does not provide adequate bioethics education. The Quality of Bioethics Education Scale revealed that the topics of human nature and human rights were relatively well taught compared to other topics. The Demand for Bioethics Education Scale determined that the majority of the participants believed that bioethics education should be a major requirement in the nursing curriculum. The findings of this study suggest that bioethics should be systemically incorporated into nursing courses, clinical practice during the program, and during continuing education.
Characteristics of Patients With Hematologic Malignancies Who Received Palliative Care Consultation Services in a Medical Center
Authors: Hung Yu-Shin , Wu Jin-Hou , Chang Hung , Wang Po-Nan , Kao Chen-Yi , Wang Hung-Ming , Liau Chi-Ting , Chen Jen-Shi , Lin Yung-Chang , Su Po-Jung , Hsieh Chia-Hsun , Chou Wen-Chi
Published: January 2013

This study aimed to compare the characteristics of patients with hematologic malignancies and solid cancers who received palliative care. A total of 124 patients with hematologic malignancy and 3032 patients with solid cancer, who received palliative care consultation services between 2006 and 2010 in a medical center in Taiwan, were retrospectively analyzed. Higher prevalence of oral stomatitis, diarrhea, and hematologic symptoms including infection, fever, severe anemia, and bleeding, and lower prevalence of constipation, abdominal distension, and pain were observed in patients with hematologic malignancies compared to that in patients with solid cancer. The interval from hospital admission to palliative care referral was longer for patients with hematologic malignancy than that for patients with solid cancer. Hematologists should refer patients earlier, and palliative care specialists should understand the specific needs of patients with hematologic malignancy.
Diencephalic Storms From Leptomeningeal Metastases and Leukoencephalopathy
Authors: Soriano Aileen , Gutgsell Terence L. , Davis Mellar P.
Published: January 2013

Diencephalic storms or paroxysmal sympathetic storms are characterized by episodic hyperhidrosis, hypertension, tachypnea, tachycardia, and abnormal posturing. These have been reported to occur in patients with hydrocephalus, intracranial tumors, and hypoxic, ischemic, or traumatic brain injury. They can be easily misdiagnosed as seizures, uncontrolled pheochromocytoma, drug withdrawal, thyroid storm, hypertensive crises, and sepsis or anxiety attacks. The most effective treatment to control these symptoms is yet to be identified. We present 2 individuals exhibiting these sympathetic surges; one whose symptoms were controlled with phenobarbital and the other with clonidine and oxycodone. Palliative medicine physicians should be made aware of this unusual complication.
More Than a Cognitive Experience
Authors: Sillince John , Shipton Helen
Published: January 2013

Literature on organizational learning (OL) lacks an integrative framework that captures the emotions involved as OL proceeds. Drawing on personal construct theory, we suggest that organizations learn where their members reconstrue meaning around questions of strategic significance for the organization. In this 5-year study of an electronics company, we explore the way in which emotions change as members perceive progress or a lack of progress around strategic themes. Our framework also takes into account whether OL involves experiences that are familiar or unfamiliar and the implications for emotions. We detected similar patterns of emotion arising over time for three different themes in our data, thereby adding to OL perspectives that are predominantly cognitive in orientation.
Variation in Emergency Department Admission Rates Across the United States
Authors: Pines Jesse M. , Mutter Ryan L. , Zocchi Mark S.
Published: January 2013

There were more than 19 million hospitalizations in 2008 from hospital-based emergency departments (EDs), representing nearly 50% of all U.S. admissions. Factors related to variation in hospital-level ED admission rates are unknown. Generalized linear models were used to assess patient-, hospital-, and community-level factors associated with ED admission rates across a sample of U.S. hospitals using Healthcare Cost and Utilization Project data. In 1,376 EDs, the mean ED admission rate, when defined as direct admissions and also transfers from one ED to another hospital, was 17.5% and varied from 9.8% to 25.8% at the 10th and 90th percentiles. Higher proportions of Medicare and uninsured patients, more inpatient beds, lower ED volumes, for-profit ownership, trauma center status, and higher hospital occupancy rates were associated with higher ED admission rates. Also, hospitals in counties with fewer primary care physicians per capita and higher county-level ED admission rates had higher ED admission rates.
Identifying Antecedents of the Strategic Game Frame
Authors: Dimitrova Daniela V. , Kostadinova Petia
Published: January 2013

Although election news framing is a burgeoning area of research, empirical studies of what factors influence frame building remain rare, especially in non-Western countries. This study investigates the use of the strategic game frame and the relationship between that frame and system-level and organizational-level factors. The analysis focuses on the coverage of campaign news in six elite Bulgarian newspapers between 1990 and 2009. Results show that the type of electoral system, number of parties in government, and newspaper specialization are significant predictors of game frame use. The results are discussed in relation to framing research in Western Europe and the United States.
A Monte Carlo Study of the Effects of Common Method Variance on Significance Testing and Parameter Bias in Hierarchical Linear Modeling
Authors: Lai Xin , Li Fuli , Leung Kwok
Published: January 2013

Despite that common method variance (CMV) is widely regarded as a serious threat to the validity of findings based on self-reports, there is insufficient research on its confounding influence. We extend Evans’s (1985) pioneering work, and the more recent works by Ostroff, Kinicki, and Clark (2002) and Siemsen, Roth, and Oliveira (2010), to delineate the influence of CMV in a two-level hierarchical linear model based on self-report data. Our simulation results clearly show that in the absence of true effects, it is extremely unlikely for CMV to generate significant cross-level interactions. In fact, if a true cross-level interaction exists, CMV tends to lower the likelihood of its identification and erroneously underestimate the regression coefficient. Our simulation results also show that CMV may lead to a false significant cross-level main effect and overestimate the regression coefficient when no true effect exists. To reduce the probability of Type I errors, we show that raising the significance level to .01, the split sample strategy, and the addition of more CMV contaminated variables are effective in the vast majority of real-life situations and are more effective than increasing the number of groups or persons in each group. Both the split sample strategy and the addition of more CMV contaminated variables are also effective in reducing parameter bias when no true cross-level main effect exists. Trade-offs associated with different strategies are discussed.
The Marketing Effectiveness of Social Media in the Hotel Industry
Authors: Leung Xi Y. , Bai Billy , Stahura Kurt A.
Published: January 2013

The unprecedented popularity of social media outlets have forced scholars to inquire about their marketing effectiveness, especially in the hotel industry. This study attempted to explore the marketing effectiveness of two different social media sites (Facebook and Twitter) in the hotel industry. Integrating the attitude-toward-the-ad (Aad) model with the concepts of attitude-toward-social-media-page, the study proposed a theoretical model of hotel social media marketing effectiveness. Based on the data collected from an online survey, the goodness of fit of the model implied that the Aad model provides an appropriate theoretical framework to explain the marketing effectiveness of social media in the hotel industry. The results revealed that hotel customers’ social media experiences influence their attitudes-toward-social-media-site, which in turn influences their attitudes-toward-hotel-brand, and that hotel customers’ attitudes-toward-hotel-brand affects their hotel booking intentions and, in turn, intentions to spread electronic word of mouth. The study also indicated that different social media sites demonstrate the same marketing effectiveness, suggesting that hotel managers use the same marketing tactics for Facebook and Twitter marketing.
Successful treatment of malakoplakia of the bladder in a kitten
Authors: Rutland Bronwyn E , Nimmo Judith , Goldsworthy Matthew , Simcock James O , Simpson Kenneth W , Kuntz Charles A
Published: January 2013

A 4-month-old female kitten presented with chronic lower urinary tract signs and Escherichia coli cystitis, and was diagnosed with urinary bladder malakoplakia based upon histopathology. The kitten was treated with a prolonged antibiotic course and the malakoplakia resolved. Malakoplakia is a chronic granulomatous reaction characterized by the formation of Michaelis–Gutman bodies within von Hansemann macrophages. It is well described in humans, but has never been documented in a living veterinary patient. This case report describes the first successful treatment of malakoplakia in veterinary medicine.
Preliminary study on mechanism of cavitation in lubricant of textured sliding bearing
Authors: Meng FM , Yang T
Published: January 2013

The mechanism of the cavitation in a lubricant of a textured sliding bearing is studied based on multiphase flow theories and tribological equations. First, a physical model for a bearing with a series of semi-spherical dimples is modeled through commercial software ANSYS. Then, influences of dimple position and sizes on the vapor volume fraction, and cavitated area of the bearing are studied with computational fluid dynamic method. Numerical results show that the obvious fluctuation of the vapor volume rate and changes in the starting and end angles of the cavitation region due to varied dimple position can occur, when the dimples are located in the cavitated region. Moreover, with increasing cavitation starting angle, the changing trend of the cavitated area is the same as that of the load-carrying capacity, but opposite to the variation trends of the friction force and further friction coefficient.
Experimental measurement and modelling of plain bearing wear in start–stop applications
Authors: Gudin Dariusz , Mian Omar , Sanders Steve
Published: January 2013

The implementation of CO2 saving technologies such as start–stop has introduced new constraints on the engine bearings and their operating environment. The number of expected start–stops of a modern hybrid engine has risen to about 1.2 million for the engine lifetime. Frequent operation under mixed and boundary lubrication regimes may noticeably increase wear and reduce the life of the bearings. The developed test rig and modelling software are capable of simulating engine transient working conditions. The test results confirmed higher wear resistance of a bearing with a polymeric overlay working under start–stop conditions in comparison to an aluminium bimetallic bearing. Simulation results calculated on the basis of the ‘Direct Contact Reaction’ and correlated with the experimental data made it possible to estimate the wear of the bearings working in different start–stop applications.
Wear performance of alumina-reinforced copper–matrix composites prepared by powder metallurgy
Authors: Zhou Guanghong , Ding Hongyan
Published: January 2013

Copper–alumina composite materials with improved electrical conductivity and tribological properties were developed. The copper–alumina composite materials were prepared by powder metallurgy using nano-Cu/Al2O3 powder. The powders were deoxidized from CuO/Al2O3 powder synthesized by coprecipitation using NH4HCO3 as precipitator and CuSO4 + NH4Al(SO4)2 as maternal solution. The wear test against 440C stainless steel was performed at room temperature using a ball-on-flat configuration with 300 µm amplitude at various normal loads ranging from 0.1 N to 1 N. The effects of load and mass fraction of Al2O3 on the friction coefficient and wear loss were investigated. Results showed that the wear loss first decreased and then increased with an increase in the mass proportion of Al2O3 from 1% to 5%. Minimum wear loss was found at 2% proportion, in which the electrical conductivity was 82% of the International Annealed Copper Standard. The friction coefficient of the copper increased slightly with an increase in load. By contrast, it first increased and then decreased for the copper–alumina composite materials. The wear loss of the copper–alumina composite materials is always lower than that of copper. The highest relative wearability is 3.13, indicating better wear resistance. The wear mechanism of copper is oxidation wear, whereas that for the copper–alumina composite materials is adhesive wear.
Adaptation and validation of the Spanish version of the Dieting Peer Competitiveness Scale to adolescents of both genders
Authors: Pamies-Aubalat Lidia , Quiles-Marcos Yolanda , Núñez-Núñez Rosa M
Published: January 2013

This study examined the Dieting Peer Competitiveness Scale; it is an instrument for evaluating this social comparison in young people. This instrumental study has two aims: The objective of the first aim was to present preliminary psychometric data from the Spanish version of the Dieting Peer Competitiveness Scale, including statistical item analysis, research about this instrument’s internal structure, and a reliability analysis, from a sample of 1067 secondary school adolescents. The second objective of the study corresponds to confirmatory factor analysis of the scale’s internal structure, as well as analysis for evidence of validity from a sample of 1075 adolescents.
Experiences and preferences of users with major mental disorders regarding helpful care in situations of mental crisis
Authors: Gudde Camilla Buch , Olsø Turid Møller , Antonsen Dag Øivind , Rø Marit , Eriksen Lasse , Vatne Solfrid
Published: January 2013

Aims: To examine the experiences of and preferences for helpful care in situations of mental crisis from the perspective of people with major mental disorders. Methods: Qualitative individual interviews with 19 users with major mental disorder, 13 men and six women, aged 22–60 years. Analysis was conducted with systematic text condensation. Results: The main tendencies among a majority of the users are a clear understanding of their own problems and ways of handling these, and the desire for early help from providers whom they know well and who are open to dialogue and reflection. A clear majority perceived a high threshold for contacting the mental health system due to negative experiences and lack of user involvement in treatment planning and implementation. Conclusion: The findings challenge traditional views of professionalism and describe important implications for mental health services from the user’s perspective. Our study provides a clear indication of the importance of becoming an active participant in one’s own life, and the need for deeper understanding among the professionals in relation to user experiences and preferences for helpful care in periods of mental health crisis in order to optimize the care.
Beyond liberal multicultural toleration: A critical approach to groups’ essentialism
Authors: Bessone Magali
Published: January 2013

The article will argue that, despite Will Kymlicka’s claims to the contrary, the concept of ‘multicultural toleration’ implicitly entails an essentialist concept of groups, which amounts to holding a negative ‘permission’, power-loaded conception of toleration and not a positive liberal ‘respect’ conception. This seems contradictory to the general goal of Kymlicka’s multiculturalism. This article will then argue that multicultural toleration is not a satisfactory concept, neither from a conceptual point of view (it is incoherent) nor from a practical point of view (it disregards important aspects of political life). Nonetheless, multiculturalism poses the question of toleration at the correct level of group relations. This article will try to sustain the double requirement of, on one hand, trying to place toleration in a collective frame and, on the other, refusing the essentialist concept of groups used by multiculturalism. The way out of this difficulty can be found in a critical ‘non-domination’ conception of toleration.
Crowdsourcing 101
Authors: Parvanta Claudia , Roth Yannig , Keller Heidi
Published: January 2013

Crowdsourcing is a problem-solving approach that taps the knowledge, energy, and creativity of a global, online community. Like marketing, crowdsourcing originated and continues to evolve in the private sector. Health communicators and social marketers can use crowdsourcing across the research-development-dissemination process. This article provides an overview of crowdsourcing and how it can be used to speed up and enhance social marketing and health communication. Nielsen’s 1/9/90% model is presented as a guide for engaging appropriate crowds for tasks throughout the development process. The four Fs that motivate online contributors—Fun, Feeling good (fulfillment), Fame, and Fortune—are also presented as ways of incentivizing crowd engagement and matching the incentive to the task at hand. Crowdsourcing resources, such as curating agencies, websites, and crowd labor markets, can be tremendous force multipliers. If done strategically, crowdsourcing has the promise of giving well-researched and creative social marketing results for less money and in less time than traditional methods.
Motor and Premotor Cortices in Subcortical Stroke
Authors: Craciunas Sorin C. , Brooks William M. , Nudo Randolph J. , Popescu Elena A. , Choi In-Young , Lee Phil , Yeh Hung-Wen , Savage Cary R. , Cirstea Carmen M.
Published: January 2013

Background. Although functional imaging and neurophysiological approaches reveal alterations in motor and premotor areas after stroke, insights into neurobiological events underlying these alterations are limited in human studies. Objective. We tested whether cerebral metabolites related to neuronal and glial compartments are altered in the hand representation in bilateral motor and premotor areas and correlated with distal and proximal arm motor impairment in hemiparetic persons. Methods. In 20 participants at >6 months postonset of a subcortical ischemic stroke and 16 age- and sex-matched healthy controls, the concentrations of N-acetylaspartate and myo-inositol were quantified by proton magnetic resonance spectroscopy. Regions of interest identified by functional magnetic resonance imaging included primary (M1), dorsal premotor (PMd), and supplementary (SMA) motor areas. Relationships between metabolite concentrations and distal (hand) and proximal (shoulder/elbow) motor impairment using Fugl-Meyer Upper Extremity (FMUE) subscores were explored. Results. N-Acetylaspartate was lower in M1 ( P = .04) and SMA ( P = .004) and myo-inositol was higher in M1 ( P = .003) and PMd ( P = .03) in the injured (ipsilesional) hemisphere after stroke compared with the left hemisphere in controls. N-Acetylaspartate in ipsilesional M1 was positively correlated with hand FMUE subscores ( P = .04). Significant positive correlations were also found between N-acetylaspartate in ipsilesional M1, PMd, and SMA and in contralesional M1 and shoulder/elbow FMUE subscores ( P = .02, .01, .02, and .02, respectively). Conclusions. Our preliminary results demonstrated that proton magnetic resonance spectroscopy is a sensitive method to quantify relevant neuronal changes in spared motor cortex after stroke and consequently increase our knowledge of the factors leading from these changes to arm motor impairment.
Priming Pharyngeal Motor Cortex by Repeated Paired Associative Stimulation
Authors: Michou Emilia , Mistry Satish , Rothwell John , Hamdy Shaheen
Published: January 2013

Background. Several stimulation parameters can influence the neurophysiological and behavioral effects of paired associative stimulation (PAS), a neurostimulation paradigm that repeatedly pairs a peripheral electrical with a central cortical (transcranial magnetic stimulation [TMS]) stimulus. This also appears to be the case when PAS is applied to the pharyngeal motor cortex (MI), with some variability in excitatory responses, questioning its translation into a useful therapy for patients with brain injury. Objective. To investigate whether repeated PAS in both “responders” and “nonresponders” could enhance cortical excitability in pharyngeal MI more robustly. Methods. Based on their responses after single PAS, healthy participants were stratified into 2 groups of “responders” and “nonresponders” and underwent 2 periods (60 minutes inter-PAS interval) of active and sham PAS in a randomized order. Neurophysiological measurements with single TMS pulses from pharyngeal motor representation were collected up to 90 minutes after the second PAS period. Results. Repeated PAS increased cortical excitability up to 95% at 60 minutes following the second PAS in both the “responders” and “nonresponders.” Moreover, cortical excitability in the “nonresponders” was significantly different after repeated PAS compared with single and sham application ( P = .02; z = −2.2). Conclusions. Double dose PAS switched “nonresponders” to “responders.” These results are important for PAS application to dysphagic stroke patients who do not initially respond to a single application.
Racial Differences in Sexual Dysfunction Among Postdeployed Iraq and Afghanistan Veterans
Authors: Hosain G. M. Monawar , Latini David M. , Kauth Michael R. , Goltz Heather Honoré , Helmer Drew A.
Published: January 2013

This study examined the racial/ethnic differences in prevalence and risk factors of sexual dysfunction among postdeployed Iraqi/Afghanistan veterans. A total of 3,962 recently deployed veterans were recruited from Houston Veterans Affairs medical center. The authors examined sociodemographic, medical, mental-health, and lifestyle-related variables. Sexual dysfunction was diagnosed by ICD9-CM code and/or medicines prescribed for sexual dysfunction. Analyses included chi-square, analysis of variance, and multivariate logistic regression. Sexual dysfunction was observed 4.7% in Whites, 7.9% in African Americans, and 6.3% in Hispanics. Age, marital status, smoking, and hypertension were risk factors for Whites, whereas age, marital status, posttraumatic stress disorder and hypertension were significant for African Americans. For Hispanics, only age and posttraumatic stress disorder were significant. This study identified that risk factors of sexual dysfunction varied by race/ethnicity. All postdeployed veterans should be screened; and psychosocial support and educational materials should address race/ethnicity-specific risk factors.
License Plates: Personalized Jurisdiction and Performativity of Rights
Authors: Marusek Sarah
Published: January 2013

Whether personal or political, license plates represent a variety of social, cultural, and legal identities. As an enlivened legal semiotic in everyday life, license plates represent the performativity of rights in which the crafting of these legal emblems depends upon the reception of a viewing audience, namely other drivers and law enforcement. License plates mirror what’s debated in American society. In jurisdictional contests involving expressions of speech and assertions of indigenous sovereignty, the license plate richly characterizes the constitutive approach to law as it transpires on roadways across the United States and particularly in Hawai‘i.1
Fighting Child Sexual Abuse
Authors: Gwirayi Pesanayi
Published: January 2013

This study investigated secondary school pupils’ views on strategies that can be used to prevent child sexual abuse (CSA). A survey design was adopted as the operational framework for data gathering. Data were collected from three secondary schools, all in the Gweru district of Zimbabwe. The sample comprised 268 secondary pupils (50% female; M age = 15.42, SD = 1.376). Each participant was asked to write down three main strategies that can be used to fight CSA on a given questionnaire. The responses were then analyzed using the thematic content analysis technique. The study revealed that most pupils believed that CSA can be prevented through teaching them about it and also reporting to the police. Another significant finding was that pupils’ responses tended to vary with gender and level of education. Whereas female respondents suggested that CSA can be fought by avoiding strangers, saying no to sexual advances, and having reliable friends, their male counterparts suggested teaching the community about CSA, forming new clubs, and enacting life imprisonment for perpetrators, among other suggestions. In terms of level of education, Form 2 participants suggested avoiding strangers, staying home at night, whereas their Form 4 counterparts suggested lessons for Guidance and Counseling, saying no to sexual advances, and having reliable friends. These findings unequivocally demonstrate the need to vigorously engage secondary school pupils in activities aimed at fighting CSA to safeguard their inalienable human rights.
Hemodynamic and genetic analysis in children with idiopathic, heritable, and congenital heart disease associated pulmonary arterial hypertension
Authors: Pfarr Nicole , Fischer Christine , Ehlken Nicola , Becker-Grünig Tabea , López-González Vanesa , Gorenflo Matthias , Hager Alfred , Hinderhofer Katrin , Miera Oliver , Nagel Christian , Schranz Dietmar , Grünig Ekkehard
Published: January 2013

Background

Aim of this prospective study was to compare clinical and genetic findings in children with idiopathic or heritable pulmonary arterial hypertension (I/HPAH) with children affected with congenital heart defects associated PAH (CHD-APAH).

Methods

Prospectively included were 40 consecutive children with invasively diagnosed I/HPAH or CHD-APAH and 117 relatives. Assessment of family members, pedigree analysis and systematic screening for mutations in TGFß genes were performed.

Results

Five mutations in the bone morphogenetic protein type II receptor (BMPR2) gene, 2 Activin A receptor type II-like kinase-1 (ACVRL1) mutations and one Endoglin (ENG) mutation were found in the 29 I/HPAH children. Two mutations in BMPR2 and one mutation in ACVRL1 and ENG, respectively, are described for the first time. In the 11 children with CHD-APAH one BMPR2 gene mutation and one Endoglin gene mutation were found. Clinical assessment of relatives revealed familial aggregation of the disease in 6 children with PAH (HPAH) and one CHD-APAH patient. Patients with mutations had a significantly lower PVR.

Conclusion

Mutations in different TGFß genes occurred in 8/29 (27.6%) I/HPAH patients and in 2/11 (18.2%) CHD-APAH patients and may influence the clinical status of the disease. Therefore, genetic analysis in children with PAH, especially in those with I/HPAH, may be of clinical relevance and shows the complexity of the genetic background.
Functional genomics of a generalist parasitic plant: Laser microdissection of host-parasite interface reveals host-specific patterns of parasite gene expression
Authors: Honaas Loren A , Wafula Eric K , Yang Zhenzhen , Der Joshua P , Wickett Norman J , Altman Naomi S , Taylor Christopher G , Yoder John I , Timko Michael P , Westwood James H , dePamphilis Claude W
Published: January 2013

Background

Orobanchaceae is the only plant family with members representing the full range of parasitic lifestyles plus a free-living lineage sister to all parasitic lineages, Lindenbergia. A generalist member of this family, and an important parasitic plant model, Triphysaria versicolor regularly feeds upon a wide range of host plants. Here, we compare de novo assembled transcriptomes generated from laser micro-dissected tissues at the host-parasite interface to uncover details of the largely uncharacterized interaction between parasitic plants and their hosts.

Results

The interaction of Triphysaria with the distantly related hosts Zea mays and Medicago truncatula reveals dramatic host-specific gene expression patterns. Relative to above ground tissues, gene families are disproportionally represented at the interface including enrichment for transcription factors and genes of unknown function. Quantitative Real-Time PCR of a T. versicolor β-expansin shows strong differential (120x) upregulation in response to the monocot host Z. mays; a result that is concordant with our read count estimates. Pathogenesis-related proteins, other cell wall modifying enzymes, and orthologs of genes with unknown function (annotated as such in sequenced plant genomes) are among the parasite genes highly expressed by T. versicolor at the parasite-host interface.

Conclusions

Laser capture microdissection makes it possible to sample the small region of cells at the epicenter of parasite host interactions. The results of our analysis suggest that T. versicolor’s generalist strategy involves a reliance on overlapping but distinct gene sets, depending upon the host plant it is parasitizing. The massive upregulation of a T. versicolor β-expansin is suggestive of a mechanism for parasite success on grass hosts. In this preliminary study of the interface transcriptomes, we have shown that T. versicolor, and the Orobanchaceae in general, provide excellent opportunities for the characterization of plant genes with unknown functions.
Prescribing ANtiDepressants Appropriately (PANDA): a cluster randomized controlled trial in primary care
Authors: Muskens Esther , Eveleigh Rhona , Lucassen Peter , van Weel Chris , Spijker Jan , Verhaak Peter , Speckens Anne , Voshaar Richard Oude
Published: January 2013

Background

Inappropriate use of antidepressants (AD), defined as either continuation in the absence of a proper indication or continuation despite the lack of therapeutic efficacy, applies to approximately half of all long term AD users.

Methods/design

We have designed a cluster randomized controlled clinical trial to assess the (cost-) effectiveness of an antidepressant cessation advice in the absence of a proper indication for maintenance treatment with antidepressants in primary care.

We will select all patients using antidepressants for over 9 months from 45 general practices. Patients will be diagnosed using the Composite International Diagnostic Interview (CIDI) version 3.0, extended with questions about the psychiatric history and previous treatment strategies. General practices will be randomized to either the intervention or the control group. In case of overtreatment, defined as the absence of a proper indication according to current guidelines, a cessation advice is given to the general practitioner. In the control groups no specific information is given. The primary outcome measure will be the proportion of patients that successfully discontinue their antidepressants at one-year follow-up. Secondary outcomes are dimensional measures of psychopathology and costs.

Discussion

This study protocol provides a detailed overview of the design of the trial. Study results will be of importance for refining current guidelines. If the intervention is effective it can be used in managed care programs.

Trial registration

NTR2032
Symptom load and functional status: results from the Ullensaker population study
Authors: Bruusgaard Dag , Tschudi-Madsen Hedda , Ihlebæk Camilla , Kamaleri Yusman , Natvig Bård
Published: January 2013

Background

There is evidence to support that the number of self-reported symptoms is a strong predictor of health outcomes. In studies examining the link between symptoms and functional status, focus has traditionally been on individual symptoms or specific groups of symptoms. We aim to identify associations between the number of self-reported symptoms and functional status.

Methods

A questionnaire was sent to people in seven age groups (N = 3227) in Ullensaker municipality in Southern Norway. The Standardised Nordic Questionnaire and the Subjective Health Complaints Inventory were used to record 10 musculoskeletal symptoms and 13 non-musculoskeletal symptoms, respectively. Four COOP-WONCA charts were used to measure functional status.

Results

We found a strong linear association between the number of self-reported symptoms and functional status. The number of symptoms explained 39.2% of the variance in functional status after adjusting for the effects of age and sex. Including individual symptoms instead of only the number of symptoms made little difference to the effect of musculoskeletal pain but affected the influence of non-muscular symptoms. Including even minor problems captured substantially more of the variance in functional status than including only serious problems.

Conclusions

The strong association between the number of symptoms and functional status, irrespective of type of symptom, might indicate that the symptoms share some common characteristics. The simple act of counting symptoms may provide an approach to study the relationships between health and function in population studies and might be valuable in research on medically unexplained conditions.
Hip fracture in hospitalized medical patients
Authors: Zapatero Antonio , Barba Raquel , Canora Jesús , Losa Juan E , Plaza Susana , San Roman Jesús , Marco Javier
Published: January 2013

Background

The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain.

Methods

We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization.

Outcome measures included rates of in-hospital fractures, length of stay and cost.

Results

A total of 1127 (0.057%) admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p < 0.001, and the mean length of stay was significantly longer for patients with a hip fracture (20.7 days vs 9.8 days; p < 0.001). Cost were higher in hip-fracture patients (6927€ per hospitalization vs 3730€ in non fracture patients). Risk factors related to fracture were: increasing age by 10 years increments (OR 2.32 95% CI 2.11-2.56), female gender (OR 1.22 95% CI 1.08-1.37), admission from nursing home (OR 1.65 95% CI 1.27-2.12), dementia (1.55 OR 95% CI1.30-1.84), malnutrition (OR 2.50 95% CI 1.88-3.32), delirium (OR 1.57 95% CI 1.16-2.14), and anemia (OR 1.30 95%CI 1.12-1.49).

Conclusions

In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.
Blood lead is significantly associated with metabolic syndrome in Korean adults: an analysis based on the Korea National Health and Nutrition Examination Survey (KNHANES), 2008
Authors: Rhee Sang Youl , Hwang You-Cheol , Woo Jeong-taek , Sinn Dong Hyun , Chin Sang Ouk , Chon Suk , Kim Young Seol Young Seol
Published: January 2013

Background

Although an association between low-level environmental heavy metal exposure and the incidence of metabolic syndrome (MS) has been hypothesized, little research on this topic has been conducted on a population-wide level.

Methods

We analyzed MS status and whole blood lead, mercury, cadmium, manganese, and creatinine-adjusted urine arsenic concentrations in 1,405 subjects, ≥ 20 years of age, who were registered for the Korea National Health and Nutrition Examination Survey, 2008.

Results

Various demographic and biochemical parameters were associated with MS and blood heavy metal status. After adjusting for these variables, lead was the only heavy metal that was significantly associated with MS. Lead concentrations in subjects with MS were significantly higher than those in subjects without MS (p = 0.015). The prevalence of MS and a moderate/high risk for cardiovascular disease, as determined by Framingham risk score, also increased significantly according to the logarithmic transformation of the lead quartile (p < 0.001). The odds ratios and 95% confidence intervals for MS were 1.56 (0.90–2.71), 1.63 (0.94–2.83), and 2.57 (1.46–4.51) for the second, third, and fourth quartiles of the log-transformed lead quartile, respectively, as compared with those of the lowest quartile after multiple adjustments for confounding factors. Serum triglyceride level was the only MS diagnostic component significantly associated with lead level in a multiple linear regression analysis (p = 0.006).

Conclusions

These findings suggest that a higher prevalence of MS is associated with higher blood lead levels in the Korean population.
Evaluation of the association between long-lasting insecticidal nets mass distribution campaigns and child malaria in Nigeria
Authors: Kyu Hmwe Hmwe , Georgiades Katholiki , Shannon Harry S , Boyle Michael H
Published: January 2013

Background

Nigeria carries the greatest malaria burden among countries in the world. As part of the National Malaria Control Strategic Plan, free long-lasting insecticidal nets (LLINs) were distributed in 14 states of Nigeria through mass campaigns led by different organizations (the World Bank, UNICEF, or the Global Fund) between May 2009 and August 2010. The objective of this study was to evaluate the association between LLIN distribution campaigns and child malaria in Nigeria.

Methods

Data were from the Nigeria Malaria Indicator Survey which was carried out from October to December 2010 on a nationally representative sample of households. Participants were women aged 15–49 years and their children aged less than five years (N = 4082). The main outcome measure was the presence or absence of malaria parasites in blood samples of children (6–59 months).

Results

Compared with children living in communities with no campaigns, those in the campaign areas were less likely to test positive for malaria after adjusting for geographic locations, community- and individual-level characteristics including child-level use of insecticide-treated nets (ITNs). The protective effects were statistically significant for the World Bank Booster Project areas (OR = 0.18, 95% CI = 0.04-0.73) but did not reach statistical significance for other campaign areas. Results also showed that community-level wealth (OR = 0.51, 95% CI = 0.34-0.76), community-level maternal knowledge regarding malaria prevention (OR = 0.70, 95% CI = 0.50-0.97), and child-level use of ITNs (OR = 0.79, 95% CI = 0.63-0.99) were negatively associated with child malaria.

Conclusions

The observed protective effects on child malaria of these campaigns (statistically significant in the World Bank Booster Project areas and non-significant in the other areas) need to be corroborated by future effectiveness studies. Results also show that improving community-level maternal knowledge through appropriate channels might be helpful in preventing child malaria in Nigeria.
Support of personalized medicine through risk-stratified treatment recommendations - an environmental scan of clinical practice guidelines
Authors: Yu Tsung , Vollenweider Daniela , Varadhan Ravi , Li Tianjing , Boyd Cynthia , Puhan Milo A
Published: January 2013

Background

Risk-stratified treatment recommendations facilitate treatment decision-making that balances patient-specific risks and preferences. It is unclear if and how such recommendations are developed in clinical practice guidelines (CPGs). Our aim was to assess if and how CPGs develop risk-stratified treatment recommendations for the prevention or treatment of common chronic diseases.

Methods

We searched the United States National Guideline Clearinghouse for US, Canadian and National Institute for Health and Clinical Excellence (United Kingdom) CPGs for heart disease, stroke, cancer, chronic obstructive pulmonary disease and diabetes that make risk-stratified treatment recommendations. We included only those CPGs that made risk-stratified treatment recommendations based on risk assessment tools. Two reviewers independently identified CPGs and extracted information on recommended risk assessment tools; type of evidence about treatment benefits and harms; methods for linking risk estimates to treatment evidence and for developing treatment thresholds; and consideration of patient preferences.

Results

We identified 20 CPGs that made risk-stratified treatment recommendations out of 133 CPGs that made any type of treatment recommendations for the chronic diseases considered in this study. Of the included 20 CPGs, 16 (80%) used evidence about treatment benefits from randomized controlled trials, meta-analyses or other guidelines, and the source of evidence was unclear in the remaining four (20%) CPGs. Nine CPGs (45%) used evidence on harms from randomized controlled trials or observational studies, while 11 CPGs (55%) did not clearly refer to harms. Nine CPGs (45%) explained how risk prediction and evidence about treatments effects were linked (for example, applying estimates of relative risk reductions to absolute risks), but only one CPG (5%) assessed benefit and harm quantitatively and three CPGs (15%) explicitly reported consideration of patient preferences.

Conclusions

Only a small proportion of CPGs for chronic diseases make risk-stratified treatment recommendations with a focus on heart disease and stroke prevention, diabetes and breast cancer. For most CPGs it is unclear how risk-stratified treatment recommendations were developed. As a consequence, it is uncertain if CPGs support patients and physicians in finding an acceptable benefit- harm balance that reflects both profile-specific outcome risks and preferences.