bluuebunny/crossref_metadata_2025 huggingface dataset:
From HIV diagnosis to initiation of treatment: Social transformation among people starting antiretroviral therapy in Peru
Authors: Waters Chloe , Wong Milagros , Nelson Adrianne Katrina , SantaCruz Janeth , Beeson Amy , Pfeiffer James , Muñoz Maribel , Castro Arachu , Shin Sonya
Published: August 2015

Social support is a key, yet elusive resource for HIV patients living in poverty in Lima, Peru. Despite a greater need for health services and encouragement from others, economic restraints, stigma, and trouble negotiating a fractured health system act as hurdles to accessing support. In this study, 33 people with HIV and 15 of their treatment supporters were interviewed upon initiation of antiretroviral therapy in order to understand changes in social support during this critical time, and how these changes affected their well-being. Everyone’s social network underwent dramatic transformation, while some were rejected upon disclosure by people they knew, many successfully trimmed their social circles to a few trusted parties. Treatment supporters were most frequently the first to whom they disclosed their HIV status, and most backed the person with HIV, although sometimes out of obligation. HIV peers became a vital new source of strength. Ultimately, people with HIV who successfully reorganized their social network drew personal strength and self-worth from new and old relationships in their lives.
Sexual Selection and Humor in Courtship
Authors: Hall Jeffrey A.
Published: August 2015

This investigation examines a sexual selection-based argument regarding humor’s role in courtship (i.e., humor production signals intelligence/creativity). Lens model ( n =100) analyses suggest that humor production on Facebook profiles were self-reported and perceived to be associated with extroversion, not intelligence. Study 2 ( n = 289) found that extroversion was associated humor production, but high school and college grade point average and American College Test (ACT) scores were not. In Study 3, pairs of opposite-sex strangers ( n = 102) interacted for 10–12 min. Males’ humor production and females’ responsive laughter were both associated with females’ dating interest. Both partners’ dating interest was associated with simultaneous laughter. Without support for the sexual selection argument, three alternative explanations of humor’s role in courtship are discussed.
Mapping rule and subversion: Perspective and the democratic turn in Machiavelli scholarship
Authors: Litvin Boris
Published: August 2015

This paper engages the debate within the ‘democratic turn’ in Machiavelli scholarship, where an ‘institutional’ approach has celebrated Machiavelli's theorisation of the institutions under which the people can rule while a ‘no-rule’ approach has traced Machiavelli's attention to the popular capacity to subvert all relations of rule. What do we make of Machiavelli's concurrent reception as a champion of popular rule and an antagonist to all rule? I argue that both institutionalising and subversive impulses appear simultaneously in Machiavelli's works, though in a dynamic for which neither of the democratic approaches adequately accounts – namely, a rhetorical dimension of Machiavelli's works wherein political knowledge unfolds from a continuous multiplicity of perspectives and the ensuing implication that perspective is crafted and shaped through political action. Perspectival readings of Machiavelli's accounts of the Capuan debate and the Ciompi rebellion thus reveal that both democratic approaches have neglected to question certain ‘princely’ orientations toward political action inherited in their conceptualisations of Machiavellian democracy. In contrast, I suggest that Machiavelli's comedy La Mandragola offers an opportunity to reframe perspective as a uniquely democratic phenomenon. Reading the comedy alongside the democratic turn, I argue that it enacts, satirises and even casts doubts on Machiavelli's princely lessons, in turn proposing a popular capacity to cultivate perspective in a newly organised public space.
Ozone Ameliorates Doxorubicine-Induced Skin Necrosis - results from an animal model
Authors: Kesik Vural , Yuksel Ramazan , Yigit Nuri , Saldir Mehmet , Karabacak Ercan , Erdem Galip , Babacan Oguzhan , Gulgun Mustafa , Korkmazer Nadir , Bayrak Ziya
Published: August 2015

Doxorubicin (DXR) extravasation result with serious morbidity like skin ulceration and necrosis. The purpose of this study is to determine the protective effects of ozone, olive oil, dimethyl sulfoxide (DMSO), and coenzyme Q10 in the treatment of DXR-induced skin ulcers on rats. After an intradermal injection of DXR on a basis of an animal extravasation model, the materials were topically applied. The ulcer sizes were measured, and a punch biopsy was taken from the extravasation site in which the skin ulcers formed at the end of the experiment. The samples were analyzed for tumor necrosis factor alpha (TNF-α), interleukin 1-beta (IL1β), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) enzymes, and examined histopathologically. The ulcer sizes clearly decreased in the study groups, including DMSO, olive oil, ozone plus coenzyme Q10, and ozone plus olive oil groups in comparison with the control group with the exception of the coenzyme Q10 group. The malondialdehyde levels were lower in the DMSO, olive oil, ozone plus olive oil, and ozone plus coenzyme Q10 groups than they were in the control group, but they were not significantly different. The TNF-α level was lower in the DMSO, ozone plus olive oil, coenzyme Q10, and ozone plus coenzyme Q10 groups in comparison with the control group. There was no significant change in the SOD, GSH-Px, and IL1β levels in the study groups in comparison with the control and the sham groups. The ozone plus olive oil group could be considered to be an alternate therapy for skin ulcers due to DXR extravasation.
Repairing Pretibial and Foot Soft Tissue Defects With Reverse Transplantation of the Medial Crural Fasciocutaneous Flap
Authors: Wu Jin , Wu Jin , Gong Xingxing , Ding Zhenqi , Lin Bin , Chen Zhida , Guo Zhimin
Published: August 2015

Soft tissue defects of the pretibial area and the foot are among the most common complications in patients with lower extremity injuries and remain a challenge for surgeons. This study examined the clinical effects of repairing pretibial and foot soft tissue defects with a medial crural fasciocutaneous flap. Twenty-three injury cases with soft tissue defects in the middle/lower parts of the tibia and ankle/heel were treated. Of these, 8 injuries were in the lower pretibial region, 11 injuries were in the heel, and 4 injuries were in the dorsalis pedis. The dimensions of the soft tissue defects ranged from 7 cm × 5 cm to 18 cm × 10 cm. The crural fasciocutaneous flap was used for wound repair in all cases. The skin harvest dimensions ranged from 12 cm × 6 cm to 23 cm × 12 cm, and the width of the reverse flap pedicle was greater than 4 cm. The patients were followed up for 6 to 27 months postsurgery. All flaps survived and appeared healthy, and leg function was satisfactorily recovered. Five patients suffered from distal flap necrosis and 2 patients suffered from effusion. The area of the crural fasciocutaneous flap harvest appeared to have a good blood supply, and the procedure was easy to perform without injuries to the main vasculature. In conclusion, the medial crural fasciocutaneous flap is a safe and effective clinical intervention for the reconstruction of soft tissue defects of the pretibial area and foot.
The Buruli Ulcer
Authors: Kumar Satendra , Basu Somprakas , Bhartiya Satyanam Kumar , Shukla Vijay Kumar
Published: August 2015

Buruli ulcer (BU) is caused by Mycobacterium ulcerans and can manifest as a simple nodule or as aggressive skin ulcers leading to debilitating osteoarthritis or limb deformity. The disease is more prevalent in those living in remote rural areas, especially in children younger than 15 years. The exact mode of transmission is possibly through traumatic skin lesions contaminated by M ulcerans. IS2404 polymerase chain reaction from ulcer swabs or biopsies is a rapid method for confirmation of BU. In coendemic countries, HIV infection complicates the progression of BU, leading to rapidly spreading osteomyelitis. Treatment is principally medical, with antitubercular drugs, and surgery is utilized for complicated disease. Because of ineffective vaccination, primary prevention is the best option for control of the disease.
Tissue-engineered tubular substitutions for urinary diversion in a rabbit model
Authors: Meng Lingchao , Liao Wenbiao , Yang Sixing , Xiong Yunhe , Song Chao , Liu Lingqi
Published: August 2015

Clinically, autologous gastrointestinal segments are traditionally used for urinary diversion. However, this procedure often causes many serious complications. Tissue engineering may provide an alternative treatment method in urinary diversion. This research aims to produce tissue-engineered tubular substitutions by using homologous adipose-derived stem cells, smooth muscle cells, and bladder acellular matrix in developing urinary diversion in a rabbit model. Adipose-derived stem cells and smooth muscle cells of rabbit were obtained and cultured in vitro. These cultured adipose-derived stem cells and smooth muscle cells were seeded onto the two sides of the bladder acellular matrix and then incubated for seven days. The cell-seeded matrix was used to build tissue-engineered tubular substitutions, which were then implanted and wrapped into the omentum in vivo for two weeks to promote angiogenesis. In the experimental group, the bladder of 20 rabbits was totally resected, and the above tissue-engineered tubular substitutions were used for urinary diversion. In the control group, bladder acellular matrix tubular substitutions with unseeded cells were implanted into the omentum and were used as urinary diversion on another five rabbits with the same process. The implants were harvested, and histological examination was conducted at 2, 4, 8, and 16 weeks after operation. Intravenous urography assessment was performed at 16 weeks postoperatively. All the rabbits were alive in the experimental group until they were sacrificed. Histological analysis of the construct displayed the presence of multilayer urothelial cells on the luminal side and organized smooth muscle tissue on the other side, and different diameters of neovascularization were clearly identified in the substitutions obtained. No leakage, stricture, or obstructions were noted with intravenous urography assessment. All the animals in the control group died within two weeks, and urine leakage, scar formation, and inflammation were detected through autopsy. This study demonstrates the feasibility of tissue-engineered tubular substitutions constructed using homologous adipose-derived stem cells, smooth muscle cells, and bladder acellular matrix for urinary diversion in a rabbit model.
The CDC Injury Center’s Response to the Growing Public Health Problem of Falls Among Older Adults
Authors: Houry Debra , Florence Curtis , Baldwin Grant , Stevens Judy , McClure Rod
Published: August 2015

Background. Older adult falls are a significant cause of morbidity and mortality in the United States. This leading cause of injury in adults aged 65 and older results in $35 billion in direct medical costs. Objective. To project the number of older adult falls by 2030 and the associated lifetime medical cost. A secondary objective is to review what clinicians can do to incorporate falls screening and prevention into their practice for community-dwelling older adults. Methods. Using the Centers for Disease Control and Prevention’s Web-based Injury Statistics Query and Reporting System and the US Census Bureau data, the number of older adults in 2030, fatal falls, and medical costs associated with fall injuries was projected. In addition, evidence-based interventions that can be integrated into clinical practice were reviewed. Results. The number of older adult fatal falls is projected to reach 100 000 per year by 2030 with an associated cost of $100 billion. By integrating screening for falls risk into clinical practice, reviewing and modifying medications, and recommending vitamin D supplementation, physicians can reduce future falls by nearly 25%. Conclusion. Falls in older adults will continue to rise substantially and become a significant cost to our health care system if we do not begin to focus on prevention in the clinical setting.
A novel mechanical design of broken rope protection device for enhancing the safety performances of overhead manned equipment in coal mine
Authors: Zhang Xiaoguang , Zhao Zhike , Liu Jigao , Zhao Yanfang , Xia Tingting , Da Jianpu
Published: August 2015

A novel mechanical design of the broken rope protection device is proposed to enhance the safety performances of the overhead manned equipment. According to the operating characteristics and functional requirements of the overhead manned equipment, a three-dimensional mechanical model of the broken rope protection device was redesigned. Based on the known parameters of the mechanical model, the stress and strength of the main components are readjusted using the statics characteristics of finite element analysis. To ensure the reliability of the control system of the broken rope protection device, the process of people’s falling, the response performance of the tension sensor, and the signal extraction of the broken rope are analyzed under different loading and unloading speeds. The working principle of the broken rope protection device is expounded in detail. The experimental results showed that better effect is obtained by the new broken rope protection device, which is characterized by good durability, low investment, and high reliability.
If three of my brothers have ankylosing spondylitis, why does the doctor say it is not necessarily hereditary? The meaning of risk in multiplex case families with ankylosing spondylitis
Authors: Peláez-Ballestas Ingris , Romero-Mendoza Martha , Burgos-Vargas Rubén
Published: August 2015

Objective

To investigate how patients with ankylosing spondylitis and their relatives in multiplex case families understand concepts of familial aggregation, heredity and risk perceptions, and its impact on decision-making.

Methods

This is a multimethod clinical investigation using field research style in 34 individuals from 10 families with ≥2 members with ankylosing spondylitis covering a wide spectrum of disease severity, educational level, and economical status. The narratives of patients and their relatives were obtained using clinical information, unstructured observation, and personal interviews, which were then transcribed verbatim, coded, and analyzed by three investigators. The interpretation of the textual data was based on two analysis styles, immersion/crystallization and interpretative grounded theory.

Results

We identified four broad interrelated interpretive units in patient and relatives narratives: (1) familial interpretation of the disease, (2) genetic risk, (3) decision-making based on risk, and (4) patient-family/physician discourse contradiction on the meaning of heredity.

Conclusions

Patient's and their relatives interpretation of familial aggregation, HLAB27, heredity, and risk perception in relation with ankylosing spondylitis involves four broad interpretive units spanning from clinical symptoms to heredity and decisions made accordingly. Their thoughts and consequent decisions are often in contradiction with the medical knowledge on the role of genetic factors in ankylosing spondylitis.
Informational needs of liver transplant recipients during a two-year posttransplant period
Authors: Ko Dami , Lee Insook , Muehrer Rebecca J
Published: August 2015

Objectives

To describe the informational needs of liver transplant (LTx) recipients, examine potential differences in informational needs by sociodemographic and clinical variables, and examine informational needs at various time points posttransplant.

Methods

A descriptive, cross-sectional design was used. Informational needs were assessed by the Informational Needs Questionnaire-liver, a new questionnaire developed to include LTx recipients' perspectives. To examine informational needs at different posttransplant time points, participants were classified into four groups (0–1, 2–4, 5–9, and 10–24 months).

Results

Participants (159) who were married, single, had higher education, or higher monthly incomes had significantly greater informational needs. Informational needs regarding disease and physical and emotional management remained high after transplant. Four subscales (medication, wound management, diet, and daily and social activities) indicated informational needs were different across time. Participants 2–4 months posttransplant had higher informational needs regarding wound management and daily and social activities. Participants 5–9 months posttransplant had the highest informational needs regarding medication and diet.

Discussion

Findings indicate informational needs vary among LTx recipients at different posttransplant time points. Marital status, education, and monthly income can influence informational needs.

Conclusion

Healthcare providers should tailor information given to LTx recipients based on informational needs. Longitudinal studies are needed to confirm changing patterns of informational needs.
Analysis of minimal cut and path sets based on direct partial Boolean derivatives
Authors: Kvassay Miroslav , Levashenko Vitaly , Zaitseva Elena
Published: August 2015

Principal steps in reliability engineering include estimation of system reliability and identification and quantification of situations which cause a system failure. There are several techniques that can be used to solve these tasks. Some of them are based on minimal cut (path) sets, which represent minimal sets of basic events, whose simultaneous occurrence leads to a failure (repair) of the system. In this article, applications of minimal cut (path) sets in reliability analysis are summarized, and their connection with direct partial Boolean derivatives is studied. In reliability analysis, direct partial Boolean derivatives identify situations in which a failure (repair) of one system component results in a system failure (repair). Therefore, they reveal the influence of one system component on the whole system. However, minimal cut (path) sets define the influence of a simultaneous failure (repair) of a group of system components on the system activity. Therefore, there should be some correlation between direct partial Boolean derivatives and minimal cut (path) sets. This correlation is studied in this article, and as a result, new algorithms for identification of minimal cut (path) sets are proposed based on this correlation.
Angiotensin-(1–7): beyond its central effects on blood pressure
Authors: Gironacci Mariela M.
Published: August 2015

Angiotensin (Ang) (1–7) is the main component of the depressor and protective arm of the renin-angiotensin system. Ang-(1–7) induces vasodilation, natriuresis and diuresis, cardioprotection, inhibits angiogenesis and cell growth and opposes the pressor, proliferative, profibrotic, and prothrombotic actions mediated by Ang II. Centrally, Ang-(1–7) induces changes in mean arterial pressure and this effect may be linked with its inhibitory neuromodulatory action on norepinephrine neurotransmission. The present review is focused on the role of Ang-(1–7) as a protective agent in the brain.
A service evaluation of the therapy assessments used for preoperative wrist surgery assessments within a single National Health Service Trust
Authors: Donnison Ella , Woodbridge Sarah
Published: August 2015

Introduction

Chronic wrist joint pain is complex and often managed surgically. Where pain predominates, but function and movement are good, conservative or less invasive procedures may be preferable, such as denervation. To aid surgical selection denervation effectiveness can be predicted by a wrist assessment including nerve blocks. While much literature exists for denervation surgery no research to date has explored nerve blocks from a therapy assessment perspective. The purpose of this service evaluation was to establish current assessment practice, provide an important starting point to discuss why assessments may be selected and aid understanding of the assessment service provided.

Methods

A service evaluation was undertaken. The assessments selected by three therapists for cases referred for a preoperative wrist assessment were recorded and analysed.

Results

Fourteen participants were recruited during a five-month period. The mean age was 57.43 years (range 21–79). Two assessments were terminated to address conservative management. Of the remaining 12 participants, assessments included range of motion, cumulative and resting pain 100% (n = 12), grip and pinch strength 92% (n = 11), function 17% (n = 2) and Baltimore Therapeutic Equipment static and dynamic movements 92% (n = 11).

Conclusion

This time-limited evaluation provides insight into the varied assessments used, by therapists within a single NHS Trust, to simulate activity and/or wrist structures under stress. The assessment is a global patient-centred process which aids identification of strategies for conservative and surgical procedures including denervation surgery. Despite the small sample, trends were noted in the practices of experienced hand therapists.
Glycemic Variability and Its Impact on Quality of Life in Adults With Type 1 Diabetes
Authors: Reddy Monika , Godsland Ian F. , Barnard Katharine D. , Herrero Pau , Georgiou Pantelis , Thomson Hazel , Johnston Desmond G. , Oliver Nick S.
Published: August 2015

Background:

There is evidence suggesting that glycemic variability reduces quality of life (QoL) in people with type 2 diabetes, but this association has not been explored in type 1 diabetes. We aimed to assess whether glycemic variability has an impact on QoL in adults with established type 1 diabetes using multiple daily injections (MDI) of insulin or continuous subcutaneous insulin infusion (CSII).

Methods:

Participants wore a blinded continuous glucose monitor for up to 5 days and completed the diabetes quality of life (DQOL) questionnaire. Glycemic variability measures were calculated using the EasyGV version 9.0 software. A correlation analysis was performed to assess whether there was a relationship between glycemic variability and measures of QoL.

Results:

In all, 57 participants with type 1 diabetes (51% male, 65% on CSII, 35% on MDI, mean [SD] age 41 [13] years, duration of diabetes 21 [12] years, HbA1c 63 [12] mmol/mol [7.9% (1.1)], body mass index 25.2 [4.0] kg/m2) were included in the analysis. No significant associations between glycemic variability and DQOL total or subscale scores were demonstrated. The glycemic variability was significantly higher for MDI participants compared to CSII participants ( P < .05 for all glycemic variability measures), but no significant difference in QoL between the 2 treatment modality groups was observed.

Conclusions:

Treatment with CSII is associated with lower glycemic variability compared to MDI. Despite this, and contrary to findings in type 2 diabetes, this study did not find an association between glycemic variability and QoL in adults with relatively well-controlled type 1 diabetes, irrespective of whether they are on MDI or CSII.
Return to Sport After Tibial Shaft Fractures
Authors: Robertson Greg A. J. , Wood Alexander M.
Published: August 2015

Context:

Acute tibial shaft fractures represent one of the most severe injuries in sports. Return rates and return-to-sport times after these injuries are limited, particularly with regard to the outcomes of different treatment methods.

Objective:

To determine the current evidence for the treatment of and return to sport after tibial shaft fractures.

Data Sources:

OVID/MEDLINE (PubMed), EMBASE, CINAHL, Cochrane Collaboration Database, Web of Science, PEDro, SPORTDiscus, Scopus, and Google Scholar were all searched for articles published from 1988 to 2014.

Study Selection:

Inclusion criteria comprised studies of level 1 to 4 evidence, written in the English language, that reported on the management and outcome of tibial shaft fractures and included data on either return-to-sport rate or time. Studies that failed to report on sporting outcomes, those of level 5 evidence, and those in non–English language were excluded.

Study Design:

Systematic review.

Level of Evidence:

Level 4.

Data Extraction:

The search used combinations of the terms tibial, tibia, acute, fracture, athletes, sports, nonoperative, conservative, operative, and return to sport. Two authors independently reviewed the selected articles and created separate data sets, which were subsequently combined for final analysis.

Results:

A total of 16 studies (10 retrospective, 3 prospective, 3 randomized controlled trials) were included (n = 889 patients). Seventy-six percent (672/889) of the patients were men, with a mean age of 27.7 years. Surgical management was assessed in 14 studies, and nonsurgical management was assessed in 8 studies. Return to sport ranged from 12 to 54 weeks after surgical intervention and from 28 to 182 weeks after nonsurgical management (mean difference, 69.5 weeks; 95% CI, –83.36 to −55.64; P < 0.01). Fractures treated surgically had a return-to-sport rate of 92%, whereas those treated nonsurgically had a return rate of 67% (risk ratio, 1.37; 95% CI, 1.20 to 1.57; P < 0.01).

Conclusion:

The general principles are to undertake surgical management for displaced fractures and to attempt nonsurgical management for undisplaced fractures. Primary surgical intervention of undisplaced fractures, however, may result in higher return rates and shorter return times, though this exposes the patient to the risk of surgical complications, which include surgical site infection and compartment syndrome.
Effects on lipid profile of supplementation with vitamin D in type 2 diabetic patients with vitamin D deficiency
Authors: Ramiro-Lozano José Manuel , Calvo-Romero José María
Published: August 2015

Background:

Epidemiological studies suggest that vitamin D status may have an influence on lipid profile.

Patients and methods:

We studied consecutive type 2 diabetic patients with vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) lower than 20 ng/ml). They were treated with 16,000 IU of calcifediol orally once a week for a minimum of 8 weeks.

Results:

A total of 28 patients were treated for a mean time of 84.1 days (range 56-120 days). All patients achieved serum levels of 25(OH)D higher than 20 ng/ml. There was significant reduction in total cholesterol (172.1 ± 32.4 versus 164.4 ± 27.3 mg/dl, p = 0.04). There were nonsignificant reductions in low-density lipoprotein (LDL) cholesterol, non-high-density lipoprotein (non-HDL) cholesterol and triglycerides. There was no change in HDL cholesterol.

Conclusions:

Correction of vitamin D deficiency in type 2 diabetic patients decreases total cholesterol. Our results do not rule out reductions in LDL cholesterol, non-HDL cholesterol and triglycerides.
Putting posthumanist theory to work to reconfigure gender in early childhood: When theory becomes method becomes art
Authors: Osgood Jayne , Red Ruby Scarlet/Miriam Giugni
Published: August 2015

This article seeks to disrupt contemporary cultural imaginations about children and childhood; we offer some provocations to think differently about the regulation and governance of gender by taking a step back to consider children and childhoods more expansively and generatively, as becomings. Underpinning these concerns is the principal objective to explore ways in which posthumanist theorizing can be translated into posthumanist methodology through arts-based practice. In an attempt to illustrate how we have approached this we revisit several core onto-epistemological dilemmas posed by Lather (1993) when she asks: what counts as valid knowledge? Which then leads us onto ask what counts as data? What does data do? And what do we do with what the data does? By experimenting with a range of mediums (photography, artwork and poetry) ‘in a game of cat’s cradle’ (Haraway, 1994) we explore the potential that posthumanist approaches offer to extend and stretch the parameters that have come to shape established ways of knowing and becoming in early childhood.
Motivation-related predictors of physical activity engagement and vitality in rheumatoid arthritis patients
Authors: Yu Chen-an , Rouse Peter C , Van Zanten Jet Veldhuijzen JCS , Metsios George S , Ntoumanis Nikos , Kitas George D , Duda Joan L
Published: August 2015

This study tests the Basic Psychological Needs Theory (within the Self-determination framework), in relation to the prediction of physical activity and well-being among rheumatoid arthritis patients. Motivation regulations for physical activity were also considered in the process model. A total of 207 patients (150 females, mean age = 58 ± 11 years) completed a questionnaire pack and structural equation modelling was used to test expected relationships. Autonomy support provided by important other(s) regarding physical activity positively predicted rheumatoid arthritis patients’ need satisfaction which positively related to autonomous reasons for physical activity participation. Autonomous motivation positively predicted reported physical activity participation levels and feelings of vitality.
The role of Aboriginal community attachment in promoting lifestyle changes after hepatitis C diagnosis
Authors: Brener Loren , Wilson Hannah , Jackson L Clair , Johnson Priscilla , Saunders Veronica , Treloar Carla
Published: August 2015

This research assessed whether greater attachment to an Aboriginal community buffers against the negative effects of stigma and promotes positive health outcomes. Aboriginal Australians ( n = 203) living with hepatitis C completed a survey assessing community attachment, stigma, resilience, quality of life, treatment intent, hepatitis C knowledge and positive lifestyle changes. A stronger sense of community attachment was associated with greater resilience, increased quality of life, less hepatitis C–related stigma and with increased lifestyle changes after diagnosis. Hence, community attachment can buffer against the negative health effects of stigma and may promote the resources to engage in positive behaviour changes, ultimately increasing long-term health outcomes.
Increased Likelihood of Missed Appointments (“No Shows”) for Racial/Ethnic Minorities in a Safety Net Health System
Authors: Shimotsu Scott , Roehrl Anne , McCarty Maribet , Vickery Katherine , Guzman-Corrales Laura , Linzer Mark , Garrett Nancy
Published: August 2015

Missed appointments have been linked to adverse outcomes known to affect racial/ethnic minorities. However, the association of missed appointments with race/ethnicity has not been determined. We sought to determine the relationships between race/ethnicity and missed appointments by performing a cross-sectional study of 161 350 patients in a safety net health system. Several race/ethnicity categories were significantly associated with missed appointment rates, including Hispanic/Latino patients, American Indian/Alaskan Native patients, and Black/African American patients, as compared with White non-Hispanic patients. Other significant predictors included Mexico as country of origin, medical complexity, and major mental illness. We recommend additional research to determine which interventions best reduce missed appointments for minority populations in order to improve the care of vulnerable patients.
In Need of Creative Mobile Service Ideas? Forget Adults and Ask Young Children
Authors: Kuzmickaja Ilona , Wang Xiaofeng , Graziotin Daniel , Dodero Gabriella , Abrahamsson Pekka
Published: August 2015

It is well acknowledged that innovation is a key success factor in the mobile service domain. Having creative ideas is the first critical step in the innovation process. Many studies suggest that customers are a valuable source of creative ideas. However, the literature also shows that adults may be constrained by existing technology frames, which are known to hinder creativity. Instead young children (aged 7-12) are considered digital natives yet are free from existing technology frames. This led us to study them as a potential source for creative mobile service ideas. A set of 41,000 mobile ideas obtained from a research project in 2006 granted us a unique opportunity to study the mobile service ideas from young children. We randomly selected two samples of ideas ( N = 400 each); one contained the ideas from young children, the other from adults (aged 17-50). These ideas were evaluated by several evaluators using an existing creativity framework. The results show that the mobile service ideas from the young children are significantly more original, transformational, implementable, and relevant than those from the adults. Therefore, this study shows that young children are better sources of novel and quality ideas than adults in the mobile services domain. This study bears significant contributions to the creativity and innovation research. It also indicates a new and valuable source for the companies that seek creative ideas for innovative products and services.
Promoting Best Practices for Managing Acute Low Back Pain in an Occupational Environment
Authors: Slaughter Amanda Lynn , Frith Karen , O’Keefe Louise , Alexander Susan , Stoll Regina
Published: August 2015

Providers treating low back pain must be confident and knowledgeable in evidence-based practice (EBP) to provide the best outcomes. An online education course was created in an effort to increase knowledge and confidence in EBP and clinical practice guidelines specific to low back pain in an occupational setting. There were 80 participants who completed the pre-test and post-test. The results showed a statistically significant improvement in knowledge and confidence scores after completion of the course. An online education course was shown to be a cost-effective, accessible tool to increase knowledge and confidence of EBP for different health care providers.
Posterior Capsular Plication Constrains the Glenohumeral Joint by Drawing the Humeral Head Closer to the Glenoid and Resisting Abduction
Authors: DeAngelis Joseph P. , Hertz Benjamin , Wexler Michael T. , Patel Nehal , Walley Kempland C. , Harlow Ethan R. , Manoukian Ohan S. , Masoudi Aidin , Vaziri Ashkan , Ramappa Arun J. , Nazarian Ara
Published: August 2015

Background:

Shoulder pain is a common problem, with 30% to 50% of the American population affected annually. While the majority of these shoulder problems improve, there is a high rate of recurrence, as 54% of patients experience persistent symptoms 3 years after onset.

Purpose:

Posterior shoulder tightness has been shown to alter glenohumeral (GH) kinematics. Clinically, posterior shoulder contractures result in a significant loss of internal rotation and abduction (ABD). In this study, the effect of a posterior capsular contracture on GH kinematics was investigated using an intact cadaveric shoulder without violating the joint capsule or the rotator cuff.

Study Design:

Controlled laboratory study.

Methods:

Glenohumeral motion, humeral load, and subacromial contact pressure were measured in 6 fresh-frozen left shoulders during passive ABD from 60° to 100° using an automated robotic upper extremity testing system. Baseline values were compared with the experimental condition in which the full thickness of posterior tissues was plicated without decompressing the joint capsule.

Results:

Posterior soft tissue plication resulted in increased compression between the humeral head and the glenoid (axial load) at 90° of ABD. Throughout ABD, the posterior contracture increased the anterior and superior moment on the humeral head, but it did not change the GH kinematics in this intact model. As a result, there was no increase in the subacromial contact pressure during ABD with posterior plication.

Conclusion:

In an intact cadaveric shoulder, posterior contracture does not alter GH motion or subacromial contact pressure during passive ABD. By tightening the soft tissue envelope posteriorly, there is an increase in compressive load on the articular cartilage and anterior/superior force on the humeral head. These findings suggest that subacromial impingement in the setting of a posterior soft tissue contracture may result from alterations in scapulothoracic motion, not changes in GH kinematics.

Clinical Relevance:

This investigation demonstrates that posterior capsular plication increases the axial load on the shoulder joint during ABD. While a significant difference from baseline was observed in the plicated condition, posterior capsular plication did not change GH motion or subacromial contact pressure significantly.
Unsuspected Traumatic Pseudoaneurysm of the Internal Carotid Artery
Authors: Hill Donald S. , Hill Jeffrey
Published: August 2015

Peripheral arterial aneurysms may be true aneurysms, a dilation of the lumen lined by the remnants of the stretched arterial wall, or a false aneurysm (pseudoaneurysm), a penetration of the luminal wall with contained flow external to the vessel. Pseudoaneurysms are typically a result of blunt or penetrating arterial trauma, which includes a variety of iatrogenic injuries. This case report describes a traumatic psuedoaneurysm of the left internal carotid artery that occurred after a fall resulting in hyperextension of the neck. The psuedoaneurysm was undetected for three months until a sonographic examination for persistent neck pain showed the lesion. Endovascular repair of the pseudoaneurysm was done without complications.
Crucial Role of Sonographic Imaging in Early Detection of Emphysematous Cholecystitis
Authors: Floyd Tiffany M. , Merideth Kelsy
Published: August 2015

Emphysematous cholecystitis is a rapidly progressing, life-threatening condition that warrants immediate surgical intervention following diagnosis. This condition is associated with a high mortality rate; therefore, early detection is essential in order for intervention and treatment to ensure the best possible patient outcome. Visualization of air within the biliary system is the hallmark of emphysematous cholycystitis, and sonography has proven to be a noninvasive, sensitive imaging modality for detection of air within the biliary system. This case study presents a patient with emphysematous cholecystitis and the role that sonographic imaging had in its early detection and diagnosis.
Genetic diminution of circulating prothrombin ameliorates multiorgan pathologies in sickle cell disease mice
Authors: Arumugam Paritha I. , Mullins Eric S. , Shanmukhappa Shiva Kumar , Monia Brett P. , Loberg Anastacia , Shaw Maureen A. , Rizvi Tilat , Wansapura Janaka , Degen Jay L. , Malik Punam
Published: August 2015

Key Points

Reduced prothrombin improves survival and ameliorates inflammation and end-organ damage without spontaneous bleeding in sickle cell mice. An individual procoagulant, prothrombin, represents a novel therapeutic target that can improve sickle cell disease outcome.
Proteasome inhibitors induce FLT3-ITD degradation through autophagy in AML cells
Authors: Larrue Clément , Saland Estelle , Boutzen Héléna , Vergez François , David Marion , Joffre Carine , Hospital Marie-Anne , Tamburini Jérôme , Delabesse Eric , Manenti Stéphane , Sarry Jean Emmanuel , Récher Christian
Published: August 2015

Key Points

Bortezomib induces the degradation of FLT3-ITD through an autophagy-dependent mechanism that contributes to cell death. This finding provides a mechanism-based rationale for the study of proteasome inhibitors in FLT3-ITD–mutant acute myeloid leukemia.
Systematics and historical biogeography of the old world butterfly subtribe Mycalesina (Lepidoptera: Nymphalidae: Satyrinae)
Authors: Aduse-Poku Kwaku , Brattström Oskar , Kodandaramaiah Ullasa , Lees David C. , Brakefield Paul M. , Wahlberg Niklas
Published: August 2015

Background

Butterflies of the subtribe Mycalesina have radiated successfully in almost all habitat types in Africa, Madagascar, the Indian subcontinent, Indo-China and Australasia. Studies aimed at understanding the reasons behind the evolutionary success of this spectacular Old World butterfly radiation have been hampered by the lack of a stable phylogeny for the group. Here, we have reconstructed a robust phylogenetic framework for the subtribe using 10 genes from 195 exemplar taxa.

Results

We recovered seven well supported clades within the subtribe corresponding to the five traditional genera (Lohora,Heteropsis, Hallelesis,Bicyclus, Mycalesis), one as recently revised (Mydosama) and one newly revised genus (Culapa). The phylogenetic relationships of these mycalesine genera have been robustly established for the first time. Within the proposed phylogenetic framework, we estimated the crown age of the subtribe to be 40 Million years ago (Mya) and inferred its ultimate origin to be in Asia. Our results reveal both vicariance and dispersal as factors responsible for the current widespread distribution of the group in the Old World tropics. We inferred that the African continent has been colonized at least twice by Asian mycalesines within the last 26 and 23 Mya. In one possible scenario, an Asian ancestor gave rise toHeteropsison continental Africa, which later dispersed into Madagascar and most likely back colonised Asia. The second colonization of Africa by Asian ancestors resulted inHallelesisandBicycluson continental Africa, the descendants of which did not colonise other regions but rather diversified only in continental Africa. The generaLohoraandMydosamaare derivatives of ancestors from continental Asia.

Conclusion

Our proposed time-calibrated phylogeny now provides a solid framework within which we can implement mechanistic studies aimed at unravelling the ecological and evolutionary processes that culminated in the spectacular radiation of mycalesines in the Old World tropics.
The FOCUS, AFFINITY and EFFECTS trials studying the effect(s) of fluoxetine in patients with a recent stroke: a study protocol for three multicentre randomised controlled trials
Authors: Mead Gillian , Hackett Maree L. , Lundström Erik , Murray Veronica , Hankey Graeme J. , Dennis Martin
Published: August 2015

Background

Several small trials have suggested that fluoxetine improves neurological recovery from stroke. FOCUS, AFFINITY and EFFECTS are a family of investigator-led, multicentre, parallel group, randomised, placebo-controlled trials that aim to determine whether routine administration of fluoxetine (20 mg daily) for 6 months after acute stroke improves patients’ functional outcome.

Methods/Design

The three trial investigator teams have collaboratively developed a core protocol. Minor variations have been tailored to the national setting in the UK (FOCUS), Australia and New Zealand (AFFINITY) and Sweden (EFFECTS). Each trial is run and funded independently and will report its own results. A prospectively planned individual patient data meta-analysis of all three trials will subsequently provide the most precise estimate of the overall effect of fluoxetine after stroke and establish whether any effects differ between trials and subgroups of patients.

The trials include patients ≥18 years old with a clinical diagnosis of stroke, persisting focal neurological deficits at randomisation between 2 and 15 days after stroke onset. Patients are randomised centrally via web-based randomisation systems using a common minimisation algorithm. Patients are allocated fluoxetine 20 mg once daily or matching placebo capsules for 6 months. Our primary outcome measure is the modified Rankin scale (mRS) at 6 months. Secondary outcomes include the Stroke Impact Scale, EuroQol (EQ5D-5 L), the vitality subscale of the Short-Form 36, diagnosis of depression, adherence to medication, adverse events and resource use. Outcomes are collected at 6 and 12 months. The methods of collecting these data are tailored to the national setting. If FOCUS, AFFINITY and EFFECTS combined enrol 6000 participants as planned, they would have 90 % power (alpha 5 %) to detect a common odds ratio of 1.16, equivalent to a 3.7 % absolute difference in percentage with mRS 0–2 (44.0 % to 47.7 %). This is based on an ordinal analysis of mRS adjusted for baseline variables included in the minimisation algorithm.

Discussion

If fluoxetine is safe and effective in promoting functional recovery, it could be rapidly, widely and affordably implemented in routine clinical practice and reduce the burden of disability due to stroke.

Trial registration

FOCUS: ISRCTN83290762 (23/05/2012), AFFINITY: ACTRN12611000774921 (22/07/2011). EFFECTS: ISRCTN13020412 (19/12/2014).
A variational inequality involving nonlocal elliptic operators
Authors: Xiang Mingqi
Published: August 2015

In this paper, we study the existence of solutions to a variational inequality involving nonlocal elliptic operators, and the problem studied here is not variational in nature. The proof of the main result is based on Schauder’s fixed point theorem combined with adequate variational arguments and a penalization technique.
RETRACTED ARTICLE: Phytochemical Screening,
Antioxidant and Antimicrobial activities of Senna
occidentalis (L.) leaves Extract
Authors: Odeja Oluwakayode , Obi Grace , Ogwuche Christiana Ene , Elemike Elias Emeka , Oderinlo Yemi
Published: August 2015

Background

Phytochemical screening, antimicrobial and antioxidant activities of
the hexane, ethylacetate and methanol crude extracts of Senna occidentalis (L.) leaves were studied in this work. The
aim of the work is to ascertain the level of antimicrobial and antioxidant
properties of different solvent extracts of Senna
occidentalis plant.

Methods

The preliminary screening of the various extracts was carried out
using standard methods and the results revealed the presence of tannins,
alkaloids, reducing sugar, phenols, anthraquinones, resins, saponins and
glycosides. The antimicrobial screening was carried out using the following
organisms; Staphylococcus aureus, Eshericha coli,
Bacillus subtilis, Pseudomonas aeruguinosa, Salmonella typhi, Klebsiellae
pneumoniae, Candida albicans, Aspergillus niger, Penicillium
notatum and Rhizopus
stolonifer. The free radical scavenging capacity using hydrogen
peroxide was equally determined to evaluate the antioxidant activities of the
extracts.

Results

The results obtained showed that Senna
occidentalis (L.) leaf extracts have interesting pharmacological
active compounds with great radical scavenging and antimicrobial effects and as
such could be used in ethno medicine for treatment of some infections and
ailments.

Conclusion

Further investigations on the chemical compositions and possible isolation of
active ingredients would be carried out.