bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful resection of a huge mediastinal liposarcoma extended to the bilateral thorax
Authors: Lin Feng , Pu Qiang , Ma Lin , Liu Chengwu , Mei Jiandong , Liao Hu , Guo Chenglin , Liu Lunxu
Published: June 2015

Liposarcoma arising in the mediastinum is extremely rare. Herein we present a case of a 47‐year‐old man with a huge posterior mediastinal tumor that extended to the bilateral thorax. The patient underwent a complete resection of the tumor and experienced an uneventful recovery. Postoperative pathology finally revealed liposarcoma. The patient underwent follow‐up for 25 months, during which time no recurrence was found.
Development and Psychometric Evaluation of a Questionnaire Based on the Nursing Outcomes Classification to Determine the Knowledge of Parents on Breast‐Feeding: Research Protocol
Authors: Paloma‐Castro Olga , Romero‐Sánchez José Manuel , Paramio‐Cuevas Juan Carlos , Pastor‐Montero Sonia María , del Carmen Sánchez‐Dalda María , Rozadillas‐Sanmiguel Elena , Moreno‐Corral Luis Javier
Published: June 2015

Purpose

To develop and psychometrically evaluate a questionnaire based on the outcome “Knowledge: Breast‐feeding” of the Nursing Outcomes Classification (NOC) to determine the knowledge of parents on breast‐feeding.

Background

TheNOCoutcome “Knowledge: Breast‐feeding” allows for nurses/midwives to assess the efficacy of interventions aimed to improve the knowledge on breast‐feeding in parents thought the clinical interview/observation. However, the use of self‐administered questionnaires by patients could facilitate its evaluation.

Methods

Two‐phased study: (1) Development of the questionnaire based on experts' opinions; (2) Methodological design to assess its psychometric properties.

Implications for Nursing Practice

The availability of tools that enable the determination of the knowledge of patients would facilitate nurses/midwives to set objectives, individualize interventions, and measure their effectiveness.
Bystander first aid in trauma – prevalence and quality: a prospective observational study
Authors: Bakke H. K. , Steinvik T. , Eidissen S.‐I. , Gilbert M. , Wisborg T.
Published: June 2015

Background

Bystander first aid and basic life support can likely improve victim survival in trauma. In contrast to bystander first aid and out‐of‐hospital cardiac arrest, little is known about the role of bystanders in trauma response. Our aim was to determine how frequently first aid is given to trauma victims by bystanders, the quality of this aid, the professional background of first‐aid providers, and whether previous first‐aid training affects aid quality.

Methods

We conducted a prospective 18‐month study in two mixed urban–rural Norwegian counties. The personnel on the first ambulance responding to trauma calls assessed and documented first aid performed by bystanders using a standard form.

Results

A total of 330 trauma calls were included, with bystanders present in 97% of cases. Securing an open airway was correctly performed for 76% of the 43 patients in need of this first‐aid measure. Bleeding control was provided correctly for 81% of 63 patients for whom this measure was indicated, and prevention of hypothermia for 62% of 204 patients. Among the first‐aid providers studied, 35% had some training in first aid. Bystanders with documented first‐aid training gave better first aid than those where first‐aid training status was unknown.

Conclusions

A majority of the trauma patients studied received correct pre‐hospital first aid, but still there is need for considerable improvement, particularly hypothermia prevention. Previous first‐aid training seems to improve the quality of first aid provided. The effect on patient survival needs to be investigated.
The paraventricular nucleus of the thalamus is differentially recruited by stimuli conditioned to the availability of cocaine versus palatable food
Authors: Matzeu Alessandra , Cauvi Gabrielle , Kerr Tony M. , Weiss Friedbert , Martin‐Fardon Rémi
Published: June 2015

The paraventricular nucleus of the thalamus (PVT) is not traditionally considered part of the brain addiction neurocircuitry but has received growing attention with regard to a role in the modulation of drug‐seeking behavior. This study sought to establish the pattern of neural activation induced by a response‐reinstating discriminative stimulus (SD) conditioned to either cocaine (COC) or a conventional reinforcer using a palatable food substance, sweetened condensed milk (SCM). Male Wistar rats were trained to associate one SD (S+; COC or SCM availability) and a distinctly different SD (S−; non‐reward; i.e. the availability of saline or the absence of SCM). Following extinction of COC‐ and SCM‐reinforced responding, rats were presented with the respective S+ or S− alone and tested for the reinstatement of reward seeking. The COC S+ and SCM S+ elicited identical reinstatement, whereas the non‐reward S− was behaviorally ineffective. PVT sections were obtained following completion of the reinstatement tests and labeled for Fos. The number of Fos+ neurons was compared among rats that were presented with the COC S+, SCM S+ or S−. Rats that were presented with the COC S+ exhibited a significant increase in Fos expression compared with rats that were presented with the S−. Moreover, Fos expression was significantly correlated with the number of reinstatement responses that were induced by the COC S+. In contrast, the SCM S+ and S− produced identical increases in Fos expression, without behaviorally relevant correlations. The findings implicate the PVT as an important site that is selectively recruited during COC‐seeking behavior.
Adding urine and saliva toxicology to SBIRT for drug screening of new patients
Authors: Magura Stephen , Achtyes Eric D. , Batts Kristin , Platt Thomas , Moore Thomas L.
Published: June 2015

Background and Objectives

To determine illicit drug use among new patients in primary medical care who denied using “street drugs” during Screening, Brief Intervention and Referral to Treatment (SBIRT).

Methods

96 new patients who denied use of “street drugs” were tested for drugs as part of routine SBIRT screening.

Results

Of those tested, 14.6% of those with urine specimens and 4.1% of those with saliva specimens tested positive for illicit drugs.

Discussion and Conclusions

Drug toxicology can detect unreported illicit drug use during SBIRT screening, with urine being superior to saliva.

Scientific Significance

Drug toxicology can increase the effectiveness of SBIRT screening in primary care medical clinics. (Am J Addict 2015;24:396 –399)
Ara h 2 and Ara 6 are the best predictors of severe peanut allergy: a double‐blind placebo‐controlled study
Authors: Kukkonen A. K. , Pelkonen A. S. , Mäkinen‐Kiljunen S. , Voutilainen H. , Mäkelä M. J.
Published: June 2015

Background

Component‐resolved diagnostics offers a modern tool in peanut allergy, but studies applying consistently double‐blind placebo‐controlled challenges are lacking. We aimed to optimize diagnostics for moderate‐to‐severe peanut allergy in a birch‐endemic region and to create an oral‐peanut challenge with its allergen activity characterized.

Methods

We performed double‐blind placebo‐controlled peanut challenges for a referred sample of 6‐ to 18‐year‐olds with peanut sensitization or a high suspicion of peanut allergy, including anaphylaxis. We measured specific IgE (sIgE) to Ara h 1, 2, 3, 6, 8, and 9. Testing of allergen activity of the challenge products was by IgE microarray inhibition.

Results

Of the 102 patients, 69 were challenge positive: 25 (36%) had severe, 36 (52%) moderate, and 8 (12%) mild symptoms; 38 (37%) received adrenalin. SIgE to Ara h 6 AUC 0.98 (95%CI, 0.96–1.00) was the best marker of moderate‐to‐severe allergy. When sIgE to Ara h 2 and Ara h 6 was measured together, all (100%) severe reactions at low doses were successfully diagnosable. SIgE to Ara h 8 had no diagnostic value, AUC 0.42 (95%CI, 0.30–0.52). Both nonroasted and roasted peanut inhibited 100% of IgE binding to Ara h 1, 2, 3, and 6. Nonroasted peanut inhibited 87% of IgE binding to Ara h 8, roasted inhibited 30%. The products lacked Ara h 9 activity.

Conclusion

Co‐sensitization to Ara h 2 and Ara h 6 was associated with severe reactions distinguishing severe allergy from mild symptoms. SIgE to Ara h 8 added no diagnostic value. Component‐resolved diagnostics reduce the need for oral challenges in peanut allergy.
The ‘four‐hour target’ and the impact on Australian metropolitan acute surgical services
Authors: Perera Marlon L. , Gnaneswaran Neiraja , Roberts Matthew J. , Giles Marian , Liew Danny , Ritchie Peter , Chan Steven T. F.
Published: June 2015

Background

The National Emergency Access Targets (NEAT), introduced in 2012, guides the clearance of emergency department (ED) presentations within 4 h of initial presentation. We aim to assess the impact of NEAT on acute surgical services at a large metropolitan centre.

Methods

A retrospective cohort study was performed and data were collected from electronic patient management systems. The control group was represented by ED presentations between June and September 2011, 1 year prior to the introduction of NEAT. The two study groups consisted of ED presentations between June and September 2012 and 2013 respectively. Outcome measures included time to appendicectomy and cholecystectomy, inpatient length of stay (IPLOS) (for operative and non‐operative cases), out‐of‐hours operating and hospital mortality rates.

Results

In total, 2619 inpatient episodes were included, with a trend showing increasing admissions throughout the study periods (P < 0.001). Time to surgical review and ED length of stay decreased significantly (P < 0.001). Time from emergency presentation to emergency appendicectomy and cholecystectomy remained unchanged and procedures performed out‐of‐hours increased significantly from 20.9% to 42.9% (P < 0.001). Median IPLOS for operative and non‐operative patients was reduced during the study from 2.05 to 1.84 days (P < 0.001). Inter‐unit transfers within 48 h of presentation increased significantly from 5.3% to 14.7% (P < 0.001).

Conclusions

The early results following the implementation of NEAT have been correlated with increased efficiency in ED clearance and increased burden on surgical operative and inpatient outcomes. While improvements in IPLOS were observed, they must be considered in the context of increased lower‐acuity admissions and out‐of‐hours operating.
What Level of Statistical Model Should We Use in Small Area Estimation?
Authors: Namazi‐Rad Mohammad‐Reza , Steel David
Published: June 2015

If unit‐level data are available, small area estimation (SAE) is usually based on models formulated at the unit level, but they are ultimately used to produce estimates at the area level and thus involve area‐level inferences. This paper investigates the circumstances under which using an area‐level model may be more effective. Linear mixed models (LMMs) fitted using different levels of data are applied in SAE to calculate synthetic estimators and empirical best linear unbiased predictors (EBLUPs). The performance of area‐level models is compared with unit‐level models when both individual and aggregate data are available. A key factor is whether there are substantial contextual effects. Ignoring these effects in unit‐level working models can cause biased estimates of regression parameters. The contextual effects can be automatically accounted for in the area‐level models. Using synthetic and EBLUP techniques, small area estimates based on different levels of LMMs are investigated in this paper by means of a simulation study.
Progression of visual field in patients with primary open‐angle glaucoma – ProgF study 1
Authors: Aptel Florent , Aryal‐Charles Nishal , Giraud Jean‐Marie , El Chehab Hussam , Delbarre Maxime , Chiquet Christophe , Romanet Jean‐Paul , Renard Jean‐Paul
Published: June 2015

Purpose

To evaluate the visual field rate of progression of patients with treated ocular hypertension (OHT) and primary open‐angle glaucoma (POAG) in clinical practice, using the mean deviation (MD) and the visual field index (VFI).

Methods

Non‐interventional cohort study. From a large multicentre database representative of the French population, 441 eyes of 228 patients with treated OHT or POAG followed up at least 6 years with Humphrey 24.2 Sita‐Standard visual field examination at least twice a year were identified. From initial data, eyes were classified in five groups: 121 with OHT, 188 with early glaucoma (MD greater than −6 dB), 45 with moderate glaucoma (MD −6 to −12 dB), 41 with advanced glaucoma (MD −12 to −18 dB) and 46 with severe glaucoma (MD less than −18 dB). Rate of progression during the follow‐up period was calculated using the trend analysis of the Guided Progression Analysis software.

Results

The mean duration of follow‐up was 8.4 ± 2.7 years and the mean number of visual field, 18.4 ± 3.5. In eyes with OHT, rate of progression was −0.09 dB/year (−0.17%VFI/year). In eyes with POAG, rate of progression was −0.32 dB/year (−0.83%VFI/year) in eyes with early glaucoma, −0.52 dB/year (−1.81%VFI/year) in moderate glaucoma, −0.54 dB/year (−2.35%VFI/year) in advanced glaucoma and −0.45 dB/year (−1.97%VFI/year) in severe glaucoma. In eyes with POAG, a significant progression (p < 0.05) was detected in 159 of 320 eyes (49.7%) with trend analysis and 117 of 320 eyes (36.6%, likely progression) or 183 of 320 eyes (57.2%, possible and likely progression) with event analysis.

Conclusions

Primary open‐angle glaucoma is a progressive disease in the majority of patients despite cautioned treatment and follow‐up. The rate of progression varies greatly among subjects.
Pseudoexfoliation and cataract surgery: a population‐based 30‐year follow‐up study
Authors: Ekström Curt , Botling Taube Amelie
Published: June 2015

Purpose

To study the relationship between pseudoexfoliation (PEX) and cataract surgery in a population in which PEX is a common finding.

Methods

Survival analyses were performed in a cohort of 760 residents 65–74 years of age, examined in a population survey in the municipality of Tierp, Sweden, during 1984–1986. To expand the cohort, participants in other studies in Tierp were enrolled. Additionally, subjects were recruited by means of glaucoma case records established at the Eye Department in Tierp in 1978–2007. In total, the cohort comprised 1471 individuals, representing more than 15 900 person‐years of risk. Information on cataract surgery was obtained from the glaucoma case records and from medical records.

Results

By the end of the study in August 2014, 564 subjects had undergone cataract surgery. Of these cases, 224 were affected by PEX at baseline. In multivariate analyses, PEX was the second most important predictor for cataract surgery after lens opacities, accounting for a 2.38‐fold (95% confidence interval 2.01–2.84) increased risk.

Conclusion

The results strongly suggest that PEX is a predictor for cataract surgery in the population under study.
Adolescents who were born extremely preterm demonstrate modest decreases in exercise capacity
Authors: Clemm Hege H. , Vollsæter Maria , Røksund Ola D. , Markestad Trond , Halvorsen Thomas
Published: June 2015

Aim

We aimed to investigate exercise capacity in adolescents who were born extremely preterm and to study changes through puberty and associations with neonatal data, exercise habits and lung function.

Methods

This Norwegian population‐based controlled cohort study focused on all infants (n = 35) born at a gestational age of ≤28 weeks or with a birthweight of ≤1000 grams in 1991–1992, together with matched term‐born controls. Participants underwent spirometry and a maximal cardiopulmonary treadmill exercise test at 10 and 18 years.

Results

At 18 years of age, mean (95% confidence interval) peak oxygen consumption (peak VO2) was 42.3 (39.2–45.4) vs 45.3 (41.3–49.3) mL/kg/min in the preterm‐ and term‐born groups, while the completed treadmill distance was 915 (837–992) vs 1017 (912–1122) metres. Peak VO2 was unrelated to neonatal factors and current lung function. Changes between 10 and 18 were similar in the two groups, and positive associations between exercise habits and peak VO2 developed during the period.

Conclusion

Exercise capacity was modestly reduced in adolescents born extremely preterm, but the values were considered normal in most participants. Changes during puberty were similar to those observed for term controls, and the findings suggest similar trainability.
Inadequate vitamin D levels are associated with culture positive sepsis and poor outcomes in paediatric intensive care
Authors: Onwuneme Chike , Carroll Aoife , Doherty Dermot , Bruell Heike , Segurado Ricardo , Kilbane Mark , Murphy Nuala , McKenna Malachi J. , Molloy Eleanor J.
Published: June 2015

Aim

This study aimed to assess vitamin D status, and its determinants, in paediatric patients with suspected sepsis who were admitted to a paediatric intensive care unit (PICU). We also investigated the association between vitamin D status and clinical outcomes.

Methods

Serum 25‐hydroxy vitamin D (25OHD) and clinical determinants were prospectively assessed in children with suspected sepsis (<12 years old) admitted to the PICU. The relationship between 25OHD and clinical outcomes was evaluated. Vitamin D status was also assessed in control children of a similar age.

Results

We enrolled 120 children with suspected sepsis admitted to the PICU and 30 paediatric controls. 25OHD was <50 nmol/L in 59% of the children admitted to the PICU and 25OHD was lower than in the controls (47 ± 29 vs 66 ± 26 nmol/L, p < 0.001). After adjusting for potential confounders, 25OHD was strongly associated with culture positive sepsis (p < 0.001), the paediatric index of mortality (p = 0.026) and the duration of mechanical ventilation (p = 0.008). There was a negative correlation between 25OHD and C‐reactive protein (CRP): each 0.1% decrease in 25OHD increased CRP (p = 0.04).

Conclusion

Children admitted to the PICU with suspected sepsis had lower 25OHD than controls and inadequate 25OHD status was associated with confirmed sepsis and poor outcomes.
Sinonasal yolk sac (Endodermal sinus) tumor in an adult female – A case report and review of the literature
Authors: Mei Xianglin , Xia Yang , Sasano Hironobu , Gao Hongwen
Published: June 2015

Yolk sac tumor (YST), also known as endodermal sinus tumor, is a highly malignant germ cell tumor that is extremely rare in the sinonasal region, especially in adults. To the best of our knowledge, only five such cases have been reported till date (four men, one woman). We present a case of sinonasal YST admixed with transitional cell carcinoma in a 58‐year‐old female. Magnetic resonance imaging revealed a mass in the right ethmoid fissure infiltrating into the posterior and anterior ethmoid sinuses and nasopharynx. Positron emission tomography examination showed a maximum standardized uptake value of 6.8. Histological examination of the biopsy specimen revealed two distinct features, YST and transitional cell carcinoma, with evidence of mutual transition that indicated the composite nature of the tumor. Immunohistochemical analysis revealed positive immunoreactivity for Sal‐like protein 4, α‐fetoprotein and glypican3, and negative immunoreactivity for placental alkaline phosphatase, CD30 and CD117 in the YST component. P40 and P63 were detected only in transitional cell carcinoma component. The tumor was subsequently excised and four cycles of adjuvant chemotherapy at intervals of 3 weeks were administered. At 8 months after surgery, there was no evidence of tumor recurrence or metastasis. We have also presented a literature review on YST in sinusoids.
Risk factors contributing to postoperative delirium in geriatric patients postorthopedic surgery
Authors: Wang Juan , Li Zhiwei , Yu Yu , Li Bo , Shao Gaohai , Wang Qunbo
Published: June 2015

Introduction

Postoperative delirium is a common clinical manifestation in geriatric patients, resulting in prolonged hospitalization and increased economic burden, in addition to higher morbidity and mortality rates. Therefore, identifying non‐obvious risk factors that contribute to the development of postoperative delirium in geriatric patients is crucial.

Methods

From January 2011 to June 2013, 200 geriatric patients of over 65 years of age scheduled for orthopedic surgery were randomly selected and statistically analyzed with respect to the effects of the following 12 factors on postoperative delirium: sex, age, anesthesia type, surgical type (i.e. spine, hip replacement, and pelvic or femoral fracture repair), operative duration, intraoperative hypoxia, intraoperative hypercapnia, intraoperative hypotension, intraoperative blood loss, preoperative affective state, postoperative sleep disorders, and underlying disease (i.e. hypertension, coronary heart disease, diabetes, hyperlipidemia, and chronic bronchitis).

Results

Seven factors – age, anesthesia type, duration of operation, intraoperative hypercapnia, intraoperative hypotension, preoperative affective state, and postoperative sleep disorders – were found to be significantly differentiated, suggesting that these factors have an impact on the development of postoperative delirium. Sex, surgical type, intraoperative hypoxia, intraoperative blood loss (with 300 ml as a cutoff value), and underlying disease were not directly related to the development of postoperative delirium.

Discussion

Advanced age (>70 years), the use of general anesthesia, longer surgical duration (>3 hours), the presence of intraoperative hypercapnia and hypotension, the presence of preoperative affective dysfunction, and the presence of postoperative sleep disorders appear to be associated with the development of postoperative delirium in geriatric patients after orthopedic surgery.
Maternal Physical Health Symptoms in the First 8 Weeks Postpartum Among Primiparous Australian Women
Authors: Cooklin Amanda R. , Amir Lisa H. , Jarman Jennifer , Cullinane Meabh , Donath Susan M. ,   The CASTLE Study Team
Published: June 2015

Background

To describe prospectively the extent, onset, and persistence of maternal physical health symptoms (cesarean delivery pain, perineal pain, back pain, constipation, hemorrhoids, urinary incontinence, bowel incontinence, and fatigue) in the first 8 weeks postpartum.

Methods

A prospective cohort of 229 primiparous women was recruited antenatally from a public and a private maternity hospital, Melbourne, Australia, between 2009 and 2011. Data were collected by self‐report questionnaires at weeks 1, 2, 3, 4, and 8.

Main outcome measures were a checklist of maternal health symptoms and a standardized assessment of fatigue symptoms.

Results

Birth‐related pain was common at week 1 (n = 80/88, 91% cesarean delivery pain; n = 92/125, 74% perineal pain), and still present for one in five women who had a cesarean birth (n = 17, 18%) at week 8. Back pain was reported by approximately half the sample at each study interval, with 25 percent (n = 48) reporting a later onset at week 2 or beyond. Fatigue was not relieved between 4 and 8 weeks.

Conclusions

Women experience significant morbidity in the early weeks postpartum, the extent of which may have been underestimated in previous research relying on retrospective recall. Findings contribute to the growing body of evidence that supports early identification, treatment, and support for women's physical health problems in the postpartum.
Immunotherapy with CpG‐ODN in neoplastic meningitis: A phase I trial
Authors: Ursu Renata , Taillibert Sophie , Banissi Claire , Vicaut Eric , Bailon Olivier , Le Rhun Emilie , Guillamo Jean‐Sebastien , Psimaras Dimitri , Tibi Annick , Sacko Adama , Marantidou Athina , Belin Catherine , Carpentier Antoine F.
Published: June 2015

TLR‐9 agonists are immunostimulating agents that have antitumor effects in animal models. A phase I trial was conducted to define the safety profile of subcutaneous injections, combined with intrathecally administration of CpG‐28, a TRL 9 agonist, in patients with neoplastic meningitis (NM). Cohorts of 3–6 patients with NM were treated for 5 weeks with escalating doses of CpG‐28. The primary endpoint was tolerance. Secondary endpoints were progression free survival (PFS) and overall survival (OS). Twenty‐nine patients were treated with CpG‐28. The primary cancers were malignant glioma, lung carcinoma, breast cancer, melanoma or melanocytoma, ependymoma, and colorectal cancer. The median age was 56 years and median Karnovsky Performance status (KPS) was 70%. The treatment was well tolerated. Adverse effects that were possibly or probably related to the studied drug were grade 2 lymphopenia, anemia and neutropenia, local erythema at injection sites, fever and seizure. There were five serious adverse events: two confusions, two infections of ventricular devices and one grade 4 thrombopenia and neutropenia. The median PFS was 7 weeks and median OS was 15 weeks. Interestingly, the median survival was slightly (but not significantly) higher in the eight patients who were concomitantly treated with bevacizumab (19 weeks vs 15 weeks; P = 0.11). CpG‐28 was well tolerated at doses up to 0.3 mg/kg subcutaneously and 18 mg intrathecally. Additional trials are warranted.
Identification of Interaction Hot Spots in Structures of Drug Targets on the Basis of Three‐Dimensional Activity Cliff Information
Authors: Furtmann Norbert , Hu Ye , Gütschow Michael , Bajorath Jürgen
Published: June 2015

Activity cliffs are defined as pairs or groups of structurally similar or analogous compounds that share the same specific activity but have large differences in potency. Although activity cliffs are mostly studied in medicinal chemistry at the level of molecular graphs, they can also be assessed by comparing compound binding modes. If such three‐dimensional activity cliffs (3D‐cliffs) are studied on the basis of X‐ray complex structures, experimental ligand–target interaction details can be taken into account. Rapid growth in the number of 3D‐cliffs that can be derived from X‐ray complex structures has made it possible to identify targets for which a substantial body of 3D‐cliff information is available. Activity cliffs are typically studied to identify structure–activity relationship determinants and aid in compound optimization. However, 3D‐cliff information can also be used to search for interaction hot spots and key residues, as reported herein. For six of seven drug targets for which more than 20 3D‐cliffs were available, series of 3D‐cliffs were identified that were consistently involved in interactions with different hot spots. These 3D‐cliffs often encoded chemical modifications resulting in interactions that were characteristic of highly potent compounds but absent in weakly potent ones, thus providing information for structure‐based design.
Is the association between socioeconomic status and nonreplaced extracted teeth mediated by dental care behaviours in adults?
Authors: Ghorbani Zahra , Peres Karen G.
Published: June 2015

Objective

To investigate whether the association between socioeconomic status (SES) and number of nonreplaced extracted teeth (NRET) is mediated by dental care behaviours (DCBs) in adults.

Methods

A random sample of adults, who participated in the 2010 dental telephone survey (n = 1100) in Tehran, Iran, was investigated. The outcome was self‐reported NRET due to dental caries or periodontal diseases. The main exposures were wealth index and education; and the potential mediators were the frequency of tooth brushing and flossing, and dental visiting in the previous year of the study. Multivariable regression analysis was applied to test mediation using the count ratios (CR) and 95% confidence intervals (CI).

Results

The response rate was 73%. The mean age was 38.99 (SD=13.83), and 50.8% were female. The mean NRET were 1.28 (95% CI 1.14; 1.41). NRET were greater among participants who had less than 12 years of schooling [CR = 4.26 (95% CI 3.52; 5.52)] and those in the poorest quintile [CR = 1.89 (95% CI 1.36; 2.61)] compared with those in the most educated and wealthiest groups, respectively. People who brushed their teeth less than twice a day [CR = 1.38 (95% CI 1.17; 1.62)] and did not use dental floss daily [CR = 1.47 (95% CI 1.24; 1.75)] were more likely to present NRET. After controlling for DCBs, a slight decrease in the CRs was observed for both the poorest (13.3%) and the less than 12 years of schooling (7.6%) groups compared to the reference groups.

Conclusions

Although DCBs were associated with both SES and NRET, they could only be partially accountable for the observed socioeconomic inequalities in NRET.
C1qrs292001 polymorphism and C1q antibodies in juvenile lupus and their relation to lupus nephritis
Authors: Mosaad Y M , Hammad A , Fawzy Z , El-Refaaey A , Tawhid Z , Hammad E M , Youssef L F , ElAttar E A A , Radwan D F , Fawzy I M
Published: June 2015

C1q deficiency is related strongly to systemic lupus erythematosus (SLE), but very few and inconsistent studies explored the single nucleotide polymorphisms of the C1q gene in relation to juvenile SLE (jSLE) and lupus nephritis (LN). The objective of this study was to analyse whether C1q rs 292001 polymorphism is associated with SLE and disease phenotype, especially nephritis, and to investigate the relation between this polymorphism and clinical data, treatment outcome, serum level of C1q protein and antibodies. Typing of C1q rs292001 polymorphism using restriction fragment length polymorphism and measuring serum levels of C1q protein and antibodies by enzyme-linked immunosorbent assay (ELISA) were performed for 130 children with SLE and 208 healthy controls. The A allele of C1q rs292001 was associated with jSLE and LN (P = 0·005 and 0·013, respectively) and the AA genotype was associated with jSLE (P = 0·036). Low serum levels of C1q protein were found in jSLE and LN (P < 0·001 and 0·009, respectively), and these levels were increased after treatment in patients with LN (P = 0·009) and active renal disease (P = 0·027). Higher titres of C1q antibodies were found in patients with LN (P = 0·015) and correlated negatively with C1q protein level (P < 0·001) and patient age (P = 0·04). The A allele and AA genotype of C1q rs292001 can be considered a susceptibility risk factor and the GG genotype could be considered protective for jSLE and LN in the studied cohort of Egyptian children. Decreased serum levels of C1q protein and increased titres of C1q antibodies may be involved in the pathogenesis of jSLE, especially LN.
Being counted? Examining the prevalence of looked‐after disabled children and young people across the UK
Authors: Hill Louise , Baker Claire , Kelly Bernadette , Dowling Sandra
Published: June 2015

Since the 1970s, there has been growing academic interest in children and young people living in state care and, more recently, in the lives of disabled children. However, there has been little attention on the lives of disabled children who are looked after by the state. This paper compares and critiques what is known about the numbers of disabled children who are looked after in England, Northern Ireland, Scotland and Wales. We discuss the conceptual and methodological limitations of systematically collecting data on disabled children in state care across the UK. We argue that to ensure that the rights of disabled children in state care are identified, acknowledged and upheld, ‘being counted’ is a fundamental first step.
Immigrant Children: Their Experience of Violence at School and Community in Host Country
Authors: Brabant Louise Hamelin , Lapierre Simon , Damant Dominique , Dubé‐Quenum Mélissa , Lessard Geneviève , Fournier Claudia
Published: June 2015

This article describes our qualitative sociological study of immigrant children's life experiences of violence. We conducted interviews with 42 first‐generation immigrant children from any country, aged 9–13 years old, living in the Quebec City region (Canada). Results from three main themes are presented: representations of violence and concrete violent acts experienced; perceived effects of violence on children health and well‐being; and reactions and coping strategies. Overall, the narratives show that they may experience racist peer violence in school that leads to suffering situations, and they consequently have to develop strategies to maintain their well‐being. Social implications are discussed.
Hand‐sewn coloanal anastomosis for low rectal cancer: technique and long‐term outcome
Authors: Tekkis P. , Tan E. , Kontovounisios C. , Kinross J. , Georgiou C. , Nicholls R. J. , Rasheed S. , Brown G.
Published: June 2015

Aim

This study compared the operative outcome and long‐term survival of three types of hand‐sewn coloanal anastomosis (CAA) for low rectal cancer.

Method

Patients presenting with low rectal cancer at a single centre between 2006 and 2014 were classified into three types of hand‐sewn CAA: type 1 (supra‐anal tumours undergoing transabdominal division of the rectum with transanal mucosectomy); type 2 (juxta‐anal tumours, undergoing partial intersphincteric resection); and type 3 (intra‐anal tumours, undergoing near‐total intersphincteric resection with transanal mesorectal excision).

Results

Seventy‐one patients with low rectal cancer underwent CAA: 17 type 1; 39 type 2; and 15 type 3. The median age of patients was 61.6 years, with a male/female ratio of 2:1. Neoadjuvant therapy was given to 56 (79%) patients. R0 resection was achieved in 69 (97.2%) patients. Adverse events occurred in 25 (35.2%) of the 71 patients with a higher complication rate in type 1 vs type 2 vs type 3 (47.1% vs 38.5% vs 13.3%, respectively; P = 0.035). Anastomotic separation was identified in six (8.5%) patients and pelvic haematoma/seroma in five (7%); two (8.3%) female patients developed a recto–vaginal fistula. Ten (14.1%) patients were indefinitely diverted, with a trend towards higher long‐term anastomotic failure in type 1 vs type 2 vs type 3 (17.6% vs 15.5% vs 6.7%). The type of anastomosis did not influence the overall or disease‐free survival.

Conclusion

CAA is a safe technique in which anorectal continuity can be preserved either as a primary restorative option in elective cases of low rectal cancer or as a salvage procedure following a failed stapled anastomosis with a less successful outcome in the latter. CAA has acceptable morbidity with good long‐term survival in carefully selected patients.
INTRANATIONAL AND INTERNATIONAL KNOWLEDGE FLOWS: EFFECTS ON THE FORMAL AND INFORMAL SECTORS
Authors: Goel Rajeev K. , Saunoris James W. , Zhang Xingyuan
Published: June 2015

This article studies the effects of international and intranational knowledge flows. Contributions include comparing the effects of knowledge flows on the formal and informal sectors and determining multilateral spatial spillovers of innovation. Results show that formal entrepreneurs respect intranational intellectual property rights, but benefit from international spillovers, especially from patents granted. In contrast, informal entrepreneurs somewhat respect intranational patents granted, but not patent applications and citations. International spillovers to the informal sector are mainly from patents granted. Spillover magnitudes are greater internationally than intranationally, and greater in the informal sector than the formal sector (except for trademarks). (JEL O33, L26, K42)
How has alcohol advertising in traditional and online media in Australia changed? Trends in advertising expenditure 1997–2011
Authors: White Victoria , Faulkner Agatha , Coomber Kerri , Azar Denise , Room Robin , Livingston Michael , Chikritzhs Tanya , Wakefield Melanie
Published: June 2015

Introduction and Aims

The aim of this study was to determine changes in advertising expenditures across eight media channels for the four main alcohol beverage types and alcohol retailers in Australia.

Design and Methods

Yearly advertising expenditures between January 1997 and December 2011 obtained from a leading media‐monitoring company. Media channels assessed were: free‐to‐air television, newspapers, magazines, radio, outdoors (billboards), cinema, direct mail (from 2005) and online (from 2008). Data were categorised into alcohol retailers (e.g. supermarkets, off‐licences) or four alcoholic beverage types (beer, wine, spirits, premixed spirits/cider). Regression analyses examined associations between year and expenditure.

Results

Total alcohol advertising expenditure peaked in 2007, then declined to 2011 (P = 0.02). Television advertising expenditure declined between 2000 and 2011 (P < 0.001), while outdoor advertising expenditure increased between 1997 and 2007. Alcohol retailers' advertising expenditure increased over time (P < 0.001), and from the mid‐2000s exceeded expenditure for any single beverage category. For both beer and spirits, television advertising expenditure declined over time (beer: P < 0.001; spirits: P < 0.001) while outdoor advertising expenditure increased (beer: P < 0.001; spirits: P = 0.02). However, the number of advertised beer (P < 0.001), spirits (P < 0.001) and wine (P = 0.01) products increased over time.

Discussion and Conclusions

Retailers are playing an increasing role in advertising alcohol. As our study excluded non‐traditional advertising media (e.g. sponsorships, in‐store) we cannot determine whether declines in television advertising have been offset by increases in advertising in newer media channels. However, our findings that media channels used for alcohol advertising have changed over time highlights the need for adequate controls on alcohol advertising in all media channels. [White V, Faulkner A, Coomber K, Azar D, Room R, Livingston M, Chikritzhs T, Wakefield M. How has alcohol advertising in traditional and online media in Australia changed? Trends in advertising expenditure 1997–2011. Drug Alcohol Rev 2015]2015;34:521–530
Towards a Radical Re‐appropriation: Gender, Development and Neoliberal Feminism
Authors: Wilson Kalpana
Published: June 2015

Tracing a complex trajectory from ‘liberal’ to ‘neoliberal’ feminism in development, this article argues that approaches to gender which are currently being promoted within neoliberal development frameworks, while often characterized as ‘instrumentalizing’ gender equality, in fact rely upon, extend and deepen gendered inequalities in order to sustain and strengthen processes of global capital accumulation in several ways. This is explored through development discourses and practices relating to microfinance, reproductive rights and adolescent girls. Drawing on examples from India, the article goes on to reflect on experiences of collective movements in which the assumptions underpinning this ‘Gender Equality as Smart Economics’ approach are challenged. Finally, it highlights several concepts associated with Marxist, Black, Post‐colonial and Queer feminisms and underlines their importance to projects seeking to critically redefine development, arguing for a radical re‐appropriation of gender in this context.
Development Alternatives
Authors: Radcliffe Sarah A.
Published: June 2015

Development alternatives arguably emerge out of practices, negotiations and critiques of dominant development narratives and paradigms. Critical Development Studies’ (CDS) practices of insightful critique and a willingness to challenge hegemonic paradigms are alive and well. Yet this article argues that CDS could fruitfully pay attention to emergent issues that have yet to receive sustained analysis and critique. The article focuses on three very different registers of development futures: evolutionary and resilience‐based thinking; post‐neoliberal experiments in Latin America; and the challenge of social heterogeneity. After summarizing the issues involved with respect to each topic, the article suggests some aspects that require further research and debate.
Discriminatory value of alanine aminotransferase for diabetes prediction: the Insulin Resistance Atherosclerosis Study
Authors: Lorenzo C. , Hanley A. J. , Rewers M. J. , Haffner S. M.
Published: June 2015

Aims

To examine the incremental usefulness of adding alanine aminotransferase to established risk factors for predicting future diabetes.

Methods

The study population of the Insulin Resistance Atherosclerosis Study included 724 people aged 40–69 years. We excluded people who had excessive alcohol intake or were treated with lipid‐lowering agents. Incident diabetes was assessed after a mean follow‐up period of 5.2 years.

Results

Alanine aminotransferase had a non‐linear relationship with incident diabetes (Wald chi‐squared test, P < 0.001; P for linearity = 0.005) independent of demographic variables, family history of diabetes, BMI and fasting glucose; therefore, we used Youden's J statistic to dichotomize alanine aminotransferase [threshold ≥ 0.43 μkat/L ( ≥ 26 IU/l)]. Dichotomized alanine aminotransferase increased the area under the receiver‐operating characteristic curve (0.805 vs. 0.823; P = 0.007) of a model that included demographic variables, family history of diabetes, BMI and fasting glucose as independent variables. The net reclassification improvement was 9.6% (95% CI 1.8–17.4; P = 0.016), and the integrated discrimination improvement was 0.031 (95% CI 0.011–0.050; P = 0.002). Dichotomized alanine aminotransferase reclassified a net of 9.6% of individuals more appropriately.

Conclusions

Alanine aminotransferase may be useful for classifying individuals who are at risk of future diabetes after accounting for the effect of other risk factors, including family history, adiposity and plasma glucose.
Comparison of approaches to combine species distribution models based on different sets of predictors
Authors: Romero David , Olivero Jesús , Brito José Carlos , Real Raimundo
Published: June 2015

Distribution models should take into account the different limiting factors that simultaneously influence species ranges. Species distribution models built with different explanatory variables can be combined into more comprehensive ones, but the resulting models should maximize complementarity and avoid redundancy. Our aim was to compare the different methods available for combining species distribution models. We modelled 19 threatened vertebrate species in mainland Spain, producing models according to three individual explanatory factors: spatial constraints, topography and climate, and human influence. We used five approaches for model combination: Bayesian inference, Akaike weight averaging, stepwise variable selection, updating, and fuzzy logic. We compared the performance of these approaches by assessing different aspects of their classification and discrimination capacity. We demonstrated that different approaches to model combination give rise to disparities in the model outputs. Bayesian integration was systematically affected by an error in the equations that are habitually used in distribution modelling. Akaike weights produced models that were driven by the best single factor and therefore failed at combining the models effectively. The updating and the stepwise approaches shared recalibration as the basic concept for model combination, were very similar in their performance, and showed the highest sensitivity and discrimination capacity. The fuzzy‐logic approach yielded models with the highest classification capacity according to Cohen's kappa. In conclusion: 1) Bayesian integration, employing the currently used equation, and the Akaike weight procedure should be avoided; 2) the updating and stepwise approaches can be considered minor variants of the same recalibrating approach; and 3) there is a trade‐off between this recalibrating approach, which has the highest sensitivity, and fuzzy logic, which has the highest overall classification capacity. Recalibration is better if unfavourable conditions in one environmental factor may be counterbalanced with favourable conditions in a different factor, otherwise fuzzy logic is better.
An investigation into the relationship between thickness variations and manufacturing techniques of mouthguards
Authors: Farrington Timothy , Coward Trevor , Onambele‐Pearson Gladys , Taylor Rebecca L. , Earl Philip , Winwood Keith
Published: June 2015

Background

The aim of this study was to measure the finished thickness of a single identical 4‐mm EVA mouthguard model from a large fabricated sample group and to evaluate the degree of material thinning and variations during the fabrication process.

Materials and methods

Twenty boxes were distributed to dental technician participants, each containing five duplicated dental models (n = 100), alongside 5 × 4 mm mouthguard blanks and a questionnaire. The mouthguards were measured using electronic callipers (resolution: ±0.01 mm) at three specific points. The five thickest and thinnest mouthguards were examined using a CT scanner to describe the surface typography unique to each mouthguard, highlighting dimensional thinning patterns during the fabrication process.

Results

Of the three measurement points, the anterior sulcus point of the mouthguard showed a significant degree of variation (up to 34% coefficient of variation), in finished mouthguard thickness between individuals. The mean thickness of the mouthguards in the anterior region was 1.62 ± 0.38 mm with a range of 0.77–2.80 mm. This variation was also evident in the occlusion and posterior lingual regions but to a lesser extent (up to 12.2% and 9.8% variations, respectively).

Conclusion

This study highlights variability in the finished thickness of the mouthguards especially in the anterior sulcus region measurement point, both within and between individuals. At the anterior region measurement point of the mouthguard, the mean thickness was 1.62 mm, equating to an overall material thinning of 59.5% when using a single 4‐mm EVA blank. This degree of thinning is comparative to previous single operator research studies.
The network structure of myrmecophilic interactions
Authors: CAGNOLO LUCIANO , TAVELLA JULIA
Published: June 2015

1. Ants establish mutualistic interactions involving a wide range of protective relationships (myrmecophily), in which they provide defence against enemies and partners provide food rewards and/or refuge. Although similar in the general outcome, myrmecophilic interactions differ in some characteristics such as quantity and quality of rewards offered by partners which may lead to different specialisation levels and, consequently, to different network properties.

2. The aim of this study was to identify structural patterns in myrmecophilic interaction networks, focusing on aspects related to specialisation: network modularity, nestedness and taxonomic relatedness of interaction ranges. To achieve this, a database of networks was compiled, including the following interactions: ants and domatia‐bearing plants (myrmecophytes); ants and extrafloral nectary‐bearing plants (EFNs); ants and floral nectary‐bearing plants (FNs); ants and Lepidoptera caterpillars; and ants andHemiptera.

3. Myrmecophilic networks differed in their topology, with ant–myrmecophyte and ant–Lepidoptera networks being similar in their structural properties. A continuum was found, ranging from highly modular networks and phylogenetically structured interaction ranges in ant–myrmecophyte followed by ant–Lepidoptera networks to low modularity and taxonomically unrelated interaction ranges in ant–Hemiptera,EFNandFNnetworks.

4. These results suggest that different network topologies may be found across communities of species with similar interaction types, but also, that similar network topologies can be achieved through different mechanisms such as those between ants and myrmecophytes orLepidoptera larvae. This study contributes to a generalisation of myrmecophilic network patterns and a better understanding of the relationship between specialisation and network topology.