bluuebunny/crossref_metadata_2025 huggingface dataset:
ASEAN and China: New Dimensions in Economic Engagement
Authors: Chakraborty Debashis , Kumar Animesh
Published: December 2012

ASEAN and China share a complex relationship in economic terms; while they collaborate in several spheres, conflict of interests is not uncommon either. The proposal for an ASEAN–China Free Trade Agreement (ACFTA) was floated in 2000, and the agreements covering merchandise trade, services trade and investment collaboration were signed in 2004, 2007 and 2009 respectively. ASEAN countries agreed to consider China as a market economy in the course of the negotiations and the ACFTA has resulted in several benefits for both parties, including tariff reduction on substantial number of product lines, considerable growth in merchandise and services trade volume, deepening of intra-regional production networks, regional cooperation on infrastructural development and so on. However, rapid growth of Chinese imports in ASEAN markets and expanding trade deficit generates apprehension in the grouping over potential domestic restructuring. Subisidies provided by the Chinese government to its domestic players also compound the problem. This article concludes that ASEAN countries need to augment their competitiveness through coordinated efforts on the one hand, and jointly negotiate with China to curb the disruptive effects of the latter’s incentive programmes, on the other.
Indonesia’s Relations with China: Productive and Pragmatic, but not yet a Strategic Partnership
Authors: Tjhin Christine Susanna
Published: December 2012

This article looks into the recent development of Indonesia’s relations with China. Notable progress can be seen in political and security relations, despite the fact that this dimension was at the core of their contentions during the 1970s and caused a freeze in diplomatic relations until the early 1990s. Economic relations, on the other hand, have long been the backbone of relations even before normalisation, but after Reformasi, economic relations have gradually been depicted as a new kind of threat even as they flourish. A unique factor contributing to this relationship is the distinctive role of Chinese Indonesians. This article also considers participation in multilateral diplomacy as an important aspect and strategy that affect bilateral relations. Under democracy, Indonesia is able to formulate a more productive and pragmatic China policy. However, since productive and pragmatic relations are not sufficiently strategic, Indonesia needs to formulate a long-term strategy to engage China and substantiate the so-called strategic partnership.
In Search of El Dorado: Chinese Diaspora in Southeast Asia
Authors: Mathew P. A.
Published: December 2012

Among all the people who have left mainland China’s shores, it is the Chinese diaspora in Southeast Asia that is the most important, not only for the numbers but also for the economic contribution they made for both the host as well as the home countries. The economic organisation of the Southeast Asian Chinese has been unique in many respects and many studies show their retention of ancient cultural practices which proved to be their strength during the post-colonial era. This article is an attempt to look at the historical trajectory of Southeast Asian Chinese, their unique business practices and how globalisation has been an element of change in terms of their outlook towards making use of business opportunities and searching for new models and patterns to survive and succeed in the global economy.
Myanmar’s China Policy: Agendas, Strategies and Challenges
Authors: Cook Alistair D. B.
Published: December 2012

Over the past two decades there has been increasing international attention to the interactions between Myanmar and China. While China has significant influence in relation to other international actors, there is also significant calculation by the government in Myanmar in an effort to ensure that no single external actor calls the policy shots. Instead, the policy choices of the government illustrate that they are calculated on a case-by-case basis to respond to emerging security threats and challenges. However, this represents only a partial truth because there are myriad actors competing for legitimacy in Myanmar which also have various relationships with external actors. Indeed, to fully understand the relationship between Myanmar and China a multifocal lens is required to appreciate the nuances and tensions within Myanmar and their effects on its overarching relationship with China. Furthermore, this lens must also be applied to China, as it too has multiple levels of engagement with Myanmar at both formal and informal levels to varying degrees. This article analyses this complex web of interactions to provide insight into the various agendas, strategies and challenges at play in the relationship between Myanmar and China.
Pharmacist-Developed Sedation Protocol and Impact on Ventilator Days
Authors: Hahn Lindsay , Beall Jennifer , Turner R. Scott , Woolley Thomas W. , Hahn Martin
Published: December 2012

Background:

Up to one-third of intensive care unit (ICU) patients require mechanical ventilation. Mechanical ventilation is associated with numerous complications including ventilator-induced lung injury and gastrointestinal bleeding due to ulcerations.1 Sedation protocols are used in order to optimize treatment and decrease days spent on mechanical ventilation.

Objective:

The purpose of this trial is to evaluate the effectiveness of an ICU sedation protocol. The primary end point was days on mechanical ventilation.

Design:

A retrospective chart review was performed. The medical records of 21 patients treated prior to the protocol and 21 patients treated after protocol implementation were reviewed.

Results:

The duration of mechanical ventilation was decreased in the postprotocol patients compared to the preprotocol patients. The mean duration of mechanical ventilation in the preprotocol group was 6.39 ± 5.24 versus the postprotocol group which was 3.78 ± 3.21 days. After implementing the sedation protocol, the number of days to extubation was decreased by 2.61 days.

Conclusion:

The use of sedation protocols can decrease the days spent on mechanical ventilation. The results also illustrate the enormous impact pharmacists have on policy and protocol development.
Psychoinformatics
Authors: Yarkoni Tal
Published: December 2012

Psychologists live in an increasingly data-rich world, and our ability to make continued progress in understanding the mind and brain depends on finding new ways to organize and synthesize an ever-expanding body of knowledge. In this article, I review current research in psychoinformatics—an emerging discipline that uses tools and techniques from the computer and information sciences to improve the acquisition, organization, and synthesis of psychological data. I focus on several areas where the application of informatics approaches has already paid large dividends, leading to advances including novel data-collection approaches, the adaptation of computational techniques and insights, the enhanced aggregation and organization of psychological data, large-scale data mining and synthesis, and improved research and publication practices. I argue that in the coming years, informatics approaches are likely to play the same instrumental role in shaping psychological research that they have already played in other fields, such as genetics and neuroscience.
They’re All the Same!. . . but for Several Different Reasons
Authors: Rubin Mark , Badea Constantina
Published: December 2012

Researchers studying people’s perceptions of variability among members of social groups, or perceived group variability, have tended to focus on the ways in which perceivers’ group affiliations lead to in-group and out-group homogeneity effects, including the other-race effect. However, recent advances have highlighted the role of additional influences. In this review, we consider the influence of (a) the perceiver’s group affiliation, (b) the group’s objective variability, (c) the group’s social position, and (d) the group’s central tendency on trait dimensions. We focus on recent research in these areas that has highlighted the strategic, context-dependent, and symbolic nature of perceived group variability. We conclude that future research needs to adopt a multicausal approach in order to provide a more complete and comprehensive account of perceived group variability.
Culture’s Constraints
Authors: Gelfand Michele J.
Published: December 2012

Recent research has identified a critical contrast between societies that are tight (i.e., societies that have strong norms and a low tolerance for deviant behavior) and those that are loose (i.e., societies that have weak norms and a high tolerance for deviant behavior). I review differences between tight and loose cultures—from differences in ecological and historical conditions to the strength of everyday social situations and individual differences in psychological processes—and discuss the implications of this cultural contrast for research and practice in psychological science.
An Examination of AVID Graduates’ College Preparation and Postsecondary Progress
Authors: Huerta Jeffery , Watt Karen M. , Reyes Patricia
Published: December 2012

This quantitative study sought to investigate how Advancement Via Individual Determination (AVID) and other high school college preparatory achievements contributed to the college success of underrepresented students enrolled in community colleges and 4-year universities. Eighty-five AVID graduates from 12 Texas high schools attending 5 Hispanic-serving higher education institutions participated in this research. AVID graduates at community colleges and universities were found to achieve intermediate outcomes of success, such as 1st-year retention, at higher rates than their institutions’ student populations.
Avatar and Utopia
Authors: Cubitt Sean
Published: December 2012

Compositing multiple plates into a single image creates challenges for lighting, grading and editing, while the distinct methods of each produces aesthetic challenges in creating apparently coherent space. The challenge is all the greater because digital screens and projectors afford only a strictly limited form of display, and the codecs associated with them share features that force these constructions of space to conform to the Cartesian grid of two-dimensional geometry. Avatar (James Cameron, 2009) attempts to build a coherent diegesis but fails because of these issues, which are redoubled in other technical domains, notably motion capture, and in the narrative. Nonetheless, ideological readings can only provide a negative response: careful analysis reveals utopian possibilities in composited live action and animated spectacle that need also to be included in the critical armoury.
Quorum-sensing regulates biofilm formation in Vibrio scophthalmi
Authors: García-Aljaro Cristina , Melado-Rovira Silvia , Milton Debra L , Blanch Anicet R
Published: December 2012

Background

In a previous study, we demonstrated thatVibrio scophthalmi, the most abundantVibriospecies among the marine aerobic or facultatively anaerobic bacteria inhabiting the intestinal tract of healthy cultured turbot (Scophthalmus maximus), contains at least two quorum-sensing circuits involving two types of signal molecules (a 3-hydroxy-dodecanoyl-homoserine lactone and the universal autoinducer 2 encoded byluxS). The purpose of this study was to investigate the functions regulated by these quorum sensing circuits in this vibrio by constructing mutants for the genes involved in these circuits.

Results

The presence of a homologue to theVibrio harveyi luxRgene encoding a main transcriptional regulator, whose expression is modulated by quorum–sensing signal molecules in other vibrios, was detected and sequenced. TheV. scophthalmiLuxR protein displayed a maximum amino acid identity of 82% with SmcR, the LuxR homologue found inVibrio vulnificus.luxRandluxSnull mutants were constructed and their phenotype analysed. Both mutants displayed reduced biofilm formationin vitroas well as differences in membrane protein expression by mass-spectrometry analysis. Additionally, a recombinant strain ofV. scophthalmicarrying the lactonase AiiA fromBacillus cereus, which causes hydrolysis of acyl homoserine lactones, was included in the study.

Conclusions

V. scophthalmishares two quorum sensing circuits, including the main transcriptional regulatorluxR, with some pathogenic vibrios such asV. harveyiandV. anguillarum. However, contrary to these pathogenic vibrios no virulence factors (such as protease production) were found to be quorum sensing regulated in this bacterium. Noteworthy, biofilm formation was altered inluxSandluxRmutants. In these mutants a different expression profile of membrane proteins were observed with respect to the wild type strain suggesting that quorum sensing could play a role in the regulation of the adhesion mechanisms of this bacterium.
A bronchofiberoscopy-associated outbreak of multidrug-resistant Acinetobacter baumanniiin an intensive care unit in Beijing, China
Authors: Xia Yukun , Lu CuiLing , Zhao Jingya , Han Gaige , Chen Yong , Wang Fang , Yi Bin , Jiang Guoqin , Hu Xiaohua , Du Xianfeng , Wang Zheng , Lei Hong , Han Xuelin , Han Li
Published: December 2012

Background

Bronchofiberscopy, a widely used procedure for the diagnosis of various pulmonary diseases within intensive care units, has a history of association with nosocomial infections. Between September and November 2009, an outbreak caused by multidrug-resistant Acinetobacter baumannii (MDR-Ab) was observed in the intensive care unit of a tertiary care hospital in Beijing, China. This study is aimed to describe the course and control of this outbreak and investigate the related risk factors.

Methods

Clinical and environmental sampling, genotyping with repetitive extragenic palindromic polymerase chain reaction (REP-PCR), and case–control risk factor analysis were performed in the current study.

Results

During the epidemic period, 12 patients were infected or colonized with MDR-Ab. Sixteen (72.7%) of twenty-two MDR-Ab isolates from the 12 patients and 22 (84.6%) of 26 MDR-Ab isolates from the bronchofiberscope and the healthcare-associated environment were clustered significantly into a major clone (outbreak MDR-Ab strain) by REP-PCR typing. Seven patients carrying the outbreak MDR-Ab strain were defined as the cases. Six of the seven cases (83%) received bronchofiberscopy versus four of the 19 controls (21%) (odds ratio, 22.5; 95% confidence interval, 2.07–244.84; P = 0.005). Several potential administrative and technical problems existed in bronchofiberscope reprocessing.

Conclusions

Bronchofiberscopy was associated with this MDR-Ab outbreak. Infection control precautions including appropriate bronchofiberscope reprocessing and environmental decontamination should be strengthened.
Risk factors affecting seroconversion after influenza A/H1N1 vaccination in hemodialysis patients
Authors: Moon Sung Jin , Lee Sang Hun , Byun Young-Ho , Yun Gi Young , Kim Seung Kyu , Seong Baik-Lin , Kim Ah Reum , sun Park Eun , Kim Hyung-Jong , Lee Jung Eun , Ha Sung Kyu , Lee Jae Myun , Park Hyeong-Cheon
Published: December 2012

Abstracts

Background

Hemodialysis (HD) patients have multiple causes of immune dysfunction and poor immune response to influenza vaccination. We investigated the antibody response rate to a pandemic H1N1/2009 influenza vaccination and clinical parameters influencing the induction of antibody responses in HD patients.

Methods

A total of 114 HD patients were vaccinated with a monovalent adjuvanted H1N1 inactivated influenza vaccine. Titers of neutralizing antibodies were evaluated by hemagglutination inhibition (HI) assay at pre- and 4 weeks after vaccination. Seroconversion was defined as either a pre-vaccination HI titer < 1:10 and a post vaccination HI titer > 1:40 or a pre-vaccination HI titer ≥ 1:10 and a minimum four-fold rise in post-vaccination HI antibody titer. Seventeen out of 114 HD patients (14.9%) tested positive for antibodies against influenza A/H1N1/2009 before vaccination. The remaining 97 baseline sero-negative patients were included in the analysis.

Results

Only 30 (30.9%) HD patients had seroconversion 4 weeks after vaccination. The elderly patients, those over 65 years of age, showed significantly lower seroconversion rate compared to younger HD patients (20.5% vs. 39.6%, p = 0.042). Furthermore, patients with hemoglobin values less than 10 g/dL had a significantly lower seroconversion rate compared to those with higher hemoglobin values (20.0 vs. 38.6%, p = 0.049). By multivariate logistic regression analysis, only age ≥65 years (OR = 0.336, 95% confidence interval (CI) 0.116-0.971, p = 0.044) and hemoglobin levels <10 g/dL (OR = 0.315, 95% CI 0.106-0.932, p = 0.037) were independently associated with seroconversion after vaccination.

Conclusions

Our data show that HD patients, especially who are elderly with low hemoglobin levels, are at increased risk for lower seroconversion rate after influenza A/H1N1 vaccination. Further studies are needed to improve the efficacy of vaccination in these high risk patients.
A prospective cohort study of stroke characteristics, care, and mortality in a hospital stroke registry in Vietnam
Authors: Tirschwell David L , Ton Thanh G N , Ly Kiet A , Van Ngo Quang , Vo Tung T , Pham Chien Hung , Longstreth William T , Fitzpatrick Annette L
Published: December 2012

Background

As low and middle-income countries such as Vietnam experience the health transition from infectious to chronic diseases, the morbidity and mortality from stroke will rise. In line with the recommendation of the Institute of Medicine’s report on “Promoting Cardiovascular Health in the Developing World” to “improve local data”, we sought to investigate patient characteristics and clinical predictors of mortality among stroke inpatients at Da Nang Hospital in Vietnam.

Methods

A stroke registry was developed and implemented at Da Nang Hospital utilizing the World Health Organization’s Stroke STEPS instrument for data collection.

Results

754 patients were hospitalized for stroke from March 2010 through February 2011 and admitted to either the intensive care unit or cardiology ward. Mean age was 65 years, and 39% were female. Nearly 50% of strokes were hemorrhagic. At 28-day follow-up, 51.0% of patients with hemorrhagic stroke died whereas 20.3% of patients with ischemic stroke died. A number of factors were independently associated with 28-day mortality; the two strongest independent predictors were depressed level of consciousness on presentation and hemorrhagic stroke type. While virtually all patients completed a CT during the admission, evidence-based processes of care such as anti-thrombotic therapy and carotid ultrasound for ischemic stroke patients were underutilized.

Conclusions

This cohort study highlights the high mortality due in part to the large proportion of hemorrhagic strokes in Vietnam. Lack of hypertension awareness and standards of care exacerbated clinical outcomes. Numerous opportunities for simple, inexpensive interventions to improve outcomes or reduce recurrent stroke have been identified.
Effectiveness of using group visit model to support diabetes patient self-management in rural communities of Shanghai: a randomized controlled trial
Authors: Liu Shengsheng , Bi Anhua , Fu Dongbo , Fu Hua , Luo Wei , Ma Xiaoying , Zhuang Liyan
Published: December 2012

Background

Diabetes has become a major public health problem in China. Support of patient self-management is a key component of effective diabetes care and improved patient outcomes. A series of peer-led community-based disease-specific self-management programs including diabetes have been widely disseminated in urban communities of Shanghai since 1999. However, the strategy of using trained lay leaders to support patient self-management faces challenges in rural communities in Shanghai. This study developed a Chinese diabetes group visit program as an alternative approach to support patient self-management and examined its effectiveness on self-management behaviors, self-efficacy and health status for patients with type 2 diabetes in rural communities of Shanghai.

Methods

208 patients with type 2 diabetes aged 35–80 years were randomly assigned to the intervention group (n=119) of 12 monthly group visit sessions or to a control group (n=89) of usual care. The trial was undertaken in two rural communities in Shanghai, China. Randomization and allocation to study group were carried out by using a random number table. Analysis of covariance was used to compare changes in the 17 self-management behavior, self-efficacy and health status related variables in two groups at 12 months’ follow-up based on 176 patients (n=98; n=78).

Results

Compared with controls, the intervention patients, on average, increased their duration of aerobic exercise by more than 40 minutes per week (p=0.001); had significant increase of 0.71 in mean score on self-efficacy to manage diabetes (p=0.02); and had significant improvements in measures of illness intrusiveness and systolic blood pressure. The intervention patients attended an average of 10.1 of the 12 program sessions with 75.6% of them attended 10 and more sessions.

Conclusion

The Chinese diabetes group visit model is a feasible, acceptable and effective alternative for supporting diabetes patient self-management in Chinese rural communities. The model requires larger studies to determine its effect on blood glucose control and health care utilization.

Trial registration

ISRCTN87909028
Health insurance coverage, medical expenditure and coping strategy: evidence from Taiwan
Authors: Fang Kuangnan , Shia Ben-Chang , Ma Shuangge
Published: December 2012

Background

The health insurance system in Taiwan is comprised of public health insurance and private health insurance. The public health insurance, called “universal national health insurance” (NHI), was first established in 1995 and amended in 2011. The goal of this study is to provide an updated description of several important aspects of health insurance in Taiwan. Of special interest are household insurance coverage, medical expenditures (both gross and out-of-pocket), and coping strategies.

Methods

Data was collected via a phone call survey conducted in August and September of 2011. A household was the unit for survey and data analysis. A total of 2,424 households covering all major counties and cities in Taiwan were surveyed.

Results

The survey revealed that households with smaller sizes and higher incomes were more likely to have higher coverage of public and private health insurance. In addition, households with the presence of chronic diseases were more likely to have both types of insurance. Analysis of both gross and out-of-pocket medical expenditure was conducted. It was suggested that health insurance could not fully remove the financial burden caused by illness. The presence of chronic disease and inpatient treatment were significantly associated with higher gross and out-of-pocket medical expenditure. In addition, the presence of inpatient treatment was significantly associated with extremely high medical expenditure. Regional differences were also observed, with households in the northern, central, and southern regions having less gross medical expenditures than those on the offshore islands. Households with the presence of inpatient treatment were more likely to cope with medical expenditure using means other than salaries.

Conclusion

Despite the considerable achievements of the health insurance system in Taiwan, there is still room for improvement. This study investigated coverage, cost, and coping strategies and may be informative to stakeholders of both basic and commercial health insurance.
Speckle echocardiographic left atrial strain and stiffness index as predictors of maintenance of sinus rhythm after cardioversion for atrial fibrillation: a prospective study
Authors: Shaikh Amir Y , Maan Abhishek , Khan Umar A , Aurigemma Gerard P , Hill Jeffrey C , Kane Jennifer L , Tighe Dennis A , Mick Eric , McManus David D
Published: December 2012

Background

Echocardiographic left atrial (LA) strain parameters have been associated with atrial fibrillation (AF) in prior studies. Our goal was to determine if strain measures [peak systolic longitudinal strain (LAS) and stiffness index (LASt)] changed after cardioversion (CV); and their relation to AF recurrence.

Methods and results

46 participants with persistent AF and 41 age-matched participants with no AF were recruited. LAS and LASt were measured before and immediately after CV using 2D speckle tracking imaging (2DSI). Maintenance of sinus rhythm was assessed over a 6-month follow up. Mean LAS was lower, and mean LASt higher, in participants with AF before CV as compared to control group (11.9 ± 1.0 vs 35.7 ± 1.7, p<0.01 and 1.31 ± 0.17 vs 0.23 ± 0.01, p<0.01, respectively). There was an increase in the mean LAS immediately after CV (11.9 ± 1.0 vs 15.9 ± 1.3, p<0.01), whereas mean LASt did not change significantly after CV (p=0.62). Although neither LAS nor LASt were independently associated with AF recurrence during the follow-up period, change in LAS after cardioversion (post-CV LAS – pre-CV LAS) was significantly higher among individuals who remained in sinus rhythm when compared to individuals with recurrent AF (3.6 ± 1.1 vs 0.4 ± 0.8, p=0.02).

Conclusions

LAS and LASt differed between participants with and without AF, irrespective of the rhythm at the time of echocardiographic assessment. Baseline LAS and LASt were not associated with AF recurrence. However, change in LAS after CV may be a useful predictor of recurrent arrhythmia.
Sequence and phylogenetic analysis of highly pathogenic avian influenza H5N1 viruses isolated during 2006–2008 outbreaks in Pakistan reveals genetic diversity
Authors: Siddique Naila , Naeem Khalid , Abbas Muhammad A , Ahmed Zaheer , Malik Salman A
Published: December 2012

Background

Since the first outbreak recorded in northern areas of Pakistan in early 2006, highly pathogenic avian influenza H5N1 viruses were isolated from commercial poultry and wild/domestic birds from different areas of Pakistan up to July 2008. Different isolates of H5N1 were sequenced to explore the genetic diversity of these viruses.

Results

Phylogenetic analysis revealed close clustering and highest sequence identity in all 8 genes to HPAI H5N1 isolates belonging to unified H5 clade 2.2, sub-lineage EMA-3 recovered from Afghanistan during the same time period. Two subgroups within Pakistani H5N1 viruses, from domestic and wild birds, were observed on the basis of their sequence homology and mutations. HPAI motif, preferred receptor specificity for α-(2, 3) linkages, potential N-linked glycosylation sites and an additional glycosylation site at the globular head of HA protein of four Pakistani H5N1 isolates. While, the amino acids associated with sensitivities to various antiviral drugs (Oseltamivir, Zanamivir, Amantadine) were found conserved for the Pakistani H5N1 isolates. Conspicuously, some important mutations observed at critical positions of antigenic sites (S141P, D155S, R162I & P181S) and at receptor binding pocket (A185T, R189K & S217P) of HA-1. A high sequence similarity between Pakistani HP H5N1 and LP H9N2 viruses was also observed. Avian like host specific markers with the exception of E627K in PB2, K356R in PA, V33I in NP, I28V in M2 and L107F in NS2 proteins were also observed.

Conclusions

Various point mutations in different genes of H5 viruses from Pakistan were observed during its circulation in the field. The outbreaks started in Khyber Pakhtoon Khawa (North West) province in 2006 and spread to the Southern regions over a period of time. Though migratory birds may have a role for this continued endemicity of clade 2.2 H5N1 viruses during 2006–2008 in Pakistan, the possibility of their transmission through legal or illegal poultry trade across the borders cannot be ignored.
Association between dietary phytochemical index and 3-year changes in weight, waist circumference and body adiposity index in adults: Tehran Lipid and Glucose study
Authors: Mirmiran Parvin , Bahadoran Zahra , Golzarand Mahdieh , Shiva Niloofar , Azizi Fereidoun
Published: December 2012

Background

High intakes of phytochemical-rich foods have favorable effects on the prevention of chronic diseases. In this study we assessed the dietary phytochemical index (PI) in relation to 3-year change in weight, waist circumference (WC), body adiposity index (BAI) among Tehranian adults.

Methods

This longitudinal study was conducted in the framework of Tehran Lipid and Glucose Study, between 2006–2008 and 2009–2011, on 1938 adults, aged 19–70 y. The usual intake of participants was measured at baseline using a validated semi-quantitative food frequency questionnaire and dietary PI was calculated. Anthropometric measures were assessed both at baseline and 3 years later. Multiple regression models were used to estimate mean difference changes in anthropometrics associated with various dietary PI.

Results

The mean age of participants was 40.4 ± 13.0 y, at baseline, respectively. Mean weight gain was 1.49 ± 5.06 kg (1.65 ± 5.3 kg in men and 1.34 ± 4.9 kg in women) during 3-year period. After adjustment for potential confounding variables including age at baseline, sex, BMI, educational levels, smoking, physical activity, total energy intake, dietary intake of carbohydrate, fat and protein, dietary intakes of whole grains in the highest quartile category of PI were inversely associated with 3-year changes in weight and WC (P for trend <0.05). Dietary intake of fruits in the highest quartile was also associated with lower weight gain during the study period (P for trend <0.05). There was significant inverse association between the highest quartile category of dietary PI with the 3-year changes in weight and BAI (P for trend <0.05).

Conclusion

Higher dietary PI could have favorable effects on prevention of weight gain and reduction of body adiposity in adults.
Therapeutic efficacy of traditional Chinese medicine, Shen-Mai San, in cancer patients undergoing chemotherapy or radiotherapy: study protocol for a randomized, double-blind, placebo-controlled trial
Authors: Lo Lun-Chien , Chen Chia-Yun , Chen Shou-Tung , Chen Hung-Chang , Lee Tsung-Chieh , Chang Cheng-Shyong
Published: December 2012

Background

Cancer is one of the major health issues worldwide. An increasing number of cancer patients are offered treatment with surgery, chemotherapy and radiotherapy. Traditional Chinese medicine (TCM) is one of the most common complementary therapies offered to cancer patients in Taiwan. We designed a randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy of TCM in patients with cancer.

Methods/design

In this study, inclusion criteria are postoperative patients with histologically confirmed cancer within 3 years who are undergoing chemotherapy or radiotherapy, more than 18 years old, have given signed informed consent, have the ability to read Chinese, and the ability for oral intake.

Exclusion criteria include being pregnant, breast feeding, having completed chemotherapy or radiotherapy, brain metastasis with Eastern Cooperative Oncology Group (ECOG) performance status of two to four, delusion or hallucinations, acute infection, and have received medications under other clinical trials.

The patients were separated into an intervention group (Shen-Mai-San, SMS) and a placebo group for four weeks using a randomized, double-blind procedure. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life questionnaire (QOL-C30) was used to evaluate the quality of life. General data, hemoglobin (Hb), hematocrit (Hct), glutamic-oxalacetic transaminase (GOT), glutamic-pyruvic transaminase (GPT), blood urea nitrogen (BUN), creatinine, carcinoembryonic antigen (CEA), TCM diagnosis data and heart rate variability (HRV) were also recorded. These data were collected at baseline, two weeks and four weeks after receiving medication. The patients were prescribed granules which contained therapeutic medicines or placebo. Paired-T test was used for statistical analysis.

Discussion

Shen-Mai-San is composed of processed Ginseng radis, Liriope spicata, and Schizandrae fructus. It was found to be effective for treating cancer-related fatigue and had anti-fatigue activity. In TCM theory, SMS has a synergistic effect for qi and yin deficiency and has the ability to prevent fatigue. The symptoms of qi and yin deficiency are similar to chemotherapy- or radiotherapy-induced side effects. In order to evaluate the efficacy of SMS on cancer treatment, we designed a randomized, double-blind, placebo-controlled trial.

Trial registration

This study is registered to Clinical Trails.gov NCT01580358
Prevalence of human papillomavirus in the cervical epithelium of Mexican women: meta-analysis
Authors: Peralta-Rodríguez Raúl , Romero-Morelos Pablo , Villegas-Ruíz Vanessa , Mendoza-Rodríguez Mónica , Taniguchi-Ponciano Keiko , González-Yebra Beatriz , Marrero-Rodríguez Daniel , Salcedo Mauricio
Published: December 2012

Background

Human Papillomavirus (HPV) in cervical epithelium has been identified as the main etiological factor in the developing of Cervical Cancer (CC), which has recently become a public health problem in Mexico. This finding has allowed for the development of vaccines that help prevent this infection. In the present study, we aimed to determine the prevalence and HPV type-distribution in Mexican women with CC, high-grade squamous intraepithelial lesion (HSIL), low-grade squamous intraepithelial lesion (LSIL), and Normal cytology (N) to estimate the impact of the HPV vaccines.

Methods

The PubMed database was used to identify and review all articles that reported data on HPV prevalence in CC, precursor lesions, and normal cytology of Mexican women.

Results

A total of 8,706 samples of the tissues of Mexican women were stratified according to diagnosis as follows: 499 for CC; 364 for HSIL; 1,425 for LSIL, and 6,418 for N. According to the results, the most prevalent genotypes are the following: HPV16 (63.1%), -18 (8.6%), -58, and −31 (5%) for CC; HPV-16 (28.3%), 58 (12.6%), 18 (7.4%), and 33 (6.5%) for HSIL; HPV-16 (13.1%), 33 (7.4%), 18 (4.2%), and 58 (2.6%) for LSIL, and HPV-16 (3.4%), 33 (2.1%), 18, and 58 (1.2%) for N.

Conclusions

Taken together, genotypes 58 and 31 (10%) are more common than type 18 (8.6%) in CC. Therefore, the inclusion of these two genotypes in a second-generation vaccine would provide optimal prevention of CC in Mexico.
The role of infectious agents in urogenital cancers
Authors: Alibek Kenneth , Karatayeva Nargis , Bekniyazov Ildar
Published: December 2012

Since the late 1990s, infectious agents have been thought to play a role in the pathogenesis of approximately 15% of cancers. It is now widely accepted that infection of stomach tissue with the bacteriaHelicobacter pyloriis an important cause of stomach adenocarcinoma. In addition, oncogenic viruses, such as papilloma viruses, herpes viruses, and hepadnaviruses are strongly associated with increased risk of cervical cancer, lymphomas, liver cancer, amongst others. However, in the scientific community the percentage of cancers caused by pathogens is believed to be far higher than 15%. A significant volume of data collected to date show an association between infectious agents and urogenital cancers. These agents includeChlamydia trachomatis,Neisseria gonorrhoea,Mycoplasma genitaliumand certain viruses that have been implicated in ovarian cancer. Other pathogens include the hepatitis C and Epstein-Barr viruses, which are potentially involved in kidney cancer. In addition, infections withSchistosoma haematobium, the human papillomavirus, and human polyomaviruses are strongly associated with an increased risk of urinary bladder cancer. This article reviews publications available to date on the role of infectious agents in urogenital cancers. A greater understanding of the role of such agents could aid the identification of novel methods of urogenital cancer treatment.
Genetic diversity among Toxoplasma gondii strains from different hosts and geographical regions revealed by sequence analysis of GRA5 gene
Authors: Chen Jia , Li Zhong-Yuan , Zhou Dong-Hui , Liu Guo-Hua , Zhu Xing-Quan
Published: December 2012

Background

Toxoplasma gondii is a highly prevalent protozoan parasite infecting a wide range of animals and humans. The epidemiological and biological diversity of T. gondii has resulted in a high genetic variation and unusual population structure in this parasite. This study examined sequence diversity in dense granule 5 (GRA5) gene among T. gondii isolates from different hosts and geographical regions.

Methods

The entire genome region of the GRA5 gene was amplified and sequenced from 14 T. gondii isolates, and phylogenetic relationship among these T. gondii isolates was reconstructed using Bayesian inference (BI) and maximum parsimony (MP) based on the GRA5 sequences.

Results

The complete sequence of the GRA5 gene was 1614 bp in length for strains TgCatBr5 and MAS, but 1617 bp for the other 12 strains. Sequence analysis identified 41 (0–1.7%) variable nucleotide positions among all isolates, with 18 variations of these being in the coding region. Variable positions in the coding region resulted in 11 amino acid substitutions, and a deletion of 3 bp in the strains TgCatBr5 and MAS leading to the deletion of one amino acid. Sequence variations resulted in the existence of polymorphic restriction sites for endonucleases Aat II and Mlu I, allowing the differentiation of the three major clonal lineage types I, II and III by PCR-RFLP. Phylogenetic analyses using BI and MP supported the clear differentiation of the examined T. gondii strains into their respective genotypes.

Conclusions

This study demonstrated the existence of sequence variability in the GRA5 gene sequence among T. gondii isolates from different hosts and geographical regions, which allowed the differentiation of the examined T. gondii strains into their respective genotypes, suggesting that this highly polymorphic GRA5 locus may provide a new genetic marker for population genetic studies of T. gondii isolates.
A patient with Graves’ disease showing only psychiatric symptoms and negativity for both TSH receptor autoantibody and thyroid stimulating antibody
Authors: Hamasaki Hidetaka , Yoshimi Taro , Yanai Hidekatsu
Published: December 2012

Background

Both thyroid stimulating hormone (TSH) and thyroid stimulating antibody (TSAb) negative Graves’s disease (GD) is extremely rare. Here we present such a patient.

Case presentation

The patient was a 76-year-old woman who was diagnosed as having schizophrenia forty years ago. She did not show characteristic symptoms for hyperthyroidism, such as swelling of thyroid, exophthalmos, tachycardia and tremor, however, she showed only psychomotor agitation. Serum free triiodothyronine and free thyroxine levels were elevated and TSH level was suppressed, suggesting the existence of hyperthyroidism. However, both the first generation TSH receptor autoantibody (TRAb1) and the thyroid stimulating autoantibody (TSAb) were negative. Slightly increased blood flow and swelling was detected by thyroid echography. Thyroid scintigraphy demonstrated diffuse and remarkably elevated uptake of 123I uptake. Finally, we diagnosed her as having GD. She was treated by using methimazole, and hyperthyroidism and her psychiatric symptoms were promptly ameliorated.

Discussion

We experienced a patient with GD who did not show characteristic symptoms except for psychiatric symptoms, and also showed negativity for both TRAb1 and TSAb. Thyroid autoantibody-negative GD is extremely rare. Thyroid scintigraphy was useful to diagnose such a patient.
The trauma patient in hemorrhagic shock: how is the C-priority addressed between emergency and ICU admission?
Authors: Peiniger Sigune , Paffrath Thomas , Mutschler Manuel , Brockamp Thomas , Borgmann Matthew , Spinella Philip C , Bouillon Bertil , Maegele Marc ,   TraumaRegister DGU
Published: December 2012

Background

Trauma is the leading cause of death in young people with an injury related mortality rate of 47.6/100,000 in European high income countries. Early deaths often result from rapidly evolving and deteriorating secondary complications e.g. shock, hypoxia or uncontrolled hemorrhage. The present study assessed how well ABC priorities (A: Airway, B: Breathing/Ventilation and C: Circulation with hemorrhage control) with focus on the C-priority including coagulation management are addressed during early trauma care and to what extent these priorities have been controlled for prior to ICU admission among patients arriving to the ER in states of moderate or severe hemorrhagic shock.

Methods

A retrospective analysis of data documented in the TraumaRegister of the ‘Deutsche Gesellschaft für Unfallchirurgie’ (TR-DGU®) was conducted. Relevant clinical and laboratory parameters reflecting status and basic physiology of severely injured patients (ISS ≥ 25) in either moderate or severe shock according to base excess levels (BE -2 to -6 or BE < -6) as surrogate for shock and hemorrhage combined with coagulopathy (Quick’s value <70%) were analyzed upon ER arrival and ICU admission.

Results

A total of 517 datasets was eligible for analysis. Upon ICU admission shock was reversed to BE > -2 in 36.4% and in 26.4% according to the subgroups. Two of three patients with initially moderate shock and three out of four patients with severe shock upon ER arrival were still in shock upon ICU admission. All patients suffered from coagulation dysfunction upon ER arrival (Quick’s value ≤ 70%). Upon ICU admission 3 out of 4 patients in both groups still had a disturbed coagulation function. The number of patients with significant thrombocytopenia had increased 5-6 fold between ER and ICU admission.

Conclusion

The C-priority including coagulation management was not adequately addressed during primary survey and initial resuscitation between ER and ICU admission, in this cohort of severely injured patients.
The effect of cassia fistula emulsion on pediatric functional constipation in comparison with mineral oil: a randomized, clinical trial
Authors: Mozaffarpur Seyyed Ali , Naseri Mohsen , Esmaeilidooki Mohammad Reza , Kamalinejad Mohammad , Bijani Ali
Published: December 2012

Background

The prevalence of Pediatric Functional Constipation (FC) has been reported between 0.7% to 29.6%. This study was conducted to compare the laxative effect of cassia fistula emulsion (CFE) with mineral oil (MO) on FC. Cassia fistula is named in Traditional Iranian Medicine (TIM) as “Folus”.

Materials and methods

A randomized clinical trial was carried on 81 children (age range: 4–13 years) with FC, according to Rome III criteria in Amirkola Children’s Hospital, Babol, Iran. They received CFE or MO randomly for three weeks. CFE was produced according to the order of TIM references. Children were counted as improved when they exited from Rome III criteria of FC. Frequency of defecation, fecal incontinence, retentive posturing, severity of pain, consistency of stool and anal leakage of oily material were compared between the two groups and with baselines. An intent-to-treat analysis was used. Safety of drugs was assessed with the evaluation of clinical adverse effects.

Results

41 children were assigned randomly to receive CFE and 40 children received MO. After three weeks of medication, 84% of children in CFE group and 50% in MO group (p = 0.002) exited from the criteria of FC, so called improved. All measurable criteria improved in both groups. The frequency of defecation in CFE group improved from 1.7 per week (before the study) to 10.6 per week (at the third week) while this parameter differed in MO group from 2 to 6.1 (p < 0.001). The severity of pain during defecation and consistency of stool improved significantly better in CFE group than MO group (p < 0.05), but there were not any significant differences between the two groups in fecal incontinence and retentive posturing. Anal leakage of oily material occurred as an important complication in MO group while the children in CFE group did not complaint it. Drug’s compliances were not significantly different in the two groups. CFE and MO did not cause clinically significant side effects.

Conclusions

CFE was most effective than MO in the 3-week treatment of children with FC.
Preparation and evaluation of inhalable itraconazole chitosan based polymeric micelles
Authors: Moazeni Esmaeil , Gilani Kambiz , Najafabadi Abdolhossein Rouholamini , reza Rouini Mohamad , Mohajel Nasir , Amini Mohsen , Barghi Mohammad Ali
Published: December 2012

Background

This study evaluated the potential of chitosan based polymeric micelles as a nanocarrier system for pulmonary delivery of itraconazole (ITRA).

Methods

Hydrophobically modified chitosan were synthesized by conjugation of stearic acid to the hydrophilic depolymerized chitosan. FTIR and 1HNMR were used to prove the chemical structure and physical properties of the depolymerized and the stearic acid grafted chitosan. ITRA was entrapped into the micelles and physicochemical properties of the micelles were investigated. Fluorescence spectroscopy, dynamic laser light scattering and transmission electron microscopy were used to characterize the physicochemical properties of the prepared micelles. The in vitro pulmonary profile of polymeric micelles was studied by an air-jet nebulizer connected to a twin stage impinger.

Results

The polymeric micelles prepared in this study could entrap up to 43.2±2.27 μg of ITRA per milliliter. All micelles showed mean diameter between 120–200 nm. The critical micelle concentration of the stearic acid grafted chitosan was found to be 1.58×10-2 mg/ml. The nebulization efficiency was up to 89% and the fine particle fraction (FPF) varied from 38% to 47%. The micelles had enough stability to remain encapsulation of the drug during nebulization process.

Conclusions

In vitro data showed that stearic acid grafted chitosan based polymeric micelles has a potential to be used as nanocarriers for delivery of itraconazole through inhalation.
Broken colinearity of the amphioxus Hox cluster
Authors: Pascual-Anaya Juan , Adachi Noritaka , Álvarez Susana , Kuratani Shigeru , D’Aniello Salvatore , Garcia-Fernàndez Jordi
Published: December 2012

Background

In most eumetazoans studied so far, Hox genes determine the identity of structures along the main body axis. They are usually linked in genomic clusters and, in the case of the vertebrate embryo, are expressed with spatial and temporal colinearity. Outside vertebrates, temporal colinearity has been reported in the cephalochordate amphioxus (the least derived living relative of the chordate ancestor) but only for anterior and central genes, namely Hox1 to Hox4 and Hox6. However, most of the Hox gene expression patterns in amphioxus have not been reported. To gain global insights into the evolution of Hox clusters in chordates, we investigated a more extended expression profile of amphioxus Hox genes.

Results

Here we report an extended expression profile of the European amphioxus Branchiostoma lanceolatum Hox genes and describe that all Hox genes, except Hox13, are expressed during development. Interestingly, we report the breaking of both spatial and temporal colinearity for at least Hox6 and Hox14, which thus have escaped from the classical Hox code concept. We show a previously unidentified Hox6 expression pattern and a faint expression for posterior Hox genes in structures such as the posterior mesoderm, notochord, and hindgut. Unexpectedly, we found that amphioxus Hox14 had the most divergent expression pattern. This gene is expressed in the anterior cerebral vesicle and pharyngeal endoderm. Amphioxus Hox14 expression represents the first report of Hox gene expression in the most anterior part of the central nervous system. Nevertheless, despite these divergent expression patterns, amphioxus Hox6 and Hox14 seem to be still regulated by retinoic acid.

Conclusions

Escape from colinearity by Hox genes is not unusual in either vertebrates or amphioxus and we suggest that those genes escaping from it are probably associated with the patterning of lineage-specific morphological traits, requiring the loss of those developmental constraints that kept them colinear.