bluuebunny/crossref_metadata_2025 huggingface dataset:
A health system in economic crises: A case study from Iceland
Authors: Olafsdottir Anna Elisabet , Allotey Pascale , Reidpath Daniel D.
Published: December 2012

Background: There has been a lack of systematic inquiry into how governments respond during times of crises, how well these responses comply with good governance, and how they affect health systems. The aim of this study was to analyse the reactions of the Icelandic health system during the first 7 months of the economic crisis in 2008. Methods: The grounded theory approach was used in data sampling, collection, and data analysis. Secondary data were collected from parliamentary documents, news, and health discussions in two of the largest newspapers in Iceland. Primary data were collected through interviews with key stakeholders in the health sector. Atlas.ti. 5.2 was used to analyse the data. Results: The health sector’s first response to the crisis was to close and merge wards on hospitals as well as making structural changes to reduce the overhead costs in healthcare institutions. The Minister of Health attempted to introduce radical changes but because of failures in good governance practices, such as a lack of transparency and fair participation together with a lack of supporting documents, the proposed changes were not executed. Conclusions: Economic crises are a critical test of health systems’ resilience. The manner in which governance practices, together with strong stewardship, influence the ability of the health system to adapt to changes and reorganise without causing stress, confusion, or anger and without changing its basic structure and function are important, and open to robust evaluation.
Online emotional appeals and political participation: The effect of candidate affect on mass behavior
Authors: Jones Philip Edward , Hoffman Lindsay H , Young Dannagal G
Published: December 2012

The role that emotions play in shaping mass political behavior is increasingly well researched. This study refocuses the debate to explore the effect that the emotions expressed by candidates (target affect) through new media have on participation, rather than the effect of emotions felt by voters (observer affect). A unique experiment embedded in a nationally representative online survey demonstrates that appeals invoking target affect can strongly increase citizens’ political participation both online and offline. Contrary to fears that the use of emotions by political elites will agitate the least knowledgeable citizens, however, the results demonstrate that it is the most politically-engaged citizens who are mobilized by such appeals. These findings have significant implications for our understanding of the participatory consequences of emotional political messages on the Internet.
‘Middle class by profession’: Class status and identification amongst the Black middle classes
Authors: Rollock Nicola , Vincent Carol , Gillborn David , Ball Stephen
Published: December 2012

Drawing on data collected during a 2-year Economic and Social Research Council-funded project exploring the educational perspectives and strategies of middle-class families with a Black Caribbean heritage, this paper examines how participants, in professional or managerial occupations, position themselves in relation to the label ‘middle class’. Our analysis reveals five distinct groupings: those who are ‘comfortably middle class’, ‘middle-class ambivalent’, ‘working class with qualification’, ‘working class’ and a final group, ‘interrogators’. However, we note considerable commonality and fluidity across these groupings in terms of participants’ reasons for and, in some cases, hesitancy around inhabiting a particular class location. These responses must be understood in the context of the relative newness of the Black middle classes and respondents’ broadly similar working-class trajectories alongside ongoing experiences of racism within a society that privileges and gives legitimacy to a dominant White middle-class norm. For many, there is not a straightforward way to be Black and middle class.
‘Dark tourism’ and the ‘kitschification’ of 9/11
Authors: Potts Tracey J
Published: December 2012

This article aims to interrogate the framing of New York’s Ground Zero as a ‘dark tourist’ destination, with particular reference to the entanglement of notions of kitsch in academic discussions of the events of 11 September 2001. What makes Ground Zero contentious, even scandalous, for many scholars is the presence of a conspicuous commodity culture around the site in the form of tourist souvenirs, leading to accusations of kitschification of memory and the constitution of visitors as ‘tourists of history’. Drawing upon theoretical ideas of Jacques Rancière, Bruno Latour and W. J. T. Mitchell around image politics, the alignment of kitsch with the figure of the tourist will be questioned, along with the conviction that the so-called teddy-bearification of 9/11 threatens the formation of dangerous political subjectivities. In attempting to rid the debates of their default settings, and reliance on essentialist notions of kitsch, it is hoped that that the way will be cleared for the sociological, ethnographic and empirical work necessary to consider the cultural and political significance of the Ground Zero souvenir economy.
Maternal hyperthyroidism alters the pattern of expression of cardiac renin-angiotensin system components in rat offspring
Authors: Lino Caroline A , Shibata Caroline ER , Barreto-Chaves Maria Luiza M
Published: December 2012

Introduction:

Changes in perinatal environment can lead to physiological, morphological, or metabolic alterations in adult life. It is well known that thyroid hormones (TH) are critical for the development, growth, and maturation of organs and systems. In addition, TH interact with the renin-angiotensin system (RAS), and both play a critical role in adult cardiovascular function. The objective of this study was to evaluate the effect of maternal hyperthyroidism on cardiac RAS components in pups during development.

Materials and methods:

From gestational day nine (GD9), pregnant Wistar rats received thyroxine (T4, 12 mg/l in tap water; Hyper group) or vehicle (control group). Dams and pups were killed on GD18 and GD20.

Results:

Serum concentrations of triiodothyronine (T3) and T4 were higher in the Hyper group than in the control group dams. Cardiac hypertrophy was observed in Hyper pups on GD20. Cardiac angiotensin-converting enzyme (ACE) activity was significantly lower in Hyper pups on both GD18 and GD20, but there was no difference in Ang I/Ang II levels. Ang II receptors expression was higher in the Hyper pup heart on GD18.

Conclusions:

Maternal hyperthyroidism is associated with alterations in fetal development and altered pattern of expression in RAS components, which in addition to cardiac hypertrophy observed on GD20 may represent an important predisposing factor to cardiovascular diseases in adult life.
Functional luminal imaging probe topography: an improved method for characterizing esophageal distensibility in eosinophilic esophagitis
Authors: Lin Zhiyue , Kahrilas Peter J. , Xiao Yinglian , Nicodème Frédéric , Gonsalves Nirmala , Hirano Ikuo , Pandolfino John E.
Published: December 2012

Objectives:

The aims of this study were to develop a new method for analysis and presentation of esophageal distensibility data using high-resolution impedance planimetry recordings during a volume-controlled distention.

Methods:

Two control subjects and six patients with eosinophilic esophagitis (EoE) with stricture, narrow caliber or normal endoscopy according to EndoFLIP studies were included for analysis. Median filtering and pulse detection techniques were applied to the pressure signal and a wavelet decomposition technique was applied to the 16 channels of raw esophageal diameter data to reduce vascular artifact, respiratory effect and remove esophageal contraction interference. These data were used to generate a functional luminal imaging probe (FLIP) topography plot that describes regional variation of cross-sectional area (CSA). A previously developed computer program was used to calculate and model the CSA-pressure data to derive the slope of line fitting and distension plateau for each individual subject. The results were compared among the four endoscopic phenotypes.

Results:

Patients with EoE and normal endoscopy had similar esophageal distensibility parameters to those of normal controls whereas patients with EoE and stricture or narrow caliber had much lower distensibility than patients with EoE and normal endoscopy. The FLIP topography plots provided a global assessment of the esophageal distensibility along the axial plane of measurement that differentiated patients with varying degrees of endoscopic abnormality.

Conclusions:

New techniques can be leveraged to improve data analysis and presentation using EndoFLIP assessment of the esophageal body in EoE. These techniques may be helpful in defining clinically relevant phenotypes and guiding treatment strategies and should be helpful in structuring future outcome trials.
The Primer for Sports Medicine Professionals on Imaging
Authors: Farshad-Amacker Nadja A. , Jain Palrecha Sapna , Farshad Mazda
Published: December 2012

Because of its inherent superior soft tissue contrast and lack of ionizing radiation, magnetic resonance imaging (MRI) is highly suited to study the complex anatomy of the shoulder joint, particularly when assessing the relatively high incidence of shoulder injuries in young, athletic patients. This review aims to serve as a primer for understanding shoulder MRI in an algorithmical approach, including MRI protocol and technique, normal anatomy and anatomical variations of the shoulder, pathologic conditions of the rotator cuff tendons and muscles, the long head of the biceps tendon, shoulder impingement, labral and glenohumeral ligament pathology, MR findings in shoulder instability, adhesive capsulitis, and osteoarthritis.
Diabetes and the elderly brain: sweet memories?
Authors: Samaras Katherine , Sachdev Perminder S.
Published: December 2012

Type 2 diabetes is common in older people and is associated with higher risk of both vascular dementia and Alzheimer’s disease. This review examines the evidence for increased risk of dementia and mild cognitive impairment in patients with diabetes and the role of potential confounders. The relationship of diabetes and impaired fasting glucose with brain structure is also reviewed, focusing on longitudinal studies in older people. The pathophysiology underlying cognitive change in type 2 diabetes is examined with reference to vascular disease, hypoglycaemia, inflammation and insulin levels. Implications for clinical care in older people with diabetes are discussed, with a recommendation for cognitive evaluation as a routine part of end-organ, diabetes complication review.
Methodological challenges in using routinely collected health data to investigate long-term effects of medication use during pregnancy
Authors: Grzeskowiak Luke E. , Gilbert Andrew L. , Morrison Janna L.
Published: December 2012

To date, the investigation of teratogenic effects of medications has largely focused on physical alterations present at birth (i.e. malformations) as opposed to functional alterations (i.e. neurodevelopment, metabolic function) that may not be apparent at birth but could influence an individual’s health and risk of disease in later life. The use of routinely collected health data represents one approach to better identifying, quantifying, and understanding the long-term risks or benefits of medication use during pregnancy. As such, the objective of this review was to identify and explore opportunities and challenges associated with using routinely collected health data to examine long-term effects of medication use during pregnancy. Drawing on published research several key methodological issues associated with their use in investigating long-term outcomes are reviewed. While significant opportunities exist to make greater use of routinely collected health data, there are a number of key challenges. Identified challenges relate to aspects of study design and analysis, and include obtaining access to data, the ability to match records across datasets and over long periods of time, how medication exposures are ascertained and classified, issues around loss to follow-up how outcomes are ascertained and classified, and the careful interpretation of results in light of study and data limitations. Understanding key challenges associated with using routinely collected health data to investigate long-term effects of medication use during pregnancy is essential in supporting their appropriate use and interpretation, which will contribute to improving the quality of research undertaken and ensure the reliability of results obtained.
Analysis of ripening-related gene expression in papaya using an Arabidopsis-based microarray
Authors: Fabi João Paulo , Seymour Graham B , Graham Neil S , Broadley Martin R , May Sean T , Lajolo Franco Maria , Cordenunsi Beatriz Rosana , Oliveira do Nascimento João Roberto
Published: December 2012

Background

Papaya (Carica papaya L.) is a commercially important crop that produces climacteric fruits with a soft and sweet pulp that contain a wide range of health promoting phytochemicals. Despite its importance, little is known about transcriptional modifications during papaya fruit ripening and their control. In this study we report the analysis of ripe papaya transcriptome by using a cross-species (XSpecies) microarray technique based on the phylogenetic proximity between papaya and Arabidopsis thaliana.

Results

Papaya transcriptome analyses resulted in the identification of 414 ripening-related genes with some having their expression validated by qPCR. The transcription profile was compared with that from ripening tomato and grape. There were many similarities between papaya and tomato especially with respect to the expression of genes encoding proteins involved in primary metabolism, regulation of transcription, biotic and abiotic stress and cell wall metabolism. XSpecies microarray data indicated that transcription factors (TFs) of the MADS-box, NAC and AP2/ERF gene families were involved in the control of papaya ripening and revealed that cell wall-related gene expression in papaya had similarities to the expression profiles seen in Arabidopsis during hypocotyl development.

Conclusion

The cross-species array experiment identified a ripening-related set of genes in papaya allowing the comparison of transcription control between papaya and other fruit bearing taxa during the ripening process.
Association between early bacterial carriage and otitis media in Aboriginal and non-Aboriginal children in a semi-arid area of Western Australia: a cohort study
Authors: Sun Wenxing , Jacoby Peter , Riley Thomas V , Bowman Jacinta , Leach Amanda Jane , Coates Harvey , Weeks Sharon , Cripps Allan , Lehmann Deborah ,   the Kalgoorlie Otitis Media Research Project Team
Published: December 2012

Background

Streptococcus pneumoniae (Pnc), nontypeable Haemophilus influenzae (NTHi) and Moraxella catarrhalis (Mcat) are the most important bacterial pathogens associated with otitis media (OM). Previous studies have suggested that early upper respiratory tract (URT) bacterial carriage may increase risk of subsequent OM. We investigated associations between early onset of URT bacterial carriage and subsequent diagnosis of OM in Aboriginal and non-Aboriginal children living in the Kalgoorlie-Boulder region located in a semi-arid zone of Western Australia.

Methods

Aboriginal and non-Aboriginal children who had nasopharyngeal aspirates collected at age 1- < 3 months and at least one clinical examination for OM by an ear, nose and throat specialist before age 2 years were included in this analysis. Tympanometry to detect middle ear effusion was also performed at 2- to 6-monthly scheduled field visits from age 3 months. Multivariate regression models were used to investigate the relationship between early carriage and subsequent diagnosis of OM controlling for environmental factors.

Results

Carriage rates of Pnc, NTHi and Mcat at age 1- < 3 months were 45%, 29% and 48%, respectively, in 66 Aboriginal children and 14%, 5% and 18% in 146 non-Aboriginal children. OM was diagnosed at least once in 71% of Aboriginal children and 43% of non-Aboriginal children. After controlling for age, sex, presence of other bacteria and environmental factors, early nasopharyngeal carriage of NTHi increased the risk of subsequent OM (odds ratio = 3.70, 95% CI 1.22-11.23) in Aboriginal children, while Mcat increased the risk of OM in non-Aboriginal children (odds ratio = 2.63, 95% CI 1.32-5.23). Early carriage of Pnc was not associated with increased risk of OM.

Conclusion

Early NTHi carriage in Aboriginal children and Mcat in non-Aboriginal children is associated with increased risk of OM independent of environmental factors. In addition to addressing environmental risk factors for carriage such as overcrowding and exposure to environmental tobacco smoke, early administration of pneumococcal-Haemophilus influenzae D protein conjugate vaccine to reduce bacterial carriage in infants, may be beneficial for Aboriginal children; such an approach is currently being evaluated in Australia.
Malaria surveillance-response strategies in different transmission zones of the People's Republic of China: preparing for climate change
Authors: Yang Guo-Jing , Tanner Marcel , Utzinger Jürg , Malone John B , Bergquist Robert , YY Chan Emily , Gao Qi , Zhou Xiao-Nong
Published: December 2012

Background

A sound understanding of malaria transmission patterns in the People’s Republic of China (P.R. China) is crucial for designing effective surveillance-response strategies that can guide the national malaria elimination programme (NMEP). Using an established biology-driven model, it is expected that one may design and refine appropriate surveillance-response strategies for different transmission zones, which, in turn, assist the NMEP in the ongoing implementation period (2010–2020) and, potentially, in the post-elimination stage (2020–2050).

Methods

Environmental data obtained from 676 locations across P.R. China, such as monthly temperature and yearly relative humidity (YRH), for the period 1961–2000 were prepared. Smoothed surface maps of the number of months suitable for parasite survival derived from monthly mean temperature and YRH were generated. For each decade, the final malaria prediction map was overlaid by two masked maps, one showing the number of months suitable for parasite survival and the other the length of YRH map in excess of 60%.

Results

Considering multiple environmental factors simultaneously, the environmental variables suitable for malaria transmission were found to have shifted northwards, which was especially pronounced in northern P.R. China. The unstable suitable regions (transmission periods between five and six months) showed increased transmission intensity due to prolonged suitable periods, especially in the central part of the country.

Conclusion

Adequate and effective surveillance-response strategies for NMEP should be designed to achieve the goal of malaria elimination in P.R. China by 2020, especially in the zones predicted to be the most vulnerable for climate change.
Fatty acids do not pay the toll: effect of SFA and PUFA on human adipose tissue and mature adipocytes inflammation
Authors: Murumalla Ravi Kumar , Gunasekaran Manoj Kumar , Padhan Jibesh Kumar , Bencharif Karima , Gence Lydie , Festy Franck , Césari Maya , Roche Régis , Hoareau Laurence
Published: December 2012

Background

On the basis that high fat diet induces inflammation in adipose tissue, we wanted to test the effect of dietary saturated and polysunsaturated fatty acids on human adipose tissue and adipocytes inflammation. Moreover we wanted to determine if TLR2 and TLR4 are involved in this pathway.

Methods

Human adipose tissue and adipocytes primary cultures were treated with endotoxin-free BSA conjugated with SFA (lauric acid and palmitic acid - LA and PA) and PUFA (eicosapentaeneic acid, docosahexaenoic acid and oleic acid - EPA, DHA and OA) with or without LPS. Cytokines were then assayed by ELISA (TNF-alpha, IL-6 and MCP-1). In order to determine if TLR2 and TLR4 are activated by fatty acid (FA), we used HEK-Blue cells transfected by genes from TLR2 or TLR4 pathways associated with secreted alkaline phosphatase reporter gene.

Results

None of the FA tested in HEK-Blue cells were able to activate TLR2 or TLR4, which is concordant with the fact that after FA treatment, adipose tissue and adipocytes cytokines levels remain the same as controls. However, all the PUFA tested: DHA, EPA and to a lesser extent OA down-regulated TNF-alpha, IL-6 and MCP-1 secretion in human adipose tissue and adipocytes cultures.

Conclusions

This study first confirms that FA do not activate TLR2 and TLR4. Moreover by using endotoxin-free BSA, both SFA and PUFA tested were not proinflammatory in human adipose tissue and adipocytes model. More interestingly we showed that some PUFA exert an anti-inflammatory action in human adipose tissue and adipocytes model. These results are important since they clarify the relationship between dietary fatty acids and inflammation linked to obesity.
Dynamics of Schistosoma haematobium egg output and associated infection parameters following treatment with praziquantel in school-aged children
Authors: Stete Katarina , Krauth Stefanie J , Coulibaly Jean T , Knopp Stefanie , Hattendorf Jan , Müller Ivan , Lohourignon Laurent K , Kern Winfried V , N’Goran Eliézer K , Utzinger Jürg
Published: December 2012

Background

Praziquantel is the drug of choice in preventive chemotherapy targeting schistosomiasis. Increasing large-scale administration of praziquantel requires monitoring of drug efficacy to detect early signs of development of resistance. Standard protocols for drug efficacy monitoring are necessary. Here, we determined the optimal time point for praziquantel efficacy assessment against Schistosoma haematobium and studied the dynamics of infection parameters following treatment.

Methods

Ninety school-aged children from south Côte d’Ivoire with a parasitologically confirmed S. haematobium infection were treated with a single oral dose of praziquantel (40 mg/kg) and followed up for 62 days post-treatment. Urine samples were collected on 23 schooldays during this period and were subjected to visual examination (macrohaematuria), urine filtration and microscopy (S. haematobium eggs) and reagent strip testing (microhaematuria, proteinuria and leukocyturia).

Results

Observed cure and egg reduction rates were highly dependent on the time point post-treatment. Egg reduction rates were high (>97%) in weeks 3–9 post-treatment. Cure rates were highest in weeks 6 (92.9%) and 9 (95.0%) post-treatment. The prevalence of infection-associated parameters decreased after treatment, reaching a minimum of 2.4% in weeks 5 (proteinuria) and 7 (leukocyturia) post-treatment, and 16.3% at the end of week 8 (microhaematuria). Macrohaematuria disappeared between weeks 3 and 6 post-treatment.

Conclusions

For monitoring praziquantel efficacy against S. haematobium, we recommend that the cure rate is assessed at week 6 post-treatment. The egg reduction rate can be evaluated earlier, from day 14 post-treatment onwards. Reagent strips are a useful additional tool for evaluating treatment outcomes in areas with high endemicity, preferably at weeks 5 and 6 post-treatment. The delayed decrease of microhaematuria confirms that lesions in the urinary tract persist longer than egg excretion post-treatment.
Soil transmitted helminths and scabies in Zanzibar, Tanzania following mass drug administration for lymphatic filariasis - a rapid assessment methodology to assess impact
Authors: Mohammed Khalfan A , Deb Rinki M , Stanton Michelle C , Molyneux David H
Published: December 2012

Background

Ivermectin and albendazole are used in annual mass drug administration (MDA) for the lymphatic filariasis elimination programmes in African countries co-endemic for onchocerciasis, but have additional impact on soil transmitted helminths and the ectoparasitic mite which causes scabies. Assessing these collateral impacts at scale is difficult due to the insensitivity of available parasite detection techniques.

Methods

The numbers of cases diagnosed with intestinal helminths and scabies and who received prescriptions for treatment were evaluated in 50 health centres in Zanzibar. Records were examined from 2000, prior to the initiation of MDA to 2005, after six rounds of MDA for lymphatic filariasis had taken place.

Results

Health centre records showed a consistent decline in the number of cases of intestinal helminths and scabies diagnosed by community health workers in Zanzibar and the number of prescriptions issued across five age groups. A 90-98% decline in soil transmitted helminths and 68-98% decline in scabies infections were recorded. Poisson regression models aggregated to both the island-level and district-level indicated that the decline was statistically significant.

Conclusions

The described method of examining health centre records has the potential for use on a large scale, despite limitations, as a rapid method to evaluate the impacts resulting from both lymphatic filariasis and onchocerciasis MDA. This would result in a reduction in the need for parasitological evaluations to determine prevalence and intensity.
The role of phosphoinositide 3-kinase subunits in chronic thyroiditis
Authors: Wojciechowska-Durczynska Katarzyna , Krawczyk-Rusiecka Kinga , Cyniak-Magierska Anna , Zygmunt Arkadiusz , Sporny Stanisław , Lewinski Andrzej
Published: December 2012

Background

The risk of neoplastic transformation in patients with chronic thyroiditis (Hashimoto’s thyroiditis – HT) is slightly increased. Genetic background of this observation is still unclear. PI3K isoforms are linked with inflammatory and neoplastic processes, thus they appear to be interesting subjects of a research in this respect. The aim of our study was to assess the PIK3CA, PIK3CB, PIK3CD and PIK3CG genes expression levels in HT.

Methods

Following conventional cytological examination, 67 thyroid FNAB specimens, received from patients with HT, were quantitatively evaluated regarding PIK3CA, PIK3CB, PIK3CD and PIK3CG expression levels by real-time PCR in the ABI PRISM ®7500 Sequence Detection System.

Results

The performed analysis has revealed significantly higher expression levels (RQ) of PIK3CD, PIK3CG and PIK3CA genes in comparison with PIK3CB gene (p<0.05) and significantly higher gene expression level of PIK3CD in comparison with PIK3CA (p<0.05).

Conclusion

The observed increased PIK3CD, PIK3CG genes expression in HT is probably related to lymphocyte infiltration commonly seen in this condition, however, the role of increased PIK3CA gene expression in the multi-step carcinogenesis process cannot be excluded.
Physical activity and mammographic density in a cohort of postmenopausal Norwegian women; a cross-sectional study
Authors: Qureshi Samera Azeem , Ellingjord-Dale Merete , Hofvind Solveig , Wu Anna H , Ursin Giske
Published: December 2012

Mammographic density (MD) is a strong risk factor for breast cancer and may represent a useful intermediate marker for breast cancer risk. Physical activity (PA) is known to be associated with a reduced risk of breast cancer. If PA is associated with MD then this would be useful for breast cancer prevention studies. MD was assessed on digitized mammograms using a computer assisted method (Madena) in 2218 postmenopausal women. A questionnaire assessed PA, by asking about the duration and intensity of light, moderate, strenuous PA/week. We used multivariate linear regression models to estimate least square means of percent MD by total and intensity of PA with adjustment for confounders. The mean age (± s.d) was 58.4 (±5.3) and mean BMI was 24.6 (±4.6). We observed a statistically significant inverse association between total PA and MD in the over-weight (BMI = 25.0-29.9) women, where mean MD among women with highest activity (>360 mins/week) was 12.6% (95%CI; 11.2%-14.0%), while among women with no activity it was 15.9% (95 CI; 13.6%-18.2%, p for trend = 0.04). There was no association in the other BMI strata. MD was 12.1% (11.2%-13.0%) in the highest group (> 180 mins/week) of moderate/strenuous activity and in the no activity group 14.8% (14.2%-15.5%, p for trend = 0.001) in the over-weight women. There was no association between light PA and MD in all women combined or in any other BMI strata. We found some evidence of an inverse association between PA and MD among overweight women.
Cost-effectiveness analyses for mirtazapine and sertraline in dementia: randomised controlled trial
Authors: Romeo Renee , Knapp Martin , Hellier Jennifer , Dewey Michael , Ballard Clive , Baldwin Robert , Bentham Peter , Burns Alistair , Fox Chris , Holmes Clive , Katona Cornelius , Lawton Claire , Lindesay James , Livingston Gill , McCrae Niall , Moniz-Cook Esme , Murray Joanna , Nurock Shirley , O'Brien John , Poppe Michaela , Thomas Alan , Walwyn Rebecca , Wilson Kenneth , Banerjee Sube
Published: December 2012

Background

Depression is a common and costly comorbidity in dementia. There are very few data on the cost-effectiveness of antidepressants for depression in dementia and their effects on carer outcomes.

Aims

To evaluate the cost-effectiveness of sertraline and mirtazapine compared with placebo for depression in dementia.

Method

A pragmatic, multicentre, randomised placebo-controlled trial with a parallel cost-effectiveness analysis (trial registration: ISRCTN88882979 and EudraCT 2006-000105-38). The primary cost-effectiveness analysis compared differences in treatment costs for patients receiving sertraline, mirtazapine or placebo with differences in effectiveness measured by the primary outcome, total Cornell Scale for Depression in Dementia (CSDD) score, over two time periods: 0–13 weeks and 0–39 weeks. The secondary evaluation was a cost-utility analysis using quality-adjusted life years (QALYs) computed from the Euro-Qual (EQ-5D) and societal weights over those same periods.

Results

There were 339 participants randomised and 326 with costs data (111 placebo, 107 sertraline, 108 mirtazapine). For the primary outcome, decrease in depression, mirtazapine and sertraline were not cost-effective compared with placebo. However, examining secondary outcomes, the time spent by unpaid carers caring for participants in the mirtazapine group was almost half that for patients receiving placebo (6.74v.12.27 hours per week) or sertraline (6.74v.12.32 hours per week). Informal care costs over 39 weeks were £1510 and £1522 less for the mirtazapine group compared with placebo and sertraline respectively.

Conclusions

In terms of reducing depression, mirtazapine and sertraline were not cost-effective for treating depression in dementia. However, mirtazapine does appear likely to have been cost-effective if costing includes the impact on unpaid carers and with quality of life included in the outcome. Unpaid (family) carer costs were lower with mirtazapine than sertraline or placebo. This may have been mediated via the putative ability of mirtazapine to ameliorate sleep disturbances and anxiety. Given the priority and the potential value of supporting family carers of people with dementia, further research is warranted to investigate the potential of mirtazapine to help with behavioural and psychological symptoms in dementia and in supporting carers.
Uterine transplantation: a step too far?
Authors: Foley Jeanette
Published: December 2012

The options currently available to women with uterine infertility are adoption or surrogacy. Recently the option of uterine transplantation has been explored which would allow a woman to carry her own genetically related child. Although this type of transplant raises similar ethical considerations to other types of non-life-saving organ transplantation, such as facial tissue and limb, it also raises its own very unique considerations. In this paper, some of the considerations surrounding uterine transplantation, such as informed consent and an individual's rights, and potential limit to reproductive autonomy are explored.
Women requesting Caesareans: ethical implications in light of the new National Institute for Clinical Excellence guidelines
Authors: Pearce Alice
Published: December 2012

As obstetric medicine has become more sophisticated, so Caesarean section (CS) has become safer. It is now seen as equally safe or, in some circumstances, safer than vaginal birth. Under the new National Institute for Clinical Excellence (NICE) guidelines on CS that were published in November 2011, requests for CS are to be given more weight. Women requesting CS can no longer be seen as compromising their control over birth. Rather, they are merely exercising their power, with the new guidelines offering them an increasing role in the decision-making process regarding how they give birth. However, these new guidelines also present new problems, bringing the rights of patients and obstetricians into conflict. In order to mediate these tensions, a virtue-based approach to obstetric ethics is needed as a supplement to the rule- and right-based guidance provided by NICE.
The ethical and policy implications of e-health and telemedicine: an ageing-focused review
Authors: Thompson Oonagh , Koumanakos Giorgos , Hadjri Karim
Published: December 2012

E-health and telemedicine programmes and systems offer much potential for supporting the health and wellbeing of older people, and are set to be promoted within the changing health-care landscape. This evolving model of technology-centred health care raises a number of ethical and regulatory issues, such as privacy, data protection, online professional practice, consent, accessibility and risk of confinement. Through this review we sought to analyse the European debate on the ethical and policy implications of e-health and telemedicine by identifying key ethical and regulatory issues and considering them against potential policy solutions.
Views of Patients about Sickle Cell Disease Management in Primary Care: A Questionnaire-Based Pilot Study
Authors: Juburi G Al , Okoye O , Majeed A , Knight Y , Green SA , Banarsee R , Nkohkwo A , Ojeer P , Ndive C , Oni L , Phekoo Kj
Published: December 2012

Summary

Objectives

To determine how patients with sickle cell disease (SCD) perceive the quality of care that they receive from their primary healthcare providers.

Design

A questionnaire-based pilot study was used to elicit the views of patients about the quality of care they have been receiving from their primary healthcare providers and what they thought was the role of primary care in SCD management.

Setting

Sickle Cell Society and Sickle Cell and Thalassaemia Centre, in the London Borough of Brent.

Participants

One hundred questionnaires were distributed to potential participants with SCD between November 2010 and July 2011 of which 40 participants responded.

Main outcome measures

Analysis of 40 patient questionnaires collected over a nine-month period.

Results

Most patients are generally not satisfied with the quality of care that they are receiving from their primary healthcare providers for SCD. Most do not make use of general practitioner (GP) services for management of their SCD. Collecting prescriptions was the reason most cited for visiting the GP.

Conclusion

GPs could help improve the day-to-day management of patients with SCD. This could be facilitated by local quality improvement schemes in areas with high disease prevalence. The results of the survey have been used to help develop a GP education intervention and a local enhanced service to support primary healthcare clinicians with SCD's ongoing management.
The fractured lab notebook: undergraduates and ecological data management training in the United States
Authors: Strasser C. A. , Hampton S. E.
Published: December 2012

Data management is a timely and increasingly important topic for ecologists. Recent funder mandates requiring data management plans, combined with the data deluge that faces scientists, make education about data management critical for any future ecologist. In this study, we surveyed instructors of general ecology courses at 48 major institutions in the United States. We chose instructors at institutions that are likely to train future ecologists, and therefore, are most likely to influence the trajectory of data management education in this field. The survey queried instructors about institution and course characteristics, the extent to which data‐related topics are included in their courses, the barriers to their teaching these topics, and their own personal beliefs and values associated with data management and stewardship. We found that, in general, data management topics are not being covered in undergraduate ecology courses for a wide range of reasons. Most often, instructors cited a lack of time and a lack of resources as barriers to teaching data management. Although data are used for instruction at some point in the majority of the courses surveyed, good data management practices and a thorough understanding of the importance of data stewardship are not being taught. We offer potential explanations for this and suggestions for improvement.
Information Theoretic Quantification of Diagnostic Uncertainty
Authors: Westover M Brandon , Eiseman Nathaniel A , Cash Sydney S , Bianchi Matt T
Published: December 2012

Diagnostic test interpretation remains a challenge in clinical practice. Most physicians receive training in the
use of Bayes’ rule, which specifies how the sensitivity and specificity of a test for a given disease combine with the pre-test
probability to quantify the change in disease probability incurred by a new test result. However, multiple studies
demonstrate physicians’ deficiencies in probabilistic reasoning, especially with unexpected test results. Information
theory, a branch of probability theory dealing explicitly with the quantification of uncertainty, has been proposed as an
alternative framework for diagnostic test interpretation, but is even less familiar to physicians. We have previously
addressed one key challenge in the practical application of Bayes theorem: the handling of uncertainty in the critical first
step of estimating the pre-test probability of disease. This essay aims to present the essential concepts of information
theory to physicians in an accessible manner, and to extend previous work regarding uncertainty in pre-test probability
estimation by placing this type of uncertainty within a principled information theoretic framework. We address several
obstacles hindering physicians’ application of information theoretic concepts to diagnostic test interpretation. These
include issues of terminology (mathematical meanings of certain information theoretic terms differ from clinical or
common parlance) as well as the underlying mathematical assumptions. Finally, we illustrate how, in information
theoretic terms, one can understand the effect on diagnostic uncertainty of considering ranges instead of simple point
estimates of pre-test probability.
Analysis of lumbar plexopathies and nerve injury after lateral retroperitoneal transpsoas approach: diagnostic standardization
Authors: Ahmadian Amir , Deukmedjian Armen R. , Abel Naomi , Dakwar Elias , Uribe Juan S.
Published: December 2012

Object

The minimally invasive lateral transpsoas approach has become an increasingly popular means of fusion. The most frequent complication is related to lumbar plexus nerve injuries; these can be diagnosed based on distribution of neurological deficit following the motor and/or sensory nerve injury. However, the literature has failed to provide a clinically relevant description of these complications. With accurate clinical diagnosis, spine practitioners can provide more precise prognostic and management recommendations to include observation, nerve blocks, neurodestructive procedures, medications, or surgical repair strategies. The purpose of this study was to standardize the clinical findings of lumbar plexopathies and nerve injuries associated with minimally invasive lateral retroperitoneal transpsoas lumbar fusion.

Methods

A thorough literature search of the MEDLINE database up to June 2012 was performed to identify studies that reported lumbar plexus and nerve injuries after the minimally invasive lateral retroperitoneal transpsoas approach. Included studies were assessed for described neurological deficits postoperatively. Studies that did attempt to describe nerve-related complications clinically were excluded. A clinically relevant assessment of lumbar plexus nerve injury was derived to standardize early diagnosis and outline prognostic implications.

Results

A total of 18 studies were selected with a total of 2310 patients; 304 patients were reported to have possible plexus-related complications. The incidence of documented nerve and/or root injury and abdominal paresis ranged from 0% to 3.4% and 4.2%, respectively. Motor weakness ranged from 0.7% to 33.6%. Sensory complications ranged from 0% to 75%. A lack of consistency in the descriptions of the lumbar plexopathies and/or nerve injuries as well as a lack of diagnostic paradigms was noted across studies reviewed. Sensory dermal zones were established and a standardized approach was proposed.

Conclusions

There is underreporting of postoperative lumbar plexus nerve injury and a lack of standardization of clinical findings of neural complications related to the minimally invasive lateral retroperitoneal transpsoas approach. The authors provide a diagnostic paradigm that allows for an efficient and accurate classification of postoperative lumbar plexopathies and nerve injuries.
In- vitro regeneration of an important medicinal plant Centella asiatica L. Urban
Authors: Jaheduzzaman Dr , Habib MA , Akter S , Banu NA , Rahman RB , Banu TA , Khan S , Islam S
Published: December 2012

An in vitro multiple shoot regeneration protocol has been developed for Centella asiatica L. Urban from the nodal and shoot tips explants using MS medium with different concentrations and combinations of growth regulators. Multiple shoot regeneration was observed from both the explants on MS containing either BAP alone or in combination with IAA, NAA and Kn. Of the two explants, nodal segment showed comparatively better response towards multiple shoot regeneration. Maximum multiple shoots were found on MS supplemented with 1.0 mg/L BAP and 0.4 mg/L NAA. For root induction, well-developed shoots were excised and cultured on both MS and half strength of MS with various concentrations of IBA, IAA and NAA. Profuse healthy rooting was obtained on MS medium containing 0.2 mg/L IBA. The well rooted plantlets were successfully transplanted to the garden soil and their survival rate under natural condition was 90-95 %. DOI: http://dx.doi.org/10.3329/bjsir.v47i3.13058 Bangladesh J. Sci. Ind. Res. 47(3), 269-272, 2012
Surface water quality around DEPZ industrial area, Savar, Dhaka
Authors: Momtaz H , Alam F , Ahsan MA , Akbor MA , Rashid MM
Published: December 2012

Some important physico-chemical properties of surface water around DEPZ industrial area, Savar were studied to evaluate the water quality. Seven water samples were collected from major waterbodies of DEPZ industrial area. The value of Physico-chemical parameter such as Temperature (57-24°C), pH (12.45-7.58), EC (12400-2060 ?s/cm), BOD5 (895-63.19 mg/L), TSS (2170-435 mg/L), TDS (6840-1036 mg/L), Turbidity (89.55-32.16 mg/L) and Salinity (7.1-1.0 ppt) were highest in the point source (W1) and began to decline as the waste dispersed through the nearby waterbodies (W2-W7). The result revealed that all the chemical constituents, except a few, were beyond the recommended limit for various uses. The lowest content of DO (0.10 mg/L) and highest content of BOD5 (895 mg/L) in point source waterbody indicate that the industries were releasing large amount of oxygen demanding organic wastes which subsequently affected all the studied waterbody. Among metal content of the study area, the value of Fe (1.331-0.443 mg/L), Zn (0.308-0.134 mg/L), Cu (0.244 0.127 mg/L) and Cr (0.615-0.055 mg/L) were gradually decreased from point source to the remote area. Point source (W1) waterbody had the highest concentration of Cr (0.615 mg/L) which exceeded the safe limit for industrial wastewater. This may be due to various chrome agent used in dyeing purposes. Anionic parameters like F- and PO4 3- were at intolerable limit in some waterbody. The coefficient of correlation analysis among physicochemical properties indicated that all the parameters had significant contribution to pollute the water. The correlation between DO and pH was strongly negative (r=-0.995**). Fe showed positive significant correlation with Zn, Cu and Cr. There was a significant positive interaction of PO4 3- with Cl- and NO3- in case of water quality deterioration. The above findings showed that the surface water around DEPZ industrial area was highly polluted by the industrial activities and was harmful for life. DOI: http://dx.doi.org/10.3329/bjsir.v47i3.13061 Bangladesh J. Sci. Ind. Res. 47(3), 279-286, 2012
A futuristic view of energy saving and related energy rebound effect in Bangladesh using complete decomposition model (CDM)
Authors: Khosruzzaman S , Asgar MA , Asgar MA , Rahman KMR , Akbar S
Published: December 2012

In this paper Complete Decomposition Model is used to compute the future energy saving pattern from the difference of the 'trend' and 'real' values of energy consumption. The 'trend' is defined as a sum of activity effect and the energy use in the base year. The 'real' is defined as a sum of energy consumption in the base year and the change in energy consumption due to the activity effect, structural effect and intensity effect. This analysis is carried out in respect of Bangladesh for the period 2008-2030. The economic sectors that are taken in to account are agriculture, industry and service. The futuristic view shows that Bangladesh can save about 47.47 MTOE in agriculture sector and 34.96 MTOE from service sector. On the other hand, industry sector, which is accounted for 58% of the total energy consumption, failed to save energy, rather the country consumed 227 MTOE more energy than usual. The energy rebound effect that relies upon the activity effect and structural effect has also been estimated to examine the energy uses pattern of these sectors. The aggregate energy rebound effect was found to be 1480 MTOE, of which activity effect and structural effect contribute 91.21% and 8.78% respectively. DOI: http://dx.doi.org/10.3329/bjsir.v47i3.13066 Bangladesh J. Sci. Ind. Res. 47(3), 313-320 2012
Response of broccoli to organic amendments and accumlation of heavy metals in it
Authors: Shorna Nurunnahar , Joardar JC , Nasreen Shamima
Published: December 2012

No abstract available DOI: http://dx.doi.org/10.3329/bjsr.v25i1.13045 Bangladesh J. Sci. Res. 25(1): 1-10, 2012
Influence of phosphorus and inoculation with Rhizobium and AM fungi on growth and dry matter yield of chickpea
Authors: Solaiman ARM , Rabbani MG , Hossain D , Hossain GMA , Alam MS
Published: December 2012

No abstract available DOI: http://dx.doi.org/10.3329/bjsr.v25i1.13047 Bangladesh J. Sci. Res. 25(1): 23-32, 2012
Effects of nitrobenzene on growth of tomato plants and accumulation of arsenic
Authors: Deb Mithila , Roy Sajal , Huq SM Imamul
Published: December 2012

No abstract available DOI: http://dx.doi.org/10.3329/bjsr.v25i1.13049 Bangladesh J. Sci. Res. 25(1): 43-52, 2012
Fungi associated with two species of Oxalis
Authors: Fatema Yasmin , Shamsi Shamim
Published: December 2012

No abstract available DOI: http://dx.doi.org/10.3329/bjsr.v25i1.13050 Bangladesh J. Sci. Res. 25(1): 53-60, 2012
A study on parametric approaches to compare areas under two correlated ROC curves
Authors: Sumi Nahid Sultana , Hossain Md Akhtar
Published: December 2012

No abstract available DOI: http://dx.doi.org/10.3329/bjsr.v25i1.13051 Bangladesh J. Sci. Res. 25(1): 61-71, 2012
Detecting jumps in correlated series
Authors: Islam M Shahidul
Published: December 2012

No abstract available DOI: http://dx.doi.org/10.3329/bjsr.v25i1.13053 Bangladesh J. Sci. Res. 25(1): 87-91, 2012