bluuebunny/crossref_metadata_2025 huggingface dataset:
Parent reflections of experiences of participating in a randomized controlled trial of a behavioral intervention for infants at risk of autism spectrum disorders
Authors: Freuler Ashley C , Baranek Grace T , Tashjian Christene , Watson Linda R , Crais Elizabeth R , Turner-Brown Lauren M
Published: October 2013

Background:

Despite the mounting evidence of efficacy of early intervention for children with autism spectrum disorders, there is little research that considers the various perceptions and resources with which parents respond to the pressures and opportunities associated with participation in early intervention. Research is particularly lacking surrounding experiences of parents with infants who are at risk of autism spectrum disorders but do not (yet) have a diagnosed condition.

Objectives:

This qualitative study aimed to explore the experiences of caregivers following their participation in a randomized controlled trial of Adapted Responsive Teaching, a parent–infant relationship-focused intervention for infants at risk of autism spectrum disorders in a community sample. Parents were randomized into either the treatment group, in which they participated in the Adapted Responsive Teaching intervention, or the community services group, in which they were provided with information regarding local early intervention services and were encouraged, but not required to, seek community services as part of their inclusion in the randomized controlled trial.

Methods:

Semistructured interviews were conducted with families following the completion of the randomized controlled trial. Participants consisted of 13 mothers and 4 fathers. Five dyads were interviewed together for a total of 14 families. Child ages ranged from 39 to 46 months at the time of interview. Analysis was conducted on 14 interviews from 10 families who were randomized into the treatment group and 4 families randomized into the community services group. Analysis was informed by a thematic analysis approach, which involved a systematic process of coding and theme identification both across and within groups.

Results:

Themes that emerged across groups included Working against all odds, Value of the personal relationship, Getting the ball rolling, and Getting dad on board. One broad theme represented the data within the groups: Win-win (Adapted Responsive Teaching group) and Navigating amidst ambiguity (community services group).

Conclusions:

This study illuminates the personal experiences and contextual influences affecting families who are participating in the randomized controlled trial through early identification of “risk” status for autism spectrum disorders in their infants. Insights gained from these interviews may serve to refine and enhance intervention models and to enhance early intervention services for families.
Parenting stress and autism: The role of age, autism severity, quality of life and problem behaviour of children and adolescents with autism
Authors: McStay Rebecca L , Dissanayake Cheryl , Scheeren Anke , Koot Hans M , Begeer Sander
Published: October 2013

While stress is a common experience for parents caring for a child with a developmental disability, current measures fail to distinguish between general stress in parents and the demands of parenting and perceptions of parenting skills (parenting stress). This study examined differences in ‘parenting stress’ reported by parents of children with autism and typically developing children. This study examined the role of child characteristics (age, autism severity, child quality of life and problem behaviour) on parenting stress in 150 parents of cognitively able children and adolescents with autism. The results revealed that child hyperactivity was the only factor significantly related to parenting stress in parents of children with autism, overruling measures of autism severity and child quality of life. This finding indicates the significant influence of problematic behaviours on parenting demands and perceptions of parenting skills in parents of children with autism, over other child characteristics conceived as within the parent’s control. Study implications for future research are discussed.
The association between emotional and behavioral problems and gastrointestinal symptoms among children with high-functioning autism
Authors: Mazefsky Carla A , Schreiber Dana R , Olino Thomas M , Minshew Nancy J
Published: October 2013

This study investigated the association between gastrointestinal symptoms and a broad set of emotional and behavioral concerns in 95 children with high-functioning autism and IQ scores ≥ 80. Gastrointestinal symptoms were assessed via the Autism Treatment Network’s Gastrointestinal Symptom Inventory, and data were gathered on autism symptom severity, adaptive behavior, and multiple internalizing and externalizing problems. The majority (61%) of children had at least one reported gastrointestinal symptom. Emotional and behavioral problems were also common but with a high degree of variability. Children with and without gastrointestinal problems did not differ in autism symptom severity, adaptive behavior, or total internalizing or externalizing problem scores. However, participants with gastrointestinal problems had significantly higher levels of affective problems. This finding is consistent with a small body of research noting a relationship between gastrointestinal problems, irritability, and mood problems in autism spectrum disorder. More research to identify the mechanisms underlying this relationship in autism spectrum disorder is warranted. Future research should include a medical assessment of gastrointestinal concerns, longitudinal design, and participants with a range of autism spectrum disorder severity in order to clarify the directionality of this relationship and to identify factors that may impact heterogeneity in the behavioral manifestation of gastrointestinal concerns.
Augmentative and alternative communication supports for adults with autism spectrum disorders
Authors: Trembath David , Iacono Teresa , Lyon Katie , West Denise , Johnson Hilary
Published: October 2013

Many adults with autism spectrum disorders have complex communication needs and may benefit from the use of augmentative and alternative communication. However, there is a lack of research examining the specific communication needs of these adults, let alone the outcomes of interventions aimed at addressing them. The aim of this study was to explore the views and experiences of support workers and family members regarding the outcomes of providing low-technology communication aids to adults with autism spectrum disorders. The participants were six support workers and two family members of six men and women with autism spectrum disorders, who had received low-technology communication aids. Using semi-structured, in-depth interviews and following thematic analysis, the results revealed strong support for, and the potential benefits of, augmentative and alternative communication for both adults with autism spectrum disorders and their communication partners. The results also revealed inconsistencies in the actions taken to support the use of the prescribed augmentative and alternative communication systems, pointing to the clinical need to address common barriers to the provision of augmentative and alternative communication support. These barriers include organisational practices and limitations in the knowledge and skills of key stakeholders, as well as problematic attitudes.
Explicit versus implicit social cognition testing in autism spectrum disorder
Authors: Callenmark Björn , Kjellin Lars , Rönnqvist Louise , Bölte Sven
Published: October 2013

Although autism spectrum disorder is defined by reciprocal social-communication impairments, several studies have found no evidence for altered social cognition test performance. This study examined explicit (i.e. prompted) and implicit (i.e. spontaneous) variants of social cognition testing in autism spectrum disorder. A sample of 19 adolescents with autism spectrum disorder and 19 carefully matched typically developing controls completed the Dewey Story Test. ‘Explicit’ (multiple-choice answering format) and ‘implicit’ (free interview) measures of social cognition were obtained. Autism spectrum disorder participants did not differ from controls regarding explicit social cognition performance. However, the autism spectrum disorder group performed more poorly than controls on implicit social cognition performance in terms of spontaneous perspective taking and social awareness. Findings suggest that social cognition alterations in autism spectrum disorder are primarily implicit in nature and that an apparent absence of social cognition difficulties on certain tests using rather explicit testing formats does not necessarily mean social cognition typicality in autism spectrum disorder.
See what I see, do as I do: Promoting joint attention and imitation in preschoolers with autism spectrum disorder
Authors: Warreyn Petra , Roeyers Herbert
Published: October 2013

Since imitation and joint attention are both important abilities for young children and since children with autism spectrum disorder show a range of problems in these domains, imitation and joint attention are important targets for intervention. In this study, we examined the possibility of promoting imitation and joint attention by means of a training programme specifically designed for low-intensity, non-residential treatment. Two matched groups of 18 children each participated in the study. The experimental group, receiving the training programme, improved significantly more on joint attention than the group receiving only treatment as usual. Only the experimental group obtained a significantly higher imitation score during the post-test compared to the pre-test. This study shows that it is possible to promote joint attention with a low-intensity treatment programme. The results concerning imitation are more modest. Future replications should involve measures of stability and generalization.
Parents’ views of the National Autistic Society’s EarlyBird Plus Programme
Authors: Cutress Anna L , Muncer Steven J
Published: October 2013

Parent training interventions are recommended for parents soon after their child’s autism spectrum condition diagnosis with the aim of improving parents’ psychological well-being and coping, as well as the child’s behaviour. This report explores parents’ views of the EarlyBird Plus Programme through data collected routinely in the post-programme questionnaire. Participants’ reported increased understanding of autism and improvements in their communication with their child and their ability to manage their child’s behaviour. Parents appeared to value the opportunity to meet with other parents, and the programme seemed acceptable to the majority of parents who attended.
Sources of variation in primary care clinical workflow: Implications for the design of cognitive support
Authors: Militello Laura G , Arbuckle Nicole B , Saleem Jason J , Patterson Emily , Flanagan Mindy , Haggstrom David , Doebbeling Bradley N
Published: October 2013

This article identifies sources of variation in clinical workflow and implications for the design and implementation of electronic clinical decision support. Sources of variation in workflow were identified via rapid ethnographic observation, focus groups, and interviews across a total of eight medical centers in both the Veterans Health Administration and academic medical centers nationally regarded as leaders in developing and using clinical decision support. Data were reviewed for types of variability within the social and technical subsystems and the external environment as described in the sociotechnical systems theory. Two researchers independently identified examples of variation and their sources, and then met with each other to discuss them until consensus was reached. Sources of variation were categorized as environmental (clinic staffing and clinic pace), social (perception of health information technology and real-time use with patients), or technical (computer access and information access). Examples of sources of variation within each of the categories are described and discussed in terms of impact on clinical workflow. As technologies are implemented, barriers to use become visible over time as users struggle to adapt workflow and work practices to accommodate new technologies. Each source of variability identified has implications for the effective design and implementation of useful health information technology. Accommodating moderate variability in workflow is anticipated to avoid brittle and inflexible workflow designs, while also avoiding unnecessary complexity for implementers and users.
Migration, regional integration and social transformation: A North–South comparative approach
Authors: Munck Ronaldo , Hyland Mary
Published: October 2013

Migration flows, regional integration and social transformation are increasingly interlinked. This article seeks to provide some clarification of these processes through a global North–South comparative approach. The authors problematize regional integration and regionalization but also the legal or rights-based approach to migration, now emerging as the dominant progressive paradigm. They propose a social transformation perspective that foregrounds the role of social movements – in this case the trade unions – in relation to migration in a regional context. This would pose an alternative form of promoting the cause of migrant workers within a mobilizing perspective which prioritizes the agency of non-state actors such as trade unions. In brief, migrants can be viewed from a citizenship optic and as bearers of individual rights but also, the authors propose, as workers who can organize collectively to pursue their objectives.
Social policy in the context of new global actors: How far is China’s developmental model in Africa impacting traditional donors?
Authors: Urbina-Ferretjans Marian , Surender Rebecca
Published: October 2013

China’s role as an emerging donor and its conceptualization of social policy in Africa has generated polarized reactions in the West. Many argue its ‘productivist’ approach is driven less by notions of citizenship and social rights, and more in terms of accumulation functions. Social investment is justified for broader economic development goals in contrast to current safety-net or ‘welfarist’ models of Western donors. While some international organizations perceive the Chinese approach as antithetical to Western goals and practice, others welcome it as an opportunity to develop new ideas about social development.This qualitative research explores to what extent and in which direction Chinese aid to Africa is influencing Western ideas about welfare policy in developing countries. The study comprises a systematic review of Sino-African and Western policy documents and in-depth interviews with senior Chinese, Western and African stakeholders. It investigates how social policy is conceptualized by those involved in Chinese aid to Africa, to what extent this differs from traditional Western approaches, and what it means for Western social development policy. The implications for understanding the drivers of global policy development and links between the economic and social dimensions of welfare are explored.
Fetal sex determination and gendered prenatal consumption
Authors: Barnes Medora W
Published: October 2013

Although expectant mothers have long purchased items in preparation for their baby’s birth, the timing and type of purchases being made have changed in response to pregnant women routinely learning the sex of their fetus through ultrasound. This article examines changes in these consumption patterns through data drawn from personal narratives with 25 women divided between two cohorts—those who gave birth in the 2000s and those who gave birth in the1970s. The routine use of ultrasound has encouraged changes in beliefs about the relationship between a fetus and its mother in younger women, which in turn inspires earlier purchases of baby items than was normative 30 years before. Not enough attention is being paid to the fact that newborn babies are more likely today than three decades ago to spend their first few months wearing gendered clothing and being surrounded by gender-specific furniture and objects, which their mothers are purchasing during pregnancy.
Longing to a fetal patient
Authors: Ozdogan Tutku , Senol Ebru , Aydemir Sukru , Yildiz Tuba , Varol Fatih
Published: October 2013

There are limitations of obstetric estimation of neonatal outcome in extremely premature newborns. Predicting outcomes, survival, and morbidity are often uncertain, such as in cases of extreme prematurity, certain fetal anomalies, intrauterine growth restriction, and intrauterine infection. Informed consent, truth telling, the maternal–fetal conflict, decision making, and the fetus as a patient are the most important issues of obstetric and neonatal ethics. Because the boundary between utility and futility is not clear, the best interest of the mother, the fetus, and the newborn will be subject of discussion every time. Here, we report a case of obstetric patient to discuss.
Playing by Doing and Players’ Localization of The Sims 2
Authors: Wirman Hanna
Published: October 2013

In this article, I will introduce how and why a group of female game modders (or “skinners”) modify the computer game The Sims 2. I will draw on examples of players’ creations that represent aspects of their Finnish cultural context to illustrate a connection between the game’s encouragement for being productive and for understanding skinning as a form of play.
Integrative Reiki for Cancer Patients
Authors: Fleisher Kimberly A. , Mackenzie Elizabeth R. , Frankel Eitan S. , Seluzicki Christina , Casarett David , Mao Jun J.
Published: October 2013

Objective. This mixed methods study sought to evaluate the outcomes of an integrative Reiki volunteer program in an academic medical oncology center setting. Method. We used de-identified program evaluation data to perform both quantitative and qualitative analyses of participants’ experiences of Reiki sessions. The quantitative data were collected pre- and postsession using a modified version of the distress thermometer. The pre- and postsession data from the distress assessment were analyzed using a paired Student’s t test. The qualitative data were derived from written responses to open-ended questions asked after each Reiki session and were analyzed for key words and recurring themes. Results. Of the 213 pre–post surveys of first-time sessions in the evaluation period, we observed a more than 50% decrease in self-reported distress (from 3.80 to 1.55), anxiety (from 4.05 to 1.44), depression (from 2.54 to 1.10), pain (from 2.58 to 1.21), and fatigue (from 4.80 to 2.30) with P < .001 for all. Using conservative estimates that treat missing data as not endorsing Reiki, we found 176 (82.6%) of participants liked the Reiki session, 176 (82.6%) found the Reiki session helpful, 157 (73.7%) plan to continue using Reiki, and 175 (82.2%) would recommend Reiki to others. Qualitative analyses found that individuals reported that Reiki induced relaxation and enhanced spiritual well-being. Conclusions. An integrative Reiki volunteer program shows promise as a component of supportive care for cancer patients. More research is needed to evaluate and understand the impact that Reiki may have for patients, caregivers, and staff whose lives have been affected by cancer.
Psychosocial Therapies for Patients With Cancer
Authors: Subnis Utkarsh B. , Starkweather Angela R. , McCain Nancy L. , Brown Richard F.
Published: October 2013

Background. As part of a new standard of quality cancer care, the Institute of Medicine has recommended inclusion of therapies that address psychosocial needs of cancer patients. A range of psychosocial therapies for managing acute and chronic stress have been developed for patients with cancer, based on the scientific framework of psychoneuroimmunology (PNI). The current review aimed to identify studies of new and emerging PNI-based psychosocial therapies in patients with cancer that have used neuroendocrine–immune biomarkers as outcomes. Specifically, this review aimed to evaluate studies based on the cancer populations involved, types of psychosocial therapies, and PNI measures employed. Methods. Methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The PubMed, EMBASE, PsychINFO, CINAHL, and Google Scholar online databases were searched using combinations of keywords obtained from previous reviews of psychosocial interventions. Studies from 2001 to 2012 were included if they ( a) were published in English, ( b) used experimental or quasi-experimental designs, ( c) evaluated psychosocial therapies, ( d) involved cancer patients, and ( e) reported results on at least one neuroendocrine or immune outcome measure. The search strategy identified 403 records and 2 stages of screening were used to eliminate irrelevant studies. Results. A total of 24 cancer-specific studies of psychosocial therapies that used PNI-based outcome measures were included in this review. Most studies included early-stage breast cancer patients, and 2 major types of therapies emerged, cognitive–behavioral therapies and complementary medical therapies. Durations of interventions ranged widely, from 1.3 hours over a single week to 27 hours over 18 weeks. Considerable diversity in PNI outcomes made statistical comparisons problematic. Studies of cognitive–behavioral therapies were found to have reported the most success in impacting PNI-based measures, which were typically functional measures of the immune system, for example, cytokines. Conclusions. Several issues related to research methodology are discussed. Most important, studies examining dose–response associations and resource allocation are needed to guide future research. A standardized panel of psychosocial instruments and biomarkers for PNI-based studies would enhance comparability of findings across studies when evaluating this body of research and assist with integrating psychosocial therapies into the standard of cancer care.
Event-Related Potentials in Substance Use Disorders
Authors: Campanella Salvatore , Pogarell Oliver , Boutros Nash
Published: October 2013

Mechanisms that mediate the transition from occasional, controlled, drug use to the impaired control that characterizes severe dependence are still a matter of investigation. The etiology of substance use disorders (SUDs) is complex, and in this context of complexity, the concept of “endophenotype,” has gained extensive popularity in recent years. The main aim of endophenotypes is to provide a simpler, more proximal target to discover the biological underpinnings of a psychiatric syndrome. In this view, neurocognitive and neurophysiological impairments that suggest functional impairments associated with SUDs have been proposed as possible endophenotypes. Because of its large amplitude and relatively easy elicitation, the most studied of the cognitive brain event-related potentials (ERPs), the P300 component, has been proposed as one possible candidate. However, if a P300 amplitude alteration is a common finding in SUDs, it is also observable in other psychiatric afflictions, suggesting that the associations found may just reflect a common measure of brain dysfunction. On this basis, it has been proposed that a multivariate endophenotype, based on a weighted combination of electrophysiological features, may provide greater diagnostic classification power than any single endophenotype. The rationale for investigating multiple features is to show that combining them provides extra useful information that is not available in the individual features, leading ultimately to a multivariate phenotype.The aim of the present article is to outline the potential usefulness of this kind of “combined electrophysiological procedure” applied to SUDs. We present a review of ERP studies, combining data from people with SUD, family members, and normal control subjects, to verify whether the combination of 4ERPs (P50, MMN, P300, and N400) may produce profiles of cortical anomalies induced by different types of SUD (alcohol vs cocaine vs cannabis vs heroin).
Nutrient Timing
Authors: Ivy John L. , Ferguson-Stegall Lisa M.
Published: October 2013

As the incidence rate of lifestyle-related chronic conditions such as cardiovascular disease, obesity, and type 2 diabetes continues to increase, the importance of regular exercise and a healthy diet for improving or maintaining good health is critical. Exercise training is known to improve fitness and many health risk factors, as well as to improve the performance of competitive athletes. It has become increasingly clear, however, that nutrient intake before, during, and after exercise sessions has a powerful influence on the adaptive response to the exercise stimuli. In this review, the science behind nutrient timing will be discussed as it relates to exercise performance, recovery, and training adaptation. Evidence will be provided that validates intake of appropriate nutrients before, during, and immediately after exercise not only to improve exercise performance but also to maximize the training response. Ultimately, the combined response to exercise and proper nutrient intake leads to not only better performance in athletes but also greater health benefits for all exercisers.
Social Theory Applied to Body Image and Chronic Illness in Youth
Authors: Quick Virginia
Published: October 2013

Changes in appearance and functional limitations of youth with chronic illness place them at greater risk for negative body image and poor psychosocial and medical outcomes compared with their healthy peers. Sociocultural pressures from the media, family, and peers, as well as social comparison processes to some extent explain the development of negative or positive body image in young people. This article discusses social theories applied to body image in young people with chronic illness, an overlooked population. A review of risk and protective factors of body dissatisfaction in this population and suggested treatment strategies/interventions in the prevention of body dissatisfaction are also considered. Reported findings may help health care providers become more aware of body image issues their young patients with chronic illness face, and posit the importance of regularly monitoring their psychosocial well-being in the efforts to curtail development of body dissatisfaction and consequential poor health outcomes.
Confidence in the criminal justice system: Differences between citizens and criminal justice officials in China
Authors: Hu Ming , Dai Mengyan
Published: October 2013

This article examines citizens’ confidence in the Chinese criminal justice system, with data from the surveys collected in three provincial capitals with a random sampling strategy in 2007 and 2008. Multivariate analyses are conducted, and follow-up questions are explored with a comparative approach to assess the differences between public perceptions and the views of criminal justice officials within the current social context. The sample sizes for citizens and officials were 217 and 90, respectively. Findings show that the majority of citizens and officials believed that there was a lack of confidence in the Chinese criminal justice system, as demonstrated in the recent ‘anger-venting’ events. This finding is inconsistent with the limited empirical literature on public attitudes in China. The important factors such as perceptions of fairness, corruption and extortion of confessions are explored, and policy implications are discussed.
Lost on the Silk Road: Online drug distribution and the ‘cryptomarket’
Authors: Martin James
Published: October 2013

The illicit drugs website, Silk Road, presents an ideal case study for how online communication technologies are transforming crime. This article seeks to locate the offences committed via Silk Road within existing cybercrime literature, and presents a new criminological concept – the cryptomarket – to outline the contours of this new generation of online illicit marketplace. Cryptomarkets are defined as a type of website that employs advanced encryption to protect the anonymity of users. The article also analyses the implications Silk Road has for drug consumers and law enforcement, as well as the potential changes to drug distribution networks that are likely to occur if Silk Road and other cryptomarkets continue to assume a greater share of the global trade in illicit drugs. In conclusion, it is argued that while Silk Road presents a less violent alternative to conventional drug distribution networks, the risks posed by the rapid proliferation of cryptomarkets more generally are largely unknown and require further research.
Clinical and Structural Effects of Traditional Chinese Medicine and the Herbal Preparation, Iberogast, in a Rat Model of Ulcerative Colitis
Authors: Mashtoub Suzanne , Hoang Bang V. , Vu Megan , Lymn Kerry A. , Feinle-Bisset Christine , Howarth Gordon S.
Published: October 2013

Plant-sourced formulations such as Iberogast and the traditional Chinese medicine formulation, Cmed, purportedly possess anti-inflammatory and radical scavenging properties. We investigated Iberogast and Cmed, independently, for their potential to decrease the severity of the large bowel inflammatory disorder, ulcerative colitis. Sprague Dawley rats (n = 8/group) received daily 1 mL gavages (days 0-13) of water, Iberogast (100 μL/200 μL), or Cmed (10 mg/20 mg). Rats ingested 2% dextran sulfate sodium or water ad libitum for 7 days commencing on day 5. Dextran sulfate sodium administration increased disease activity index scores from days 6 to 12, compared with water controls ( P < .05). On day 10, 200 μL Iberogast decreased disease activity index scores in colitic rats compared with colitic controls ( P < .05). Neither Iberogast nor Cmed achieved statistical significance for daily metabolic parameters or colonic crypt depth. The therapeutic effects of Iberogast and Cmed were minimal in the colitis setting. Further studies of plant extracts are required investigating greater concentrations and alternative delivery systems.
Cytotoxic, Antimutagenic, and Antioxidant Activities of Methanolic Extract and Chalcone Dimers (Lophirones B and C) Derived From Lophira alata (Van Tiegh. Ex Keay) Stem Bark
Authors: Ajiboye Taofeek O. , Yakubu Musa T. , Oladiji Adenike T.
Published: October 2013

The cytotoxic, antimutagenic, and antioxidant activities of methanolic extract and lophirones B and C derived from Lophira alata stem bark were evaluated. The extract and lophirones B and C significantly ( P < .05) reduced the viability of Ehrlich ascites carcinoma cells. There were concentration-dependent reduction in 4-nitro- o-aminophenylenediamine and benzo[ a]pyrene–induced frame shift mutation as well as aflatoxin B1–induced base pair substitution by the extract and lophirones B and C. The extract and lophirones B and C concentration dependently scavenged DPPH radical, superoxide anion radical, hydrogen peroxide, hydroxyl radicals, and reduced ferric ion in the potassium hexacyanoferrate III reducing system. The results obtained from this study revealed that methanolic extract and lophirones B and C derived from Lophira alata stem bark posses anticancer, antimutagenic, and antioxidant activities, with lophirone C producing the best anticancer, antimutagenic, and antioxidant activities. The acclaimed anticancer activity of Lophira alata may be attributed to lophirones B and C.
Nutritional Status and Other Baseline Predictors of Mortality among HIV-Infected Children Initiating Antiretroviral Therapy in Tanzania
Authors: Mwiru Ramadhani S. , Spiegelman Donna , Duggan Christopher , Seage George R. , Semu Helen , Chalamilla Guerino , Kisenge Rodrick , Fawzi Wafaie W.
Published: October 2013

Background:

We assembled a prospective cohort of 3144 children less than 15 years of age initiating antiretroviral therapy (ART) in Dar es Salaam, Tanzania.

Methods:

The relationships of nutritional status and other baseline characteristics in relation to mortality were examined using Cox proportional hazards model.

Results:

Compared with children with weight for age (WAZ) > -1, those with WAZ ≤ -2 to < -3 had a nearly double risk of death (relative risk [RR], 1.85; 95% confidence interval [CI], 1.10-3.11), and among those with WAZ ≤ -3, the risk more than tripled (RR, 3.36; 95% CI, 2.12-5.32). Other baseline risk factors for overall mortality included severe anemia ( P < .001), severe immune suppression ( P = .02), history of tuberculosis ( P = .01), opportunistic infections ( P < .001), living in the poorest district ( P < .001), and advanced World Health Organization stage ( P = .003).

Conclusions:

To sustain the obtained benefit of ART in this setting, interventions to improve nutritional status may be used as an adjunct to ART.
Altered glycosylation of platelet-derived von Willebrand factor confers resistance to ADAMTS13 proteolysis
Authors: McGrath Rachel T. , van den Biggelaar Maartje , Byrne Barry , O’Sullivan Jamie M. , Rawley Orla , O’Kennedy Richard , Voorberg Jan , Preston Roger J. S. , O’Donnell James S.
Published: October 2013

Key Points

Platelet-VWF exists as a distinct natural glycoform. Platelet-VWF is resistant to ADAMTS13 proteolysis.
Coordinated and unique functions of the E-selectin ligand ESL-1 during inflammatory and hematopoietic recruitment in mice
Authors: Sreeramkumar Vinatha , Leiva Magdalena , Stadtmann Anika , Pitaval Christophe , Ortega-Rodríguez Inés , Wild Martin K. , Lee Brendan , Zarbock Alexander , Hidalgo Andrés
Published: October 2013

Key Points

ESL-1 and PSGL-1 cooperate to mediate E-selectin binding, myeloid homeostasis, and inflammatory cell recruitment. ESL-1 dominates E-selectin binding and homing of hematopoietic progenitors.
Regional differences in trait-like characteristics of the waking EEG in early adolescence
Authors: Benz Dominik C , Tarokh Leila , Achermann Peter , Loughran Sarah P
Published: October 2013

Background

The human waking EEG spectrum shows high heritability and stability and, despite maturational cortical changes, high test-retest reliability in children and teens. These phenomena have also been shown to be region specific. We examined the stability of the morphology of the wake EEG spectrum in children aged 11 to 13 years recorded over weekly intervals and assessed whether the waking EEG spectrum in children may also be trait-like. Three minutes of eyes open and three minutes of eyes closed waking EEG was recorded in 22 healthy children once a week for three consecutive weeks. Eyes open and closed EEG power density spectra were calculated for two central (C3LM and C4LM) and two occipital (O1LM and O2LM) derivations. A hierarchical cluster analysis was performed to determine whether the morphology of the waking EEG spectrum between 1 and 20 Hz is trait-like. We also examined the stability of the alpha peak using an ANOVA.

Results

The morphology of the EEG spectrum recorded from central derivations was highly stable and unique to an individual (correctly classified in 85% of participants), while the EEG recorded from occipital derivations, while stable, was much less unique across individuals (correctly classified in 42% of participants). Furthermore, our analysis revealed an increase in alpha peak height concurrent with a decline in the frequency of the alpha peak across weeks for occipital derivations. No changes in either measure were observed in the central derivations.

Conclusions

Our results indicate that across weekly recordings, power spectra at central derivations exhibit more “trait-like” characteristics than occipital derivations. These results may be relevant for future studies searching for links between phenotypes, such as psychiatric diagnoses, and the underlying genes (i.e., endophenotypes) by suggesting that such studies should make use of more anterior rather than posterior EEG derivations.
The effects of different doses of estradiol (E2) on cerebral ischemia in an in vitro model of oxygen and glucose deprivation and reperfusion and in a rat model of middle carotid artery occlusion
Authors: Ma Yu-Long , Qin Pei , Li Yan , Shen Lan , Wang Shi-Quan , Dong Hai-Long , Hou Wu-Gang , Xiong Li-Ze
Published: October 2013

Background

Because neuroprotective effects of estrogen remain controversial, we aimed to investigate the effect of different doses of estradiol (E2) on cerebral ischemia using both in vivo and in vitro experiments.

Results

PC12 cells were cultured at physiological (10 nM and 20 nM) or pharmacological (10 μM and 20 μM) dosages of E2 for 24 hours (h). The results of 5-bromodeoxyuridine (Brdu) incorporation and flow cytometric analysis showed that physiological doses of E2 enhanced cell proliferation and pharmacological doses of E2 inhibited cell proliferation. After the cells were exposed to oxygen and glucose deprivation (OGD) for 4 h and reperfusion for 20 h, the results of 3-(4, 5-dimethylthiazol-2-yl) 2, 5-diphenyl tetrazolium bromide (MTT) assay, lactate dehydrogenase (LDH) release assay, flow cytometric analysis and Western blot analysis showed that physiological doses of E2 enhanced cell viability, reduced cell apoptosis and decreased the expression of pro-apoptotic protein caspase-3. In contrast, pharmacological doses of E2 decreased cell viability and induced cell apoptosis. In vivo, adult ovariectomized (OVX) female rats received continuous subcutaneous injection of different doses of E2 for 4 weeks. Transient cerebral ischemia was induced for 2 h using the middle cerebral artery occlusion (MCAO) technique, followed by 22 h of reperfusion. The results of Garcia test, 2, 3, 5-triphenyltetrazolium chloride (TTC) staining showed that 6 μg/kg and 20 μg/kg E2 replacement induced an increase in neurological deficit scores, a decrease in the infarct volume and a reduction in the expression of caspase-3 when compared to animals in the OVX group without E2 treatment. However, 50 μg/kg E2 replacement treatment decreased neurological deficit scores, increased the infarct volume and the expression of caspase-3 when compared to animals in the control group and 6 up/kg or 20 μg/kg E2 replacement group.

Conclusion

We conclude that physiological levels of E2 exhibit neuroprotective effects on cerebral ischemia; whereas, pharmacological or supraphysiological doses of E2 have damaging effects on neurons after cerebral ischemia.
“Unique trend” and “contradictory trend” in discrimination of primary synchronous lung cancer and metastatic lung cancer
Authors: Shen Cheng , Xu Huan , Liu Lunxu , Zhou Yubin , Chen Dali , Du Heng , Han Zhaojie , Che Guowei
Published: October 2013

Background

Distinguishing between multiple primary lung cancers and metastatic tumors is often difficult when the tumor histology is same. Since genomic instability is a common feature of cancer, we hypothesized that independently arising neoplasms in an individual patient would exhibit measurable genomic variation, enabling discrimination of tumor lineage and relatedness. The feasibility of analyzing genomic instability expression profiles to distinguish multiple primary lung cancers from metastatic tumors was evaluated.

Methods

This study enrolled 13 patients, with multiple primary lung cancers demonstrating with the histology, who underwent surgery between April 2003 and December 2012 at the Department of the Thoracic Surgery at West China Hospital in Sichuan province of China and 10 patients who were diagnosed as metastasis disease during the same period for comparison purposes. Genomic DNA from lung cancers from individual patients was analyzed by six microsatellites (D2S1363, D6S1056, D7S1824, D10S1239, D15S822, and D22S689) with PCR to identify discordant allelic variation. The experiments were approved by the West China Hospital Ethics committee (No.2013 (33)) and all patients agreed to participate in the study and signed an informed consent form.

Results

All of the 10 patients with distant metastasis showed a consistent consequence that we called “unique trend” between primary tumor and distant metastasis. The “trend” is representive in this study, which means that all alleles corresponding to six microsatellite markers were detected in DNA from primary tumors but were reduced or not observed in DNA from metastatic tumors. In the group of synchronous lung tumor with different histological types, the result showed a “contradictory trend”. Some alleles were detected in DNA from primary tumors but were reduced or not observed in DNA from metastatic tumors and other alleles corresponding to six microsatellite markers were detected in DNA from metastatic tumors but were reduced or not observed in DNA from primary tumors. In the third group (synchronous lung tumor with same histological types), 2 of 8 patients showed “unique trend” and the others showed “contradictory trend”.

Conclusions

With polymorphic microsatellite markers, the “unique trend” that represents metastasis cancers and the “contradictory trend” that represents primary multiple tumors are useful in the diagnosis between tumors found at the same time in the pulmonary even diagnosed with the histopathological evaluation from a single patient.
Increase in the astaxanthin synthase gene (crtS) dose by in vivo DNA fragment assembly in Xanthophyllomyces dendrorhous
Authors: Contreras Gabriela , Barahona Salvador , Rojas María Cecilia , Baeza Marcelo , Cifuentes Víctor , Alcaíno Jennifer
Published: October 2013

Background

Xanthophyllomyces dendrorhous is a basidiomycetous yeast that is relevant to biotechnology, as it can synthesize the carotenoid astaxanthin. However, the astaxanthin levels produced by wild-type strains are low. Although different approaches for promoting increased astaxanthin production have been attempted, no commercially competitive results have been obtained thus far. A promising alternative to facilitate the production of carotenoids in this yeast involves the use of genetic modification. However, a major limitation is the few available molecular tools to manipulate X. dendrorhous.

Results

In this work, the DNA assembler methodology that was previously described in Saccharomyces cerevisiae was successfully applied to assemble DNA fragments in vivo and integrate these fragments into the genome of X. dendrorhous by homologous recombination in only one transformation event. Using this method, the gene encoding astaxanthin synthase (crtS) was overexpressed in X. dendrorhous and a higher level of astaxanthin was produced.

Conclusions

This methodology could be used to easily and rapidly overexpress individual genes or combinations of genes simultaneously in X. dendrorhous, eliminating numerous steps involved in conventional cloning methods.
An oxygen enrichment device for lowlanders ascending to high altitude
Authors: Shen Guanghao , Wu Xiaoming , Tang Chi , Yan Yili , Liu Juan , Guo Wei , Jing Da , Lei Tao , Tian Yue , Xie Kangning , Luo Erping , Zhang Jianbao
Published: October 2013

Background

When ascending to the high altitude, people living in low altitude areas will suffer from acute mountain sickness. The aim of this study is to test the hypothesis that whether an oxygen concentration membrane can be made and used to construct a new portable oxygen enrichment device for individuals in acute exposure to the high altitude.

Methods

The membrane was fabricated using vinylsiloxane rubber, polyphenylene oxide hydrogen silicone polymers, chloroplatinic acid and isopropyl alcohol. The membrane was assembled in a frame and the performance was tested in terms of concentration of oxygen, flow rate of oxygen enriched air, pressure ratio across the membrane and ambient temperature. Furthermore, the oxygen concentration device was constructed using the membrane, a DC fan, vacuum pump and gas buffer. A nonrandomized preliminary field test was conducted, in which eight healthy male subjects were flown to Tibet (Lhasa, 3,700 m). First, subjects wore the oxygen enrichment device and performed an incremental exercise on cycle ergometer. The test included heart rate (HR), saturation of peripheral oxygen (SpO2) and physical work capacity (PWC). Then, after a rest period of 4 hours, the experimental protocol was repeated without oxygen enrichment device.

Results

The testing showed that the membrane could increase the oxygen concentration by up to 30%. Simulation test indicated that although the performance of the oxygen enrichment device decreased with altitudes, the oxygen concentration could still maintain 28% with flow rate of enriched air 110 cm3/s at 5000 m. The field test showed that higher SpO2, lower HR, and better PWC (measured by the PWC-170) were observed from all the subjects using oxygen enrichment device compared with non-using (P < 0.01).

Conclusions

We concluded that the new portable oxygen enrichment device would be effective in improving exercise performance when ascending to the high altitude.
Control of thumb force using surface functional electrical stimulation and muscle load sharing
Authors: Westerveld Ard J , Schouten Alfred C , Veltink Peter H , van der Kooij Herman
Published: October 2013

Background

Stroke survivors often have difficulties in manipulating objects with their affected hand. Thumb control plays an important role in object manipulation. Surface functional electrical stimulation (FES) can assist movement. We aim to control the 2D thumb force by predicting the sum of individual muscle forces, described by a sigmoidal muscle recruitment curve and a single force direction.

Methods

Five able bodied subjects and five stroke subjects were strapped in a custom built setup. The forces perpendicular to the thumb in response to FES applied to three thumb muscles were measured. We evaluated the feasibility of using recruitment curve based force vector maps in predicting output forces. In addition, we developed a closed loop force controller. Load sharing between the three muscles was used to solve the redundancy problem having three actuators to control forces in two dimensions. The thumb force was controlled towards target forces of 0.5 N and 1.0 N in multiple directions within the individual’s thumb work space. Hereby, the possibilities to use these force vector maps and the load sharing approach in feed forward and feedback force control were explored.

Results

The force vector prediction of the obtained model had small RMS errors with respect to the actual measured force vectors (0.22±0.17 N for the healthy subjects; 0.17±0.13 N for the stroke subjects). The stroke subjects showed a limited work range due to limited force production of the individual muscles. Performance of feed forward control without feedback, was better in healthy subjects than in stroke subjects. However, when feedback control was added performances were similar between the two groups. Feedback force control lead, especially for the stroke subjects, to a reduction in stationary errors, which improved performance.

Conclusions

Thumb muscle responses to FES can be described by a single force direction and a sigmoidal recruitment curve. Force in desired direction can be generated through load sharing among redundant muscles. The force vector maps are subject specific and also suitable in feedforward and feedback control taking the individual’s available workspace into account. With feedback, more accurate control of muscle force can be achieved.