bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomechanical Comparison of Arthroscopic Single- and Double-Row Repair Techniques for Acute Bony Bankart Lesions
Authors: Spiegl Ulrich J. , Smith Sean D. , Todd Jocelyn N. , Coatney Garrett A. , Wijdicks Coen A. , Millett Peter J.
Published: July 2014

Background:

Single- and double-row arthroscopic reconstruction techniques for acute bony Bankart lesions have been described in the literature.

Hypothesis:

The double-row fixation technique would provide superior reduction and stability of a simulated bony Bankart lesion at time zero in a cadaveric model compared with the single-row technique.

Study Design:

Controlled laboratory study.

Methods:

Testing was performed on 14 matched pairs of glenoids with simulated bony Bankart fractures with a defect width of 25% of the glenoid diameter. Half of the fractures were repaired with a double-row technique, while the contralateral glenoids were repaired with a single-row technique. The quality of fracture reduction was measured with a coordinate measuring machine. To determine the biomechanical stability of the repairs, specimens were preconditioned with 10 sinusoidal cycles between 5 and 25 N at 0.1 Hz and then pulled to failure in the anteromedial direction at a rate of 5 mm/min. Loads at 1 mm and 2 mm of fracture displacement were determined.

Results:

The double-row technique required significantly higher forces to achieve fracture displacements of 1 mm (mean, 60.6 N; range, 39.0-93.3 N; P = .001) and 2 mm (mean, 94.4 N; range, 43.4-151.2 N; P = .004) than the single-row technique (1 mm: mean, 30.2 N; range, 14.0-54.1 N and 2 mm: mean, 63.7 N; range, 26.6-118.8 N). Significantly reduced fracture displacement was seen after double-row repair for both the unloaded condition (mean, 1.1 mm; range, 0.3-2.4 mm; P = .005) and in response to a 10-N anterior force applied to the defect (mean, 1.6 mm; range, 0.5-2.7 mm; P = .001) compared with single-row repair (unloaded: mean, 2.1 mm; range, 1.3-3.4 mm and loaded: mean, 3.4 mm; range, 1.9-4.7 mm).

Conclusion:

The double-row fixation technique resulted in improved fracture reduction and superior stability at time zero in this cadaveric model.

Clinical Relevance:

This information may influence the surgical technique used to treat large osseous Bankart fractures and the postoperative rehabilitation protocols implemented when such repair techniques are used.
Where Planning Meets the Law
Authors: Mualam Nir
Published: July 2014

Planning-related conflicts have been well documented in academic literature. However, the appeal tribunal, a prominent site where these conflicts are deliberated, remains an underexamined area of study. Where appeal tribunals are addressed, the literature has not focused much attention on appellate bodies or the contents of their decisions. The main purpose of this article is to explore appeal tribunals in the field of land-use planning. This is done through an exploratory survey and reorganization of current literature. The article highlights the international prevalence of appeal tribunals, offers insight about their role, points to existing gaps in knowledge, and explores future research needs.
Nimesulide-Induced Acute Hepatitis
Authors: Sbeit Wisam , Krivoy Norberto , Shiller Moshe , Farah Raymond , Cohen Hector I , Struminger Lili , Reshef Ron
Published: July 2014

OBJECTIVE:

To report the occurrence of nimesulide-induced acute hepatitis confirmed by biopsy and an in vitro lymphocyte toxicity assay.

CASE SUMMARY:

A 54-year-old Arabic woman treated with nimesulide for chronic low back pain was admitted to the hospital with acute hepatitis confirmed by biopsy. Her liver function test results returned to normal within one month after nimesulide discontinuation. An in vitro lymphocyte toxicity assay confirmed that the liver injury was due to nimesulide exposure.

DISCUSSION:

A case of acute hepatitis secondary to nimesulide, confirmed by biopsy and a laboratory in vitro assay, is described. Although the occurrence of clinically significant liver damage due to nonsteroidal antiinflammatory drugs (NSAIDs) is low, the enormous consumption of these drugs has made them an important cause of liver damage. Nimesulide, a relatively new NSAID commonly used in Europe, with a relative selectivity to cyclooxygenase type 2, can cause a wide range of liver injuries, from mild abnormal liver function to severe liver injuries. These effects are usually reversible on discontinuation of the drug, but occasionally can progress to fatal hepatic failure.

CONCLUSIONS:

Drug-induced acute hepatitis is a well-recognized adverse effect of many drugs, including nimesulide. Identification of a drug as a cause for this life-threatening disease is important because the discontinuation of it may be life saving. This article confirms the occurrence of nimesulide-induced hepatitis. It also highlights the importance of monitoring liver function test results after initiating therapy with such a drug.
Oral Bexarotene in the Treatment of Cutaneous T-Cell Lymphoma
Authors: Wong Siu-Fun
Published: July 2014

OBJECTIVE:

To review the preclinical and clinical information related to oral bexarotene approved by the Food and Drug Administration for the treatment of cutaneous manifestations of cutaneous T-cell lymphoma (CTCL) in patients who are refractory to at least one prior systemic therapy.

DATA SOURCES:

Literature accessed through MEDLINE (from 1990 to July 2000) and provided by the manufacturer. Key search terms included bexarotene, Targretin, LGD1069, and cutaneous T-cell lymphoma.

DATA SYNTHESIS:

The management of CTCL remains controversial due to its rarity in the US and its heterogeneity. An evaluation focusing on the pharmacology of bexarotene and its role in the management of the different stages of CTCL was conducted.

CONCLUSIONS:

Bexarotene has demonstrated activity in the treatment of CTCL. The oral route of administration and the adverse effect profile of bexarotene appear to make this drug a favorable option for the treatment of CTCL compared with other systemic therapies. Phase III randomized studies are needed to determine the clinical benefits of bexarotene as monotherapy or combination therapy in the treatment of CTCL.
Is More Than One Quinolone Needed in Clinical Practice?
Authors: Paladino Joseph A
Published: July 2014

OBJECTIVE:

To review clinical information on fluoroquinolone antimicrobials to distinguish between these agents and help define their place in clinical practice.

DATA SOURCES:

Primary and review articles on fluoroquinolones available commercially in the US as of August 2000 were identified through MEDLINE (from 1993–August 2000) and secondary sources.

STUDY SELECTION AND DATA EXTRACTION:

All pertinent, published, clinical trials for levofloxacin, moxifloxacin, and gatifloxacin were included. Minimal data were included for quinolones with restricted or limited uses, including trovafloxacin, sparfloxacin, enoxacin, and lomefloxacin. Due to the quantity of data on ciprofloxacin, only more recent or pivotal trials or articles summarizing data on specific infections were included. Relevant information was included if it was believed to assist in differentiating between the fluoroquinolones for infections for which these agents would most commonly be considered.

DATA SYNTHESIS:

Fluoroquinolones are a potent class of intravenous and oral broad-spectrum antimicrobial agents used for treating a wide range of community-acquired and nosocomial infections. More than 10 quinolones have been approved for use; although some of these have been withdrawn from the market, numerous others are under investigation. It has become increasingly important to be able to differentiate between these agents.

CONCLUSIONS:

Differences in safety, antimicrobial spectrum of activity, and resistance development support the selective use of various fluoroquinolones in differing clinical situations.
Acetazolamide in Critically Ill Neonates and Children With Metabolic Alkalosis
Authors: Andrews Megan G. , Johnson Peter N. , Lammers Erin M. , Harrison Donald L. , Miller Jamie L.
Published: July 2014

Background: Acetazolamide is an option for hypochloremic metabolic alkalosis, but there are limited reports in children. Objective: To describe the acetazolamide regimen and outcomes in critically ill children with metabolic alkalosis. Methods: This was a descriptive, retrospective study of patients <18 years of age who received ≥3 doses of acetazolamide for metabolic alkalosis (ie, pH > 7.45 and bicarbonate [HCO3] > 26 mEq/L). Patients receiving other treatments for metabolic alkalosis within 24 hours of acetazolamide were excluded. The primary objective was to identify the mean dose and duration of acetazolamide. Secondary objectives were to determine the number of patients with treatment success (ie, serum HCO3 22-26 mEq/L) and occurrence of adverse events. Results: Thirty-four patients were included for analysis, the median age was 0.25 years (range = 0.05-12 years). The acetazolamide regimen included a mean dose of 4.98 ± 1.14 mg/kg for a mean number of 6.1 ± 5.3 (range = 3-24) doses. The majority (70.6%) received acetazolamide every 8 hours. Treatment success was achieved in 10 (29.4%) patients. Statistically significant differences were noted between the pre-acetazolamide and post-acetazolamide pH and HCO3, 7.51 ± 0.05 versus 7.37 ± 0.05 ( P < .001) and 39.4 ± 6.1 mEq/L versus 31.4 ± 7.5 mEq/L ( P < .001), respectively. Conclusions: This is the first study to evaluate acetazolamide dosing for metabolic alkalosis in children with and without cardiac disease. Acetazolamide treatment resulted in improved HCO3, but the majority of patients did not achieve our definition of treatment success. Future studies should elucidate the optimal acetazolamide regimen.
BK Virus Encephalitis
Authors: Chittick Paul , Williamson John C. , Ohl Christopher A.
Published: July 2014

Objective: To describe a case of BK virus encephalitis with attempted direct antiviral therapy, review the reported cases of BK virus in the central nervous system, and report the novel use of intravenous cimetidine in place of oral probenecid to minimize the toxicities of intravenous cidofovir. Case Summary: A 36-year-old male with acute myelomonocytic leukemia and subsequent myelodysplastic syndrome underwent allogeneic hematopoietic stem cell transplant. His course was complicated by severe graft-versus-host disease involving his skin and gastrointestinal tract. Five weeks after transplantation, he developed fever and confusion. Magnetic resonance imaging was suggestive of limbic encephalitis and cerebrospinal fluid tested positive for BK virus. Therapy with intravenous cidofovir was thought to be indicated. Although probenecid is commonly used to minimize the toxicities of cidofovir, the patient’s severe graft-versus-host disease raised concerns about absorption of oral medications. Based on animal models and pharmacokinetic data, intravenous cimetidine was used in place of oral probenecid. Despite these therapies, the patient’s mental status did not improve. He developed progressive organ system failure, and care was ultimately withdrawn. Discussion: BK virus is increasingly described as a cause of encephalitis. The majority of reported cases have occurred in immunocompromised patients and have generally had a poor outcome. This case describes attempted antiviral therapy using cidofovir, the antiviral agent used most frequently in other syndromes due to BK virus. Intravenous cimetidine is a novel modality used to minimize ocular and renal toxicities frequently seen with cidofovir, and we believe this warrants further investigation. Conclusions: BK virus may be a cause of encephalitis in immunocompromised hosts, and cidofovir represents a possible treatment option. Intravenous cimetidine can be considered to minimize toxicities associated with cidofovir use in patients unable to tolerate or absorb oral probenecid.
Bleeding Events Following Concurrent Use of Warfarin and Oseltamivir by Medicare Beneficiaries
Authors: Mosholder Andrew D. , Racoosin Judith A. , Young Stephanie , Wernecke Michael , Shoaibi Azadeh , MaCurdy Thomas E. , Worrall Christopher , Kelman Jeffrey A.
Published: July 2014

Background: During the 2009 H1N1 influenza pandemic, the UK Medicines and Healthcare Products Regulatory Agency received case reports suggesting a potentiation of warfarin anticoagulation by the antiviral drug oseltamivir. We evaluated this putative interaction using Medicare data. Objective: To determine the frequency of bleeding following addition of oseltamivir or comparator drugs among Medicare beneficiaries taking warfarin. Methods: This was a retrospective cohort evaluation using Medicare nationwide data. Cohort members were Medicare Parts A, B, and D beneficiaries from June 30, 2006 to October 31, 2010 receiving warfarin for at least 1 month prior to a concomitant drug of interest (oseltamivir, ampicillin, trimethoprim–sulfamethoxazole (TMP-SMX), and angiotensin-converting enzyme (ACE) inhibitors). Bleeding within 14 days of new prescriptions for oseltamivir or comparators was identified using inpatient or emergency department ICD-9 (International Classification of Diseases, ninth revision) discharge diagnosis codes for gastrointestinal hemorrhage, epistaxis, hematuria, and intracranial bleeding. Patients with bleeding within 30 days preceding the prescription concomitant to warfarin were excluded. Results: With concomitant ACE inhibitors as reference, adjusted odds ratios (ORs) for any bleeding events within 14 days were 1.47 (95% confidence interval [CI] = 1.08-1.88), 1.24 (95% CI = 0.97-1.57), and 2.74 (95% CI = 2.53-3.03), for warfarin plus ampicillin, oseltamivir, and TMP-SMX, respectively. In a sensitivity analysis, adjusted ORs over a 7-day period were 1.89 (95% CI = 1.29-2.59), 1.47 (95% CI = 1.06-2.02), and 3.07 (95% CI = 2.76-3.49) for warfarin plus ampicillin, oseltamivir, and TMP-SMX, respectively. Conclusions: Bleeding with oseltamivir plus warfarin was not significantly increased over a 14-day observation period; a sensitivity analysis showed a statistically significant increase over a 7-day period; in contrast, the data consistently showed the known tendency of TMP-SMX to potentiate the effects of warfarin. The results should be interpreted with the limitations of this approach in mind, including the inability to control for unmeasured confounders.
Acute Ischemic Stroke Following Cardioversion in a Patient Receiving Dabigatran
Authors: Faust Andrew C. , Smith Megan B. , Kawalsky Darryl
Published: July 2014

Objective: To report a case of acute ischemic stroke following electrical cardioversion in a patient currently anticoagulated with dabigatran 150 mg twice daily. Case Summary: A 74-year-old man, who had been adherent with more than 6 weeks of dabigatran 150 mg twice daily therapy, presented with a dense left-sided hemiparesis 72 hours following a repeat electrical cardioversion. Both computed tomography and magnetic resonance angiogram confirmed a right middle cerebral artery infarct. A transesophageal echocardiogram performed after the cerebrovascular accident failed to demonstrate a cardiac source of embolus. The patient previously underwent cardioversion 4 weeks prior with no evidence at that time of thrombus or spontaneous echo contrast on transesophageal echocardiogram. Discussion: Dabigatran was approved in the United States in late 2010 for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. Post hoc data from the phase III trial suggest a low risk of embolism following cardioversion. Since there are no conventional coagulation measures to reliably demonstrate the level of anticoagulation in patients on dabigatran, clinicians must rely solely on patient history when assessing the safety of cardioverting a patient on this medication. Data have suggested increased pro-inflammatory mediators and increased risk of myocardial infarction with oral direct thrombin inhibitors, which may have manifested as a cerebral or carotid artery thrombosis in situ. Conclusion: Novel oral anticoagulants are attractive options for anticoagulation required with cardioversion. Although this case report may not preclude use of dabigatran for this purpose, it illustrates that use of this drug is not without risks. Additional investigation into the pro-inflammatory nature of the oral direct thrombin inhibitors is needed.
Assessing the Implementability of Clinical Pharmacist Interventions in Patients With Chronic Kidney Disease
Authors: Salgado Teresa M. , Correr Cassyano J. , Moles Rebekah , Benrimoj Shalom I. , Fernandez-Llimos Fernando
Published: July 2014

Background: Pharmacy practice studies have been criticized for presenting poor intervention description, which has serious implications when attempting to replicate interventions elsewhere. Evidence of improved outcomes for patients with chronic kidney disease (CKD) following pharmacist intervention exist in the literature, but similar concerns with intervention description have been raised. Objective: To assess the implementability of evidence-based clinical pharmacist interventions in patients with CKD, based on the information contained in the published manuscripts. Methods: PubMed was searched to retrieve systematic reviews addressing the role of pharmacists in patients with CKD. Primary studies describing clinical pharmacy services in CKD were subsequently extracted. To describe and characterize pharmacists’ interventions, the DEPICT (Descriptive Elements of Pharmacist Intervention Characterization Tool) was applied. Studies were independently classified as “implementable” or “nonimplementable” by 2 authors, based on whether they could be easily implemented into practice using the description provided in the article. Finally, implementable interventions were grouped in different areas. Results: Five reviews were retrieved, and 39 original studies were analyzed. Of these, 59.0% were classified as nonimplementable. Among implementable interventions, 6 evidence-based areas of pharmacist interventions were identified: anemia, renal osteodystrophy, and cardiovascular risk factors management, medication appropriateness evaluation and medication reconciliation, patient education and compliance, and cost containment. Conclusions: Information contained in most articles reporting pharmacist interventions in CKD is not sufficient to ensure the implementation of the service in clinical practice. Pharmacy practice research articles should be written with the aim of improving clinical practice and not just showing the results of pharmacists’ interventions.
Multivariate Analysis of Factors Associated With Persistent Colesevelam Treatment Among Patients With Hypercholesterolemia
Authors: Romanelli Robert J. , Leahy Angela , Jukes Trevor , Ye Xin , Kang Amiee , Ishisaka Denis Y.
Published: July 2014

Background: Persistent treatment with lipid-lowering therapies is important for achieving optimal clinical outcomes. To date, no study has evaluated the real-world use of colesevelam and the factors associated with persistent colesevelam treatment. Objective: The primary objective of this study was to examine patient demographic and characteristics associated with persistent colesevelam treatment in real-world clinical practice. Methods: In this retrospective cohort study, adult patients with hypercholesterolemia, an initial order for colesevelam between January 2004 and December 2011, a low-density lipoprotein cholesterol (LDL-C) value ≤3 months from the initial order date (baseline), and ≥12 months of follow-up were identified through electronic health records. Persistent treatment was defined as no medication order gap >30 days during a 12-month period. Multivariate logistic regression was performed to assess factors associated with persistent treatment. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. A P value <.05 was considered statistically significant. Results: A total of 971 patients met eligibility criteria. Forty-nine percent of patients had ≥12 months of persistent treatment. Multivariate analysis showed that female sex (OR = 0.69; 95% CI = 0.53, 0.90; P = .004) was associated with lesser odds of persistence, whereas baseline LDL-C at goal (1.39; 1.06, 1.82; P = .015) and concomitant use of the intestinal cholesterol absorption inhibitor ezetimibe (1.64; 1.18, 2.28; P = .003) were associated with greater odds of persistence. Conclusions: This study identified several patient demographic and characteristics associated with persistent colesevelam treatment that may help develop strategies to improve treatment persistence and optimize clinical outcomes.
Missed Drug Therapy Alerts as a Consequence of Incomplete Electronic Patient Records in Dutch Community Pharmacies
Authors: Floor-Schreudering Annemieke , Heringa Mette , Buurma Henk , Bouvy Marcel L. , De Smet Peter A. G. M.
Published: July 2014

Background: Complete and up-to-date medical and pharmaceutical information in the electronic patient record (EPR) is a prerequisite for risk management in community pharmacy. Objectives: To analyze which information is missing in the EPR and which drug therapy alerts, therefore, fail to appear. Methods: Pharmacy students selected patients who were dispensed a prescription drug and enlisted for >3 months in the participating pharmacies. Patients received a questionnaire in which they were asked to verify their medication history, and to provide additional patient information. For each enrolled patient, the students collected all relevant information from the EPR. Self-reported data from the patient were compared with data retrieved from the EPR. Missed information in the EPR was evaluated based on national professional guidelines. Results: Questionnaires were received from 67% of the selected patients (442/660). Prescription drugs were missing in the EPR of 14% of the 442 patients, nonprescription drugs in 44%, diseases in 83%, and intolerabilities in 16%. In 38% of the patients (166/442), drug therapy alerts failed to appear because of missing information: drug-disease interactions in 34% of the patients, duplicate medications in 4%, drug-drug interactions (DDIs) in 4%, and drug intolerabilities in 2%. Among the (non-)prescription drugs missing, NSAIDs were most frequently responsible for the missed alerts. Diseases most frequently associated with missed alerts were gastroesophageal reflux disease, renal insufficiency, asthma/chronic obstructive pulmonary disease, and heart failure. Conclusions: Relevant patient information was frequently missing in the EPRs. The nonappearance of drug therapy alerts may have had clinical consequences for patients.
Safety and Efficacy of Metformin in Patients With Type 2 Diabetes Mellitus and Chronic Hepatitis C
Authors: Harris Kira , Smith Lisa
Published: July 2014

Objective: To evaluate the safety and efficacy of metformin in patients with type 2 diabetes mellitus (T2DM) and chronic hepatitis C virus (HCV) with or without cirrhosis and hepatocellular carcinoma (HCC). Data Sources: A PubMed (1946-August 2013) search using the keywords type 2 diabetes mellitus, metformin, hepatitis C virus, cirrhosis, and hepatocellular carcinoma was conducted. The references in published articles were reviewed to identify additional references for inclusion. Study Selection and Data Extraction: Studies written in English, evaluating metformin use in human patients with T2DM and chronic HCV were included. Data Synthesis: Eight studies met criteria for inclusion. Two prospective, randomized controlled trials showed increased benefit with metformin on virological response in patients with insulin resistance receiving HCV treatment. A prospective observational study evaluated metformin exclusively in patients with T2DM and HCV and showed significant reductions in the occurrence of HCC, liver-related death, and liver transplant. Four retrospective case control studies showed a decreased risk of HCC with metformin treatment in patients with T2DM and chronic liver disease. Finally, a retrospective cohort study indicated an increased survival rate in patients with diabetes and HCC undergoing radiofrequency ablation. Although diarrhea was increased in patients receiving metformin, no serious adverse effects, including lactic acidosis, were reported. Conclusions: Metformin may provide benefit in the treatment of HCV and in reducing the risk of HCC in patients with T2DM and HCV. Further long-term, randomized controlled trials are needed to adequately assess the safety and efficacy of metformin therapy in patients with comorbid diabetes and chronic HCV.
Use of Fluoxetine in Anorexia Nervosa Before and After Weight Restoration
Authors: Sebaaly Jamielynn C. , Cox Stephanie , Hughes Caitlin M. , Kennedy M. Lindsey Hedgepeth , Garris Shauna S.
Published: July 2014

Objective: To examine the evidence for the use of fluoxetine in treatment of underweight and weight-restored patients with anorexia nervosa (AN) and provide recommendations for the clinical usefulness of fluoxetine in AN. Data Sources: Literature was accessed via PubMed through June 2013 using the terms fluoxetine and anorexia nervosa. In addition, reference citations from publications identified were reviewed. Study Selection and Data Extraction: Randomized controlled trials published in English identified from the data sources were evaluated. Studies including the use of fluoxetine in underweight or weight-restored patients with AN were included. Studies of fluoxetine in preclinical animal models of anorexia nervosa were excluded. Data Synthesis: AN is a serious psychiatric illness with no currently approved medication therapy. Because patients with AN frequently display symptoms of major depressive and obsessive-compulsive disorders, medication therapy is commonly used in attempts to improve these symptoms and prevent relapses of AN. Antidepressants such as fluoxetine are the most frequently used medications for these symptoms. The evidence for fluoxetine in the treatment of AN is controversial, particularly in patients who remain underweight. One theory of inefficacy is that underweight patients do not have the nutrients required to make serotonin, therefore preventing selective serotonin reuptake inhibitors from taking effect. Another theory involves dysregulation of the serotonin receptor. Despite the lack of evidence, fluoxetine may still be useful in certain underweight and weight-restored patients. Conclusions: The risk-benefit ratio of fluoxetine in underweight and weight-restored patients with AN is undefined by clinical trials; therefore, clinical experience must be applied for its use in this patient population.
More Questions Than Answers in ICU Delirium
Authors: Flannery Alexander H. , Flynn Jeremy D.
Published: July 2014

With the release of the updated pain, agitation, and delirium guidelines by the Society of Critical Care Medicine, a number of new and updated recommendations are provided regarding the pharmacological prevention and treatment of ICU delirium. Whereas this is important to understand the limitations of existing literature in interpreting the guideline recommendations, it also provides an opportunity to identify those areas of practice where we need further knowledge. We discuss 5 of the most critical questions in our view regarding pharmacological therapy for ICU delirium in an attempt to highlight areas of this ICU condition that are much deserving of further research, including the deliriogenic potential of dexmedetomidine, optimal sedative choices for the delirious ICU patient, pharmacological prophylaxis for ICU delirium, optimal treatment duration for ICU delirium, and the impact of pharmacotherapy on long-term cognitive outcomes in ICU survivors. A multitude of opportunities for further research exist in the above areas for clinicians and researchers interested in this ICU condition.
Extending the Effects of the Carceral State
Authors: Walker Hannah L.
Published: July 2014

Rates of contact with the criminal justice system are geographically and racially sensitive such that some groups of people experience contact at much higher rates than others. The negative effects of personal contact with the criminal justice system are well documented. Less well understood are the effects of the criminal justice system on those who have not had personal contact but who are members of groups where contact is a common occurrence. This research explores the political effects of the carceral state for the second group, and finds that proximal contact mobilizes, an effect that is most pronounced for nonwhites.
How do prostitution customers value health and position health in their discussions? Qualitative analysis of online forums
Authors: Regushevskaya Elena , Tuormaa Tuija
Published: July 2014

Aim: Information on the health values and positioning of health among prostitution customers is limited. The aim is to explore the positioning of health among prostitution customers using data from Internet forums in Finland. Methods: Qualitative study using a purposive sample of public online forums among prostitution customers in 2002–2012. Results: Health beliefs in relation to infections and risky sexual behavior were diverse, from correct to false. Although men were aware of health risks in prostitution, it was common to have multiple sexual partners and unprotected sex. Although there were men who warned others about possible health consequences when a condom is not used, typically men were proud not to use a condom with a prostitute and found different explanations for not using a condom. Condom breakage was not an issue discussed in forums. Unexpected findings were beliefs that one fifth of the Nordic population is resistant to HIV, that the possibility of HIV transmission is exaggerated by medical specialists, and that men should control their behavior in order not to degrade prostitutes. Discussions on health service use were few. Conclusions: Sexual satisfaction and entertainment were the main reasons to post in the analyzed forums. Health discussion was not common. Although condom use was reported, attention to health risks was selective. Information on health service use was limited, which may suggest this topic was not valued among men and should be a topic of future studies.
Cholera outbreaks (2012) in three districts of Nepal reveal clonal transmission of multi-drug resistant Vibrio choleraeO1
Authors: Dixit Sameer M , Johura Fatema-Tuz , Manandhar Sulochana , Sadique Abdus , Rajbhandari Rajesh M , Mannan Shahnewaj B , Rashid Mahamud-ur , Islam Saiful , Karmacharya Dibesh , Watanabe Haruo , Sack R Bradley , Cravioto Alejandro , Alam Munirul
Published: July 2014

Background

Although endemic cholera causes significant morbidity and mortality each year in Nepal, lack of information about the causal bacterium often hinders cholera intervention and prevention. In 2012, diarrheal outbreaks affected three districts of Nepal with confirmed cases of mortality. This study was designed to understand the drug response patterns, source, and transmission ofVibrio choleraeassociated with 2012 cholera outbreaks in Nepal.

Methods

V. cholerae(n = 28) isolated from 2012 diarrhea outbreaks {n = 22; Kathmandu (n = 12), Doti (n = 9), Bajhang (n = 1)}, and surface water (n = 6; Kathmandu) were tested for antimicrobial response. Virulence properties and DNA fingerprinting of the strains were determined by multi-locus genetic screening employing polymerase chain reaction, DNA sequencing, and pulsed-field gel electrophoresis (PFGE).

Results

AllV. choleraestrains isolated from patients and surface water were confirmed to be toxigenic, belonging to serogroup O1, Ogawa serotype, biotype El Tor, and possessed classical biotype cholera toxin (CTX). Double-mismatch amplification mutation assay (DMAMA)-PCR revealed theV. choleraestrains to possess the B-7 allele ofctxsubunit B. DNA sequencing oftcpArevealed a point mutation at amino acid position 64 (N → S) while thectxABpromoter revealed four copies of the tandem heptamer repeat sequence 5'-TTTTGAT-3'.V. choleraepossessed all the ORFs of the Vibrio seventh pandemic island (VSP)-I but lacked the ORFs 498–511 of VSP-II. All strains were multidrug resistant with resistance to trimethoprim-sulfamethoxazole (SXT), nalidixic acid (NA), and streptomycin (S); all carried the SXT genetic element. DNA sequencing and deduced amino acid sequence ofgyrAandparCof the NARstrains (n = 4) revealed point mutations at amino acid positions 83 (S → I), and 85 (S → L), respectively. Similar PFGE (NotI) pattern revealed the NepaleseV. choleraeto be clonal, and related closely withV. choleraeassociated with cholera in Bangladesh and Haiti.

Conclusions

In 2012, diarrhea outbreaks in three districts of Nepal were due to transmission of multidrug resistantV. choleraeEl Tor possessing cholera toxin (ctx) B-7 allele, which is clonal and related closely withV. choleraeassociated with cholera in Bangladesh and Haiti.
Long-term outcome of early stage prostate cancer treated with brachytherapy analysis after a mean follow-up of 7 years
Authors: Yan Weigang , Chen Jian , Zhou Yi , Zhou Zhien , Mai Zhipeng , Ji Zhigang , Li Hanzhong , Zhang Fuquan
Published: July 2014

Purpose

To investigate the long-term efficacy of 125I brachytherapy in early-stage prostate cancer and to identify correlating factors.

Methods

This study included 117 cases of early stage prostate cancer. The patients ranged in age from 51 to 84 years, with a mean of 73 years. The features of the study population were as follows: the PSA ranged from 0.4 to 47.6 ng/ml (median, 14.7); the Gleason score ranged from 4 to 9 (mean, 6.4); the clinical stage ranged from T1b to T2c; and the positive biopsy rate ranged from 0.08 to 1.0 (mean, 0.45). The mean D90 was 142 Gy and ranged from 106 Gy to 170 Gy. The numbers of low-risk, intermediate-risk and high-risk prostate cancer cases were 22, 29 and 66, respectively. The biochemical no evidence of disease (bNED) rate and overall survival were recorded. Factors that correlated with the outcomes were evaluated.

Results

With a mean follow up of 84 months, 33 cases had biochemical recurrence, with a bNED rate of 72%. The overall survival rate was 90%, and the cancer-specific survival rate was 97%. The bNED rates in the low-risk, intermediate-risk and high-risk groups were 86%, 79% and 64%, respectively (P = 0.040). The patients with PSA <20 ng/ml, a positive biopsy rate lower than 0.5, and D90 ≥ 140 Gy had lower biochemical recurrence (P = 0.028, 0.006, 0.009, respectively).

Conclusions

The long-term efficacy of 125I brachytherapy in early stage prostate cancer was shown. bNED is related to risk stratification, PSA level, positive biopsy rate and D90.
Prevalence, components and associated demographic and lifestyle factors of the metabolic syndrome in type 2 diabetes mellitus
Authors: Mogre Victor , Salifu Zenabankara S , Abedandi Robert
Published: July 2014

Background

Adults with the metabolic syndrome (MetS) are twice as likely to die from and three times as likely to have a heart attack or stroke compared with people without the syndrome. About 70-80% of type 2 diabetes mellitus (type 2 DM) patients are diagnosed with the MetS. Investigating the occurrence of the MetS in type 2 DM patients is critical for cardiovascular disease prevention. We evaluated the prevalence and components of the MetS and its associated clinical and demographic factors in a Ghanaian adult population with DM 2.

Methods

This cross-sectional study was conducted among 200 previously diagnosed type 2 DM patients receiving care from an outpatient clinic of the Tamale Teaching Hospital, Ghana. Anthropometric measurements of waist circumference (cm), weight (Kg) and height (m) were measured appropriately. Clinical data were obtained from the personal health record files of the participants. MetS was defined according to the International Diabetes Federation criteria.

Results

The prevalence of MetS was 24.0% (n=48). The prevalence was higher in women (27.3%, n= 42) compared to men (13.0%, n=6). The commonest occurring components of the MetS included abdominal obesity (77.0%) and elevated FPG (77.0%) denoting uncontrolled diabetes. The prevalence of elevated BP was found to be 44.0%(n=88) and was higher in men (56.5%) than in women (40.3%). Factors that were found to be associated to the MetS were being overweight/obese (Crude OR = 2.9, 95% CI = 1.43 – 5.90, p=0.004), ever tried to lose weight (Crude OR = 2.5, 95% CI = 1.24 – 4.94, p=0.015) and having diabetes for over 5 years (Crude OR = 11.3, 95% CI = 5.26 – 24.08, p<0.001). Other factors that were associated to the MetS were current smokers (Crude OR = 6.8, 95% CI = 1.21- 38.49, p=0.030) and alcohol drinkers (Crude OR = 3.1, 95% CI = 1.23 – 7.65, p=0.018).

Conclusion

A comparatively low prevalence of the MetS was found. More females than males had the MetS. Uncontrolled diabetes and abdominal obesity were prevalent. The factors identified by our univariate logistic regression model were not significant predictors of the MetS in our multivariate model.
An essential role for IFN-β in the induction of IFN-stimulated gene expression by LPS in macrophages
Authors: Sheikh Faruk , Dickensheets Harold , Gamero Ana M , Vogel Stefanie N , Donnelly Raymond P
Published: July 2014

TLR agonists such as LPS and poly(I:C) induce expression of type I IFNs, such as IFN-α and -β, by macrophages. To examine the role of IFN-β in the induction of ISGs by LPS, we compared the ability of LPS to induce ISGF3 activity and ISG expression in bone marrow–derived macrophages from WT and Ifnb1−/− mice. We found that LPS treatment activated ISGF3 and induced expression of ISGs such as Oas1, Mx1, Ddx58 (RIG-I), and Ifih1 (MDA5) in WT macrophages, but not in macrophages derived from Ifnb1−/− mice or Ifnar1−/− mice. The inability of LPS to induce activation of ISGF3 and ISG expression in Ifnb1−/− macrophages correlated with the failure of LPS to induce activation of STAT1 and -2 in these cells. Consistent with these findings, LPS treatment also failed to induce ISG expression in bone marrow–derived macrophages from Stat2 KO mice. Although activation of ISGF3 and induction of ISG expression by LPS was abrogated in Ifnb1−/− and Ifnar1−/− macrophages, activation of NF-κB and induction of NF-κB-responsive genes, such as Tnf (TNF-α) and Il1b (IL-1β), were not affected by deletion of either the IFN-β or IFN-αR1 genes. These findings demonstrate that induction of ISGF3 activity and ISG expression by LPS is critically dependent on intermediate production of IFN-β and autocrine signaling through type I IFN receptors.
Coalescence of B cell receptor and invariant chain MHC II in a raft-like membrane domain
Authors: Hauser Julian T , Lindner Robert
Published: July 2014

The BCR binds antigen for processing and subsequent presentation on MHC II molecules. Polyvalent antigen induces BCR clustering and targeting to endocytic processing compartments, which are also accessed by Ii-MHC II. Here, we report that clustered BCR is able to team up with Ii-MHC II already at the plasma membrane of mouse B-lymphocytes. Colocalization of BCR and Ii-MHC II on the cell surface required clustering of both types of molecules. The clustering of only one type did not trigger the recruitment of the other. Ii-bound MIF (a ligand of Ii) also colocalized with clustered BCR upon oligomerization of MIF on the surface of the B cell. Abundant surface molecules, such as B220 or TfnR, did not cocluster with the BCR. Some membrane raft-associated molecules, such as peptide-loaded MHC II, coclustered with the BCR, whereas others, such as GM1, did not. The formation of a BCR- and Ii-MHC II-containing membrane domain by antibody-mediated clustering was independent of F-actin and led to the coendocytosis of its constituents. With a rapid Brij 98 extraction method, it was possible to capture this membrane domain biochemically as a DRM. Ii and clustered BCR were present on the same DRM, as shown by immunoisolation. The coalescence of BCR and Ii-MHC II increased tyrosine phosphorylation, indicative of enhanced BCR signaling. Our work suggests a novel role for MIF and Ii-MHC II in BCR-mediated antigen processing.
Developmental and Adaptive Functioning in Children With Retinoblastoma: A Longitudinal Investigation
Authors: Willard Victoria W. , Qaddoumi Ibrahim , Chen Si , Zhang Hui , Brennan Rachel , Rodriguez-Galindo Carlos , Wilson Matthew W. , Phipps Sean
Published: July 2014

Purpose

To determine the developmental trajectory of early cognitive and adaptive skills in young children with retinoblastoma from diagnosis to 5 years of age.

Patients and Methods

Ninety-four patients with retinoblastoma treated according to an institutional protocol underwent serial assessments of cognitive and adaptive functioning at age 6 months and 1, 2, 3, and 5 years. Data were analyzed by treatment strata, with patients with 13q deletion analyzed separately.

Results

At baseline, across all patients (except those with 13q deletion), developmental functioning was comparable with the normative mean, with mean scores for all strata within the average range. However, at age 5 years, developmental functioning was in the low average range and significantly below normative means. The trajectories of developmental functioning demonstrated significant decline over time, although this varied by treatment group/strata. Patients treated with enucleation only evidenced the greatest decline in cognitive functioning; significant change was not observed in patients treated with other modalities. Notable declines in parent-reported communication skills were observed in the majority of patients. Patients with 13q deletion evidenced delayed cognitive functioning at baseline, but minimal declines were observed through age 3 years. However, significant decreases in adaptive functioning were demonstrated over time for the 13q deletion subset.

Conclusion

The declines in functioning observed in this study were unexpected, as was the poorer performance of the enucleation-only group. This highlights the necessity of continuing to assess cognitive functioning in patients with retinoblastoma as they age. Additional research is necessary to determine the long-term trajectory of cognitive development in this population.
The Effect of Aerodynamic Braking on the Inertial Power Requirement of Flapping Flight: Case Study of a Gull
Authors: Burgess S.C. , Lock R.J. , Wang J. , Sattler G.D. , Oliver J.D.
Published: July 2014

There has been an unresolved question of whether there is any significant degree of aerodynamic braking during wing deceleration in the flapping flight of birds, with direct analogies existing with flapping micro air vehicles. Some authors have assumed a complete conversion of kinetic energy into (useful) aerodynamic work during wing deceleration. Other authors have assumed no aerodynamic braking. The different assumptions have led to predictions of inertial power requirements in birds differing by a factor of 2. Our work is the first to model the aerodynamic braking forces on the wing during wing deceleration. A model has been developed that integrates the aerodynamic forces along the length of the wing and also throughout the wing beat cycle. A ring-billed gull was used in a case study and an adult specimen was used to gather morphometric data including a steady state measurement of the lift coefficient. The model estimates that there is a 50% conversion of kinetic energy into useful aerodynamic work during wing deceleration for minimum power speed. This aerodynamic braking reduces the inertial power requirement from 11.3% to 8.5% of the total power. The analysis shows that energy conversion is sensitive to wing inertia, amplitude of flapping, lift coefficient and wing length. The aerodynamic braking in flapping micro air vehicles can be maximised by maximising flap angle, maximising wing length (for a given inertia), minimising inertia and maximising lift coefficient.
Voice Operated Micro Air Vehicle
Authors: Kumar P Sathish , Suraj S , Subramanian Venkata R , Raghavan Vinay V
Published: July 2014

This paper presents the design of a Micro Air Vehicle (MAV) operated by speech commands. A person from a base station can comfortably control the motion of the MAV by issuing speech commands. This system proposes to have two units, one in the base station which is the control unit and the other is a flying machine. The base station unit consists of a Digital Signal Processor (DSP) which performs a speaker dependent speech recognition algorithm for a predefined command library. The DSP generates control signals which are wirelessly transmitted to the MAV. A Field Programmable Gate Array (FPGA) is placed in the MAV for on-board operations. The FPGA receives the wirelessly transmitted control signals and alters the motion of the MAV based on the control signals received. The MAV consists of a single rotating wing with two rotors placed on either side of the fuselage, providing it with the capability of vertical take-off and landing (VTOL).
Complex Modeling and Adaptive Sliding Control Law for Mars Airplane
Authors: Liu Yanbin , Yang Chaoxing , Lu Yuping
Published: July 2014

The application of an airplane to explore Mars may become an important research aera due to some distinctive advantages such as the large detection range and good maneuvering characteristics. Also, the resulting works have the strong forward-looking and driving actions which are helpful for mankind to realize the intergrated design dreams concerning aerospace technologies. This paper discusses the complex modeling and sliding control law design issues for Mars airplane. First, the particular features with regard to atmospheric environment on Mars are considered to explain the Martian flight principles as well as to provide the faced new challeges in comparison to the conventional airpalne on Earth. Afterwards, the mathematical model of Mars airplane is established using the isolation methods, and based on this built model the dynamic characteratics are analyzed under the Martian atmospheric environment in order to indicate the importance of the control actions. Furthermore, the sliding control law is proposed to meet the anticipated demands including robust stability and adaptive track response. Finally, a simulation example is given to verify the effectiveness of the proposed modeling and control methods, and the according works will also provide the good theoretical reserve and technical support to independently develop Mars airplane in the future.
Generation and Limiters of Rogue Waves
Authors: Babanin A.V. , Rogers W.E.
Published: July 2014

Rogue waves are abnormally high, with respect to the mean, waves in the ocean. Present understanding of their nature will be reviewed and discussed. Rogue waves can be due to quasi-linear superpositions of waves and nonlinear effects such as instabilities of wave trains. Both appear to be important and possible. Individual waves can be focused into a superposition due to either dispersive or directional features of wave fields. While probability of the former in oceanic conditions is very low, the directional focusing appears to be rare but regular events. Nonlinear wave fields should be separated into stable and unstable conditions, with different probability distributions for wave heights/crests. In stable conditions, wave statistics are determined by the quasi-linear focusing, whereas in unstable wave trains high transient wave events can occur. Their maximal height/steepness is determined by combined dynamics of the instability growth and the limiting wave breaking.
Analysis of Flow through Ocean Energy Harvesting Bidirectional Impulse Turbine
Authors: Badhurshah Rameez , Samad Abdus , Sangwai Jitendra
Published: July 2014

Oscillating water column based wave energy device uses bi-directional flow impulse turbine. In this paper, a computational analysis of an impulse turbine has been performed using Ansys-CFX 14.0 code. Initially, a CAD model was prepared and unstructured meshing strategy was implemented in the flow domain. Reynolds-averaged Navier Stokes equations were solved to analyse the fluid flow properties. The efficiency, torque coefficient and input coefficient were compared for the evaluations. The flow features through the turbine shows that the flow separation occurs near the trailing edge of the suction surface of the blade.