bluuebunny/crossref_metadata_2025 huggingface dataset:
‘New’ and distributed leadership in quality and safety in health care, or ‘old’ and hierarchical? An interview study with strategic stakeholders
Authors: McKee Lorna , Charles Kathryn , Dixon-Woods Mary , Willars Janet , Martin Graham
Published: October 2013

Objectives

We aimed to explore the views of strategic level stakeholders on leadership for quality and safety in the UK National Health Service.

Methods

We interviewed 107 stakeholders with close involvement in quality and safety as professionals, managers, policy makers or commentators. Analysis was based on the constant comparative method.

Results

Participants identified the crucial role of leadership in ensuring safe, high quality care. Consistent with the academic literature, participants distinguished between traditional hierarchical ‘concentrated’ leadership associated with particular positions, and distributed leadership involving those with particular skills and abilities across multiple institutional levels. They clearly and explicitly saw a role for distributed leadership, emphasizing that all staff had responsibility for leading on patient safety and quality. They described the particular value of leadership coalitions between managers and clinicians. However, concern was expressed that distributed leadership could mean confusion about who was in charge, and that at national level it risked creating a vacuum of authority, mixed messages, and conflicting expectations and demands. Participants also argued that hierarchically based leadership was needed to complement distributed leadership, not least to provide focus, practical support and expertise, and managerial clout.

Conclusions

Strategic level stakeholders see the most effective form of leadership for quality and safety as one that blends distributed and concentrated leadership. Policy and academic prescriptions about leadership may benefit from the sophisticated and pragmatic know-how of insiders who work in organizations that remain permeated by traditional structures, cleavages and power relationships.
Multimorbidity and delivery of care for long-term conditions in the English National Health Service: baseline data from a cohort study
Authors: Bower Peter , Hann Mark , Rick Jo , Rowe Kelly , Burt Jenni , Roland Martin , Protheroe Joanne , Richardson Gerry , Reeves David
Published: October 2013

Objectives

Many patients with long-term conditions have multiple conditions. Current delivery of care is not designed around their needs and they may face barriers to effective self-management. This study assessed the relationships between multimorbidity, the delivery of care, and self-management.

Methods

We surveyed 2439 patients with long-term conditions concerning their experience of the delivery of care and self-management in England in 2011. We assessed multimorbidity in terms of a count of long-term conditions and the presence of ‘probable depression’. We explored the relationships between multimorbidity, patient experience of the delivery of care, and self-management

Results

Neither measure of multimorbidity was a significant predictor of patients’ experience of the delivery of care. Patients with multimorbidity reported higher levels of self-management behaviour, while the presence of depression was associated with less positive attitudes towards self-management.

Conclusions

The current data do not demonstrate a consistent impact of multimorbidity on patients’ experience of care or on self-management. Further research is required to assess those types of multimorbidity that are associated with significant deficits, or to identify other aspects of care that might be problematic in the context of multiple conditions.
Comparison of sedentary behaviors between children with autism spectrum disorders and typically developing children
Authors: Must Aviva , Phillips Sarah M , Curtin Carol , Anderson Sarah E , Maslin Melissa , Lividini Keith , Bandini Linda G
Published: October 2013

Time spent in sedentary behavior is largely due to time spent engaged with electronic screen media. Little is known about the extent to which sedentary behaviors for children with autism spectrum disorder differ from typically developing children. We used parental report to assess and compare time spent in sedentary behaviors for 53 children with autism spectrum disorder and 58 typically developing children aged 3–11 years. We also determined how sedentary behavior was related to child weight status (body mass index z-score). Overall, children with autism spectrum disorder spent an hour more in sedentary behaviors on weekdays compared to typically developing children (5.2 vs 4.2 h, p = 0.03), and most of this difference was due to screen time. The age- and sex-adjusted estimate of weekday total daily screen time was 1.6 h (typically developing) compared to 2.5 h (autism spectrum disorder, p = 0.004 for difference). A significant relationship between BMI z-score and total sedentary behavior time on weekend days was observed among young children with ASD, but not among TD children. The modest association between weekend sedentary behaviour time and BMI z-score among children with ASD suggests that sedentary behaiour is linked to relative weight status in these children. Further research is needed to confirm these findings and identify causal pathways.
Foreign reporting and sourcing practices in the network sphere: A quantitative content analysis of the Arab Spring in Belgian news media
Authors: Van Leuven Sarah , Heinrich Ansgard , Deprez Annelore
Published: October 2013

This article analyzes foreign news coverage and sourcing practices in contemporary newsrooms. It builds on theories concerned with the interplay between digital technologies and journalistic practice to explore the use of social media sources at professional journalistic outlets. The central research question deals with the diversity of sources in Belgian newspaper and TV news coverage of the grass roots uprisings in Egypt, Tunisia and Syria in 2011. The quantitative content analysis shows how journalists under normal circumstances in their coverage of the street protests in Egypt and Tunisia still value traditional sourcing practices. In contrast, coverage of the Syrian uprising displays more characteristics of network journalism practices, which can be related to factors of proximity regarding news values. Moreover, we found that when covering Syria, Belgian journalists relied more on on-the-ground, non-mainstream sources that circumvented the restricted information access by means of digital networks and social media platforms.
The role of Facebook users’ self-systems in generating social relationships and social capital effects
Authors: Jin Chang-Hyun
Published: October 2013

The aim of this research was to investigate the effects of online social networking use on bridging and bonding social relationships as well as on social capital effects. The study examined how the self-systems of users of the social networking website Facebook (where a self-system comprises four elements—self-efficacy, self-assertion, social presence, and self-esteem) and intensity of use affected the abovementioned social relations and social capital effects. Using data from a survey of Facebook users ( n =306), the result revealed that Facebook users’ self-systems played an important role in the formation of bridging and bonding social relationships as well as in generating social capital effects. However, self-esteem did not affect bonding social relationships significantly. The study also found that Facebook users’ self-systems mediated the relationship between bridging and bonding social relationships and social capital effects.
Framing the cuts: An analysis of the BBC’s discursive framing of the ConDem cuts agenda
Authors: Kay Jilly Boyce , Salter Lee
Published: October 2013

This study analyses the discursive framing of the British government’s economic policies by BBC News Online. Specifically, it focuses on the coverage of the government’s Comprehensive Spending Review in 2010, in which the details of the Chancellor of the Exchequer’s broader ‘austerity’ agenda were released. Using frame analysis informed by critical theory, we analyse three online BBC features and compare their framing of the economic crisis – and the range of possible policy responses to it – with that of the government’s.

In addition, we analyse editorial blogs and training materials associated with the BBC’s special ‘Spending Review season’; we also situate the analysis in the historical context of the BBC’s relationship with previous governments at moments of political and economic crisis.

Contrary to dominant ideas that the BBC is biased to the left, our findings suggest that its economic journalism discursively normalises neoliberal economics, not necessarily as desirable, but certainly as inevitable.
Towards more balanced news access? A study on the impact of cost-cutting and Web 2.0 on the mediated public sphere
Authors: Van Leuven Sarah , Deprez Annelore , Raeymaeckers Karin
Published: October 2013

In order to assess the impact of cost-cutting and digitalization on the expansion or contraction of the mediated public sphere, we developed a quantitative and longitudinal content analysis focused on sourcing practices for foreign news reporting in four Belgian newspapers (1995–2010). The results show little to no shift in the news access of different types of sources. Political sources dominate foreign news output, but ordinary citizens also play a significant role. Although it becomes clear that Belgian journalists often do not explicitly mention their use of news agency copy, recycled news articles or PR material, our findings indicate that concerns about cost-cutting in newsrooms or sanguinity about the democratic potential of Web 2.0 seem exaggerated, at least in the Belgian context.
Self reported experiences of therapy following child sexual abuse: Messages from a retrospective survey of adult survivors
Authors: Allnock Debbie , Hynes Patricia , Archibald Martha
Published: October 2013

• Summary:

This article explores retrospective accounts of childhood sexual abuse survivors’ experiences of therapeutic support received before the age of 18 in the United Kingdom. The survey formed part of a broad programme of research on therapeutic interventions for children affected by sexual abuse, by the National Society for the Prevention of Cruelty to Children (NSPCC) under the Rebuilding Childhoods programme. The primary aim of the survey was to explore what was helpful in young survivors’ experiences ( n= 299) of therapy to inform the development of a new NSPCC service. Of these 299 respondents (aged 18–35), only 52 reported receiving formal therapeutic provision following the abuse and this article relates to this smaller subset.

• Findings:

Respondents revealed that therapeutic factors such as therapist characteristics and interpersonal communication were crucial in informing their perceptions of therapy received. However, pre-therapy factors such as high level of need and unstable personal circumstances at the time of accessing support also influenced respondent ability to engage in the therapeutic process. Although the types of therapy accessed differed for respondents, there were common elements reported relating to therapist characteristics and skills which were important in determining respondent views.

• Applications:

The findings suggest that while there is no one-size-fits all approach, there are key characteristics of the relationship between child and therapist that must be considered and that assessment and on-going professional judgement is key to engaging children and maximising their therapeutic experiences. The findings also suggest the importance of listening to children’s preferences and keeping children informed.
The Hidden History of Food System Planning
Authors: Vitiello Domenic , Brinkley Catherine
Published: October 2013

Urban planning practitioners and academics generally view food system planning as a recent area of study, originating little more than a decade ago. Yet, food planning has a long and multifaceted history. Though not theorized as food system planning in most of the secondary literature in planning history, it is not hard to find when we look, even at some of the most familiar, seminal plans and scholarship in planning history. In this article, we trace the broad continuities and major changes in North American food planning, focusing on physical planning, regional economic development, and community economic development from the age of colonization to the present. The planners of early American cities necessarily organized urban environments and metropolitan infrastructure around agriculture, and some helped to build an international food economy. Since the nineteenth century, professional planners and their grassroots counterparts have struggled to manage the challenges posed by the industrial food system and society, in which the place of agriculture in the city is more ambiguous and contested.
Click, Clack, Move
Authors: Vettraino Elinor , Linds Warren , Goulet Linda
Published: October 2013

This article explores the arts’ potential to transform the relationships between students and teachers, so that education becomes an “as if” world, where education is an act of social justice. Interweaving themes from the children’s book Click Clack Moo, Cows that Type with theories of transformative pedagogy and their own teaching practices in Canada and Scotland, the authors look at the metonymic way in which the children’s story, as a form of performative writing, explores democracy, leadership, and group dynamics. Drawing from a concept of social justice as being a multi- or interdisciplinary experience that enables individuals to make sense of the social system around them, we explore how we have embraced transformative pedagogy in working with groups. In the process of the workshop, a shared space is opened up, where the exploration of stories can lead all participants to engage in transformative dialogue through visual images, movement, sound and physicality.
The continued relevance of the concept of propaganda: Propaganda as ritual in contemporary Hungary
Authors: Bajomi-Lázár Péter , Horváth Dorka
Published: October 2013

We will, in this paper, argue that the concept of propaganda is still relevant in the context of post-communist Hungary. More particularly, we will suggest that, in contrast to the period 1998-2010 when modern political marketing methods were applied widely, the political campaigns launched under Viktor Orbán’s second government (2010–present) have marked a paradigm shift in the history of political communication in Hungary, best described as the revival of old-school propaganda. First, drawing on a distinction by Gunther and Diamond between proto-hegemonic and pluralist parties in the political realm, we will attempt to establish a theoretical dichotomy between political propaganda and political marketing in the communicative domain. Then we will demonstrate – through an analysis of three campaigns launched during the past three years – that the communication of the ruling proto-hegemonic Fidesz party and its Christian Democratic coalition ally meets the criteria of classic political propaganda. Finally, we will apply neo-Durkheimian media theory to describe the selected political campaigns as communication rituals and attempt to show that political propaganda may, under specific circumstances, actively involve, engage and mobilize target audiences.1
Persistent idiopathic facial pain
Authors: O'Neill Francis , Wilkinson Greg
Published: October 2013

Persistent idiopathic facial pain (PIFP), formerly known as ‘atypical facial pain’, is a dull, constant, poorly localised ache in the face (most commonly the maxilla) that is not associated with any other clinical signs or pathology. It has no known cause and is therefore not a true diagnosis but rather a description. This article sets out to describe the ways in which PIFP may present in primary care, and discuss the key differential diagnoses to be excluded.
Safety of new oral anticoagulant drugs: a perspective
Authors: Vílchez Juan Antonio , Gallego Pilar , Lip Gregory Y.H.
Published: October 2013

The recent development of new oral anticoagulants (NOACs) offers the possibility of efficacy, relative safety and convenience compared with warfarin. This could lead to greater patient compliance, with easier management and improved provision of thromboprophylaxis. Safety whilst using NOACs should be focused on bleeding cases, surgery or on the management of patients receiving anticoagulant therapy with concomitant impairment of renal function, especially since many NOACs are dependent on renal excretion. Thus, if the clearance creatinine indicates severe renal impairment, NOACS will be contraindicated or their dose needs to be changed. In patients who need surgery, there are published protocols of management, depending on the severity of the intervention and renal function. In the case of severe hemorrhage, requiring rapid reversal of the anticoagulant effect and in the absence of specific antidotes, alternatives such as one of the nonspecific haemostatic agents must be considered. Clinical evaluation in bleeding situations and a meticulous risk–benefit appraisal for NOACs is needed, and these procoagulant agents and patients must be monitored closely. This article provides an overview of the pharmacology and potential risks, as well as the efficacy and safety of NOACs.
Patients’ Response Toward an Automated Orthopedic Osteoporosis Intervention Program
Authors: Varacallo Matthew A. , Fox Edward J. , Paul Emmanuel M. , Hassenbein Susan E. , Warlow Pamela M.
Published: October 2013

Osteoporosis is overshadowed in an era of chronic illnesses, and a care gap exists between physicians and patients. The aim of this study was to determine the effectiveness of implementing an automated system for identifying and sending a letter to patients at high risk for osteoporosis. Patients 50 years of age and older were tagged with an International Classification of Diseases, Ninth Revision, diagnostic code upon initial visit to the emergency department (ED), identifying potential fragility fractures. Automatically generated letters were sent via our osteoporosis database system to each patient 3 months after the initial visit to the ED. The letter indicated that he or she was at risk for osteoporosis and suggested that the patient schedule a follow-up appointment with a physician. Patients were subsequently telephoned 3 months after receiving the letter and asked about their current plan for follow-up. The control group did not receive a letter after departure from the ED. In the control group, 84 (85.71%) individuals of the total 98 did not have any follow-up but the remaining 14 (14.29%) sought a follow-up. In the intervention group, 62 (60.19%) individuals of 103 did schedule a follow-up, while the remaining 41 (39.81%) did not seek a follow-up. Thus, the patient follow-up response rate after fracture treatment improved with intervention ( P < .0001). Current literature has demonstrated the low rate of follow-up care addressing osteoporosis in patients experiencing fragility fractures (1%-25% without intervention). Research has shown the effectiveness of various types of intervention programs for improving the continuum of care for these high-risk patients. Nonautomated intervention programs can have a multitude of human-related system failures in identifying these patients. Our study successfully implements an automated system that is able to be applied to most hospitals with minimal cost and resources.
The Effect of Depressive Symptoms and CD4 Count on Adherence to Highly Active Antiretroviral Therapy in Sub-Saharan Africa
Authors: Memiah Peter , Shumba Constance , Etienne-Mesubi Martine , Agbor Solomon , Hossain Mian B. , Komba Patience , Niyang Mercy , Biadgilign Sibhatu
Published: October 2013

Background:

Studies have identified several programmatic and nonprogrammatic indicators that affect adherence to highly active antiretroviral therapy (HAART). Depression has been shown to impact adherence to HAART. This cross-sectional analysis of data collected from Nigeria, Uganda, Zambia, and Tanzania in 2008 examined the relationship between levels of depressive symptoms, clinical progression, and adherence to HAART.

Methods:

A multinational, multicenter, observational, retrospective cross-sectional evaluation of a population of focus comprised randomly selected patients on HAART. The dependent variable was adherence to HAART. The primary variable of interest to be assessed was patients’ level of depressive symptom score. A multivariable logistic regression model was used to examine the relationship between explanatory variables and adherence to HAART.

Results:

A total of 2344 patients were recruited for adherence survey. About 70% of the study sample reported having some level of depression. Logistic regression results show that patients who reported, respectively, low, moderate, and high levels of depressive symptoms are 35% ( P < .001), 56% ( P < .001), and 64% ( P < .001) less likely to adhere to HAART than those who reported having no depressive symptoms. At multivariate analysis, adherence to HAART was independently associated with the levels of depressive symptoms, older age, CD4 count >200 cells/mm3, Truvada (tenofovir [TDF]/emtricitabine [FTC])-based regimens, good knowledge about HAART, and longer period on therapy.

Conclusions:

These results indicate that mental health and clinical parameters are significant factors in determining patients’ adherence to their HAART, which need to be more aggressively addressed as a critical component of care and treatment support.
Characteristics and Factors Associated with the Clinical Forms of Lipoatrophy during Highly Active Antiretroviral Therapy in Ouagadougou, Burkina Faso
Authors: Guira Oumar , Tiéno Hervé , Yaméogo Bertille , Diendéré Arnaud Eric , Korsaga Nina , Sagna Yempabou , Zoungrana Lassané , Diallo Ismael , Traoré René , Drabo Joseph Youssouf
Published: October 2013

Background:

We aimed to study the factors associated with clinical forms of lipoatrophy in patients receiving highly active antiretroviral therapy (HAART) in Yalgado Ouédraogo Teaching Hospital, Ouagadougou, Burkina Faso.

Methods:

This cross-sectional review from March 10 to November 10, 2011, included a nonprobability sample of HIV-infected adults receiving antiretroviral (ARV) medications for at least 6 months and monitored in the internal medicine department. The diagnosis of lipoatrophy was clinical.

Results:

Three hundred patients were included. The sex ratio was 0.4 and the mean age was 42.1 ± 8.5 years. The mean duration of HAART was 73.2 ± 30.9 months. In all, 97 (32.3%) patients had lipoatrophy: 75 (25%) isolated and 22 (7.3%) mixed syndrome. Facial lipoatrophy was frequent (61.8%). Isolated lipoatrophy was associated with male sex ( P = .002) and body mass index ≤25 ( P < .05). Mixed syndrome was associated with female sex ( P = .002), age >42 years ( P < .05), physical activity ( P = .003), smoking ( P = .001), stavudine (d4T; P = .0001), or protease inhibitors ( P = .01).

Conclusion:

Prevention of lipoatrophy associated with HAART requires the exclusion of modifiable risk factors that we identified.
A comparison of the efficacy and safety of once-daily fluticasone furoate/vilanterol with twice-daily fluticasone propionate/salmeterol in moderate to very severe COPD
Authors: Agustí Alvar , de Teresa Luis , De Backer Wilfried , Zvarich Michael T. , Locantore Nicholas , Barnes Neil , Bourbeau Jean , Crim Courtney
Published: October 2013

Fluticasone furoate/vilanterol trifenatate (FF/VI) is a once-daily inhaled corticosteroid/long-acting β2-agonist combination in development for chronic obstructive pulmonary disease (COPD) treatment. We compared the efficacy and safety of FF/VIversusfluticasone propionate/salmeterol (FP/SAL) twice daily over 12 weeks.

Moderate to very severe COPD patients received FF/VI 100/25 μg once daily in the morning (n=266) or FP/SAL 500/50 μg twice daily (n=262). The primary end-point was a change from baseline in 0–24 h weighted mean forced expiratory volume in 1 s (wmFEV1) at 12 weeks. Additional end-points included time to 100 mL improvement from baseline on day 1 and a change from baseline in St George's Respiratory Questionnaire (SGRQ). Safety was also assessed.

wmFEV1(mean 130 mL) was greater and time to 100 mL improvement shorter (median 16 min) with FF/VI than FP/SAL (weighted mean 108 mL, median 28 min). Health status (SGRQ total score) improved in both groups (FF/VI -4.3 units, FP/SAL -3.0 units). Differences between treatments were not statistically significant. Six patients in the FF/VI (2%) and three in the FP/SAL (1%) arm experienced serious adverse events, none of which were considered to be drug related.

Improvements in lung function and health status were not significantly different between FF/VI 100/25 μg once daily and FP/SAL 500/50 μg twice daily; there was no apparent difference between the safety profiles of either therapy.
COPD phenotypes in biomass smoke-versustobacco smoke-exposed Mexican women
Authors: Camp Pat G. , Ramirez-Venegas Alejandra , Sansores Raul H. , Alva Luis F. , McDougall Jill E. , Sin Don D. , Paré Peter D. , Müller Nestor L. , Silva C. Isabela S. , Rojas Carlos E. , Coxson Harvey O.
Published: October 2013

We hypothesised that biomass smoke exposure is associated with an airway-predominant chronic obstructive pulmonary disease (COPD) phenotype, while tobacco-related COPD is associated with an emphysema-predominant phenotype.

In this cross-sectional study, female never-smokers with COPD and biomass exposure (n=21) and female ex-cigarette smokers with COPD without biomass exposure (n=22) completed computed tomography (CT) at inspiration and expiration, pulmonary function, blood gas, exercise tolerance, and quality of life measures. Two radiologists scored the extent of emphysema and air trapping on CT. Quantitative emphysema severity and distribution and airway wall thickness were calculated using specialised software.

Women in the tobacco group had significantly more emphysema than the biomass group (radiologist score 2.3versus0.7, p=0.001; emphysema on CT 27%versus19%, p=0.046; and a larger size of emphysematous spaces, p=0.006). Women in the biomass group had significantly more air trapping than the tobacco group (radiologist score 2.6 and 1.5, respectively; p=0.02) and also scored lower on the symptom, activities and confidence domains of the quality of life assessment and had lower oxygen saturation at rest and during exercise (p<0.05).

Biomass smoke exposure is associated with less emphysema but more air trapping than tobacco smoke exposure, suggesting an airway-predominant phenotype.
Lipid exposure prediction enhances the inference of rotational angles of transmembrane helices
Authors: Lai Jhih-Siang , Cheng Cheng-Wei , Lo Allan , Sung Ting-Yi , Hsu Wen-Lian
Published: October 2013

Background

Since membrane protein structures are challenging to crystallize, computational approaches are essential for elucidating the sequence-to-structure relationships. Structural modeling of membrane proteins requires a multidimensional approach, and one critical geometric parameter is the rotational angle of transmembrane helices. Rotational angles of transmembrane helices are characterized by their folded structures and could be inferred by the hydrophobic moment; however, the folding mechanism of membrane proteins is not yet fully understood. The rotational angle of a transmembrane helix is related to the exposed surface of a transmembrane helix, since lipid exposure gives the degree of accessibility of each residue in lipid environment. To the best of our knowledge, there have been few advances in investigating whether an environment descriptor of lipid exposure could infer a geometric parameter of rotational angle.

Results

Here, we present an analysis of the relationship between rotational angles and lipid exposure and a support-vector-machine method, called TMexpo, for predicting both structural features from sequences. First, we observed from the development set of 89 protein chains that the lipid exposure, i.e., the relative accessible surface area (rASA) of residues in the lipid environment, generated from high-resolution protein structures could infer the rotational angles with a mean absolute angular error (MAAE) of 46.32˚. More importantly, the predicted rASA from TMexpo achieved an MAAE of 51.05˚, which is better than 71.47˚ obtained by the best of the compared hydrophobicity scales. Lastly, TMexpo outperformed the compared methods in rASA prediction on the independent test set of 21 protein chains and achieved an overall Matthew’s correlation coefficient, accuracy, sensitivity, specificity, and precision of 0.51, 75.26%, 81.30%, 69.15%, and 72.73%, respectively. TMexpo is publicly available at http://bio-cluster.iis.sinica.edu.tw/TMexpo.

Conclusions

TMexpo can better predict rASA and rotational angles than the compared methods. When rotational angles can be accurately predicted, free modeling of transmembrane protein structures in turn may benefit from a reduced complexity in ensembles with a significantly less number of packing arrangements. Furthermore, sequence-based prediction of both rotational angle and lipid exposure can provide essential information when high-resolution structures are unavailable and contribute to experimental design to elucidate transmembrane protein functions.
MicroRNA-146 function in the innate immune transcriptome response of zebrafish embryos to Salmonella typhimurium infection
Authors: Ordas Anita , Kanwal Zakia , Lindenberg Valesca , Rougeot Julien , Mink Matyas , Spaink Herman P , Meijer Annemarie H
Published: October 2013

Background

MicroRNAs (miRNAs) have recently been shown to play important roles in development of the immune system and in fine-tuning of immune responses. Human miR-146 family members are known as inflammation-inducible miRNAs involved in negative feedback regulation of Toll-like receptor (TLR) signalling. Dysregulation of the miR-146 family has often been linked to inflammatory diseases and malignancies. This study reports on miR-146a and miR-146b as infection-inducible miRNAs in zebrafish, which has emerged as a model species for human disease.

Results

Using a custom-designed microarray platform for miRNA expression we found that both members of the zebrafish miR-146 family, miR-146a and miR-146b, were commonly induced by infection of zebrafish embryos with Salmonella typhimurium and by infection of adult fish with Mycobacterium marinum. The induction of these miRNAs was confirmed by Taqman miRNA assays. Subsequently, we used zebrafish embryos, in which adaptive immunity is not yet active, as an in vivo system to investigate the role of miR-146 in the innate immune response to S. typhimurium infection. Knockdown of traf6 and use of myd88 mutants demonstrated that the induction of miR-146a and miR-146b by S. typhimurium infection was affected by disruption of the MyD88-Traf6 pathway that mediates transduction of TLR signals and cytokine responses. In turn, knockdown of miR-146 itself had no major effects on the expression of known targets of MyD88-Traf6 signalling. Instead, RNA sequencing analysis showed that miR-146 knockdown led to an increased induction of six members of the apolipoprotein gene family in S. typhimurium-infected embryos.

Conclusion

Based on microarray analysis and Taqman miRNA assays we conclude that members of the miR-146 family, which is highly conserved between fish and human, are induced by bacterial infection in zebrafish in a MyD88 and Traf6 dependent manner. The combined knockdown of miR-146a and miR-146b in zebrafish embryos infected with S. typhimurium had no major effect on the expression of pro-inflammatory genes and transcription factors known to be downstream of the MyD88-Traf6 pathway. In contrast, apolipoprotein-mediated lipid transport emerged as an infection-inducible pathway under miR-146 knockdown conditions, suggesting a possible function of miR-146 in regulating lipid metabolism during inflammation.
Depression prevalence and primary care among vulnerable patients at a free outpatient clinic in Paris, France, in 2010: results of a cross-sectional survey
Authors: Rondet Claire , Cornet Philippe , Kaoutar Bacha , Lebas Jacques , Chauvin Pierre
Published: October 2013

Background

Data on the prevalence of depression and on how a depressive episode prompts the sufferer to seek primary care are not scarce, but the available evidence on the prevalence of depression among immigrants and poor people who frequent general practice facilities is scarce. The Baudelaire Outpatient Clinic at the Saint-Antoine Hospital in Paris provides free medical and social assistance to the poor and/or uninsured. The goal of our study was to estimate the prevalence of depression among these outpatients, to characterize this depressed population, and to analyze its demand for primary care for depressive episodes.

Methods

From September to December 2010, we conducted a cross-sectional, observational survey among users of the Baudelaire Outpatient Clinic. French-speaking patients attending the clinic between September 15 and December 30, 2010 who agreed to answer a questionnaire administered face-to-face before their consultation were included in the study. The chi-squared test (or Fisher’s exact test for small samples) was used for the comparisons of proportions. Logistic regression models were estimated, along with the odds ratios (OR) and their 95% confidence intervals (95% CIs), for the multivariate analysis of factors associated with depression and healthcare-seeking. Models were estimated separately for men and women, since sex was an interaction factor. The statistical analyses were performed using Stata v. 10 software (StataCorp LP, College Station, Texas, USA).

Results

Of the 250 patients included (mean age: 45 years), 52.0% were men and 52.4% were immigrants. Close to 40% of them reported having no supplemental health insurance. The estimated prevalence of depression in this population was 56.7%. Depression was more prevalent among the women, immigrants, and people from the poorer socioeconomic groups. Only half of these depressed patients, mostly women, reported having discussed their depression with a physician. French nationality and complete health insurance coverage were associated with more-frequent healthcare-seeking. Few patients reported having been asked about their morale by the physician they consulted, and almost 80% would have liked to be asked about this more often.

Conclusion

Depression is a real public health problem, particularly among people from disadvantaged backgrounds, and should be included in their overall management.
The health, social and educational needs of children who have survived meningitis and septicaemia: the parents’ perspective
Authors: Clark Laura J , Glennie Linda , Audrey Suzanne , Hickman Matthew , Trotter Caroline L
Published: October 2013

Background

Survivors of bacterial meningitis and septicaemia can experience a range of after-effects. There is little published research on the needs and provision of aftercare for children surviving bacterial meningitis and septicaemia.

Methods

Mixed methods study employing a survey and follow-up interviews with a sample of survey participants recruited from Meningitis Research Foundation’s member database and social media.

Results

Of 194 eligible survey respondents, 77% reported at least moderate short-term after-effects, and 57% a need for aftercare or support. Most parents reported that their child received a hearing test (98%) and follow-up appointment with a paediatrician (66%). Psychosocial after-effects were most common and the greatest need was for educational support. About half of participants felt their children’s needs for aftercare were met. We conducted interviews with 18 parents. Findings suggest access could be limited by: parents’ inability to navigate systems in place, child’s age, and delayed identification of sequelae. Parents felt a comprehensive explanation of possible after-effects on discharge from hospital was required, and found uncertain prognoses difficult. Good communication between professionals enabled a service tailored to the child’s needs.

Conclusions

Our study supports the NICE and SIGN guidelines and highlights areas for improvement in the aftercare of these children.
Intimate partner violence against women in the Erbil city of the Kurdistan region, Iraq
Authors: Al-Atrushi Hazha H , Al-Tawil Namir G , Shabila Nazar P , Al-Hadithi Tariq S
Published: October 2013

Background

Violence against women is a worldwide problem and serious human rights abuse that occurs among all social, cultural, economic and religious groups. There is a paucity of research on intimate partner violence against women in Iraq, particularly in the Kurdistan region. This study assessed the prevalence of emotional, physical and sexual intimate partner violence against women and the impact of physical violence in Erbil, the main city of the Iraqi Kurdistan region.

Methods

A cross-sectional study was carried out on a convenience sample of 800 Kurdish ever married women. Women (aged 16 to 65 years) attending two public hospitals in Erbil city for reproductive health problems were included in the study. The study was conducted between 1st of October 2009 and 30th of March 2011. Each woman was seen only once. Intimate partner violence was assessed by administering a modified version of the World Health Organization’s domestic violence questionnaire through direct interview by a female doctor. Prevalence of intimate partner violence was assessed by timing (lifetime or past year), frequency (once, 2–5 times, > 5 times), and type (emotional, physical, and sexual violence). Descriptive statistical analysis was conducted with calculation of frequencies and percentages of women who reported different types, severities and impact of intimate partner violence.

Results

The prevalence of the overall lifetime and the overall past year intimate partner violence against women was 58.6% and 45.3%, respectively. The proportions of women experienced at least one form of lifetime intimate partner violence were: 52.6% for emotional abuse; 38.9% for physical violence; and 21.1% for sexual violence, while 43.3%, 15.1%, and 12.1% of women experienced at least one form of past year emotional, physical and sexual violence, respectively. Among those with lifetime physical violence, 11.6% were subjected to more serious injuries like stab wound, broken teeth or broken bones.

Conclusions

There is a high prevalence of intimate partner violence, in particular emotional abuse behavior, against the women attending hospitals in Erbil. Physical violence is also a significant problem particularly in terms of its consequences.
Comparison of methods for detoxification of spruce hydrolysate for bacterial cellulose production
Authors: Guo Xiang , Cavka Adnan , Jönsson Leif J , Hong Feng
Published: October 2013

Background

Bacterial cellulose (BC) is a nanostructured material with unique properties and wide applicability. In order to decrease the production cost of bacterial cellulose, lignocellulose-based media have considerable potential as alternative cost-effective feedstocks. However, pretreatment and enzymatic hydrolysis of lignocellulose to sugars also generate fermentation inhibitors. Detoxification of lignocellulosic hydrolysates is needed to achieve efficient production of BC. In this investigation, different methods for detoxification of spruce hydrolysate prior to production of BC were compared with respect to effects on potential inhibitors and fermentable sugars, sugar consumption, BC yield, and cell viability. The objectives were to identify efficient detoxification methods and to achieve a better understanding of the role played by different inhibitors in lignocellulosic hydrolysates.

Results

In a first series of experiments, the detoxification methods investigated included treatments with activated charcoal, alkali [sodium hydroxide, calcium hydroxide (overliming), and ammonium hydroxide], anion and cation ion-exchange resins, and reducing agents (sodium sulfite and sodium dithionite). A second series of detoxification experiments included enzymatic treatments (laccase and peroxidase). The potential inhibitors studied included aliphatic acids, furan aldehydes, and phenolic compounds. The best effects in the first series of detoxification experiments were achieved with activated charcoal and anion exchanger. After detoxification with activated charcoal the BC yield was 8.2 g/L, while it was 7.5 g/L in a reference medium without inhibitors. Treatments with anion exchanger at pH 10 and pH 5.5 gave a BC yield of 7.9 g/L and 6.3 g/L, respectively. The first series of experiments suggested that there was a relationship between the BC yield and phenolic inhibitors. Therefore, the second series of detoxification experiments focused on treatments with phenol-oxidizing enzymes. The BC yield in the laccase-detoxified hydrolysate reached 5.0-5.5 g/L after 14 days cultivation, which demonstrated the important inhibitory role played by phenolic compounds.

Conclusions

The investigation shows that detoxification methods that efficiently remove phenolics benefit bacterial growth and BC production. Negative effects of salts could not be excluded and the osmotolerance of Gluconacetobacter xylinus needs to be further investigated in the future. Combinations of detoxification methods that efficiently decrease the concentration of inhibitors remain as an interesting option.
An edge-directed interpolation method for fetal spine MR images
Authors: Yu Shaode , Zhang Rui , Wu Shibin , Hu Jiani , Xie Yaoqin
Published: October 2013

Background

Fetal spinal magnetic resonance imaging (MRI) is a prenatal routine for proper assessment of fetus development, especially when suspected spinal malformations occur while ultrasound fails to provide details. Limited by hardware, fetal spine MR images suffer from its low resolution.

High-resolution MR images can directly enhance readability and improve diagnosis accuracy. Image interpolation for higher resolution is required in clinical situations, while many methods fail to preserve edge structures. Edge carries heavy structural messages of objects in visual scenes for doctors to detect suspicions, classify malformations and make correct diagnosis. Effective interpolation with well-preserved edge structures is still challenging.

Method

In this paper, we propose an edge-directed interpolation (EDI) method and apply it on a group of fetal spine MR images to evaluate its feasibility and performance. This method takes edge messages from Canny edge detector to guide further pixel modification. First, low-resolution (LR) images of fetal spine are interpolated into high-resolution (HR) images with targeted factor by bi-linear method. Then edge information from LR and HR images is put into a twofold strategy to sharpen or soften edge structures. Finally a HR image with well-preserved edge structures is generated. The HR images obtained from proposed method are validated and compared with that from other four EDI methods. Performances are evaluated from six metrics, and subjective analysis of visual quality is based on regions of interest (ROI).

Results

All these five EDI methods are able to generate HR images with enriched details. From quantitative analysis of six metrics, the proposed method outperforms the other four from signal-to-noise ratio (SNR), peak signal-to-noise ratio (PSNR), structure similarity index (SSIM), feature similarity index (FSIM) and mutual information (MI) with seconds-level time consumptions (TC). Visual analysis of ROI shows that the proposed method maintains better consistency in edge structures with the original images.

Conclusions

The proposed method classifies edge orientations into four categories and well preserves structures. It generates convincing HR images with fine details and is suitable in real-time situations. Iterative curvature-based interpolation (ICBI) method may result in crisper edges, while the other three methods are sensitive to noise and artifacts.
Ontogenetic allometry of the Beagle
Authors: Helmsmüller Daniela , Wefstaedt Patrick , Nolte Ingo , Schilling Nadja
Published: October 2013

Background

Mammalian juveniles undergo dramatic changes in body conformation during development. As one of the most common companion animals, the time line and trajectory of a dog’s development and its body’s re-proportioning is of particular scientific interest. Several ontogenetic studies have investigated the skeletal development in dogs, but none has paid heed to the scapula as a critical part of the mammalian forelimb. Its functional integration into the forelimb changed the correspondence between fore- and hindlimb segments and previous ontogenetic studies observed more similar growth patterns for functionally than serially homologous elements. In this study, the ontogenetic development of six Beagle siblings was monitored between 9 and 51 weeks of age to investigate their skeletal allometry and compare this with data from other lines, breeds and species.

Results

Body mass increased exponentially with time; log linear increase was observed up to the age of 15 weeks. Compared with body mass, withers and pelvic height as well as the lengths of the trunk, scapula, brachium and antebrachium, femur and crus exhibited positive allometry. Trunk circumference and pes showed negative allometry in all, pelvis and manus in most dogs. Thus, the typical mammalian intralimb re-proportioning with the proximal limb elements exhibiting positive allometry and the very distal ones showing negative allometry was observed. Relative lengths of the antebrachium, femur and crus increased, while those of the distal elements decreased.

Conclusions

Beagles are fully-grown regarding body height but not body mass at about one year of age. Particular attention should be paid to feeding and physical exertion during the first 15 weeks when they grow more intensively. Compared with its siblings, a puppy’s size at 9 weeks is a good indicator for its final size. Among siblings, growth duration may vary substantially and appears not to be related to the adult size. Within breeds, a longer time to physically mature is hypothesized for larger-bodied breeding lines. Similar to other mammals, the Beagle displayed nearly optimal intralimb proportions throughout development. Neither the forelimbs nor the hindlimbs conformed with the previously observed proximo-distal order of the limb segment’s growth gradients. Potential factors responsible for variations in the ontogenetic allometry of mammals need further evaluation.