bluuebunny/crossref_metadata_2025 huggingface dataset:
Turismo, turistas e paisagem
Authors: Marujo Noémi , Santos Norberto
Published: March 2014

O turismo e a paisagem são dois elementos que estão intimamente ligados e particularmente ancorados no território. O turismo recorre a diversos instrumentos para vender os lugares. Todavia, a paisagem funciona como elemento central do marketing territorial. Em muitos casos, é a paisagem que seduz ou influencia o desejo dos turistas pela procura de novos lugares ou por mais procura nos destinos que visitam. Na verdade, muitas experiências turísticas são construídas e adquiridas através da paisagem. É através dos diferentes ‘olhares’, projetados para a paisagem e percebidos através dela, que o turista constrói novas imagens, novos signos e novas experiências. O presente artigo analisa, numa perspetiva geográfica, a relação do turismo e do turista com a paisagem. Os autores utilizaram como suporte metodológico a revisão bibliográfica e recorreram a exemplos práticos na Vila de Monsaraz (Alentejo – Portugal) onde, através da observação direta e do recurso à fotografia, descreveram a forma como o turista se comporta no momento da sua chegada à referida vila.
La planificación de los destinos turísticos mexicanos: una receta mil veces vanagloriada
Authors: Gómez Nieves Salvador
Published: March 2014

Este trabajo trata de responder, entre otras, a la cuestión de si la planificación, tal como se ha venido realizando en los últimos tiempos en México, ha sido un instrumento eficaz para el desarrollo de los destinos costeros. Para ello se examinan dos modelos de análisis: el ciclo de vida de los destinos turísticos y el paradigma del posturismo, ya que aun cuando sus explicaciones no parecen satisfactorias, han influido en la configuración del pensamiento latinoamericano en la materia y son los que, de forma frecuente, asumen los agentes que, supuestamente, determinan el rumbo del turismo en el futuro. Una de las tesis que se manejan en el trabajo es que, a pesar de la euforia planificadora en este país, el éxito de los planes turísticos es relativo.
Vivir bien, buen vivir: caminar con los dos pies
Authors: Tortosa Blasco José María
Published: March 2014

El texto recoge, a modo de introducción, una reflexión sobre el concepto del Buen Vivir/Vivir bien, los motivos de su relativo éxito en el contexto latinoamericano y su importancia tanto en el terreno simbólico como en su capacidad de revelar los errores del desarrollo en el sistema mundial. El Buen Vivir/Vivir Bien es un concepto en construcción, y de ahí la importancia de avanzar en la identificación de variables e indicadores que permitan su medición.
El buen (con)vivir, una utopía por (re)construir: alcances de la Constitución de Montecristi
Authors: Acosta Alberto
Published: March 2014

En este texto se realiza un análisis desde la perspectiva andina del concepto del Buen Vivir a partir de la Constitución ecuatoriana, redactada en Montecristi y aprobada en 2008. En ésta, el Buen Vivir es un derecho reconocido junto a los derechos de la Naturaleza. En el contenido de esta Constitución afloran múltiples propuestas para impulsar transformaciones de fondo, construidas a lo largo de muchas décadas de resistencias y de luchas sociales, en las que se fueron construyendo propuestas alternativas de desarrollo e incluso alternativas al desarrollo, como lo es el Buen Vivir para el desarrollo de la ciudadanía y los pueblos.
Estado, crisis y acumulación: análisis de un marco conceptual para la comprensión de la historia argentina reciente
Authors: Plá Jésica Lorena
Published: March 2014

El artículo tiene como objetivo aportar elementos que permitan comprender los procesos históricos de Argentina en las últimas tres décadas. Para ello, se realiza un análisis de tres periodos: la dictadura militar del año 1976; el proceso hiperinflacionario del año 1989 y la crisis del año 2001-2002. No se pretende realizar un análisis exhaustivo de cada uno de esos procesos, sino determinar las características generales que, dentro de un marco general de análisis denominado marxismo abierto, pueden establecerse en cada uno de ellos, en pos de establecer las potencialidades del mismo.
(Non)linear instability of periodic traveling waves: Klein–Gordon and KdV type equations
Authors: Angulo Pava Jaime , Natali Fabio
Published: March 2014

We prove the existence and nonlinear instability of periodic traveling wave solutions for the critical one-dimensional Klein–Gordon equation. We also establish a linear instability criterium for a KdV type system. An application of this approach is made to obtain the linear/nonlinear instability of vector cnoidal wave profiles. Finally, via a theoretical and numerical approach we show the linear stability or instability of periodic positive and sign changing waves, respectively, for the critical Korteweg–de Vries equation.
Nonautonomous Klein–Gordon–Maxwell systems in a bounded domain
Authors: d'Avenia Pietro , Pisani Lorenzo , Siciliano Gaetano
Published: March 2014

This paper deals with the Klein–Gordon–Maxwell system in a bounded spatial domain with a nonuniform coupling. We discuss the existence of standing waves in equilibrium with a purely electrostatic field, assuming homogeneous Dirichlet boundary conditions on the matter field and nonhomogeneous Neumann boundary conditions on the electric potential. Under suitable conditions we prove existence and nonexistence results. Since the system is variational, we use Ljusternik–Schnirelmann theory.
Growth and survival of lung cancer cells: regulation by kallikrein-related peptidase 6 via activation of proteinase-activated receptor 2 and the epidermal growth factor receptor
Authors: Michel Noémie , Heuzé-Vourc’h Nathalie , Lavergne Elise , Parent Christelle , Jourdan Marie-Lise , Vallet Amandine , Iochmann Sophie , Musso Orlando , Reverdiau Pascale , Courty Yves
Published: March 2014

The dysregulated expression of kallikrein-related peptidase 6 (KLK6) is involved in non-small cancer (NSCLC) cell growth. However, the mechanism that sustains KLK6 signaling remains unknown. We used an isogenic non-small cell lung cancer (NSCLC) cell model system to demonstrate that KLK6 promotes the proliferation of lung tumoral cells and restrains their apoptosis in vitro via ligand-dependent EGFR transactivation. KLK6 activated the ERK and Akt pathways and triggered the nuclear translocation of β-catenin. The stimulating effects of KLK6 required its proteolytic activity and were dependent on the protease-activated receptor 2 (PAR2). These observations support the concept of a role for KLK6 in the oncogenesis of NSCLC.
Is change in health behavior of Dutch medical students related to change in their ideas on how a physician’s lifestyle influences their patient’s lifestyle?
Authors: Ketelaar Sarah M. , Frings-Dresen Monique H.W. , Sluiter Judith K.
Published: March 2014

Background: A change of medical students’ health behavior over time may be related to a change in their opinion regarding the relationship between physicians’ own health behavior and effective healthy lifestyle counseling in patients.

Objective: To investigate Dutch medical students’ (1) change of health behavior over time, (2) change of opinion over time regarding the relationship between a physician’s own health behavior and effective healthy lifestyle counseling in patients, and (3) the relationship between these aspects.

Method: All medical students from two Dutch medical schools were invited to fill out an online questionnaire in 2010. Respondents of 2010 were invited for 2011. Health behavior was assessed with five aspects: drinking behavior, smoking, eating habits, sleeping behavior, and sexual behavior. Their opinion regarding the relationship between their own health behavior and effective healthy lifestyle counseling in patients was assessed with one statement.

Results: At baseline, 2016 medical students (41%) participated, and at 1 year follow-up 1078 medical students (53%) participated. Fourteen percent adopted healthier behavior over time, and 12% adopted unhealthier behavior. Twelve percent positively changed their opinion, and 13% negatively changed their opinion. Participants who adopted unhealthier behavior were more inclined to also have negatively changed their opinion than participants who adopted healthier behavior (statistically nonsignificant difference, p=0.38).

Conclusions: No significant relationship was found between a change in health behavior of Dutch medical students and a change of their opinion regarding the relationship between physicians’ own healthy lifestyle and their ability to effectively influence patients to adhere to a healthy lifestyle.
ICTAC nomenclature of thermal analysis (IUPAC Recommendations 2014)
Authors: Lever Trevor , Haines Peter , Rouquerol Jean , Charsley Edward L. , Van Eckeren Paul , Burlett Donald J.
Published: March 2014

The widespread use of thermal analysis (TA) by scientists as a laboratory technique carries with it a working vocabulary. This document is intended to provide those working in the field with a consistent set of definitions to permit clear and precise communication as well as understanding. Included in the document are the definitions of 13 techniques, 54 terms within the glossary, as well as symbols and units.
Natural compounds as light stabilizer for a starch-based biodegradable polymer
Authors: Dintcheva NadkaTz. , La Mantia Francesco Paolo , Arrigo Rossella
Published: March 2014

The photooxidation behavior of a commercial starch-based biodegradable polymer, i.e., new generation Mater-Bi, loaded with natural stabilizers was investigated in consideration for outdoor agricultural applications. The photooxidation behavior of the biodegradable films was monitored mainly by mechanical tests and spectroscopic analysis. In order to formulate biodegradable films without any synthetic compounds, suitable for outdoor applications and with good photooxidation stability, antioxidants such as α-tocopherol and quercetin (Q) were considered. The results obtained using natural compounds were compared with those obtained by using a synthetic antioxidant and a light stabilizer. Among the investigated natural compounds, the flavonoid compound seemed to work better than the antioxidant and the improvement in the photooxidation behavior of the biodegradable film was very similar to that obtained using the synthetic light stabilizer. A flavonoid compound can be considered as an outstanding natural stabilizer to replace synthetic light stabilizers in the formulation of 100% natural compounds based films, suitable for outdoor applications.
New unsymmetrical digycolamide ligands for
trivalent actinide separation
Authors: Ravi Jammu , Venkatesan K. A. , Antony M. P. , Srinivasan T. G. , Vasudeva Rao P. R.
Published: March 2014

New unsymmetrical diglycolamides (UDGAs), N, N-di-butyl-N′, N′-di-dodecyl-3-oxapentane-1,5-diamide
(C12-C4), N, N-di-dodecyl-N′, N′-di-hexyl-3-oxapentane-1,5-diamide (C12-C6),
N, N-di-decyl-N′, N′-di-dodecyl-3-oxapentane-1,5-diamide (C12-C10) have been synthesized, and evaluated for
the separation of americium(III) and europium(III) from nitric acid medium. The extraction behavior of Am(III), Eu(III), and Sr(II) in
a solution of these UDGAs in n-dodecane was studied as a function of concentration of nitric acid in the aqueous phase. The
distribution ratio of Am(III) and Eu(III) increased with increase in the concentration of nitric acid. The third phase formation
behavior of nitric acid and neodymium(III) in 0.1 M UDGA/n-dodecane was studied. The third phase formation was not
observed in all these UDGAs in n-dodecane (0.1 M), when the concentration of Nd(III) was ∼ 500 mM in
3–4 M nitric acid. The stoichiometry of Am(III)-UDGA was determined from the slope analysis of the extraction data, which
indicated the formation of 1:3 complex in all cases. Our studies revealed that the UDGA ligands with dodecyl group attached to one
amidic nitrogen atom is inevitable for preventing third phase formation and the alkyl group at the other amidic nitrogen can be varied
from butyl to decyl group for obtaining efficient extraction of trivalent actinides from high-level nuclear waste.
Office Hours: How (Critical) Norm Research Can Regain Its Voice
Authors: Engelkamp Stephan , Glaab Katharina , Renner Judith
Published: March 2014

Social Science research cannot be neutral. It always involves, so the argument of this article, the (re)production of social reality and thus has to be conceived as political practice. From this perspective, the present article looks into constructivist norm research. In the first part, we argue that constructivist norm research is political insofar as it tends to reproduce Western values that strengthen specific hegemonic discursive structures. However, this particular political position is hardly reflected on in norm research. Hence, it is our goal in the second part of the article to outline research strategies potentially useful in reflective and critical norm research. We propose a critical research program based upon three central methodological steps that are inspired by post-structuralism: first, the questioning of global hegemonic values; second, the reconstruction of marginalized knowledge; and third, the explicit reflection of one’s own research perspective.
Racial and Ethnic Differences Associated With Feeding- and Activity-Related Behaviors in Infants
Authors: Perrin Eliana M. , Rothman Russell L. , Sanders Lee M. , Skinner Asheley C. , Eden Svetlana K. , Shintani Ayumi , Throop Elizabeth M. , Yin H. Shonna
Published: March 2014

OBJECTIVE:

To examine parental reports of feeding and activity behaviors in a cohort of parents of 2-month-olds and how they differ by race/ethnicity.

METHODS:

Parents participating in Greenlight, a cluster, randomized trial of obesity prevention at 4 health centers, were queried at enrollment about feeding and activity behaviors thought to increase obesity risk. Unadjusted associations between race/ethnicity and the outcomes of interest were performed by using Pearson χ2 and Kruskal-Wallis tests. Adjusted analyses were performed by using proportional odds logistic regressions.

RESULTS:

Eight hundred sixty-three parents (50% Hispanic, 27% black, 18% white; 86% Medicaid) were enrolled. Exclusive formula feeding was more than twice as common (45%) as exclusive breastfeeding (19%); 12% had already introduced solid food; 43% put infants to bed with bottles; 23% propped bottles; 20% always fed when the infant cried; 38% always tried to get children to finish milk; 90% were exposed to television (mean, 346 minutes/day); 50% reported active television watching (mean, 25 minutes/day); and 66% did not meet “tummy time” recommendations. Compared with white parents, black parents were more likely to put children to bed with a bottle (adjusted odds ratio [aOR] = 1.97, P < .004; bottle propping, aOR = 3.1, P < .001), and report more television watching (aOR = 1.6, P = .034). Hispanic parents were more likely than white parents to encourage children to finish feeding (aOR = 1.9, P = .007), bottle propping (aOR = 2.5, P = .009), and report less tummy time (aOR = 0.6, P = .037).

CONCLUSIONS:

Behaviors thought to relate to later obesity were highly prevalent in this large, diverse sample and varied by race/ethnicity, suggesting the importance of early and culturally-adapted interventions.
Common and Costly Hospitalizations for Pediatric Mental Health Disorders
Authors: Bardach Naomi S. , Coker Tumaini R. , Zima Bonnie T. , Murphy J. Michael , Knapp Penelope , Richardson Laura P. , Edwall Glenace , Mangione-Smith Rita
Published: March 2014

BACKGROUND AND OBJECTIVES:

Inpatient pediatric mental health is a priority topic for national quality measurement and improvement, but nationally representative data on the patients admitted or their diagnoses are lacking. Our objectives were: to describe pediatric mental health hospitalizations at general medical facilities admitting children nationally; to assess which pediatric mental health diagnoses are frequent and costly at these hospitals; and to examine whether the most frequent diagnoses are similar to those at free-standing children’s hospitals.

METHODS:

We examined all discharges in 2009 for patients aged 3 to 20 years in the nationally representative Kids’ Inpatient Database (KID) and in the Pediatric Health Information System (free-standing children’s hospitals). Main outcomes were frequency of International Classification of Diseases, Ninth Revision, Clinical Modification–defined mental health diagnostic groupings (primary and nonprimary diagnosis) and, using KID, resource utilization (defined by diagnostic grouping aggregate annual charges).

RESULTS:

Nearly 10% of pediatric hospitalizations nationally were for a primary mental health diagnosis, compared with 3% of hospitalizations at free-standing children’s hospitals. Predictors of hospitalizations for a primary mental health problem were older age, male gender, white race, and insurance type. Nationally, the most frequent and costly primary mental health diagnoses were depression (44.1% of all mental health admissions; $1.33 billion), bipolar disorder (18.1%; $702 million), and psychosis (12.1%; $540 million).

CONCLUSIONS:

We identified the child mental health inpatient diagnoses with the highest frequency and highest costs as depression, bipolar disorder, and psychosis, with substance abuse an important comorbid diagnosis. These diagnoses can be used as priority conditions for pediatric mental health inpatient quality measurement.
Attention Deficit Disorder, Stimulant Use, and Childhood Body Mass Index Trajectory
Authors: Schwartz Brian S. , Bailey-Davis Lisa , Bandeen-Roche Karen , Pollak Jonathan , Hirsch Annemarie G. , Nau Claudia , Liu Ann Y. , Glass Thomas A.
Published: March 2014

BACKGROUND:

Childhood attention-deficit/hyperactivity disorder (ADHD) has been associated with childhood and adult obesity, and stimulant use with delayed childhood growth, but the independent influences are unclear. No longitudinal studies have examined associations of ADHD diagnosis and stimulant use on BMI trajectories throughout childhood and adolescence.

METHODS:

We used longitudinal electronic health record data from the Geisinger Health System on 163 820 children ages 3 to 18 years in Pennsylvania. Random effects linear regression models were used to model BMI trajectories with increasing age in relation to ADHD diagnosis, age at first stimulant use, and stimulant use duration, while controlling for confounding variables.

RESULTS:

Mean (SD) age at first BMI was 8.9 (5.0) years, and children provided a mean (SD) of 3.2 (2.4) annual BMI measurements. On average, BMI trajectories showed a curvilinear relation with age. There were consistent associations of unmedicated ADHD with higher BMIs during childhood compared with those without ADHD or stimulants. Younger age at first stimulant use and longer duration of stimulant use were each associated with slower BMI growth earlier in childhood but a more rapid rebound to higher BMIs in late adolescence.

CONCLUSIONS:

The study provides the first longitudinal evidence that ADHD during childhood not treated with stimulants was associated with higher childhood BMIs. In contrast, ADHD treated with stimulants was associated with slower early BMI growth but a rebound later in adolescence to levels above children without a history of ADHD or stimulant use. The findings have important clinical and neurobiological implications.
PDA Ligation and Health Outcomes: A Meta-analysis
Authors: Weisz Dany E. , More Kiran , McNamara Patrick J. , Shah Prakesh S.
Published: March 2014

BACKGROUND AND OBJECTIVE:

Patent ductus arteriosus (PDA) ligation has been variably associated with neonatal morbidities and neurodevelopmental impairment (NDI). The objective was to systematically review and meta-analyze the impact of PDA ligation in preterm infants at <32 weeks’ gestation on the risk of mortality, severe neonatal morbidities, and NDI in early childhood.

METHODS:

Medline, Embase, Cochrane Central Register of Controlled Trials, Education Resources Information Centre (ERIC), Cumulative Index to Nursing and Allied Health (CINAHL), PsycINFO, and the Dissertation database were searched (1947 through August 2013). Risk of bias was assessed by using the Newcastle-Ottawa Scale and the Cochrane Risk of Bias tool. Meta-analyses were performed by using a random-effects model. Unadjusted and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were pooled when appropriate.

RESULTS:

Thirty-nine cohort studies and 1 randomized controlled trial were included. Nearly all cohort studies had at least moderate risk of bias mainly due to failure to adjust for survival bias and important postnatal preligation confounders such as ventilator dependence, intraventricular hemorrhage, and sepsis. Compared with medical treatment, surgical ligation was associated with increases in NDI (aOR: 1.54; 95% CI: 1.01–2.33), chronic lung disease (aOR: 2.51; 95% CI: 1.98–3.18), and severe retinopathy of prematurity (aOR: 2.23; 95% CI: 1.62–3.08) but with a reduction in mortality (aOR: 0.54; 95% CI: 0.38–0.77). There was no difference in the composite outcome of death or NDI in early childhood (aOR: 0.95; 95% CI: 0.58–1.57).

CONCLUSIONS:

Surgical ligation of PDA is associated with reduced mortality, but surviving infants are at increased risk of NDI. However, there is a lack of studies addressing survival bias and confounding by indication.
Seafood through time revisited: the Phanerozoic increase in marine trophic resources and its macroevolutionary consequences
Authors: Allmon Warren D. , Martin Ronald E.
Published: March 2014

We review and synthesize multiple biotic and abiotic proxies for marine nutrient and food availability, primary productivity, and food quality (stoichiometry) and propose what their relationships may have been to macroevolutionary processes, especially speciation. This review confirms earlier suggestions that there has been an overall increase in marine primary productivity over the Phanerozoic, but indicates that the increase has been irregular and that present levels may not be the peak. We integrate these indicators into a new estimate of relative primary productivity in the global ocean through the Phanerozoic. We then combine multiple, frequently conflicting ecological-evolutionary hypotheses into a general model for how primary production may affect speciation over geological time scales. This model, an elaboration and extension of the “speciation cycle” previously proposed by Grant and Grant, attempts to explain why an increase in food supply sometimes is associated with decreased diversity, and at other times with increased diversification. We propose some simple tests for the application of this model to the fossil record.
Pulsing hydrology determines top‐down control of basal resources in a tropical river–floodplain ecosystem
Authors: Winemiller Kirk O. , Montaña Carmen G. , Roelke Daniel L. , Cotner James B. , Montoya José Vicente , Sanchez Luzmila , Castillo Maria Mercedes , Layman Craig A.
Published: March 2014

Variable hydrology of rivers strongly affects biophysical factors that influence primary production and population densities, thereby affecting the relative influence of bottom‐up and top‐down processes in trophic networks. Many tropical floodplain rivers have sustained seasonal flood pulses driven by precipitation patterns of the Intertropical Convergence Zone. These changes in flow alter concentrations of dissolved nutrients, aquatic primary productivity, and per‐unit‐area densities of aquatic organisms. Therefore, one would predict that the strength of top‐down effects of animals on basal resources should shift as the annual flood pulse progresses. We conducted a series of field experiments in a Neotropical lowland river to test for effects of hydrologic phase, habitat (in‐channel vs. floodplain aquatic habitat), and benthic‐feeding fish and meiofauna on particulate organic matter, chlorophyll, and benthic microalgae. Net ecosystem productivity of this oligotrophic river is higher during the low phase of the annual flood cycle, which is also when resident fishes are at highest densities and there is a seasonal influx of migratory benthic‐feeding fish. We therefore hypothesized that top‐down effects of benthic‐feeding fish would fluctuate temporally, with strongest effects during low water levels. We found that fish controlled the abundance of particulate organic matter and algae on solid substrates, but not on sand, during falling‐ and low‐water phases within both channel and floodplain habitats. Except for diatom assemblages, which responded to fish exclusion, the taxonomic structure of algal and meiofauna assemblages was not significantly influenced by fish‐exclusion treatments, but varied in relation to habitat type and hydrologic phase. Meiofauna densities were highest during the low‐water period; experimental exclusion of meiofauna during this period had a significant effect on accumulation of particulate organic matter in sand. By controlling abundance of important basal resources, fishes and meiofauna have a large potential to influence other components of this tropical ecosystem. Our findings emphasize the predictable, gradual, changes in consumer–resource interactions associated with the seasonal flood pulse in tropical river systems.
Direct and indirect effects of warming on aphids, their predators, and ant mutualists
Authors: Barton Brandon T. , Ives Anthony R.
Published: March 2014

Species exist within communities of other interacting species, so an exogenous force that directly affects one species can indirectly affect all other members of the community. In the case of climate change, many species may be affected directly and subsequently initiate numerous indirect effects that propagate throughout the community. Therefore, the net effect of climate change on any one species is a function of the direct and indirect effects. We investigated the direct and indirect effects of climate warming on corn leaf aphids, a pest of corn and other grasses, by performing an experimental manipulation of temperature, predators, and two common aphid‐tending ants. Although warming had a positive direct effect on aphid population growth rate, warming reduced aphid abundance when ants and predators were present. This occurred because winter ants, which aggressively defend aphids from predators under control temperatures, were less aggressive toward predators and less abundant when temperatures were increased. In contrast, warming increased the abundance of cornfield ants, but they did not protect aphids from predators with the same vigor as winter ants. Thus, warming broke down the ant–aphid mutualism and counterintuitively reduced the abundance of this agricultural pest.
Exploring the Role of Midwives in Uganda’s Postabortion Care: Current Practice, Barriers, and Solutions
Authors: Bacon Alixandra , Ellis Cathryn , Rostoker Jean-Francois , Olaro Anne Apoko
Published: March 2014

Annually, upward of 100,000 Ugandan women receive care after a spontaneous or induced abortion. Abortion-related complications account for up to 26% of maternal deaths. Pilot projects have trained Ugandan midwives in the use of manual vacuum aspiration (MVA) for postabortion care (PAC), but to date there is no published literature exploring midwifery training and PAC practices. To better understand how PAC is provided in public Ugandan hospitals, the midwife’s training and role in PAC and the perceived barriers to providing PAC, interviews with midwives were conducted at 3 public hospitals. A framework analysis of emergent and a priori themes was conducted. Fewer than half of midwives interviewed had received formal PAC training. Current clinical practice in PAC includes MVA, dilatation and curettage, and medical management with misoprostol. Participants identified barriers to providing PAC, which include shortage of staff and equipment, transportation, cultural issues, and gender inequality. Solutions include increased staffing on maternity wards, training more midwives to perform MVA, and improved planning and communication with National Medical Stores. Community sensitization and support for young pregnant women is needed.
The Role of Children with Congenital Anomalies in Generating Parental Depressive Symptoms
Authors: Sundus Ayesha , Siddique Osama , Ibrahim Mohammad Faisal , Aziz Sina , Khan J. A.
Published: March 2014

Background:

Many expectant parents wish to have a normal child. Unfortunately this does not always happen and some of them may have a child with birth defects leading to detrimental psychological effects on the parents. One of the common presentations generally observed is depression. The presence of depressive symptoms amongst such parents needs to be recorded to find out its prevalence. The results of such finding can help shape future programs for the prevention and treatment in this population group. This study will therefore explore the extent of depressive symptoms amongst parents of children with congenital anomalies.

Methods:

A case control study design was chosen. Ethical Review Board gave approval for the study on December 31, 2010, and the collection of data was started on January 5, 2011. Two randomly chosen samples of 132 parents each were collected from National Institute of Child Health (NICH), Ida Rieu, and Civil Hospital Karachi (CHK) over 8 months. First group consisted of parents of children with congenital anomalies and the second group was chosen as the control group from general population. Zung scale was used to record the presence of depressive symptoms in these two populations. Mann-Whitney test was performed to compare the depression scores.

Results:

The scale was completed by 132 parents in both sets. The parents of children with congenital anomalies showed greater (p < 0.0001) depressive symptoms. Mothers displayed greater (p = 0.029) depressive symptoms than fathers.

Conclusion:

The parents of children with anomalies (60.6%) had more depressive symptoms than parents of normal children (27.3%).
Improving the Doctor-Patient Relationship in China: The Role of Balint Groups
Authors: Jing Wei , Otten Heide , Sullivan Leonie , Lovell-Simons Laurie , Granek-Catarivas Martine , Fritzsche Kurt
Published: March 2014

Objective:

Doctor-patient relationships in China have been deteriorating for the past 10 years. Many Chinese doctors are involved in tense and conflictual doctor-patient relationships. Most patients do not trust doctors or other medical staff and physical attacks on these professionals have become a common event. The Balint group offers a better understanding of the doctor-patient relationship in a safe environment and relieves the doctors from the daily stress.

Method:

This article (1) describes the specifics of Balint work in China, (2) reports experiences from the first International Balint Conference in China, and (3) compares these experiences with the doctor-patient relationship described by Michael and Enid Balint in the 1950s.

Results:

Chinese doctors have a great need to communicate, to share their own feelings of powerlessness, helplessness, frustration, and anger. The Balint method is highly appreciated in China. All participants experienced the 2½-day meeting as very helpful. Also, in China, Balint work as relationship work in the analytical group process fosters the ability for introspection alongside openness, unconscious processes, “thinking outside the box,” “courage of one's own stupidity,” and “beginner's spirit,” thus promoting the individuation, the “small but significant change in the personality of the doctor.”

Conclusions:

Perhaps Balint work in China is a contribution to the integration of traditional Chinese virtues: benevolence, tolerance, magnanimity, and prudence with modern medicine. Balint work could be an alternative to the outcome-oriented pressure to perform and to the machine paradigm of biomedicine.
Gender differences in suicide in Serbia within the period 2006-2010
Authors: Dedic Gordana
Published: March 2014

Background/Aim. The complex multifactorial etiology of suicide suggests the
need to consider gender differences when developing effective strategies for
suicide prevention. The aim of this study was to examine the suicide rates
and/or trends obtained for population as a whole, including gender
differences in cases of committed suicide and to consider factors (age
groups, education, employment, marital status, nationality and methods)
associated with it in Serbia within the period 2006-2010. Methods. Data were
obtained from the Statistical Office of the Republic of Serbia. Their
classification related to the suicide method was carried out on the basis of
ICD-X Code, WHO 1992 (International Statistical Classification of Diseases
and Related Health Problems 10th revision, World Health Organization).
Statistical analysis was done by using the crude specific suicide rate.
Results. Within the period 2006-2010 the total number of suicides in Serbia
was 6,673, of which 71.9% were males and 28.1% females (male to female
suicide ratio 2.56 : 1). Their average rate was 18.15 per 100,000 persons,
namely, 26.85 per 100,000 for males and 9.92 per 100,000 for females. Suicide
was most often committed by married males and females with high school
education, retired, by the Serbs. The suicide rate in Serbia increased
paralelly with the age of suicide committers and it was the highest in
subjects of both genders aged over 75 years. The most common suicide method
in males (62.78%) and in females (58.38%) was hanging and strangling. The
second most common method in males was by firearm (18.65%) and in females
poisoning (19.26%). Conclusions. Suicide prevention Programme should be
primarily oriented toward the male population because it is more exposed to
stress in the period of social transition, but males are still less ready to
ask for doctor's help when having some problems with mental health.
Controlled release of amoxicillin from bacterial cellulose membranes
Authors: Pavaloiu Ramona-Daniela , Stoica Anicuta , Stroescu Marta , Dobre Tanase
Published: March 2014

Bacterial cellulose (BC), a natural polymer with unique physical and mechanical properties, has several applications in the biomedical field, including drug loading and controlled drug delivery. For this study, a Box-Behnken experimental design was employed as a statistical tool to optimize the release of a model drug, amoxicillin, from BC membranes. Independent variables studied were the concentration of the drug (X1), the concentration of glycerol (X2) and the concentration of a permeation enhancer (X3). From the variables studied, drug concentration had the highest effect on drug release. Among the other independent variables, th linear and quadratic X2 terms, the linear X3 term and the interaction term X2X3 were found to affect the release of amoxicillin from bacterial cellulose membranes.
Topological spaces compact with respect to a set of filters
Authors: Lipparini Paolo
Published: March 2014

If is a family of filters over some set I, a topological space X is sequencewise
-compact if for every I-indexed sequence of elements of X there is such that the sequence has an F-limit point. Countable compactness, sequential compactness, initial κ-compactness, [λ; µ]-compactness, the Menger and Rothberger properties can all be expressed in terms of sequencewise -compactness for appropriate choices of . We show that sequencewise -compactness is preserved under taking products if and only if there is a filter such that sequencewise -compactness is equivalent to F-compactness. If this is the case, and there exists a sequencewise -compact T
1 topological space with more than one point, then F is necessarily an ultrafilter. The particular case of sequential compactness is analyzed in detail.
Decentralized control synthesis for bilinear systems using orthogonal functions
Authors: Attia Mohamed , Ayadi Badii , Braiek Naceur
Published: March 2014

In this paper, we propose the development of a new technique of decentralized control for bilinear systems, through using orthogonal functions. The use of this tool allows the conversion of differential state equations to a set of algebraic ones by projecting the system input and output variables into orthogonal functions basis and then using the operational properties of these orthogonal functions. The optimum decentralized control parameters for the interconnected bilinear system can then be determined through comparison of the response behaviour with the chosen reference model.
Turbinoplasty with Quantic Molecular Resonance in the Treatment of Persistent Moderate-Severe Allergic Rhinitis: Comparative Analysis of Efficacy
Authors: Businco Lino Di Rienzo , Businco Andrea Di Rienzo , Ventura Luca , Laurino Salvatore , Lauriello Maria
Published: March 2014

Background

Allergic rhinitis (AR) presents as the main and most invasive symptom in the blocking of the nose. This condition is almost always related to hypertrophy of the inferior turbinates. When the medical treatments are found to be insufficient to solve the obstructive symptom of the patient, the quality of life is considerably impaired and it is often necessary to submit the patient to a surgical approach. In the present study we aimed to establish the efficacy and safety of a new technique recently introduced for the shrinkage of hypertrophic turbinates using a specific device, based on a new radiofrequency energy that does not produce thermal mucosal damage, viz., quantic molecular resonance (QMR) in a group of patients with persistent moderate–severe allergic rhinitis, in addition to standard medical treatment (nasal steroid and oral antihistamine).

Methods

All patients were randomly assigned to two homogeneous groups (group A, control subjects; group B, treated patients); each group included 145 individuals. During the study, both groups received standard medications (ebastine, 10-mg tablet, and budesonide nasal spray at 100 micrograms/nostril per day) for 90 days. Before the medical treatment, patients in group B underwent inferior endoscopic turbinoplasty using QMR. All of the patients enrolled in this study were submitted to a complete otorhinolaryngologic evaluation with objective clinical examination (basal rhinomanometry, nasal provocation test rhinomanometry, and mucociliary transport time), endoscopy, and questionnaires (22-item Sino-Nasal Outcome Test and visual analog scale for nasal symptoms).

Results

Greater efficacy has been achieved using a combined approach with the association of medical and QMR treatment, compared with medical treatment alone, in the control of AR associated with hypertrophy of the inferior turbinates, in particular in the reduction of turbinate volume at rhinoendoscopy.

Conclusion

QMR inferior turbinoplasty, in conjunction with medical therapy, improves the nasal flow, without any thermal mucosal damage, more effectively when compared with medical treatment alone in persistent moderate-to-severe AR. In particular, local reactivity, as measured with nasal provocation test, was noticeably reduced.
Accuracy of Phenotyping Chronic Rhinosinusitis in the Electronic Health Record
Authors: Hsu Joy , Pacheco Jennifer A. , Stevens Whitney W. , Smith Maureen E. , Avila Pedro C.
Published: March 2014

Background

Chronic rhinosinusitis (CRS) is prevalent, morbid, and poorly understood. Extraction of electronic health record (EHR) data of patients with CRS may facilitate research on CRS. However, the accuracy of using structured billing codes for EHR-driven phenotyping of CRS is unknown. We sought to accurately identify CRS cases and controls using EHR data and to determine the accuracy of structured billing codes for identifying patients with CRS.

Methods

We developed and validated distinct algorithms to identify patients with CRS and controls using International Classification of Diseases, Ninth Revision (ICD-9) and Current Procedural Terminology codes. We used blinded clinician chart review as the reference standard to evaluate algorithm and billing code accuracy.

Results

Our initial control algorithm achieved a control positive predictive value (PPV) of 100% (i.e., negative predictive value of 100% for CRS). Our initial algorithm for CRS cases relied exclusively on billing codes and had a low case PPV (54%). Notably, ICD-9 code 471.x was associated with a case PPV of 85%, whereas the case PPV of ICD-9 code 473.x was only 34%. After multiple algorithm iterations, we increased the case PPV of our final algorithm to 91% by adding several requirements, e.g., that ICD-9 codes occur with 1 or more evaluations by a CRS specialist to enhance availability of objective clinical data for accurately phenotyping CRS.

Conclusion

These algorithms are an important first step to identify patients with CRS, and may facilitate EHR-based research on CRS pathogenesis, morbidity, and management. Exclusive use of coded data for phenotyping CRS has limited accuracy, especially because CRS symptomatology overlaps with that of other illnesses. Incorporating natural language processing (e.g., to evaluate results of nasal endoscopy or sinus computed tomography) into future work may increase algorithm accuracy and identify patients whose disease status may not be ascertained by only using billing codes.
Electrolyzed Acid Water Nasal Irrigation after Functional Endoscopic Sinus Surgery
Authors: Jiang Rong-San , Liang Kai-Li , Wu Shang-Heng , Su Mao-Chang , Chen Wen-Kang , Lu Fung-Jou
Published: March 2014

Background

Electrolyzed acid water (EAW) has been recognized to have strong bactericidal activity, and the feasibility and safety of EAW irrigation in body cavities has been reported in the literature. This study was conducted to evaluate the effect of EAW nasal irrigation on the postoperative care of functional endoscopic sinus surgery (FESS).

Methods

Patients with chronic rhinosinusitis who received FESS for treatment were recruited and randomly assigned to three groups at 1 month postoperatively. Patients in group 1 received EAW for nasal irrigation daily for 2 months, those in group 2 received neutral normal saline (NS) daily for 2 months, and those in group 3 did not receive nasal irrigation after surgery. Before and 3 months after FESS, sinonasal symptoms were assessed by questionnaire and patients received endoscopic examination, acoustic rhinometry, smell test, saccharine transit test, and bacterial culture from middle meatus.

Results

There were 185 patients enrolled between May 2009 and March 2012. Among the patients who completed the study, 36 received EWA irrigation, 35 received NS irrigation, and 39 (group 3) received no irrigation. Patients with nasal irrigation had a better outcome based on questionnaire score and saccharine transit time. However, there was no difference in outcome between patients who received irrigation with EAW and NS.

Conclusion

Our study showed that EWA irrigation did not confer a greater benefit than that of NS irrigation in post-FESS care.
Eosinophil–Epithelial Cell Interactions Stimulate the Production of MUC5AC Mucin and Profibrotic Cytokines Involved in Airway Tissue Remodeling
Authors: Shimizu Shino , Kouzaki Hideaki , Ogawa Takao , Takezawa Kumiko , Tojima Ichiro , Shimizu Takeshi
Published: March 2014

Background

Predominant eosinophil infiltration and tissue remodeling are common characteristics of chronic airway inflammation such as nasal polyposis and bronchial asthma. This study was designed to elucidate the role of eosinophils in tissue remodeling of chronic airway inflammation; eosinophil–epithelial interactions were examined by the coculture of airway epithelial cell line NCI-H292 with the eosinophilic cell line EoL-1 or with human blood eosinophils.

Methods

The coculture-induced production of MUC5AC mucin, platelet-derived growth factor AB (PDGF-AB), vascular endothelial growth factor (VEGF), transforming growth factor (TGF) beta1, and interleukin-8 (IL-8) were evaluated by enzyme-linked immunosorbent assay and reverse transcription–polymerase chain reaction.

Results

Eosinophil–epithelial interactions significantly stimulated the secretion of MUC5AC, PDGF-AB, VEGF, TGF-beta1, and IL-8 in culture supernatants. The epidermal growth factor receptor tyrosine kinase inhibitor AG1478 inhibited the coculture-induced secretion of MUC5AC, PDGF-AB, VEGF, and IL-8. Neutralizing antibodies directed against TGF-alpha or amphiregulin and pan-metalloproteinase inhibitor GM6001 inhibited the coculture-induced secretion of MUC5AC and amphiregulin from the cocultured NCI-H292 cells. Coculture of NCI-H292 cells with peripheral blood eosinophils also significantly stimulated MUC5AC production.

Conclusion

The results of this study indicate that eosinophil–epithelial cell interactions are important in the pathogenesis of tissue remodeling of eosinophil-predominant airway inflammation such as occurs in nasal polyposis and bronchial asthma.
The Role of Hypoxia-Inducible Factor 1α in Allergic Rhinitis
Authors: Mo Ji-Hun , Kim Ji-Hye , Lim Dae Jun , Kim Eun Hee
Published: March 2014

Background

Hypoxia-inducible factor (HIF) 1alpha is expressed under hypoxic conditions and plays an important role in immune and inflammatory responses. The role of HIF-1alpha in allergic airways has been investigated mainly in bronchial asthma. This study investigated the role of HIF-1alpha in mouse models and patients with allergic rhinitis (AR).

Methods

Balb/c mice were sensitized with ovalbumin (OVA) and alum and were challenged intranasally with OVA. The HIF-1alpha inhibitor, 2-methoxyestradiol (2-ME), was administered intraperitoneally and multiple parameters of allergic responses were evaluated. HIF-1alpha and vascular endothelial growth factor (VEGF) mRNA and protein expression were also evaluated in patients with AR and a correlation analysis between mRNA expression and allergic symptoms was performed.

Results

In mouse models, the HIF-1alpha inhibitor 2-ME reduced allergic symptoms and eosinophilic infiltration into the nasal mucosa. 2-ME was found to suppress IgE production and inhibit local Th2 cytokine transcription in the nasal mucosa and systemic Th2 cytokine production by splenocytes. 2-ME also decreased HIF-1 and VEGF expression in nasal mucosa. An increase in HIF-1alpha and VEGF expression in the nasal mucosa of patients with AR was also observed.

Conclusion

Our data suggest that HIF-1alpha plays an important role in mouse models and patients with AR. HIF-1alpha inhibitors induce antiallergic effects by decreasing both local and systemic Th2 cytokine (IL-4 and IL-5) production, IgE production, and eosinophil infiltration into the nasal mucosa in an AR model. HIF-1alpha and VEGF expression increased in the nasal mucosa of patients with AR, showing the role of HIF-1alpha in disease pathogenesis.
Valproic Acid Promotes Neural Regeneration of Olfactory Epithelium in Adult Mice after Methimazole-Induced Damage
Authors: Ogawa Takao , Takezawa Kumiko , Shimizu Shino , Shimizu Takeshi
Published: March 2014

Background

Recent experiments have revealed that valproic acid (VPA), a histone deacetylase inhibitor, has neuroregenerative effects in rodent models of spinal cord and optic nerve injury. VPA has a potential to provide a new therapeutic strategy for sensorineural olfactory dysfunction. To elucidate the effects of VPA on regeneration of olfactory sensory neurons, we examined the in vivo effects of oral VPA administration on recovery from methimazole-induced degeneration of olfactory neuroepithelium in mice.

Methods

Male ICR mice (10 weeks old) were intraperitoneally injected with methimazole (75 mg/kg), an olfactory toxic reagent, to induce degenerative changes in the olfactory neuroepithelium. The effects of daily VPA administration on recovery from methimazole-induced changes were examined histologically.

Results

Oral VPA administration dose dependently enhanced increases in epithelial thickness and number of olfactory marker protein (OMP) positive cells in the olfactory epithelium during recovery from methimazole-induced degeneration. VPA also enhanced early increases in the number of Ki-67+ and growth-associated protein-43+ cells during the regeneration of olfactory neuroepithelium.

Conclusion

VPA administration promotes regeneration of olfactory sensory neurons in damaged neuroepithelium by stimulating the proliferation and differentiation of olfactory precursor cells. VPA has been used for several decades to safely treat neurological disorders. VPA may provide a new therapeutic strategy for the treatment of olfactory dysfunction caused by degeneration of the olfactory neuroepithelium.