bluuebunny/crossref_metadata_2025 huggingface dataset:
A retrospective, multicenter study evaluating the prognostic value of minor salivary gland histology in a large cohort of patients with primary Sjögren’s syndrome
Authors: Carubbi F , Alunno A , Cipriani P , Bartoloni E , Baldini C , Quartuccio L , Priori R , Valesini G , De Vita S , Bombardieri S , Gerli R , Giacomelli R
Published: October 2014

Objective

The objective of this report is to investigate the prognostic value of minor salivary glands (MSG) assessment, routinely performed with hematoxilin-eosin (H&E) staining, for the diagnosis of primary Sjögren’s syndrome (pSS).

Methods

We retrospectively evaluated clinical, serological and histological features of 794 pSS patients. H&E-stained sections were assessed using the Chisholm and Mason grading system and/or the focus score (FS).

Results

FS allowed the identification of a number of differences in the disease spectrum, and its prognostic role was further confirmed by quantifying the association between FS value and clinical/serological variables with binary logistic regression. Moreover, hypocomplementemia and FS resulted the only variables associated with lymphoma at univariate analysis, and FS appeared to be associated with lymphoma independently on complement fraction concentrations. Conversely, when patients were divided according to the Chisholm and Mason grading system, we failed to observe any significant difference between subgroups.

Conclusion

In addition to its diagnostic role, our data seem to support that the routine assessment of MSG-FS with H&E staining is useful to predict at the time of diagnosis the adverse outcomes, such as lymphoma and extraglandular manifestations, that complicate the pSS course. On this basis, it should be recommended that an MSG biopsy be performed even in those patients displaying clinical and serological criteria, allowing the diagnosis of pSS independent of histological status.
Acute longitudinal myelitis following Cryptococcus laurentii pneumonia in a patient with systemic lupus erythematosus
Authors: Conti F , Spinelli F R , Colafrancesco S , Truglia S , Ceccarelli F , Fattapposta F , Sorice M , Capozzi A , Ferretti G , Priori R , Martinelli F , Pirone C , Alessandri C , Valesini G
Published: October 2014

Central nervous system (CNS) involvement in systemic lupus erythematosus (SLE) is reported in about 50% of patients. Among the neuropsychiatric features of SLE, myelopathy, including acute transverse myelitis (ATM) or acute longitudinal myelitis (ALM), represents an uncommon event. A possible vascular aetiology of SLE myelopathies has been hypothesized and it seems to be much more associated to SLE-associated antiphospholipid syndrome (APS). Furthermore, a possible infectious cause of ATM or ALM in healthy subjects has been described. SLE patients are susceptible to infection due to the disease itself or to the immunosuppressive therapy. Cryptococci non-neoformans have been rarely associated to infections in humans. Here we describe the case of a 47-year-old woman with SLE and Sjögren Syndrome who developed an ALM concurrently with a Cryptococcus laurentii pneumonia. The patient was treated with antimycotics, high doses of glucocorticoids and intravenous immunoglobulins with a significant clinical and radiological improvement. As far as we know, this is the first case of Cryptococcus laurentii infection and ALM in a patient with SLE who later developed a seronegative APS. Even though myelopathy may be considered primarily associated to SLE, a possible role of the infection in ALM development cannot be excluded.
The efficacy of calcineurin inhibitors for the treatment of interstitial lung disease associated with polymyositis/dermatomyositis
Authors: Kurita T , Yasuda S , Amengual O , Atsumi T
Published: October 2014

Interstitial lung disease (ILD) in patients with polymyositis (PM) and dermatomyositis (DM) is often resistant to treatment and life threatening, being recognized as one of the severest complication in these autoimmune disorders. Patients with clinically amyopathic dermatomyositis (CADM) or those with anti-CADM140/MDA5 antibody are especially prone to develop rapidly progressive interstitial pneumonia. We retrospectively analyzed 46 patients with PM/DM admitted to our hospital and identified DM, rapidly progressive disease, honeycomb lung, CADM and extensive ILD as risk factors for recurrence or death. In the presence of two or more risk factors, the sensitivity and specificity for the prediction of death or relapse were 81.3% and 76.7%, respectively. Calcineurin inhibitors have been widely used as induction and maintenance therapy for PM/DM-associated ILD. Recently we reported the benefit of tacrolimus on the disease-free survival and event-free survival of the patients with PM/DM-associated ILD. Among those patients treated with tacrolimus, poor prognostic factors for death, recurrence or severe adverse event were identified as acute progression of the disease, honeycomb lung, forced vital capacity (FVC) less than 80% and having DM. The potential effectiveness of an intensive therapy protocol with triple therapy that comprises high-dose corticosteroids, calcineurin inhibitors and cyclophosphamide has been reported.
Censored linear regression models for irregularly observed longitudinal data using the multivariate-t distribution
Authors: Garay Aldo M , Castro Luis M , Leskow Jacek , Lachos Victor H
Published: October 2014

In acquired immunodeficiency syndrome (AIDS) studies it is quite common to observe viral load measurements collected irregularly over time. Moreover, these measurements can be subjected to some upper and/or lower detection limits depending on the quantification assays. A complication arises when these continuous repeated measures have a heavy-tailed behavior. For such data structures, we propose a robust structure for a censored linear model based on the multivariate Student’s t-distribution. To compensate for the autocorrelation existing among irregularly observed measures, a damped exponential correlation structure is employed. An efficient expectation maximization type algorithm is developed for computing the maximum likelihood estimates, obtaining as a by-product the standard errors of the fixed effects and the log-likelihood function. The proposed algorithm uses closed-form expressions at the E-step that rely on formulas for the mean and variance of a truncated multivariate Student’s t-distribution. The methodology is illustrated through an application to an Human Immunodeficiency Virus-AIDS (HIV-AIDS) study and several simulation studies.
On the analysis of composite measures of quality in medical research
Authors: Moineddin Rahim , Meaney Christopher , Grunfeld Eva
Published: October 2014

Composite endpoints are commonplace in biomedical research. The complex nature of many health conditions and medical interventions demand that composite endpoints be employed. Different approaches exist for the analysis of composite endpoints. A Monte Carlo simulation study was employed to assess the statistical properties of various regression methods for analyzing binary composite endpoints. We also applied these methods to data from the BETTER trial which employed a binary composite endpoint. We demonstrated that type 1 error rates are poor for the Negative Binomial regression model and the logistic generalized linear mixed model (GLMM). Bias was minimal and power was highest in the binomial logistic regression model, the linear regression model, the Poisson (corrected for over-dispersion) regression model and the common effect logistic generalized estimating equation (GEE) model. Convergence was poor in the distinct effect GEE models, the logistic GLMM and some of the zero-one inflated beta regression models. Considering the BETTER trial data, the distinct effect GEE model struggled with convergence and the collapsed composite method estimated an effect, which was greatly attenuated compared to other models. All remaining models suggested an intervention effect of similar magnitude. In our simulation study, the binomial logistic regression model (corrected for possible over/under-dispersion), the linear regression model, the Poisson regression model (corrected for over-dispersion) and the common effect logistic GEE model appeared to be unbiased, with good type 1 error rates, power and convergence properties.
Lifestyle Health Behaviors of Hong Kong Chinese
Authors: Chan Choi Wan , Leung Sau Fong
Published: October 2014

Sociodemographics affect health through pathways of lifestyle choices. Using data from a survey of 467 Hong Kong Chinese, this study aims to examine the prevalence of their lifestyle behaviors, identify profiles based on their sociodemographic and lifestyle variables, and compare differences among the profile groups. Two-step cluster analysis was used to identify natural profile groups within the data set: only 37% of the participants engaged in regular physical exercises, and less than 50% monitored their dietary intake carefully. The analysis yields 2 clusters, representing a “healthy” and a “less-healthy” lifestyle group. The “less-healthy” group was predominantly male, younger, employed, and had high-to-middle levels of education. The findings reveal the lifestyle behavior patterns and sociodemographic characteristics of a high-risk group, which are essential to provide knowledge for the planning of health promotion activities.
Barriers to Qualitative Dementia Research
Authors: Carmody John , Traynor Victoria , Marchetti Elena
Published: October 2014

As our population is aging, the global prevalence of dementia is rising. Recent extensive reviews of the dementia literature highlight a clear need for additional qualitative research to address the experiences of people with dementia and their carers. To date, the vast majority of published dementia research is quantitative in nature and, perhaps not surprisingly, attracts the bulk of government funding. In contrast, qualitative dementia research is poorly resourced and less frequently published. Although a myriad of factors are responsible for this dichotomy, we propose that inadequate funding represents the “elephant in the room” of dementia research. In this article, we describe and emphasize the need for qualitative dementia research, highlight existing barriers, and outline potential solutions. Examples of barriers are provided and theoretical underpinnings are proposed.
A Unique Drug Distribution Process for Radium Ra 223 Dichloride Injection and Its Implication for Product Quality, Patient Privacy, and Delineation of Professional Responsibilities
Authors: Dansereau Raymond N.
Published: October 2014

On May 15, 2013, Bayer Healthcare Pharmaceuticals announced that it had received marketing approval for the therapeutic radioactive medication radium Ra 223 dichloride injection (Xofigo; Ra 223). The product acquisition and distribution process for hospital-based nuclear pharmacies and nuclear medicine services is unlike any other. The product is distributed as a low-risk compounded sterile preparation through a single compounding nuclear pharmacy located in Denver, Colorado, pursuant to a prescription. This model for drug distribution and delivery to the user institution has implications for product quality, patient privacy, and delineation of professional responsibilities.
A Case Report
Authors: Chen Ko-Chin , Su Tzu-Cheng , Chen Dar-Ren , Liou Jia-Hung
Published: October 2014

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic tumor that typically occurs in older adults. Patients with BPDCN usually present with solitary or multiple skin lesions. Localized or disseminated lymphadenopathy at presentation is common. A case report illustrating histopathologically proven BPDCN initially misdiagnosed as breast infiltrating ductal carcinoma in a 39-year-old woman is presented. In this case, the patient presented with a breast mass without an obvious skin lesion initially. The morphology of the tumor cells mimicked high grade breast carcinoma cells. Without complete immunohistochemical study, this case was initially misdiagnosed as infiltrating ductal carcinoma. Reviewing the previous literature about BPDCN, no case with a breast mass and an absence of characteristic skin lesions initially has been reported. The purpose for which we are discussing this case is to reduce misdiagnosis when the initial symptom is unusual.
Implications of the Implicit Association Test D-Transformation for Psychological Assessment
Authors: Blanton Hart , Jaccard James , Burrows Christopher N.
Published: October 2014

Psychometricians strive to eliminate random error from their psychological inventories. When random error affecting tests is diminished, tests more accurately characterize people on the psychological dimension of interest. We document an unusual property of the scoring algorithm for a measure used to assess a wide range of psychological states. The “D-score” algorithm for coding the Implicit Association Test (IAT) requires the presence of random noise in order to obtain variability. Without consequential degrees of random noise, all individuals receive extreme scores. We present results from an algebraic proof, a computer simulation, and an online survey of implicit racial attitudes to show how trial error can bias IAT assessments. We argue as a result that the D-score algorithm should not be used for formal assessment purposes, and we offer an alternative to this approach based on multiple regression. Our critique focuses primarily on the IAT designed to measure unconscious racial attitudes, but it applies to any IAT developed to provide psychological assessments within clinical, organizational, and developmental branches of psychology—and in any other field where the IAT might be used.
Elevated RANTES Level Is Associated With Metabolic Syndrome and Correlated With Activated Platelets Associated Markers in Healthy Younger Men
Authors: Ueba Tetsuya , Nomura Shosaku , Inami Norihito , Yokoi Takashi , Inoue Tooru
Published: October 2014

The objective of this study was to clarify the relationship of regulated on activation normal T cell expressed and secreted (RANTES) levels with metabolic syndrome (MS) and activated platelets-associated markers. We conducted a cross-sectional study of 210 healthy Japanese male volunteers (mean age 41 years old) who did not take any medications and were free of cardiovascular or cerebrovascular disease. The RANTES is correlated with age, diastolic blood pressure, and fast glucose by multivariate analysis using the cardiovascular risk factors ( R2 = .396, P < .001). The plasma RANTES level is significantly associated with MS after adjusting for age ( P = .040). Once plasma interleukin 6, an activator of platelets, and plasma platelet-derived microparticles, a marker for activated platelets, are put into the equation, plasma RANTES level is significantly correlated with the activated platelet-associated markers ( R2 = .396, P < .001). These suggest the possible role of elevated RANTES in the forerunner of atherosclerosis in healthy younger men.
The Dark Ghetto revisited: Kenneth B Clark’s classic analysis as cutting edge criminology
Authors: Currie Elliott , Goddard Tim , Myers Randolph R
Published: October 2014

In this article we revisit one of the classic works of the 1960s on crime and delinquency in poor communities: Kenneth B Clark’s Dark Ghetto. Our exploration reveals its insights to be extremely relevant today both in understanding the roots of the self-destructive violence that tears at those communities and in thinking about how to combat the structural conditions and individual mentalities that generate it. Beyond the specific theoretical and methodological lessons that can be gleaned from Dark Ghetto, Clark’s work serves as a much-needed illustration of how theoretical insights derived from intensive qualitative research that is attuned to political, historical, and economic realities—and their human consequences—can enhance criminological theory, and align with progressive movements for social change.
The guideline and target values for total volatile organic compound concentrations in industrial indoor environments in Finland
Authors: Tuomi T. , Vainiotalo S.
Published: October 2014

As an indicator of general indoor air quality in industrial facilities, the concentrations of total volatile organic compounds (TVOC) were determined in the workplaces of 37 industry sectors during the years of 2006–2011. For comparison, the TVOC levels in office-type workplaces were also determined. Based on the results, the TVOC target and guideline values are proposed for industrial workplaces. The geometric mean and median concentrations in the industrial workplaces were 778 and 845 µg/m3, respectively, while the 90th, 25th percentiles were, respectively, 6616 and 270 µg/m3. In the office-type environments, the geometric mean and median concentrations were 55 and 50 µg/m3, and the 90th and 25th percentiles were 230 and 27 µg/m3. Based on the measured TVOC distributions and the target values previously set, we propose a TVOC target value of 300 µg/m3 and guideline value of 3000 µg/m3 for the general indoor air in industrial workplaces. The concentration of 3000 µg/m3 could be achieved with reasonable measures by most industry sectors, but does not guarantee that the inhalation exposure to volatile organic compounds in the occupational environments is free from health concerns or perceived discomfort. Therefore, when reasonably achievable, a TVOC concentration close to or below the target value is recommended. This would make the TVOC levels in industrial facilities similar to those in the non-occupational indoor environments.
Nobody’s Innocent
Authors: Buechel Berno , Emrich Eike , Pohlkamp Stefanie
Published: October 2014

Customers who boycott an organization after some scandal may actually exacerbate the fraud problem they would like to prevent. This conclusion is derived from a game-theoretic model that introduces a third player into the standard inspection game. Focusing on the example of doping in professional sports, we observe that doping is prevalent in equilibrium because customers undermine an organizer’s incentives to inspect the athletes. Establishing transparency about doping tests is necessary but not sufficient to overcome this dilemma. Our analysis has practical implications for the design of anti-doping policies as well as for other situations of fraudulent activities.
Treatment Guided by an Online Course
Authors: Ford Hannah A. , Nangle Douglas W.
Published: October 2014

This article describes the successful treatment of a 16-year-old female presenting with chronic posttraumatic stress disorder (PTSD) related to alleged childhood sexual abuse using trauma-focused cognitive behavioral therapy (TF-CBT). Treatment was delivered by a graduate student who learned the treatment through the completion of an online training course and was supervised by a licensed clinical psychologist. Both the student and the supervisor had extensive training and experience in the delivery of cognitive behavioral therapy (CBT) interventions for adolescents. Several challenges were encountered, most notably the reemergence of legal proceedings related to the alleged abuse during the course of treatment. Treatment implications are discussed, including the need to tailor manualized treatments for particular clients and the utility of online training courses. Overall, this case study adds to the limited literature on the treatment of chronic PTSD in adolescents and provides support for the transportability of TF-CBT to practice settings, as well as the dissemination potential of an online course.
Past Forward
Authors: Shevah Dana , Kallus Rachel
Published: October 2014

This article argues that planning benefits from a historical perspective, affording planners better understanding of current contexts, situations, and the different actors involved. This article draws on integrated historical knowledge acquired from archival research and fieldwork in order to discuss Moshav Gadish, planned and implemented as part of Israel’s nation-building project in the 1950s. Combining official planning material and residents’ personal stories, it highlights the gap between planning intentions and actuality on the ground. A “thick description” of Gadish, derived from the need for deeper understanding of previous planning decisions, emphasizes current planning issues and suggests future planning approaches.
Diagnostic performance of CE-MRA in grading stenosis and therapy planning with TASC II classification
Authors: Wurz Clemens , Davari Amir , Ackermann Hanns , Vogl Thomas J
Published: October 2014

Objectives

To assess to what extent results of CE-MRA coincide with DSA in grading of stenosis and planning of therapy in patients with PAOD.

Materials and methods

Retrospectively, images of 71 PAOD-patients were studied by three observers. For evaluation, the lower limb was subdivided into 31 segments and categorized with TASCII-score.

Results

In grading stenosis, both modalities agreed in 93.26%. CE-MRA achieved sensitivity of 92.69% and specificity of 96.87% (κ = 0.88). The concordance of TASCII-classification was almost perfect.

Conclusion

CE-MRA is an excellent method for the evaluation of PAOD with some tendency to overrate the grade of stenosis.
Comparison of morphological and rheological conditions between conventional and eversion carotid endarterectomy using computational fluid dynamics – a pilot study
Authors: Demirel S , Chen D , Mei Y , Partovi S , von Tengg-Kobligk H , Dadrich M , Böckler D , Kauczor HU , Müller-Eschner M
Published: October 2014

Purpose:

To compare postoperative morphological and rheological conditions after eversion carotid endarterectomy versus conventional carotid endarterectomy using computational fluid dynamics.

Basic methods:

Hemodynamic metrics (velocity, wall shear stress, time-averaged wall shear stress and temporal gradient wall shear stress) in the carotid arteries were simulated in one patient after conventional carotid endarterectomy and one patient after eversion carotid endarterectomy by computational fluid dynamics analysis based on patient specific data.

Principal findings:

Systolic peak of the eversion carotid endarterectomy model showed a gradually decreased pressure along the stream path, the conventional carotid endarterectomy model revealed high pressure (about 180 Pa) at the carotid bulb. Regions of low wall shear stress in the conventional carotid endarterectomy model were much larger than that in the eversion carotid endarterectomy model and with lower time-averaged wall shear stress values (conventional carotid endarterectomy: 0.03–5.46 Pa vs. eversion carotid endarterectomy: 0.12–5.22 Pa).

Conclusions:

Computational fluid dynamics after conventional carotid endarterectomy and eversion carotid endarterectomy disclosed differences in hemodynamic patterns. Larger studies are necessary to assess whether these differences are consistent and might explain different rates of restenosis in both techniques.
The incidence and morphological features of pyramidal lobe on thyroid ultrasound
Authors: Mortensen C , Lockyer H , Loveday E
Published: October 2014

The aim of this article is to document the incidence and appearances of the pyramidal lobe of the thyroid gland, and discuss the clinical relevance of this entity in sonographic practice. A prospective study was undertaken over a period of 10 months. A total of 416 consecutive patients attending head and neck ultrasound lists were scanned by a single experienced radiologist or an advanced practitioner sonographer. At the time of reporting, the presence of a pyramidal lobe was recorded. The anatomical morphology was classified into five subgroups devised for the purposes of the study. Appearances were documented in both normal and pathological glands. Of the total number of patients scanned, 90 patients were found to have pyramidal lobes, giving an overall incidence of 21%. In all, 51% were found to originate from the right of the isthmus, 46% from the left and 2% from the midline. One patient had two pyramidal lobes. A significant number of patients having routine neck ultrasounds have an incidental finding of a pyramidal lobe. Ultrasound is an effective modality for the demonstration and classification of the pyramidal lobe, as well as identification of pathology. It is important for radiologists to be aware of this normal variation, as it may be the site of primary or recurrent thyroid pathology. Radiologists should report it where relevant to ensure adequate surgical treatment of pathological glands.
Morphological and functional relationships with ultrasound measured muscle thickness of the upper extremity and trunk
Authors: Abe Takashi , Loenneke Jeremy P. , Thiebaud Robert S. , Loftin Mark
Published: October 2014

Unless a subject’s muscle is relatively small, a single image from a standard ultrasound can only measure muscle thickness (MT). Thus, it is important to know whether MT is related to morphological and functional characteristics of individual muscles of the extremity and trunk. In this review, we summarize previously published articles in the upper extremity and trunk demonstrating the relationships between ultrasound-measured MT and muscle morphology (cross-sectional area, CSA and muscle volume, MV) and muscular or respiratory function. The linear relationship between MT and muscle CSA or MV has been observed in biceps brachii, triceps brachii, pectoralis major, psoas major, and supraspinatus muscles. Previous studies suggest that MT in the upper arm and trunk may reflect muscle CSA and MV for the individual muscles. Unfortunately, few studies exist regarding the functional relationship with ultrasound MT in the upper extremity and trunk. Future research is needed to investigate these findings further.
‘Diversity’ policies, integration and internal security: The case of France
Authors: Mattelart Tristan , Hargreaves Alec G
Published: October 2014

The term ‘cultural diversity’ has been widely used in France since the beginning of the 21st century as a standard way of referring to policies aimed at improving the representation of ethnic minorities in the audio-visual media. Frequently invoked, the notion of ‘diversity’ is seldom questioned. While endowed with a powerful incantatory power, it is not without its problems. Its looseness obfuscates the policy objectives pursued in its name, just as its seeming novelty prevents us from seeing those initiatives in a historical perspective. Tracing the genealogy of diversity policies in France, this article demonstrates that they have sought not only to promote the integration of ethnic minorities but also – and no less importantly – to protect internal security.
The perils of early study discontinuation
Authors: Nusbaum Neil
Published: October 2014

Clinical trials in medicine often derive their financial support from the manufacturer of a device or pharmaceutical, but one must view with caution trial designs that allow an interested sponsor to terminate data collection.
Oral verapamil in paroxysmal supraventricular tachycardia recurrence control: a randomized clinical trial
Authors: Shaker Hossein , Jahanian Fatemeh , Fathi Marzieh , Zare MohammadAmin
Published: October 2014

Background:

Adenosine is the first-line medication in patients with paroxysmal supraventricular tachycardia. Because it is cleared so rapidly from the circulation, recurrence of paroxysmal supraventricular tachycardia after initial successful conversion may occur.

Objective:

This study was conducted to evaluate the role of oral verapamil administration to control early recurrences of paroxysmal supraventricular tachycardia after adenosine infusion.

Methods:

Patients with acute paroxysmal supraventricular tachycardia and no contraindications for adenosine or verapamil treatment were included in study. All patients received an adenosine protocol (6 mg rapid bolus intravenous injection followed by two repeated doses of 12 mg if necessary). Patients in the adenosine-only group did not received any other medications but patients in the adenosine/verapamil group received 40 mg verapamil orally immediately after converting the rhythm to sinus rhythm. All patients were followed up for 6 h in the acute care area of the emergency department under continuous cardiac monitoring.

Results:

A total of 113 patients were assessed for eligibility and 92 patients were randomized into two groups (adenosine only versus adenosine/verapamil). There was no statistically significant difference in paroxysmal supraventricular tachycardia recurrence rate between the two groups in the first 30 min after treatment. Recurrence rate was statistically significantly lower in the adenosine/verapamil group than in the adenosine-only group between 30 and 120 min after treatment and thereafter. Two patients in the adenosine-only group experienced flushing and one patient in the adenosine/verapamil group experienced decreased systolic blood pressure.

Conclusion:

Oral verapamil can decrease paroxysmal supraventricular tachycardia recurrence after successful control with intravenous adenosine.
Maternal Self-efficacy and Family Health Routines
Authors: James Kathy , Matsangas Panagiotis , Connelly Cynthia D.
Published: October 2014

Purpose: Family health is a system comprising routines or habitual practices. This study investigated the relationships between maternal self-efficacy (SE) and obesity, habitual smoking, breastfeeding, and children’s sleeping patterns. Methods: Participants (98 women) attending a weight loss clinic reported on themselves and their 172 biological children. Mothers provided demographic information for parents and children and completed the 20-item Family Nutrition and Physical Activity Scale (FNPA). Maternal SE was assessed with a 13-item Confidence Survey, which measures confidence to carry out activities related to healthy family meals and family activity. FNPA results have been reported in an earlier publication. Results: Normal-weight mothers had more favorable (higher) SE scores compared with overweight mothers. There were positive relationships between SE and the FNPA and children’s sleep patterns in younger children. There were no significant relationships between SE and children’s body mass index (BMI), breastfeeding patterns, or parental smoking habits. Higher SE was associated with FNPA constructs related to family and meal patterns, restriction/reward, screen time behavior and monitoring, family activity involvement and family routine. Children’s BMI was correlated with mother’s FNPA score. Breastfeeding was associated with only the family environment construct of FNPA and ethnicity. Conclusion: This study looked at relationships between SE and selected behaviors that have been associated with family health. Maternal SE has positive relationships with some healthy habits/family routines. More research is needed regarding the factors that influence SE in family systems for health promotion.
A Superhumanization Bias in Whites’ Perceptions of Blacks
Authors: Waytz Adam , Hoffman Kelly Marie , Trawalter Sophie
Published: October 2014

The present research provides the first systematic empirical investigation into superhumanization, the attribution of supernatural, extrasensory, and magical mental and physical qualities to humans. Five studies test and support the hypothesis that White Americans superhumanize Black people relative to White people. Studies 1–2b demonstrate this phenomenon at an implicit level, showing that Whites preferentially associate Blacks versus Whites with superhuman versus human words on an implicit association test and on a categorization task. Studies 3–4 demonstrate this phenomenon at an explicit level, showing that Whites preferentially attribute superhuman capacities to Blacks versus Whites, and Study 4 specifically shows that superhumanization of Blacks predicts denial of pain to Black versus White targets. Together, these studies demonstrate a novel and potentially detrimental process through which Whites perceive Blacks.
Outpatient rigid cystoscopy: Is it acceptable to women?
Authors: Basak Sambita , Johnson Helen , Pradhan Ashish
Published: October 2014

Objective:

Flexible cystoscopy is commonly performed as an outpatient procedure whereas rigid cystoscopy is performed under general anaesthesia by urogynaecologists because of a perception that it is painful. The aim of this study is to assess women’s experience of outpatient cystoscopy (OC) with rigid cystoscope.

Materials and methods:

The first 56 women who attended our newly established OC service with rigid cystoscope were recruited prospectively for the study. They were requested to complete a questionnaire (with visual analogue scale) based on their expectations prior to the procedure. A post-procedure questionnaire was given to quantify their experience after the OC. Two patients were excluded from the study as they did not complete the questionnaire appropriately. Wilcoxon signed ranks test was used to compare the scores for comfort, pain and anxiety in the pre- and post-procedure questionnaires.

Results:

A total of 52/54 patients (96.3%) were fully satisfied at the end of the procedure as indicated in their visual analogue scale score of 10/10. Most patients found the procedure more comfortable and less painful than expected. There were no post-operative complications.

Conclusion:

OC with a rigid cystoscope is a well-tolerated, safe, cost-effective ambulatory service resulting in good patient experience.
A critical examination of the climate engineering moral hazard and risk compensation concern
Authors: Reynolds Jesse
Published: October 2014

The widespread concern that research into and potential implementation of climate engineering would reduce mitigation and adaptation is critically examined. First, empirical evidence of such moral hazard or risk compensation in general is inconclusive, and the empirical evidence to date in the case of climate engineering indicates that the reverse may occur. Second, basic economics of substitutes shows that reducing mitigation in response to climate engineering implementation could provide net benefits to humans and the environment, and that climate engineering might theoretically increase mitigation through strong income effects. Third, existing policies strive to promote other technologies and measures, including climate adaptation, which induce analogous risk-compensating behaviours. If the goal of climate policy is to minimize climate risks, this concern should not be grounds for restricting or prohibiting climate engineering research. Three potential means for this concern to manifest in genuinely deleterious ways, as well as policy options to reduce these effects, are identified.
Developing role models for health in the fire service: a pilot case study
Authors: Cheskin Lawrence J , Abel Michelle L , Bailey Maryanne M , Burnett Monica , Frutchey Robin , Goheer Attia , Ram Anita , Pollack Keshia M
Published: October 2014

Summary

Objectives

The objectives of this case study were to develop role models for health in the fire service through knowledge and behaviour change, to improve the role models’ own health, and to facilitate behaviour change in other firefighters through their example.

Design

Volunteers interested in improving their own health and serving as role models to others in the fire service were identified at a statewide Maryland fire service leadership meeting.

Setting

Participants worked with the Johns Hopkins Weight Management Center to learn how to improve their own health and shared that knowledge with others in their fire departments.

Participants

Three Maryland fire service leaders were recruited at a leadership meeting with the goal of improving their own health and becoming role models. One participant dropped out shortly after beginning, while two male participants, aged 57 and 61, completed the study.

Main outcome measures

Quantitative measures were collected at baseline and 12 months, and included weight, blood pressure and fasting glucose and cholesterol. Semi-structured interviews were conducted approximately 14 months postintervention to determine the participants’ perceptions of their own health and impact on others in the fire service.

Results

Each participant had biweekly to monthly visits over a one-year period to learn the knowledge and skills that would assist him with improving dietary behaviours, increasing fitness and achieving a healthy weight. Case study participants experienced reductions in body weight (−13% and −11% of total body weight), glucose and blood pressure. Qualitative one-on-one interviews conducted postintervention with the participants revealed that they embraced their status as role models and felt their success inspired other firefighters. Their experiences suggest that role models can play an important role in helping firefighters increase self-efficacy, self-regulation and social support in the workplace environment.

Conclusions

These findings provide promising evidence for the use of role models to improve health, especially in the workplace.
Much more than gastro-enteritis: a severe case of hypo-pituitarism
Authors: Vandermolen Sebastian , Anandagoda Nelomi , Krishnakumar Sarietha
Published: October 2014

Lesson

While well described in text books, acute presentations of hypo-pituitarism are rare and must be considered when patients present with vague symptoms with poor response to standard resuscitation procedures.
Hospital-wide infection control practice and Meticillin-resistant Staphylococcus aureus (MRSA) in the intensive care unit (ICU): an observational study
Authors: Thompson David S , Workman Rella
Published: October 2014

Summary

Objectives

To estimate trends in infection/colonisation with meticillin-resistant Staphylococcus aureus (MRSA) in an intensive care unit (ICU).

Design

Observational study of results of ICU admission and weekly screens for MRSA.

Setting and Participants

All ICU admissions in 2001–2012.

Interventions

ICU admissions were screened for MRSA throughout. In late 2006, screening was extended to the whole hospital and extra measures taken in ICU.

Main outcome measures

Prevalence of MRSA in ICU admissions and number acquiring MRSA therein.

Results

In all, 366 of 6565 admissions to ICU were MRSA positive, including 270 of 4466 coming from within the hospital in which prevalence increased with time prior to transfer to ICU. Prevalence in this group was 9.4% (8.2–10.6) in 2001–2006, decreasing to 3.4% (2.3–4.5) in 2007–2009 and 1.3% (0.6–2.0) in 2010–2012, p < 0.001, due to decreased prevalence in those spending >5 days on wards before ICU admission: 18.9% (15.6–22.2) in 2001–2006, 7.1% (4.0–10.2) in 2007–2009 and 1.6% (0.1–3.1) in 2010–2012, p < 0.001. In addition, 201 patients acquired MRSA within ICU, the relative risk being greater when known positives present: 4.34 (3.98–4.70), p < 0.001. Acquisition rate/1000 bed days decreased from 13.3 (11.2–15.4) in 2001–2006 to 3.6 (2.6–4.6) in 2007–2012, p < 0.0001. Of 41 ICU-acquired MRSA bacteraemias, 38 were in 2001–2006. The risk of bacteraemia in those acquiring MRSA decreased from 25% (18.1–31.9) in 2001–2006 to 6.1% (0–12.8) thereafter, p = 0.022.

Conclusions

Following better hospital-wide infection control, fewer MRSA-positive patients were admitted to ICU with a parallel decrease in acquisition therein. Better practice there reduced the risk of bacteraemia.
Retrospective observational study examining indications for hospitalisation among haemodialysis patients at one of the Ministry of Health Hospitals in Makkah, Saudi Arabia
Authors: Hassanien Amal A , Majeed Azeem , Watt Hilary
Published: October 2014

Summary

Objectives

To examine the indications for hospitalisations among haemodialysis patients.

Design

A retrospective observational study.

Setting

Alnoor Kidney Centre in Al Noor Specialist Hospital, Makkah City, Saudi Arabia, which is a Ministry of Health hospital.

Participants

Participants were prevalent patients with end-stage renal disease on regular haemodialysis in 2011, who had received haemodialysis for more than three months. Each patient was followed up retrospectively, from the first date of initiating haemodialysis to the end of 2011.

Main outcome measures

(i) The primary reasons for hospital admissions and (ii) risk factors that increase the number of hospital admissions and which increase length of stay in hospital.

Results

The primary reasons for hospital admissions associated with increases in the length of stay in hospital were diseases of the circulatory system (which increased hospital bed days by 70%; 95% CI: 11–161%; p value = 0.01 compared to all other reasons). The risk factors that increased the number of hospital admissions per patient-year at risk were increasing age (incidence rate ratio [IRR] = 1.02 per 1 year of age; 95% CI: 1.01–1.03; p value = < 0.0001); receiving haemodialysis through a catheter compared to arteriovenous fistula (IRR = 2.55; 95% CI: 1.14–4.97; p value = 0.001) and diabetes as a cause of renal disease compared to hypertension (IRR = 1.84; 95% CI: 1.29–2.63; p value = 0.001).

Conclusion

Indications for hospitalisation and consequences of practices related to hospitalisation for haemodialysis patients should be studied in further research to provide a comprehensive evidence-based management policy for haemodialysis patients in Saudi Arabia.
Using stakeholder perspectives to develop an ePrescribing toolkit for NHS Hospitals: a questionnaire study
Authors: Lee Lisa , Cresswell Kathrin , Slee Ann , Slight Sarah P , Coleman Jamie , Sheikh Aziz
Published: October 2014

Summary

Objective

To evaluate how an online toolkit may support ePrescribing deployments in National Health Service hospitals, by assessing the type of knowledge-based resources currently sought by key stakeholders.

Design

Questionnaire-based survey of attendees at a national ePrescribing symposium.

Setting

2013 National ePrescribing Symposium in London, UK.

Participants

Eighty-four delegates were eligible for inclusion in the survey, of whom 70 completed and returned the questionnaire.

Main outcome measures

Estimate of the usefulness and type of content to be included in an ePrescribing toolkit.

Results

Interest in a toolkit designed to support the implementation and use of ePrescribing systems was high ( n = 64; 91.4%). As could be expected given the current dearth of such a resource, few respondents ( n = 2; 2.9%) had access or used an ePrescribing toolkit at the time of the survey. Anticipated users for the toolkit included implementation ( n = 62; 88.6%) and information technology ( n = 61; 87.1%) teams, pharmacists ( n = 61; 87.1%), doctors ( n = 58; 82.9%) and nurses ( n = 56; 80.0%). Summary guidance for every stage of the implementation ( n = 48; 68.6%), planning and monitoring tools ( n = 47; 67.1%) and case studies of hospitals’ experiences ( n = 45; 64.3%) were considered the most useful types of content.

Conclusions

There is a clear need for reliable and up-to-date knowledge to support ePrescribing system deployments and longer term use. The findings highlight how a toolkit may become a useful instrument for the management of knowledge in the field, not least by allowing the exchange of ideas and shared learning.
Temporal Dynamics of Attentional Bias
Authors: Zvielli Ariel , Bernstein Amit , Koster Ernst H. W.
Published: October 2014

Biases of emotional attention are believed to be central to human (mal)adaptation and multiple forms of psychopathology. Yet fundamental questions remain regarding the nature and empirical study of attentional bias (AB). We thus aimed to (a) test a novel conceptualization and related operationalization of AB expression in time and (b) illuminate the nature of AB and specifically its temporal expression. We examined AB expression in time by means of a novel trial-level bias score (TL-BS) analysis of dot probe task data in two experiments—among spider phobics and healthy controls, and among smoking-deprived daily smokers. Findings revealed evidence of the dynamic expression of AB in time; furthermore, TL-BS parameters demonstrated unique associations with psychopathology and addiction beyond traditional bias score. The present research may help to bring the conceptualization and quantification of AB closer to the nature of the phenomenon and thereby advance basic and clinical knowledge.
Risk for Revision After Anterior Cruciate Ligament Reconstruction Is Higher Among Adolescents
Authors: Faunø Peter , Rahr-Wagner Lene , Lind Martin
Published: October 2014

Background:

The number of children and adolescents with anterior cruciate ligament (ACL) reconstructions is increasing, and disturbing reports on high rerupture rates in this group have been noted.

Purpose:

To describe the outcome of ACL reconstruction in children and adolescents based on data from the Danish Knee Ligament Reconstruction Registry (DKRR).

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Data were retrieved from the DKRR, a national population-based registry. The analysis was based on a population of 14,806 ACL-reconstructed patients. The outcome was evaluated using risk of ACL revision, subjective outcome score (Knee injury and Osteoarthritis Outcome Score [KOOS]), Tegner function score, and objective knee laxity. Three age groups were defined (A, <13 years; B, 13-15 years; and C, 15-20 years) and compared with D, patients ≥20 years (adults). There were 95 patients in group A, 327 in B, 2888 in C, and 11,496 in D.

Results:

There was a significantly increased risk of revision surgery in the age groups B (6.7%) and C (4.9%) compared with the adults in group D (2.0%). Objective knee laxity did not differ between the 4 groups. Groups A, B, and C had a higher score on the combined KOOS symptoms, pain, sport, and quality of life subscales (KOOS4; 79.6, 76.6, and 73.1, respectively) compared with the adults (69.7). Group B had higher KOOS quality of life (76.6) and sports (71.1) scores than did group C (73.1 and 66.4, respectively). The Tegner activity score did not differ between the 4 groups. No impact of the use of extracortical graft fixation was detected in the youngest age group.

Conclusion:

Study results indicated an increased risk of graft failure in patients between 13 and 20 years of age. This is in contrast to the better subjective and equal objective knee score found in the same age groups.

Clinical Relevance:

The new knowledge about the high revision rate among ACL-reconstructed teenagers is important for evidence-based preoperative information of ACL patients and their parents.
Critical Assessment 9: Wrought magnesium alloys
Authors: Robson J. D.
Published: October 2014

This assessment is focussed on wrought magnesium alloys for lightweight applications, particularly in the transport sector. The challenges to their wider use are summarised, including poor low temperature formability, corrosion issues, dissimilar metal joining, and limited precipitation strengthening. The fundamental origins of these challenges, and current research to address them, are highlighted. Key developments such as the use of dilute rare earth additions to manipulate texture for improved formability are discussed. Opportunities to exploit the unique properties of wrought magnesium alloys where further research is required are identified.
The formin DIAPH1 (mDia1) regulates megakaryocyte proplatelet formation by remodeling the actin and microtubule cytoskeletons
Authors: Pan Jiajia , Lordier Larissa , Meyran Deborah , Rameau Philippe , Lecluse Yann , Kitchen-Goosen Susan , Badirou Idinath , Mokrani Hayat , Narumiya Shuh , Alberts Arthur S. , Vainchenker William , Chang Yunhua
Published: October 2014

Key Points

DIAPH1 (mDia1) is involved in both Rho-mediated actin polymerization and microtubule assembly and stability during proplatelet formation.
Interleukin 27 inhibits cytotoxic T-lymphocyte-mediated platelet destruction in primary immune thrombocytopenia
Authors: Zhou Hai , Qiu Ji-hua , Wang Tong , Yu Ying-yi , Liu Xue-na , Li Xin , Wang Ya-wen , Hou Yu , Li Li-zhen , Liu Xin-guang , Hou Ming , Peng Jun
Published: October 2014

Key Points

IL-27 inhibits CTL cytotoxicity toward autologous platelets via decreasing granzyme B expression in ITP.