bluuebunny/crossref_metadata_2025 huggingface dataset:
Mindfulness-Based Stress Reduction Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia Comorbid With Cancer: A Randomized, Partially Blinded, Noninferiority Trial
Authors: Garland Sheila N. , Carlson Linda E. , Stephens Alisa J. , Antle Michael C. , Samuels Charles , Campbell Tavis S.
Published: January 2014

Purpose

Our study examined whether mindfulness-based stress reduction (MBSR) is noninferior to cognitive behavioral therapy for insomnia (CBT-I) for the treatment of insomnia in patients with cancer.

Patients and Methods

This was a randomized, partially blinded, noninferiority trial involving patients with cancer with insomnia recruited from a tertiary cancer center in Calgary, Alberta, Canada, from September 2008 to March 2011. Assessments were conducted at baseline, after the program, and after 3 months of follow-up. The noninferiority margin was 4 points measured by the Insomnia Severity Index. Sleep diaries and actigraphy measured sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency. Secondary outcomes included sleep quality, sleep beliefs, mood, and stress.

Results

Of 327 patients screened, 111 were randomly assigned (CBT-I, n = 47; MBSR, n = 64). MBSR was inferior to CBT-I for improving insomnia severity immediately after the program (P = .35), but MBSR demonstrated noninferiority at follow-up (P = .02). Sleep diary–measured SOL was reduced by 22 minutes in the CBT-I group and by 14 minutes in the MBSR group at follow-up. Similar reductions in WASO were observed for both groups. TST increased by 0.60 hours for CBT-I and 0.75 hours for MBSR. CBT-I improved sleep quality (P < .001) and dysfunctional sleep beliefs (P < .001), whereas both groups experienced reduced stress (P < .001) and mood disturbance (P < .001).

Conclusion

Although MBSR produced a clinically significant change in sleep and psychological outcomes, CBT-I was associated with rapid and durable improvement and remains the best choice for the nonpharmacologic treatment of insomnia.
Effectiveness of the Quadrivalent Human Papillomavirus Vaccine Against Cervical Dysplasia in Manitoba, Canada
Authors: Mahmud Salaheddin M. , Kliewer Erich V. , Lambert Pascal , Bozat-Emre Songul , Demers Alain A.
Published: January 2014

Purpose

Effectiveness of the quadrivalent human papillomavirus (QHPV) vaccine against cervical dysplasia has not been estimated using population-based individual level data. We assessed the vaccine effectiveness (VE) of the QHPV vaccine against cervical dysplasia using data collected routinely in Manitoba.

Methods

Females ≥ 15 years old who received the QHPV vaccine in Manitoba between September 2006 and April 2010 privately (n = 3,541) were matched on age to up to three nonvaccinated females (n = 9,594). We used Cox regression models to estimate the hazard ratios for three outcomes: atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesions (LSILs), and high-grade SILs (HSILs).

Results

Among the 15- to 17-year-olds, the adjusted VE estimates were 35% (95% CI, −19% to 65%), 21% (−10% to 43%), and −1% (−44% to 29%) against the detection of HSILs, LSILs, and ASCUS, respectively. The corresponding estimates were higher (46% [0% to 71%], 35% [10% to 54%], and 23% [−8% to 45%]) among those who had ≥ one Pap smear after enrollment. The QHPV vaccine was associated with 23% (−17% to 48%) reduction in HSIL risk among those ≥ 18 with no history of abnormal cytology, but there was no evidence of protection among those with such a history (−8% [−59% to 27%]).

Conclusion

A significant percentage of vaccinated women may not be protected against HSIL and lesser dysplasia especially if they were vaccinated at older age (≥ 18) or had abnormal cytology before vaccination. These findings affirm the importance of vaccination before any significant exposure to HPV occurs and underscore the need for screening programs that cover all sexually active women, even if they were vaccinated.
Two new Mastogloia species (Bacillariophyceae), M. parlibellioides and M. lyra, from coral reefs in Guam, Western Pacific1
Authors: Lobban Christopher S. , Pennesi Chiara
Published: January 2014

This paper describes the morphology of two new species of Mastogloia identified during a survey of the marine benthic diatom flora of Guam. Mastogloia parlibellioides sp. nov., classified in the section Decussatae, is distinctive in the combination of its valve shape and stria pattern reminiscent of Parlibellus, as well as the presence of rudimentary division walls extending from the free margin to the middle of each partectum. Mastogloia lyra sp. nov., classified in the section Sulcatae, subgroup 2, has internal lyre-shaped lateral sterna and partecta that are displaced toward the midline of the valve by a siliceous flange, which shows oblique partectal ducts. The descriptions of these two new species increase the knowledge base of biodiversity in a Pacific Ocean Mastogloia hotspot.
A reconstruction theorem for abelian categories of twisted sheaves
Authors: Antieau Benjamin
Published: January 2014

We use an idea of Rosenberg to prove a reconstruction theorem for abelian categories of
α-twisted quasi-coherent sheaves on quasi-compact and quasi-separated schemes X when

α
∈
Br
(
X
)

$\alpha \in \operatorname{Br}(X)$

. By applying the work of Toën on derived Azumaya algebras, we give a
proof of Căldăraru's conjecture.
Differential diagnosis: the key to reducing diagnosis error, measuring diagnosis and a mechanism to reduce healthcare costs
Authors: Maude Jason
Published: January 2014

Differential diagnosis has been taught in medical schools for over 100 years and yet it is not routinely carried out in practice; nor is it required to be documented within medical notes. I strongly believe that the routine use of a differential diagnosis would not only substantially reduce the level of diagnostic error but would also greatly reduce the cost of healthcare. This solution to the seemingly intractable problems of diagnostic error and rising healthcare costs is simple and has been with us for 100 years!
Figure and ground in physician misdiagnosis: metacognition and diagnostic norms
Authors: Hamm Robert M.
Published: January 2014

Meta-cognitive awareness, or self reflection informed by the “heuristics and biases” theory of how experts make cognitive errors, has been offered as a partial solution for diagnostic errors in medicine. I argue that this approach is not as easy nor as effective as one might hope. We should also promote mastery of the basic principles of diagnosis in medical school, continuing medical education, and routine reflection and review. While it may seem difficult to attend to both levels simultaneously, there is more to be gained from attending to both than from focusing only on one.
Bias: a normal operating characteristic of the diagnosing brain
Authors: Croskerry Pat
Published: January 2014

People diagnose themselves or receive advice about their illnesses from a variety of sources ranging from their family or friends, alternate medicine, or through conventional medicine. In all cases, the diagnosing mechanism is the human brain which normally operates under the influence of a variety of biases. Most, but not all biases, reside in intuitive decision making, and no individual or group is immune from them. Two biases in particular, bias blind spot and myside bias, have presented obstacles to accepting the impact of bias on medical decision making. Nevertheless, there is now a widespread appreciation of the important role of bias in the majority of medical disciplines. The dual process model of decision making now seems well accepted, although a polarization of opinions has arisen with some arguing the merits of intuitive approaches over analytical ones and vice versa. We should instead accept that it is not one mode or the other that enables well-calibrated thinking but the discriminating use of both. A pivotal role for analytical thinking lies in its ability to allow decision makers the means to detach from the intuitive mode to mitigate bias; it is the gatekeeper for the final diagnostic decision. Exploring and cultivating such debiasing initiatives should be seen as the next major research area in clinical decision making. Awareness of bias and strategies for debiasing are important aspects of the critical thinker’s armamentarium. Promoting critical thinking in undergraduate, postgraduate and continuing medical education will lead to better calibrated diagnosticians.
Expanding the Shopping Cart or Improving Its Contents: A Study on “Modern” Retail in India
Authors: Roy Devesh , Joshi Pramod Kumar , Karandikar Bhushana , Joshi Shwetima , Sonkar Vinay Kumar
Published: January 2014

Several factors (including rising incomes, urbanization, a young population, and more women in the labor force) have influenced retailing in India in recent years, with the emergence and rapid spread of supermarkets being the most dramatic change. Without disputing the high growth rates of organized retail in the food sector, in this study we test whether supermarket growth is associated with greater demand for nonprice attributes such as food safety and customization of products. Using on-site surveys at supermarkets in three Indian cities of different population sizes and income levels, and using ordered models for consumer choice, we find that nonprice attributes remain subordinate to price for consumers in supermarkets. At the same time, rising import penetration in supermarkets creates an outlet where some consumers can satisfy their demand for nonprice attributes that are not provided by domestic products. The fact that such attributes are not demanded of domestic products and that imports fill in to provide these nonprice attributes implies that demand pull for back-end development is weak in Indian food retail. This is important, because a command approach by the government to induce back-end development will work only if enforcement is strong, which seems unlikely.
Conflict-Induced Poverty: Evidence from Colombia
Authors: Lemus Natalia
Published: January 2014

Colombia is a country with both high incidence of poverty and an ongoing civil conflict. This study uses measures of government deterrence and anti-narcotic activity as instruments of conflict-specific variables to estimate the impact of conflict on poverty in Colombia. Using census-level data at the municipality level for 2005, I assess the effect of conflict on both the urban and rural incidence of the newly developed Multidimensional Poverty Index. The findings show that the incidence of conflict significantly increases rural, but not urban, poverty. This is consistent with the fact that most of the conflict in Colombia takes place in rural areas. I also explore the lagged effect of conflict on poverty to conclude that it lasts for at least 3 years, but decreases over time. Finally, I show that the results are robust to a battery of additional specifications, including the use of alternative conflict data and a modified version of the dependent variable.
Differentiating between Cushing's disease and pseudo-Cushing's syndrome: comparison of four tests
Authors: Alwani R A , Schmit Jongbloed L W , de Jong F H , van der Lely A J , de Herder W W , Feelders R A
Published: January 2014

Objective

To evaluate the diagnostic performance of four different tests in order to differentiate between Cushing's disease (CD) and pseudo-Cushing's syndrome (PCS).

Methods

In this prospective study, a total of 73 patients with clinical features of hypercortisolism and insufficient suppression of serum cortisol after 1 mg overnight dexamethasone and/or an elevated excretion of cortisol in 24-h urine samples were included. The circadian rhythm of serum cortisol levels as well as midnight serum cortisol (MserC) levels were assessed in all 73 patients. Late-night salivary cortisol (LNSC) concentrations were obtained in 44 patients. The dexamethasone–CRH (Dex–CRH) test was performed in 54 patients.

Results

Fifty-three patients were diagnosed with CD and subsequently treated. Twenty patients were classified as having PSC. Serum cortisol circadian rhythm: the diurnal rhythmicity of cortisol secretion was retained in PCS. A cortisol midnight:morning ratio of >0.67 is highly suggestive of CD (positive predictive value (PPV) 100% and negative predictive value (NPV) 73%). MserC concentration >243 nmol/l has a PPV of 98% in predicting true CD (NPV 95%). LNSC level >9.3 nmol/l predicted CD in 94% of patients (NPV 100%). Dex–CRH test: after 2 days of dexamethasone suppression, a CRH-stimulated cortisol level >87 nmol/l (T=15 min) resulted in a PPV of 100% and an NPV of 90%.

Conclusion

The Dex–CRH test as well as a single measurement of cortisol in serum or saliva at late (mid-) night demonstrated high diagnostic accuracy in differentiating PCS from true CD.
Thyroid autoantibodies per se do not impair intracytoplasmic sperm injection outcome in euthyroid healthy women
Authors: Tan Susanne , Dieterle Stefan , Pechlavanis Sonali , Janssen Onno E , Fuhrer Dagmar
Published: January 2014

Objective

Autoimmune thyroid disease (AITD) has been associated with adverse pregnancy outcomes in subfertile women with spontaneous and assisted reproductive technology-induced pregnancies. The underlying pathophysiology is still elusive and an association with thyroid dysfunction or other infertility causes is discussed. However, whether thyroid autoimmunity (TAI) per se has a negative impact on female fertility has not yet been clarified. In this study, we investigated whether TAI in healthy women undergoing intracytoplasmic sperm injection (ICSI) for male infertility may affect pregnancy outcome.

Design

A retrospective, single-centre study.

Methods

The ICSI outcome data obtained from 835 euthyroid women (age: 31.4±4.3 years, BMI: 23.7±4.2 kg/m2) were correlated with pre-ICSI TAI status. The known causes of female subfertility were excluded. Outcome parameters included rates of pregnancy, birth, miscarriage and preterm delivery. Blood analysis was carried out retrospectively using blood samples drawn before ICSI. TAI was defined by elevation of anti-thyroperoxidase- or anti-thyroglobulin-antibodies >100 U/l.

Results

TAI-positive and -negative groups did not differ in age, BMI or TSH levels. TAI status did not influence any ICSI outcome parameters. In contrast, increasing maternal age was significantly correlated with lower pregnancy rate (odds ratio (OR): 0.94 (95% CI: 0.91–0.97); P=0.0003) and birth rate (OR: 0.93 (95% CI: 0.09–0.97); P<0.0001).

Conclusions

Our study suggests that TAI per se does not influence ICSI outcome. A strict definition of AITD and TAI and consideration of TAI-associated and -independent confounders are important to further elucidate the interplay between TAI and reproduction.
Vitamin D supplementation and strontium ranelate absorption in postmenopausal women with low bone mass
Authors: Vilaça Tatiane , Camargo Marília Brasílio Rodrigues , Rocha Olguita Ferreira , Lazaretti-Castro Marise
Published: January 2014

Background

Strontium ranelate is used to treat osteoporosis. Calcium (Ca) and strontium (Sr) have common chemical features and are absorbed by the same pathways. Vitamin D has a main role in calcium intestinal absorption. The aim of this study was to investigate whether vitamin D status is a determinant of strontium ranelate absorption.

Methods

Twenty-five patients with vitamin D deficiency (25(OH)D<50 nmol/l) and 25 with vitamin D sufficiency (25(OH)D>75 nmol/l) underwent a 4-h oral Sr overload test. Sr absorption was evaluated as the fraction of absorbed dose and the area under the curve. After the baseline overload test, the deficient patients were treated until reaching sufficient vitamin D levels (25(OH)D>75 nmol/l) and the test was repeated.

Results

Changing vitamin D status from deficient to sufficient resulted in a significant increase in 1,25(OH)2D (24.97±4.64×34.62±9.14 pg/ml,P<0.001) and a reduction in parathyroid hormone (73.87±37.50×58.24±20.13 pg/ml,P=0.006). Nevertheless, no differences were found in the parameters used to evaluate Sr absorption between the vitamin D deficient and sufficient groups. In addition, vitamin D3 replacement in the deficient group did not result in enhanced Sr absorption.

Conclusion

Vitamin D status did not interfere with strontium ranelate absorption. Taking into account the benefits of adequate vitamin D status in osteoporotic patients, we strongly recommend the treatment of vitamin D deficiency. However, the data demonstrate that such treatment does not enhance strontium ranelate absorption in patients with mild deficiency.
Identification of differentially expressed proteins in fresh and frozen–thawed boar spermatozoa by iTRAQ-coupled 2D LC–MS/MS
Authors: Chen Xiaoli , Zhu Huabin , Hu Chuanhuo , Hao Haisheng , Zhang Junfang , Li Kunpeng , Zhao Xueming , Qin Tong , Zhao Kan , Zhu Huishan , Wang Dong
Published: January 2014

Cryodamage is a major problem in semen cryopreservation, causing changes in the levels of proteins that influence the function and motility of spermatozoa. In this study, protein samples prepared from fresh and frozen–thawed boar spermatozoa were compared using the isobaric tags for relative and absolute quantification (iTRAQ) labeling technique coupled to 2D LC–MS/MS analysis. A total of 41 differentially expressed proteins were identified and quantified, including 35 proteins that were present at higher levels and six proteins that were present at lower levels in frozen–thawed spermatozoa by at least a mean of 1.79-fold (P<0.05). On classifying into ten distinct categories using bioinformatic analysis, most of the 41 differentially expressed proteins were found to be closely relevant to sperm premature capacitation, adhesions, energy supply, and sperm–oocyte binding and fusion. The expression of four of these proteins, SOD1, TPI1, ODF2, and AKAP3, was verified by western blot analysis. We propose that alterations in these identified proteins affect the quality of cryopreserved semen and ultimately lower its fertilizing capacity. This is the first study to compare protein levels in fresh and frozen–thawed spermatozoa using the iTRAQ technology. Our preliminary results provide an overview of the molecular mechanisms of cryodamage in frozen–thawed spermatozoa and theoretical guidance to improve the cryopreservation of boar semen.
Spermatogonial stem cells from domestic animals: progress and prospects
Authors: Zheng Yi , Zhang Yaqing , Qu Rongfeng , He Ying , Tian Xiue , Zeng Wenxian
Published: January 2014

Spermatogenesis, an elaborate and male-specific process in adult testes by which a number of spermatozoa are produced constantly for male fertility, relies on spermatogonial stem cells (SSCs). As a sub-population of undifferentiated spermatogonia, SSCs are capable of both self-renewal (to maintain sufficient quantities) and differentiation into mature spermatozoa. SSCs are able to convert to pluripotent stem cells duringin vitroculture, thus they could function as substitutes for human embryonic stem cells without ethical issues. In addition, this process does not require exogenous transcription factors necessary to produce induced-pluripotent stem cells from somatic cells. Moreover, combining genetic engineering with germ cell transplantation would greatly facilitate the generation of transgenic animals. Since germ cell transplantation into infertile recipient testes was first established in 1994,in vivoandin vitrostudy and manipulation of SSCs in rodent testes have been progressing at a staggering rate. By contrast, their counterparts in domestic animals, despite the failure to reach a comparable level, still burgeoned and showed striking advances. This review outlines the recent progressions of characterization, isolation,in vitropropagation, and transplantation of spermatogonia/SSCs from domestic animals, thereby shedding light on future exploration of these cells with high value, as well as contributing to the development of reproductive technology for large animals.
Fetal–maternal communication: the role of Notch signalling in embryo implantation
Authors: Cuman Carly , Menkhorst Ellen , Winship Amy , Van Sinderen Michelle , Osianlis Tiki , Rombauts Luk J , Dimitriadis Evdokia
Published: January 2014

The establishment of a successful pregnancy requires the implantation of a competent blastocyst into a ‘receptive’ endometrium, facilitating the formation of a functional placenta. Inadequate or inappropriate implantation and placentation is a major reason for infertility and is thought to lead to first-trimester miscarriage, placental insufficiency and other obstetric complications. Blastocyst–endometrial interactions are critical for implantation and placental formation. The Notch signalling family is a receptor–ligand family that regulates cellular processes as diverse as proliferation, apoptosis, differentiation, invasion and adhesion. Notch signalling is achieved via cell–cell interaction; thus, via Notch, cells can have direct effects on the fate of their neighbours. Recently, a number of studies have identified Notch receptors and ligands in the endometrium, blastocyst and placenta. This review collates current knowledge of this large receptor–ligand family and explores the role of Notch signalling during implantation and placentation, drawing on information from both human and animal studies. Overall, the evidence suggests that Notch signalling is a critical component of fetal–maternal communication during implantation and placentation and that abnormal Notch expression is associated with impaired placentation and pre-eclampsia.
Intermittent Maple Syrup Urine Disease: Two Case Reports
Authors: Axler Olof , Holmquist Peter
Published: January 2014

The presenting symptoms and clinical course of 2 cases of intermittent maple syrup urine disease (MSUD) are described. Intermittent MSUD is a potentially life-threatening metabolic disorder caused by a deficiency of branched-chain α-keto acid dehydrogenase, the enzyme complex that decarboxylates the 3 branched-chain amino acids. In contrast to classic MSUD, children with the intermittent form show normal development with normal intelligence and, when asymptomatic, normal levels of branched-chain amino acids. Symptoms usually appear between 5 months and 2 years of age, when a trivial infection such as otitis media or viral gastroenteritis triggers catabolism of muscle protein. Intermittent MSUD should be suspected in cases of common infections with a clinically atypical course, especially in children displaying ataxia or marked drowsiness.
Association of Maternal Self-Medication and Over-the-Counter Analgesics for Children
Authors: Jensen Janne Fangel , Gottschau Mathilde , Siersma Volkert Dirk , Graungaard Anette Hauskov , Holstein Bjørn Evald , Knudsen Lisbeth Ehlert
Published: January 2014

OBJECTIVE:

Self-medication with over-the-counter (OTC) analgesics, such as paracetamol (PCM), among children and adolescents is increasing and constitutes an important public health issue internationally. Reasons for this development are unclear; parental influence is suggested. Our objective was to examine whether self-medication with OTC analgesics among school-aged children is influenced by maternal self-reported health and medicine use, taking the child’s frequency of pain into account.

METHODS:

A quantitative cross-sectional survey was conducted on 131 children aged 6 to 11 years and their mothers in the framework of the Demonstration Of A Study To Coordinate And Perform Human Biomonitoring On A European Scale (DEMOCOPHES) European project. Participants were selected from 1 urban and 1 rural area of Denmark, and equally distributed in age and gender. Data were collected through structured interviews with all children and self-report questionnaires for mothers regarding health, pain, and medicine use.

RESULTS:

After adjusting for several sociodemographic and health parameters, maternal use of OTC analgesics was significantly associated with self-medication with OTC analgesics, particularly PCM, in our population of schoolchildren, even when the child’s pain was adjusted for (odds ratio 3.00, P = .008). A clear association between child pain and OTC analgesic use was not found. Additionally, maternal health (self-rated health, chronic pain, chronic disease, daily medicine intake) did not significantly influence child use of OTC analgesics.

CONCLUSIONS:

Maternal self-medication with OTC analgesics is associated with self-medication of OTC analgesics, predominantly PCM, among school-aged children, perhaps more than the child’s pain. Maternal health seems of less importance. Information to parents about pain self-management is important to promote appropriate PCM use among schoolchildren.
Sexting and Sexual Behavior in At-Risk Adolescents
Authors: Houck Christopher D. , Barker David , Rizzo Christie , Hancock Evan , Norton Alicia , Brown Larry K.
Published: January 2014

OBJECTIVES:

This study aimed to examine the prevalence of sexting behaviors (sexually explicit messages and/or pictures) among an at-risk sample of early adolescents as well as the associations between sexting behaviors and sexual behaviors, risk-related cognitions, and emotional regulation skills. It also aimed to determine whether differences in risk were associated with text-based versus photo-based sexts.

METHODS:

Seventh-grade adolescents participating in a sexual risk prevention trial for at-risk early adolescents completed a computer-based survey at baseline regarding sexting behavior (having sent sexually explicit messages and/or pictures), sexual activities, intentions to have sex, perceived approval of sexual activity, and emotional regulation skills.

RESULTS:

Twenty-two percent of the sample reported having sexted in the past 6 months; sexual messages were endorsed by 17% (n = 71), sexual messages and photos by 5% (n = 21). Pictures were endorsed significantly more often by females (χ2[2] = 7.33, P = .03) and Latinos (χ2[2] = 7.27, P = .03). Sexting of any kind was associated with higher rates of engaging in a variety of sexual behaviors, and sending photos was associated with higher rates of sexual activity than sending text messages only. This was true for a range of behaviors from touching genitals over clothes (odds ratio [OR] = 1.98, P = .03) to oral sex (OR = 2.66, P < .01) to vaginal sex (OR = 2.23, P < .01).

CONCLUSIONS:

Sexting behavior (both photo and text messages) was not uncommon among middle school youth and co-occurred with sexual behavior. These data suggest that phone behaviors, even flirtatious messages, may be an indicator of risk. Clinicians, parents, and health programs should discuss sexting with early adolescents.
Preterm Infant’s Early Crying Associated With Child’s Behavioral Problems and Parents’ Stress
Authors: Korja Riikka , Huhtala Mira , Maunu Jonna , Rautava Päivi , Haataja Leena , Lapinleimu Helena , Lehtonen Liisa
Published: January 2014

OBJECTIVE:

To study how the early crying behavior of preterm infants at term, 6 weeks, and 5 months of corrected age is related to later behavioral problems at age 3 and 4 years and parenting stress at 2 and 4 years.

METHODS:

The study group included 202 live-born, low birth weight infants (birth weight ≤1500 g) born from January 2001 through December 2006 at the Turku University Hospital, Finland. A Baby Day Diary was used to assess the preterm infants’ crying behavior at term, 6 weeks, and 5 months of corrected age. The children’s behavior was assessed using the Child Behavior Check List at 3 and 4 years old, and parenting stress was assessed by using the Parenting Stress Index when the child was 2 and 4 years old.

RESULTS:

The duration and frequency of crying bouts in infancy was associated with Child Behavior Check List scores at 4 years old and to both mothers’ and fathers’ stress when the child was 2 and 4 years old.

CONCLUSIONS:

Early excessive crying, especially if lasting up to 5 months of corrected age, is a clinically relevant signal in preterm infants because it may reflect infants’ regulatory problems and/or parenting stress. The crying behavior of preterm infants should be systematically inquired about at well-baby clinics.
Preventing Early Infant Sleep and Crying Problems and Postnatal Depression: A Randomized Trial
Authors: Hiscock Harriet , Cook Fallon , Bayer Jordana , Le Ha ND , Mensah Fiona , Cann Warren , Symon Brian , St James-Roberts Ian
Published: January 2014

OBJECTIVE:

To evaluate a prevention program for infant sleep and cry problems and postnatal depression.

METHODS:

Randomized controlled trial with 781 infants born at 32 weeks or later in 42 well-child centers, Melbourne, Australia. Follow-up occurred at infant age 4 and 6 months. The intervention including supplying information about normal infant sleep and cry patterns, settling techniques, medical causes of crying and parent self-care, delivered via booklet and DVD (at infant age 4 weeks), telephone consultation (8 weeks), and parent group (13 weeks) versus well-child care. Outcomes included caregiver-reported infant night sleep problem (primary outcome), infant daytime sleep, cry and feeding problems, crying and sleep duration, caregiver depression symptoms, attendance at night wakings, and formula changes.

RESULTS:

Infant outcomes were similar between groups. Relative to control caregivers, intervention caregivers at 6 months were less likely to score >9 on the Edinburgh Postnatal Depression Scale (7.9%, vs 12.9%, adjusted odds ratio [OR] 0.57, 95% confidence interval [CI] 0.34 to 0.94), spend >20 minutes attending infant wakings (41% vs 51%, adjusted OR 0.66, 95% CI 0.46 to 0.95), or change formula (13% vs 23%, P < .05). Infant frequent feeders (>11 feeds/24 hours) in the intervention group were less likely to have daytime sleep (OR 0.13, 95% CI 0.03 to 0.54) or cry problems (OR 0.27, 95% CI 0.08 to 0.86) at 4 months.

CONCLUSIONS:

An education program reduces postnatal depression symptoms, as well as sleep and cry problems in infants who are frequent feeders. The program may be best targeted to frequent feeders.
Effect of Cognitive Activity Level on Duration of Post-Concussion Symptoms
Authors: Brown Naomi J. , Mannix Rebekah C. , O’Brien Michael J. , Gostine David , Collins Michael W. , Meehan William P.
Published: January 2014

OBJECTIVE:

To determine the effect of cognitive activity level on duration of post-concussion symptoms.

METHODS:

We conducted a prospective cohort study of patients who presented to a Sports Concussion Clinic within 3 weeks of injury between October 2009 and July 2011. At each visit, patients completed a scale that recorded their average level of cognitive activity since the previous visit. The product of cognitive activity level and days between visits (cognitive activity-days) was calculated and divided into quartiles. Kaplan-Meier Product Limit method was used to generate curves of symptom duration based on cognitive activity level. To adjust for other possible predictors of concussion recovery, we constructed a Cox proportional hazard model with cognitive activity-days as the main predictor.

RESULTS:

Of the 335 patients included in the study, 62% were male, 19% reported a loss of consciousness, and 37% reported experiencing amnesia at the time of injury. The mean age of participants was 15 years (range, 8–23) and the mean number of previous concussions was 0.76; 39% of athletes had sustained a previous concussion. The mean Post-Concussion Symptom Scale score at the initial visit was 30 (SD, 26). The overall mean duration of symptoms was 43 days (SD, 53). Of all variables assessed, only total symptom burden at initial visit and cognitive activity level were independently associated with duration of symptoms.

CONCLUSIONS:

Increased cognitive activity is associated with longer recovery from concussion. This study supports the use of cognitive rest and adds to the current consensus opinion.
Xylitol Syrup for the Prevention of Acute Otitis Media
Authors: Vernacchio Louis , Corwin Michael J. , Vezina Richard M. , Pelton Steven I. , Feldman Henry A. , Coyne-Beasley Tamera , Mitchell Allen A.
Published: January 2014

BACKGROUND:

Acute otitis media (AOM) is a common childhood illness and the leading indication for antibiotic prescriptions for US children. Xylitol, a naturally occurring sugar alcohol, can reduce AOM when given 5 times per day as a gum or syrup, but a more convenient dosing regimen is needed for widespread adoption.

METHODS:

We designed a pragmatic practice-based randomized controlled trial to determine if viscous xylitol solution at a dose of 5 g 3 times per day could reduce the occurrence of clinically diagnosed AOM among otitis-prone children 6 months through 5 years of age.

RESULTS:

A total of 326 subjects were enrolled, with 160 allocated to xylitol and 166 to placebo. In the primary analysis of time to first clinically diagnosed AOM episode, the hazard ratio for xylitol versus placebo recipients was 0.88 (95% confidence interval [CI] 0.61 to 1.3). In secondary analyses, the incidence of AOM was 0.53 episodes per 90 days in the xylitol group versus 0.59 in the placebo group (difference 0.06; 95% CI –0.25 to 0.13); total antibiotic use was 6.8 days per 90 days in the xylitol group versus 6.4 in the placebo group (difference 0.4; 95% CI –1.8 to 2.7). The lack of effectiveness was not explained by nonadherence to treatment, as the hazard ratio for those taking nearly all assigned xylitol compared with those taking none was 0.93 (95% CI 0.56 to 1.57).

CONCLUSIONS:

Viscous xylitol solution in a dose of 5 g 3 times per day was ineffective in reducing clinically diagnosed AOM among otitis-prone children.
Surgical Treatments for Otitis Media With Effusion: A Systematic Review
Authors: Wallace Ina F. , Berkman Nancy D. , Lohr Kathleen N. , Harrison Melody F. , Kimple Adam J. , Steiner Michael J.
Published: January 2014

BACKGROUND AND OBJECTIVE:

The near universality of otitis media with effusion (OME) in children makes a comparative review of treatment modalities important. This study's objective was to compare the effectiveness of surgical strategies currently used for managing OME.

METHODS:

We identified 3 recent systematic reviews and searched 4 major electronic databases. Eligible studies included randomized controlled trials, nonrandomized trials, and cohort studies that compared myringotomy, adenoidectomy, tympanostomy tubes (tubes), and watchful waiting. Using established criteria, pairs of reviewers independently selected, extracted data, rated risk of bias, and graded strength of evidence of relevant studies. We incorporated meta-analyses from the earlier reviews and synthesized additional evidence qualitatively.

RESULTS:

We identified 41 unique studies through the earlier reviews and our independent searches. In comparison with watchful waiting or myringotomy (or both), tubes decreased time with OME and improved hearing; no specific tube type was superior. Adenoidectomy alone, as an adjunct to myringotomy, or combined with tubes, reduced OME and improved hearing in comparison with either myringotomy or watchful waiting. Tubes and watchful waiting did not differ in language, cognitive, or academic outcomes. Otorrhea and tympanosclerosis were more common in ears with tubes. Adenoidectomy increased the risk of postsurgical hemorrhage.

CONCLUSIONS:

Tubes and adenoidectomy reduce time with OME and improve hearing in the short-term. Both treatments have associated harms. Large, well-controlled studies could help resolve the risk-benefit ratio by measuring acute otitis media recurrence, functional outcomes, quality of life, and long-term outcomes. Research is needed to support treatment decisions in subpopulations, particularly in patients with comorbidities.
Defect-induced resonances in photonic microdisk resonators for enhancement of nanoparticle – resonance mode interaction
Authors: Ostrowski M. , Duan X. , Yi Y.
Published: January 2014

We present results of theoretical and experimental studies of whispering-gallery modes in optical microdisk resonators interacting with subwavelength dielectric particles. We predict theoretically and confirm by direct observations that, contrary to the generally accepted models, both peaks of the particle-induced doublet of resonances are red shifted with respect to the position of the initial resonance.
Improved light extraction efficiency of cerium-doped biomedical imaging scintillator by monolayers of periodic arrays of polystyrene spheres
Authors: Liu B. , Duan X. , Yi Y.
Published: January 2014

Monolayers of arrays of periodic polystyrene (PS) spheres are designed to couple onto the surface of cerium-doped lutetium-yttrium oxyorthosilicate scintillator to improve the light extraction efficiency. The enhancement of extraction efficiency up to 38% relative to the reference case without polystyrene spheres is achieved. Combining with the simulation for the transmission as well as its dispersion relation, detailed analysis of the effect of whispering gallery modes and diffraction on the extraction mechanism are given. As a result, the optimal diameter of 414 nm is obtained based on a trade-off between the transmission loss and the diffraction enhancement.
Enabling Solar Fuels Technology With High Throughput Experimentation
Authors: Gregoire J. M. , Haber J. A. , Mitrovic S. , Xiang C. , Suram S. , Newhouse P. F. , Soedarmadji E. , Marcin M. , Kan K. , Guevarra D. , Jones R. , Becerra N. , Cornell E. W. , Jin J.
Published: January 2014

The High Throughput Experimentation (HTE) project of the Joint Center for Artificial Photosynthesis (JCAP, http://solarfuelshub.org/) performs accelerated discovery of new earth-abundant photoabsorbers and electrocatalysts. Through collaboration within the DOE solar fuels hub and with the broader research community, the new materials will be utilized in devices that efficiently convert solar energy, water and carbon dioxide into transportation fuels. JCAP-HTE builds high-throughput pipelines for the synthesis, screening and characterization of photoelectrochemical materials. In addition to a summary of these pipelines, we will describe several new screening instruments for high throughput (photo-)electrochemical measurements. These instruments are not only optimized for screening against solar fuels requirements, but also provide new tools for the broader combinatorial materials science community. We will also describe the high throughput discovery, follow-on verification, and device implementation of a new quaternary metal oxide catalyst. This rapid technology development from discovery to device implementation is a hallmark of the multi-faceted JCAP research effort.
Multi-Channel Radiometry in MMW Imaging Systems
Authors: Ablyazov V. S. , Abramov V. V. , Lyubchenko V. E. , Mourzabulatov K. T. , Turigin S. Yu.
Published: January 2014

State of the art in development of millimeter wave radiometric imaging systems is analyzed and discussed. One-dimension array of 16 radiometers with mechanical scanning of the offset parabolic antenna is experimentally demonstrated that offers rms 0.03 K at time constant 1 s and instant field of view of 4×60 mrad.
Growth and Electrical Properties of ZnO Grown by Closed Space Vapor Transport on Sapphire Substrates
Authors: Mimila-Arroyo J. , Rommeluère J.F. , Barbé M. , Jomard F. , Tromson-Carli A. , Gorochov O. , Marfaing Y. , Galtier P.
Published: January 2014

The growth of ZnO films deposited by Closed Space Vapor Transport (CSVT) on sapphire substrates has been investigated. Deposition on R oriented sapphire substrates gives rise to a-(11-20) oriented ZnO films. Under optimised conditions, flat surfaces can be achieved and rocking curves with full half width below 500 arcsec are observed. The electrical properties of the films were studied. Hall measurements reveal that the measured n-carrier concentration decreases linearly upon the thickness of the sample. This is interpreted as interface conduction probably related to diffusion of aluminium from the substrate. On thinnest films, the n-carrier concentration can be dramatically decreased with thermal annealing under oxygen. Furthermore, the effect of this annealing under oxygen is found to be completely reversible after a further thermal annealing under oxygen free atmosphere.
Gender and racial inequalities in trends of oral cancer mortality in Sao Paulo, Brazil
Authors: Antunes José Leopoldo Ferreira , Toporcov Tatiana Natasha , Biazevic Maria Gabriela Haye , Boing Antonio Fernando , Bastos João Luiz
Published: January 2014

OBJECTIVE:To analyse recent trends in oral cancer mortality, focusing specifically on differences concerning gender and race.METHODS:Official information on deaths and population in the city of Sao Paulo, 2003 to 2009, were used to estimate mortality rates from oral cancer (C00 to C10, International Classification of Diseases, 10th Revision), adjusted for age and stratified by gender (females and males) and race (blacks and whites). The Prais-Winsten auto-regression procedure was used to analyse the time series.RESULTS:During the study period, 8,505 individuals living in the city of Sao Paulo died of oral cancer. Rates increased for females (rate of yearly increase = 4.4%, 95%CI 1.4;7.5), and levelled off for men, which represents an inversion of previous trends among genders in the city. Increases were identified for blacks, with a high rate of yearly increase of 9.1% (95%CI 5.5;12.9), and levelled off for whites. Oral cancer mortality in blacks almost doubled during the study period, and surpassed mortality in whites for almost all categories.CONCLUSIONS:Mortality presented a higher increase among women than in men, and it doubled among backs. The surveillance of trends of oral cancer mortality across gender and racial groups may contribute to implementing socially appropriate health policies, which concurrently reduce the burden of disease and the attenuation of unfair, avoidable and unnecessary inequalities in health.
Mortalidade por intoxicação ocupacional relacionada a agrotóxicos, 2000-2009, Brasil
Authors: Santana Vilma Sousa , Moura Maria Claudia Peres , Nogueira Flávia Ferreira e
Published: January 2014

OBJETIVO: Estimar o coeficiente de mortalidade por intoxicações ocupacionais relacionadas aos agrotóxicos no Brasil.MÉTODOS: Utilizaram-se dados do Sistema de Informações sobre Mortalidade de 2000 a 2009 referentes aos diagnósticos de intoxicação por agrotóxicos, T60.0-T60.4, T60.8 e T60.9, X48, Y18, e Z578 da CID-10, para a causa básica ou associadas; a natureza ocupacional foi identificada pelo registro no campo ,  e se a  era na agropecuária. Foram excluídos homicídios e suicídios. Para cálculo da mortalidade, o número de trabalhadores da agropecuária foi obtido do Instituto Brasileiro de Geografia e Estatística, projeções do Sistema de Contas Nacionais.RESULTADOS: Foram encontrados registros de 2.052 óbitos por intoxicação por agrotóxicos no Brasil, dos quais 36,2% (n = 743) não continham dados sobre a ocupação. Dentre os 1.309 restantes, 679 (51,9%) eram trabalhadores da agropecuária. A mortalidade por intoxicação ocupacional por agrotóxicos caiu de 0,56/100.000 (2000 a 2001) para 0,39/100.000 (2008 a 2009) entre trabalhadores no período, maior queda entre os homens que entre as mulheres. Os homens tiveram maiores estimativas de mortalidade por esse tipo de intoxicação em todos os anos. A maior parte dos óbitos foi causada por agrotóxicos do tipo organofosforados e carbamatos. O número de óbitos por esse tipo de intoxicação declinou em todas as regiões, exceto no Nordeste.CONCLUSÕES: É necessária a melhoria dos registros das declarações de óbito, em especial da ocupação e da relação dos diagnósticos com o trabalho, fundamentais para o controle e prevenção mais adequados para esses acidentes de trabalho. Atenção especial deve ser dirigida à região Nordeste do Brasil.
Violência e sofrimento mental em homens na atenção primária à saúde
Authors: Albuquerque Fernando Pessoa de , Barros Claudia Renata dos Santos , Schraiber Lilia Blima
Published: January 2014

OBJETIVO: Analisar a associação entre agravos à saúde mental masculina e episódios de violência sofrida.MÉTODOS: Estudo transversal com 477 homens usuários de serviços de atenção primária de 18 a 60 anos, em São Paulo, SP, 2002-2003. A seleção amostral foi do tipo consecutivo, por ordem de chegada em dois serviços de atenção primária. Coletaram-se: características sociodemográficas, de saúde e relatos de experiência de violência sofrida na vida e/ou testemunhada na infância. Informações em prontuários sobre uso do serviço de saúde mental e/ou queixas/diagnósticos psicológicos em consulta da clínica médica foram usadas para construção da variável de desfecho "sofrimento mental". As variáveis foram descritas por frequências absolutas e relativas. As associações foram testadas usando modelo confirmatório de regressão multivariada de Poisson com variância robusta e ajustada por faixa etária, situação conjugal, escolaridade, testemunho de violência na infância e uso de substância psicoativa.RESULTADOS: A prevalência de sofrimento mental foi de 29,4%. Sofrimento mental foi associado a sofrer violência física e/ou sexual recorrente na vida (RP 1,75; IC95% 1,13;2,72). A associação com episódio único de violência perdeu significância após a inclusão de uso de substância psicoativa no modelo. Examinada a fração atribuível à violência física e/ou sexual recorrente para o sofrimento mental dos homens encontrou-se 30,4%.CONCLUSÕES: A relação entre sofrer violência e sofrimento mental, salientada nos estudos com mulheres, mostra-se relevante para a saúde dos homens e evidencia a necessidade da identificação, nos serviços de saúde, das situações de violência experimentadas pela população masculina. Para homens, essa relação mostrou ser influenciada pela presença de uso de substância psicoativa, o que deve ser mais trabalhado pelos serviços de saúde.
Estimativas da prevalência de desnutrição infantil nos municípios brasileiros em 2006
Authors: Benício Maria Helena D'Aquino , Martins Ana Paula Bortoletto , Venancio Sonia Isoyama , Barros Aluísio Jardim Dornellas de
Published: January 2014

OBJETIVO: Estimar a prevalência da desnutrição infantil para os municípios brasileiros.MÉTODOS: Utilizou-se modelo de regressão logística multinível para estimar a probabilidade individual de desnutrição em 5.507 municípios brasileiros em 2006, em função de fatores preditivos agrupados segundo níveis hierárquicos. A variável resposta foi a desnutrição infantil (crianças de seis a 59 meses com estatura para idade e sexo inferior a -2 escores Z, segundo o padrão da Organização Mundial da Saúde). As variáveis preditivas foram determinantes da desnutrição aferidos de forma semelhante pela Pesquisa Nacional sobre Demografia e Saúde-2006 e pela Amostra do Censo de 2000. No nível 1 (individual): sexo e idade; no nível 2 (domiciliar): variáveis socioeconômicas, água com canalização interna, área urbana ou rural; e no nível 3 (municipal): localização do município e cobertura da Estratégia Saúde da Família em 2006.RESULTADOS: Detectou-se elevação estatisticamente significativa da chance de desnutrição nas crianças do sexo masculino, que moravam em domicílios com duas ou mais pessoas por cômodo, pertencentes aos quintos inferiores do escore socioeconômico, com três ou mais crianças < 5 anos, que não dispunham de água encanada ou localizados na Região Norte. Verificou-se associação dose-resposta negativa entre a cobertura da Estratégia Saúde da Família e a chance de desnutrição (p = 0,007). Cobertura municipal da Estratégia Saúde da Família > 70% mostrou redução de 45% na chance de desnutrição infantil. Estimativas da prevalência de desnutrição infantil mostraram que a maioria dos municípios estudados apresentou risco de desnutrição sob controle, muito baixo ou baixo. Riscos de maior magnitude foram encontrados em 158 dos municípios, na Região Norte.CONCLUSÕES: A desnutrição infantil como problema de saúde pública concentra-se nos municípios da Região Norte do País, onde a cobertura da Estratégia Saúde da Família é mais baixa. Detectou-se efeito de proteção da Estratégia Saúde da Família em relação à desnutrição infantil no País como um todo, independentemente de outros determinantes do problema.