bluuebunny/crossref_metadata_2025 huggingface dataset:
Effective policy mechanisms for an equitable geographical distribution of general practitioners: a qualitative comparative analysis of the accessibility of primary care in Europe
Authors: Ozegowski Susanne
Published: July 2013

Objectives

To explore the effectiveness of four different policy mechanisms in achieving a more equitable geographical distribution of general practitioners (GPs) in European countries. The following mechanisms were analysed: (1) interventions during medical training; (2) financial incentives; (3) quotas to allocate GPs to regions and (4) capitation-based remuneration.

Methods

A macro-comparative method, namely, fuzzy set qualitative comparative analysis, was employed to explore the distributional effectiveness of the four mechanisms. A literature review yielded information on the use of these mechanisms in the 21 European countries included, while country-specific equity in the geographic GP distribution served as the outcome variable.

Results

Quotas determining the number of GPs per region proved to be highly effective in producing an equitable GP distribution if calculated based on health care needs. Remunerating GPs largely through capitation payments also proved to be an effective policy mechanism. Financial bonuses to GPs practising in under-served areas and interventions during medical training had little or no impact.

Conclusion

Several high income countries have a maldistribution of primary care physicians to the detriment of rural or socially deprived areas. Policy makers have instituted a variety of policies to counter this. This study helps to identify mechanisms which are likely to be more and less effective.
Development and implementation of a nurse-led walk-in centre: evidence lost in translation?
Authors: Desborough Jane , Parker Rhian , Forrest Laura
Published: July 2013

Objectives

The design of the first Australian public nurse-led primary care walk-in centre was modelled on those established in the English National Health Service (NHS). An independent evaluation of the first 12 months of operation of the Australian Capital Territory (ACT) Health walk-in centre, in 2011, analysed the translation of evidence from the national evaluation of the NHS walk-in centres to the policy development and implementation of the ACT walk-in centre. Whilst in a number of ways the evidence was used well, our interest for this paper was to examine three areas identified as problematic and to identify the points at which the evidence was lost or diluted.

Methods

In addition to data obtained through nurse and key stakeholder interviews for the evaluation, an analysis was undertaken of documents on the planning and establishment of the ACT walk-in centre, either provided to the evaluation team or made publicly available.

Results

Three areas were identified as problematic in the way that evidence from the NHS evaluation was translated: the use of clinical decision support software (CDSS); the marketing of the walk-in centre; and its location.

Conclusions

Our examination indicates that despite seeking evidence to inform the development of the ACT walk-in centre, the evidence was not fully used and some clear lessons ignored, resulting in much of the evidence being lost in translation.
Displaced looks: The lived experience of beauty and racism
Authors: Figueroa Mónica G. Moreno
Published: July 2013

With a focus on appearance and racialised perceptions of skin colour, this paper discusses the differences between being and feeling acceptable, pretty or ugly and the possibility of such displacement (from being to feeling or vice versa), as a way to understand what beauty does in people’s lives. The paper explores the fragility of beauty in relation to the visibility of the body in specific racialised contexts. It investigates the claim that beauty can be considered a feeling that emphasises processes (what beauty does) rather than contents (what beauty is). Drawing from life stories with Mexican women, I examine their concerns about visibility, temporality and appearance as expressions of racist practices and ideas, within a context where the racial project of mestizaje (racial mixture) is in operation. Beauty matters as it makes evident the pervasiveness of racism in the everyday. The lived experience of beauty, in its displacement and fragility, as a feeling and as resource, can also point to some of the strategies to resist, cope and get on.
Affective sex: Beauty, race and nation in the sex industry
Authors: Rivers-Moore Megan
Published: July 2013

This article considers the role of beauty in Costa Rican sex work. In the context of sex tourism, beauty operates as affective labour performed by sex workers, labour that is mediated by deeply contradictory understandings of race and nation. Theorising beauty as a form of affective labour means thinking about beauty as value, as something that circulates, can be exchanged and is ultimately relational. While Costa Rica's national mythology has long focused on claims to white origins, sex tourists identify local women's ‘exoticism’ and non-whiteness as particularly appealing. Commercial sex does not simply depend on an imperial male gaze, but rather requires us to consider how particular national mythologies about race are linked to ideals of attractiveness in complex ways. I also explore how women experience and manage their sexual attractiveness to foreign tourists in their daily lives and work.
‘Decent girls with good hair’: Beauty, morality and race in Venezuela
Authors: Nichols Elizabeth Gackstetter
Published: July 2013

This article describes the use of idealised women's bodies as avatars of national identity and morality in early twentieth century Venezuela, as evidenced in works of classic literature from the period 1929–1949. Referencing two of Venezuela's most prominent authors, Teresa de la Parra and Antonia Palacios, the article describes how young girls in Venezuela in the first half of the twentieth century were enculturated to pursue ‘white’ ideals of beauty perceived as morally superior. Using the examples of Parra's semi-autobiographical novel Memorias de Mamá Blanca and Palacios’ similarly autobiographical Ana Isabel, una niña decente, this study investigates the topic of identity formation and the state, especially in regards to the control of women's sexuality and women's bodies in state ideologies, while exploring the specific racial overtones of beauty practices and education.
Articulations of eroticism and race: Domestic service in Latin America
Authors: Wade Peter
Published: July 2013

‘Service’, particularly ‘domestic service’, operates as a specific articulation or intersection of processes of race, class, gender and age that reiterates images of the sexual desirability of some women racially marked by blackness or indigeneity in Latin America. The sexualisation of racially subordinated people has been linked to the exercise of power. This article focuses on an aspect of subordination related to the condition of being a servant, and the ‘domestication’ and ‘acculturation’ that domestic service implies in societies where black and indigenous people are often linked to ‘backwardness’. Perceived racial otherness, class subordination, gender, age and domesticated servitude together reinforce an erotic image of sexual availability, particularly in younger women.
A beleza abre portas: Beauty and the racialised body among black middle-class women in Salvador, Brazil
Authors: Gordon Doreen
Published: July 2013

Beauty is constantly lived and incorporated as a meaningful social category in Brazil and intersects with racialised and gendered ways of belonging to the Brazilian nation. In this article, I deploy ethnographic material to show how middle-class women self-identifying as black embody and experience beauty and how, through practices and discourses centred on physical appearance, they both reinforce and challenge broader social and racial inequalities in Brazil.
The performativity of Black beauty shame in Jamaica and its diaspora: Problematising and transforming beauty iconicities
Authors: Tate Shirley
Published: July 2013

Black beauty shame emerges within the Black/white binary because of the beauty values sedimented in our structure of feeling since African enslavement. This article does not start from white beauty as the ideal, but focuses on the performativity of Black beauty shame as it transforms or intensifies the meanings of parts of the body in Jamaica and its UK diaspora. Using extracts from interviews with UK Jamaican heritage women, the discussion illustrates how Black beauty shame produces such intensification. First, where white beauty is iconic and reproduces the Black other as ‘ugly’, and second, where the Black ‘mixed race’ body is constructed as ‘other’ because of Black Nationalist discourses on beauty. The women’s critique of the shaming event shows that shame is undone through dis-identification as speakers draw on alternative beauty discourses to produce new beauty subjectivities. Dis-identification illustrates the transformational potential of shame as new Black beauty positionings emerge within the diaspora, drawing on beauty ideologies and models from Jamaica and thus destabilising the Black/white binary.
Misses in “Hot Hand” Research
Authors: Arkes Jeremy
Published: July 2013

Until recently, no study has found evidence for the “hot hand” in the National Basketball Association. Thus, many researchers have claimed that the hot hand and momentum effects are myths. This article presents simulations that demonstrate how the primary methods for estimating the hot hand effect understate the effect and have a low chance of detecting significance and that the infrequency of the hot hand contributes to the understated estimates and the inability of tests to detect significance. These results suggest that recent research showing a small hot hand effect for free throws is indicative of a much larger hot hand effect.
The Philosophy of Tax: A Review of David Foster Wallace’s The Pale King
Authors: Shanske Darien
Published: July 2013

David Foster Wallace’s last novel, The Pale King,1 revolves around the administration of the federal income tax. Wallace’s portrayal of this system, for all its hilarity and incisiveness, might ultimately seem a bit banal because he emphasizes that the tax system is boring; surely we all knew that. Yet the portrayal of boredom in The Pale King is nuanced and provocative, recalling a long tradition of thinking about modernity and boredom. Most notably, Kierkegaard diagnosed modernity as an age beset by a particular form of boredom. In the modern age people have more and more leisure, but less and less guidance as to how to lead one’s life either through religion or the rigorous patterns of agricultural life, and thus modern people have found themselves bored in a new way. This insight was picked up on by many and was most developed by Martin Heidegger. What can one learn about tax from learning more about boredom? Within the novel it is observed that a new notion of the “interesting” arose along with the new modern kind of boredom. One needs to find something interesting to fend off boredom. Looked at in this way, the most profound way to alter our engagement with a tax system that is boring would not be to make it interesting, but to make it neither boring nor interesting. What would such a tax system look like? Wallace suggests that it would be a system soberly administered by adults, much like the other key parts of the apparatus central to modernity.
Simultaneous modified Camitz opponensplasty using a pulley at the radial side of the flexor retinaculum in severe carpal tunnel syndrome
Authors: Kato N. , Yoshizawa T. , Sakai H.
Published: July 2013

Camitz opponensplasty using the palmaris longus has been used in patients undergoing open carpal tunnel release. It is considered to have several advantages over other opponensplasty techniques, but it provides weak flexion and pronation, which are prerequisites for opposition. To address this shortcoming, we have used a modified Camitz procedure with a pulley at the radial side of the dissected flexor retinaculum and have assessed the results in comparison with the conventional Camitz procedure. Both procedures provided significant improvements in palmar abduction and Disabilities of the Arm, Shoulder, and Hand and Kapandji scores at 3 months post-operatively, but patients who underwent the modified Camitz procedure showed better improvement in pulp pinch, palmar abduction, and thumb pronation.
Neurohospitalists: Perceived Need and Training Requirements in Academic Neurology
Authors: Probasco John C. , George Benjamin P. , Dorsey E. Ray , Venkatesan Arun
Published: July 2013

Background and Purpose:

We sought to determine the current practices and plans for departmental hiring of neurohospitalists at academic medical centers and to identify the core features of a neurohospitalist training program.

Methods:

We surveyed department chairs or residency program directors at 123 Accreditation Council for Graduate Medical Education (ACGME)-accredited US adult neurology training programs.

Results:

Sixty-three(51% response rate) responded, 76% of whom were program directors. In all, 24 (38%) academic neurology departments reported employing neurohospitalists, and an additional 10 departments have plans to hire neurohospitalists in the next year. In all, 4 academic neurology departments have created a neurohospitalist training program, and 10 have plans to create a training program within the next 2 years. Hospitals were the most frequent source of funding for established and planned programs (93% of those reporting). Most (n = 39; 65%) respondents felt that neurohospitalist neurology should be an ACGME-accredited fellowship. The highest priority neurohospitalist training elements among respondents included stroke, epilepsy, and consult neurology as well as patient safety and cost-effective inpatient care. The most important procedural skills for a neurohospitalist, as identified by respondents, include performance of brain death evaluations, lumbar punctures, and electroencephalogram interpretation.

Conclusions:

Neurohospitalists have emerged as subspecialists within neurology, growing both in number and in scope of responsibilities in practice. Neurohospitalists are in demand among academic departments, with many departments developing their existing presence or establishing a new presence in the field. A neurohospitalist training program may encompass training in stroke, epilepsy, and consult neurology with additional focus on patient safety and cost-effective care.
Macrophage Activation Syndrome in a Patient With Adult Still’s Disease Following Rituximab
Authors: Fischbach Keely E. , Coe Brian , Radwan Mohamed , Rodriguez Julio , Carter John , Rumbak Mark J.
Published: July 2013

Objective. To present the first case report of macrophage activation syndrome presenting as systemic inflammatory response syndrome secondary to rituximab. Design. Case report with review of the literature. Setting. Intensive care unit of university hospital. Patient. A 21-year-old female, who was diagnosed at age 19 with adult Still’s disease after having recurrent fevers, salmon-colored rash, polyarthralgias, and ferritin level of 24 000 ng/mL, was admitted to the hospital with fever, tachycardia, hypotension, leukocytosis, lethargy, and diarrhea. Intervention. The use of anakinra in the setting of systemic inflammatory response syndrome and macrophage activation syndrome. Results. The use of anakinra in patients with macrophage activation syndrome reduced inflammatory markers, lowered ferritin levels, and improved the patient’s symptoms as well as aided in recovery from cytokine-induced cardiomyopathy. Conclusions. This case illustrates this rare, but potentially life-threatening, side effect of rituximab and further adds to the growing literature that anakinra can be used in macrophage activation syndrome and suggests the possibility of other uses in the intensive care unit in the future.
Harm Reduction Behind Bars
Authors: Miller Emma R. , Moore Jan M. , Bi Peng
Published: July 2013

We aimed to identify how strategies to reduce the risk of hepatitis C virus (HCV) in prisons could be implemented in a way that is acceptable to those with the responsibility for implementing them. Prison officer and nurse perceptions of HCV and attitudes toward a range of harm reduction interventions, including clean needle and bleach provision, were explored. In the context of highly prevalent feelings of resentment, most of the proposed strategies were perceived by all staff as a threat for officers and a privilege for prisoners. Addressing the underlying concerns of prison staff is essential in achieving a fully collaborative harm reduction effort. Ongoing resistance to proposed harm reduction strategies underscores the relevance of these findings for prison settings in Australia and elsewhere.
The Consequences of Teaching Critical Sociology on Course Evaluations
Authors: (Raj) Sethuraju Nadarajan , Prew Paul , Abdi Abdihakin , Pipkins Martel
Published: July 2013

While there has been a great deal of literature addressing students’ perceptions of bias in the classroom, there has been little in the way of examining the relationship between the student evaluations and the pedagogy used to examine sociological issues in class. We conducted a case study that reviewed and coded the written comments on Professor Prew’s Introduction to Sociology course evaluations in the 2008-2009 academic year. We assessed whether there was a correlation between the quantitative feedback on evaluations and the open-ended comments regarding the professor’s critical sociological perspective. Using means, ANOVA, and correlations, we specifically tested to see if students who left qualitative comments that contain overtly negative assessments of Professor Prew’s critical sociological perspective evaluated the course more negatively than those who are neutral or complimentary regarding his perspective. The findings show a positive correlation between negative attitudes regarding critical sociology and lower evaluation scores.
Internal Iliac Artery Aneurysm Detected by Sonography
Authors: Freel Kimberly Ann , Nutley Wanda K.
Published: July 2013

Internal iliac artery aneurysms are rare and seldom imaged with sonography in an acute situation. This case study illustrates a ruptured internal iliac artery aneurysm and shows the correlation of sonographic images with computed tomographic images in an emergent setting.
An evolutionarily conserved program of B-cell development and activation in zebrafish
Authors: Page Dawne M. , Wittamer Valerie , Bertrand Julien Y. , Lewis Kanako L. , Pratt David N. , Delgado Noemi , Schale Sarah E. , McGue Caitlyn , Jacobsen Bradley H. , Doty Alyssa , Pao Yvonne , Yang Hongbo , Chi Neil C. , Magor Brad G. , Traver David
Published: July 2013

Key Points

B cells appear in zebrafish by 3 weeks of development, supporting previous data that this is the transition point to adult hematopoiesis. Shifting sites of B-cell development likely occur in all jawed vertebrates.
Mer receptor tyrosine kinase is a therapeutic target in pre–B-cell acute lymphoblastic leukemia
Authors: Linger Rachel M. A. , Lee-Sherick Alisa B. , DeRyckere Deborah , Cohen Rebecca A. , Jacobsen Kristen M. , McGranahan Amy , Brandão Luis N. , Winges Amanda , Sawczyn Kelly K. , Liang Xiayuan , Keating Amy K. , Tan Aik Choon , Earp H. Shelton , Graham Douglas K.
Published: July 2013

Key Points

Mer tyrosine kinase is aberrantly expressed in ∼30% of pediatric pre–B-ALL patients, including most patients with an E2A-PBX1 translocation. Mer inhibition decreased B-ALL cell survival signal transduction, caused chemosensitization, and prolonged survival in a xenograft model.
Rituximab prophylaxis prevents corticosteroid-requiring chronic GVHD after allogeneic peripheral blood stem cell transplantation: results of a phase 2 trial
Authors: Cutler Corey , Kim Haesook T. , Bindra Bhavjot , Sarantopoulos Stefanie , Ho Vincent T. , Chen Yi-Bin , Rosenblatt Jacalyn , McDonough Sean , Watanaboonyongcharoen Phandee , Armand Philippe , Koreth John , Glotzbecker Brett , Alyea Edwin , Blazar Bruce R. , Soiffer Robert J. , Ritz Jerome , Antin Joseph H.
Published: July 2013

Key Points

Rituximab prevents steroid-requiring chronic graft-vs-host disease when given after peripheral blood stem cell transplantation. Overall survival is improved with rituximab after allogeneic peripheral blood stem cell transplantation when compared with a control cohort.
Fast online and index-based algorithms for approximate search of RNA sequence-structure patterns
Authors: Meyer Fernando , Kurtz Stefan , Beckstette Michael
Published: July 2013

Background

It is well known that the search for homologous RNAs is more effective if both sequence and structure information is incorporated into the search. However, current tools for searching with RNA sequence-structure patterns cannot fully handle mutations occurring on both these levels or are simply not fast enough for searching large sequence databases because of the high computational costs of the underlying sequence-structure alignment problem.

Results

We present new fast index-based and online algorithms for approximate matching of RNA sequence-structure patterns supporting a full set of edit operations on single bases and base pairs. Our methods efficiently compute semi-global alignments of structural RNA patterns and substrings of the target sequence whose costs satisfy a user-defined sequence-structure edit distance threshold. For this purpose, we introduce a new computing scheme to optimally reuse the entries of the required dynamic programming matrices for all substrings and combine it with a technique for avoiding the alignment computation of non-matching substrings. Our new index-based methods exploit suffix arrays preprocessed from the target database and achieve running times that are sublinear in the size of the searched sequences. To support the description of RNA molecules that fold into complex secondary structures with multiple ordered sequence-structure patterns, we use fast algorithms for the local or global chaining of approximate sequence-structure pattern matches. The chaining step removes spurious matches from the set of intermediate results, in particular of patterns with little specificity. In benchmark experiments on the Rfam database, our improved online algorithm is faster than the best previous method by up to factor 45. Our best new index-based algorithm achieves a speedup of factor 560.

Conclusions

The presented methods achieve considerable speedups compared to the best previous method. This, together with the expected sublinear running time of the presented index-based algorithms, allows for the first time approximate matching of RNA sequence-structure patterns in large sequence databases. Beyond the algorithmic contributions, we provide with RaligNAtor a robust and well documented open-source software package implementing the algorithms presented in this manuscript. The RaligNAtor software is available at http://www.zbh.uni-hamburg.de/ralignator.
Dynamic compartment specific changes in glutathione and ascorbate levels in Arabidopsis plants exposed to different light intensities
Authors: Heyneke Elmien , Luschin-Ebengreuth Nora , Krajcer Iztok , Wolkinger Volker , Müller Maria , Zechmann Bernd
Published: July 2013

Background

Excess light conditions induce the generation of reactive oxygen species (ROS) directly in the chloroplasts but also cause an accumulation and production of ROS in peroxisomes, cytosol and vacuoles. Antioxidants such as ascorbate and glutathione occur in all cell compartments where they detoxify ROS. In this study compartment specific changes in antioxidant levels and related enzymes were monitored among Arabidopsis wildtype plants and ascorbate and glutathione deficient mutants (vtc2-1 and pad2-1, respectively) exposed to different light intensities (50, 150 which was considered as control condition, 300, 700 and 1,500 μmol m-2 s-1) for 4 h and 14 d.

Results

The results revealed that wildtype plants reacted to short term exposure to excess light conditions with the accumulation of ascorbate and glutathione in chloroplasts, peroxisomes and the cytosol and an increased activity of catalase in the leaves. Long term exposure led to an accumulation of ascorbate and glutathione mainly in chloroplasts. In wildtype plants an accumulation of ascorbate and hydrogen peroxide (H2O2) could be observed in vacuoles when exposed to high light conditions. The pad2-1 mutant reacted to long term excess light exposure with an accumulation of ascorbate in peroxisomes whereas the vtc2-1 mutant reacted with an accumulation of glutathione in the chloroplasts (relative to the wildtype) and nuclei during long term high light conditions indicating an important role of these antioxidants in these cell compartments for the protection of the mutants against high light stress.

Conclusion

The results obtained in this study demonstrate that the accumulation of ascorbate and glutathione in chloroplasts, peroxisomes and the cytosol is an important reaction of plants to short term high light stress. The accumulation of ascorbate and H2O2 along the tonoplast and in vacuoles during these conditions indicates an important route for H2O2 detoxification under these conditions.
Unexpected random urinary protein:creatinine ratio results–limitations of the pyrocatechol violet-dye method
Authors: De Silva Dane A , Halstead Anne C , Côté Anne-Marie , Sabr Yasser , von Dadelszen Peter , Magee Laura A
Published: July 2013

Background

For clinicians, it is important to rely on accurate laboratory results for patient care and optimal use of health care resources. We sought to explore our observations that urine protein:creatinine ratios (PrCr) ≥30 mg/mmol are seen not infrequently associated with normal pregnancy outcome.

Methods

Urine samples were collected prospectively from 160 pregnant women attending high-risk maternity clinics at a tertiary care facility. Urinary protein was measured using a pyrocatechol violet assay and urinary creatinine by an enzymatic method on Vitros analysers. Maternal/perinatal outcomes were abstracted from hospital records.

Results

91/233 (39.1%) samples had a PrCr ≥30 mg/mmol, especially when urinary creatinine concentration was <3 mM (94.1%) vs. ≥3 mM (16.4%) (p < 0.001). When using the last sample before delivery, 47/160 (29.4%) had a PrCr ≥30 mg/mmol in diluted urine vs. only 17/160 (15.4%) in more concentrated urine (p < 0.001); PrCr positive results were also more frequent among the 32 (20.0%) women with known normal pregnancy outcome (90.9% vs. 0) (p < 0.001). Using the same analyser, 0.12 g/L urinary protein was ‘detected’ in deionised water. Re-analysis of data from two cohorts revealed substantially less inflation of PrCr in dilute urine using a pyrogallol red assay.

Conclusions

Random urinary PrCr was overestimated in dilute urine when tested using a common pyrocatechol violet dye-based method. This effect was reduced in cohorts when pyrogallol red assays were used. False positive results can impact on diagnosis and patient care. This highlights the need for both clinical and laboratory quality improvement projects and standardization of laboratory protein measurement.
CXCR7 is induced by hypoxia and mediates glioma cell migration towards SDF-1α
Authors: Esencay Mine , Sarfraz Yasmeen , Zagzag David
Published: July 2013

Background

Glioblastomas, the most common and malignant brain tumors of the central nervous system, exhibit high invasive capacity, which hinders effective therapy. Therefore, intense efforts aimed at improved therapeutics are ongoing to delineate the molecular mechanisms governing glioma cell migration and invasion.

Methods

In order to perform the studies, we employed optimal cell culture methods and hypoxic conditions, lentivirus-mediated knockdown of protein expression, Western Blot analysis, migration assays and immunoprecipitation. We determined statistical significance by unpaired t-test.

Results

In this report, we show that U87MG, LN229 and LN308 glioma cells express CXCR7 and that exposure to hypoxia upregulates CXCR7 protein expression in these cell lines. CXCR7-expressing U87MG, LN229 and LN308 glioma cells migrated towards stromal-derived factor (SDF)-1α/CXCL12 in hypoxic conditions in the Boyden chamber assays. While shRNA-mediated knockdown of CXCR7 expression did not affect the migration of any of the three cell lines in normoxic conditions, we observed a reduction in the migration of LN229 and LN308, but not U87MG, glioma cells towards SDF-1α in hypoxic conditions. In addition, knockdown of CXCR7 expression in LN229 and LN308 glioma cells decreased levels of SDF-1α-induced phosphorylation of ERK1/2 and Akt. Inhibiting CXCR4 in LN229 and LN308 glioma cells that were knocked down for CXCR7 did not further reduce migration towards SDF-1α in hypoxic conditions and did not affect the levels of phosphorylated ERK1/2 and Akt. Analysis of immunoprecipitated CXCR4 from LN229 and LN308 glioma cells revealed co-precipitated CXCR7.

Conclusions

Taken together, our findings indicate that both CXCR4 and CXCR7 mediate glioma cell migration towards SDF-1α in hypoxic conditions and support the development of therapeutic agents targeting these receptors.
The overall health and risk factor profile of Australian Aboriginal and Torres Strait Islander participants from the 45 and up study
Authors: Gubhaju Lina , McNamara Bridgette J , Banks Emily , Joshy Grace , Raphael Beverley , Williamson Anna , Eades Sandra J
Published: July 2013

Background

Despite large disparities in health outcomes between Aboriginal and non-Aboriginal Australians, detailed evidence on the health and lifestyle characteristics of older Aboriginal Australians is lacking. The aim of this study is to quantify socio-demographic and health risk factors and mental and physical health status among Aboriginal participants from the 45 and Up Study and to compare these with non-Aboriginal participants from the study.

Methods

The 45 and Up Study is a large-scale study of individuals aged 45 years and older from the general population of New South Wales, Australia responding to a baseline questionnaire distributed from 2006–2008. Odds ratios (OR) and 95% confidence intervals (CI) of self-reported responses from the baseline questionnaire for Aboriginal versus non-Aboriginal participants relating to socio-demographic factors, health risk factors, current and past medical and surgical history, physical disability, functional health limitations and levels of current psychological distress were calculated using unconditional logistic regression, with adjustments for age and sex.

Results

Overall, 1939 of 266,661 45 and Up Study participants examined in this study identified as Aboriginal and/or Torres Strait Islander (0.7%). Compared to non-Aboriginal participants, Aboriginal participants were significantly more likely to be: younger (mean age 58 versus 63 years); without formal educational qualifications (age- and sex- adjusted OR = 6.2, 95% CI 5.3-7.3); of unemployed (3.7, 2.9-4.6) or disabled (4.6, 3.9-5.3) work status; and with a household income < $20,000/year versus ≥ $70,000/year (5.8, 5.0-6.9). Following additional adjustment for income and education, Aboriginal participants were significantly more likely than non-Aboriginal participants to: be current smokers (2.4, 2.0-2.8), be obese (2.1, 1.8-2.5), have ever been diagnosed with certain medical conditions (especially: diabetes [2.1, 1.8-2.4]; depression [1.6, 1.4-1.8] and stroke [1.8, 1.4-2.3]), have care-giving responsibilities (1.8, 1.5-2.2); have a major physical disability (2.6, 2.2-3.1); have severe physical functional limitation (2.9, 2.4-3.4) and have very high levels of psychological distress (2.4, 2.0-3.0).

Conclusions

Aboriginal participants from the 45 and Up Study experience greater levels of disadvantage and have greater health needs (including physical disability and psychological distress) compared to non-Aboriginal participants. The study highlights the need to address the social determinants of health in Australia and to provide appropriate mental health services and disability support for older Aboriginal people.
Insulin resistance is significantly associated with the metabolic syndrome, but not with sonographically proven peripheral arterial disease
Authors: Vonbank Alexander , Saely Christoph H , Rein Philipp , Drexel Heinz
Published: July 2013

Objective

Insulin resistance (IR) is the key feature of the metabolic syndrome (MetS); its association with peripheral arterial disease (PAD) is unclear. We hypothesized that IR is associated with both the MetS and sonographically proven PAD.

Methods

IR was determined by the Homeostasis Model Assessment (HOMA) index in 214 patients with sonographically proven PAD as well as in 197 controls, who did not have a history of PAD and in whom coronary artery disease was ruled out angiographically; the MetS was defined according to NCEP-ATPIII criteria.

Results

HOMA IR scores were significantly higher in MetS patients than in subjects without the MetS (5.9 ± 6.2 vs. 2.9 ± 3.9; p <0.001). However, HOMA IR did not differ significantly between patients with PAD and controls (4.2 ± 5.4 vs. 3.3 ± 4.3; p = 0.124). When both, the presence of MetS and of PAD were considered, HOMA IR was significantly higher in patients with the MetS both among those with PAD (6.1 ± 5.7 vs. 3.6 ± 5.2; p<0.001) and among controls (5.8 ± 6.8 vs. 2.3 ± 1.8; p <0.001), whereas it did not differ significantly between patients with PAD and controls among patients with the MetS (5.8 ± 6.8 vs. 6.1 ± 5.7; p = 0.587) nor among those without the MetS (2.3 ± 1.8 vs. 3.6 ± 5.2; p = 0.165). Similar results were obtained with the International Diabetes Federation definition of the MetS.

Conclusion

IR is significantly associated with the MetS but not with sonographically proven PAD.
Video-assisted thoracoscopic surgery versus robotic-assisted thoracoscopic surgery in the surgical treatment of Masaoka stage I thymoma
Authors: Ye Bo , Tantai Ji-Cheng , Li Wang , Ge Xiao-Xiao , Feng Jian , Cheng Ming , Zhao Heng
Published: July 2013

Background

The purpose of this study was to compare perioperative outcomes in patients who underwent video-assisted thoracoscopic surgery or robot-assisted thoracoscopic surgery and assess the feasibility of robotic-assisted thymectomy for the treatment of Masaoka stage I.

Methods

We evaluated the short-term outcomes of 46 patients who underwent surgery for Masaoka stage I thymoma without myasthenia gravis between January 2009 and June 2012. Of these patients, 25 received unilateral video-assisted thoracoscopic surgery (VATS group) and the rest 21 recieved unilateral robotic-assisted thoracoscopic surgery (RATS group). We evaluated the duration of surgery, amount of intraoperative blood loss, duration of chest drainage, duration of postoperative hospital stay, hospitalization costs, postoperative complications and oncological outcomes.

Results

The duration of surgery was not significantly different between the two groups. Intraoperative blood loss volumes did not differ significantly between the VATS and RATS groups (86.8 mL and 58.6 mL, respectively; P=0.168). The postoperative hospital stay was significantly shorter in the RATS group (3.7 days vs. 6.7 days; P <0.01), and the postoperative pleural drainage volume of the RATS group was significantly less than VATS group (1.1 days vs. 3.6 days; P <0.01). No patients in the RATS group needed conversion to open surgery. However, in the VATS series, one patient had conversion to an open procedure. No surgical complications were observed except that one case had pulmonary atelectasis in the RATS group and one case developed pneumonia after surgery. Use of robot is much more expensive than video. No early recurrence was observed in both groups.

Conclusions

Robotic thymectomy is feasible and safe for Masaoka stage I thymoma. RATS is equally minimally invasive as VATS and results in a shorter drainage period and reduced hospital stay compared with the VATS approach.
Diagnosis and treatment of cystic renal cell carcinoma
Authors: Zhang Jiexiu , Liu Bianjiang , Song Ninghong , Hua Lixin , Wang Zengjun , Gu Min , Yin Changjun
Published: July 2013

Background

To summarize the diagnosis and treatment of cystic renal cell carcinoma (CRCC).

Methods

A retrospective study was conducted on 13 patients with CRCC at our center from August 2004 to April 2012. The pathologic features, clinical manifestation, imaging characteristics, treatment, and prognosis of CRCC were summarized according to available literature.

Results

Of the 13 patients, 11 were diagnosed with CRCC by preoperative B ultrasonography and computed tomography (CT) scan. The remaining two cases were initially misdiagnosed with simple renal cysts. Open radical nephrectomy was performed on two of the 13 cases, laparoscopic radical nephrectomy on seven cases, and open partial nephrectomy on four cases. All diagnoses of CRCC were confirmed by pathological examination. After the operation, all patients had an uneventful recovery. During the follow-up (range, 6–60 months), the serum creatinine concentrations and GFR of the partially removed kidneys remained stable within the normal range. No tumor recurrence or metastasis occurred.

Conclusions

By combining imaging examinations (B ultrasonography and CT scan) with intraoperative pathological examination, most cases of CRCC can be diagnosed and treated promptly and accurately. Nephrectomy is the first-line therapy. Nephron-sparing surgery should be preferred for CRCC. After a successful operation, the prognosis of CRCC is good.
M-CSF increases proliferation and phagocytosis while modulating receptor and transcription factor expression in adult human microglia
Authors: Smith Amy M , Gibbons Hannah M , Oldfield Robyn L , Bergin Peter M , Mee Edward W , Curtis Maurice A , Faull Richard L M , Dragunow Mike
Published: July 2013

Background

Microglia are the primary immune cells of the brain whose phenotype largely depends on their surrounding micro-environment. Microglia respond to a multitude of soluble molecules produced by a variety of brain cells. Macrophage colony-stimulating factor (M-CSF) is a cytokine found in the brain whose receptor is expressed by microglia. Previous studies suggest a critical role for M-CSF in brain development and normal functioning as well as in several disease processes involving neuroinflammation.

Methods

Using biopsy tissue from patients with intractable temporal epilepsy and autopsy tissue, we cultured primary adult human microglia to investigate their response to M-CSF. Mixed glial cultures were treated with 25 ng/ml M-CSF for 96 hours. Proliferation and phagocytosis assays, and high through-put immunocytochemistry, microscopy and image analysis were performed to investigate microglial phenotype and function.

Results

We found that the phenotype of primary adult human microglia was markedly changed following exposure to M-CSF. A greater number of microglia were present in the M-CSF- treated cultures as the percentage of proliferating (BrdU and Ki67-positive) microglia was greatly increased. A number of changes in protein expression occurred following M-CSF treatment, including increased transcription factors PU.1 and C/EBPβ, increased DAP12 adaptor protein, increased M-CSF receptor (CSF-1R) and IGF-1 receptor, and reduced HLA-DP, DQ, DR antigen presentation protein. Furthermore, a distinct morphological change was observed with elongation of microglial processes. These changes in phenotype were accompanied by a functional increase in phagocytosis of Aβ1-42peptide.

Conclusions

We show here that the cytokine M-CSF dramatically influences the phenotype of adult human microglia. These results pave the way for future investigation of M-CSF-related targets for human therapeutic benefit.
Pediatric femoral shaft fractures: treatment strategies according to age - 13 years of experience in one medical center
Authors: Sela Yaron , Hershkovich Oded , Sher-Lurie Nir , Schindler Amos , Givon Uri
Published: July 2013

Objective

The objective of this study was to analyze our experience in treating femoral shaft fractures with different strategies, focusing on the first year after injury when the choice of method would have the greatest impact.

Methods

We reviewed the medical records of all children treated for femoral shaft fractures in our institution between 1997 and 2010. They were divided according to therapeutic approach: spica cast, skin traction, titanium elastic nail (TEN), external fixator, intramedullary medullary nail (IMN), and plating.

Results

The 212 patients included 150 boys and 62 girls (M/F ratio 2.4:1, mean age 5 years, range 0–16). The postoperative radiographic results demonstrated solid union in all patients, with no malunions. Of the 151 children in the spica cast group, 10 required re-manipulation and casting due to loss of reduction with unaccepted angulation, 10 had contact dermatitis, and 2 had fever and pressure sores. All 21 elastic nail group children underwent re-operation to remove the hardware: 3 had soft tissue irritation at the insertion points, and 3 had leg length discrepancy (LLD). Of the 14 external fixation patients, 4 had LLD, 1 had a pin tract infection, and 1 had a fracture through a pinhole after a fall. There were no complications in the 12 IMN patients, the 3 plating patients, or the 11 skin traction patients. LLD rates in the spica group were 10.5% higher compared to those in the control group (other treatment modalities) (P = .03).

Conclusions

TEN treatment was superior to spica casting for children who had reached an average age of 4 years.
Implementing a new EPR lineshape parameter for organic radicals in carbonaceous matter
Authors: Bourbin Mathilde , Du Yann Le , Binet Laurent , Gourier Didier
Published: July 2013

Background

Electron Paramagnetic Resonance (EPR) is a non-destructive, non-invasive technique useful for the characterization of organic moieties in primitive carbonaceous matter related to the origin of life. The classical EPR parameters are the peak-to-peak amplitude, the linewidth and the g factor; however, such parameters turn out not to suffice to fully determine a single EPR line.

Results

In this paper, we give the definition and practical implementation of a new EPR parameter based on the signal shape that we call the R
10 factor. This parameter was originally defined in the case of a single symmetric EPR line and used as a new datation method for organic matter in the field of exobiology.

Conclusion

Combined to classical EPR parameters, the proposed shape parameter provides a full description of an EPR spectrum and opens the way to novel applications like datation. Such a parameter is a powerful tool for future EPR studies, not only of carbonaceous matter, but also of any substance which spectrum exhibits a single symmetric line.

Reproducibility

The paper is a literate program—written using Noweb within the Org-mode as provided by the Emacs editor— and it also describes the full data analysis pipeline that computes the R
10 on a real EPR spectrum.
Approaches towards the synthesis of a novel class of 2-amino-5-arylazonicotinate, pyridazinone and pyrido[2,3-d]pyrimidine derivatives as potent antimicrobial agents
Authors: Ibrahim Hamada Mohamed , Behbehani Haider , Elnagdi Mohamed H
Published: July 2013

Background

Despite significant progresses in antimicrobial therapy, infectious diseases caused by bacteria and fungi remain a major worldwide health problem because of the rapid development of resistance to existing antimicrobial drugs. Therefore, there is a constant need for new antimicrobial agents. There are a large number of heterocyclic derivatives containing nitrogen atoms that possess a broad spectrum of biological activities including pyridine and pyridazine, which are two of the most important heterocycles in medicinal chemistry.

Results

The reaction of 3-oxo-2-arylhydrazonopropanals 2 with ethyl cyanoacetate and malononitrile 3a,b has led to the formation of 2-amino-5-arylazo-6-aryl substituted nicotinates 8a-k as sole isolable products when the aryl group in the arylazo moiety was substituted with an electron-withdrawing group like Cl, Br, NO2. The pyridazinones 10 were formed from the same reaction when the arylazo moiety was phenyl or phenyl substituted with an electron-donating group. The 2-aminoazonicotinates 8 were condensed with DMF-DMA to afford the amidines 13a,b, which then were cyclized to afford the targeted pyrido[2,3-d]pyrimidine derivatives 15a,b, respectively. The structures of all new substances prepared in this investigation were determined by using X-ray crystallographic analysis and spectroscopic methods. Most of the synthesized compounds were tested and evaluated as antimicrobial agents and the results indicated that many of the obtained compounds exhibited high antimicrobial activity comparable to ampicillin, which was used as the reference compound.

Conclusion

A general rule for the synthesis of 2-amino-5-arylazo-6-aryl substituted nicotinic acid and pyridazinone was established using 3-oxo-2-arylhydrazonopropanal as a precursor. Moreover, a novel route to pyrido[2,3-d]pyrimidine was achieved. Most of the synthesized compounds were found to exhibit strong inhibitory effects on the growth of Gram-positive bacteria especially Bacillus subtilis. Compounds 1a, 8a-h, 10a-c, 15b and 16 showed a broad spectrum of antimicrobial activity against B. subtilis.
Systemic administration of 3-bromopyruvate reveals its interaction with serum proteins in a rat model
Authors: Kunjithapatham Rani , Geschwind Jean-Francois H , Rao Pramod P , Boronina Tatiana N , Cole Robert N , Ganapathy-Kanniappan Shanmugasundaram
Published: July 2013

Background

3-bromopyruvate (3-BrPA) is a glycolytic inhibitor that affects cancer cells by targeting energy metabolism. Preclinical reports have established that a 1.75 mM dose of 3-BrPA is effective and sufficient to inhibit tumor growth when administered under a loco-regional approach (intraarterial and intratumoral). This loco-regional therapeutic dose was found to be nontoxic when given systemically as well. Yet, the mechanism underlying this lack of toxicity of 1.75 mM 3-BrPA during systemic delivery is unknown. Here, we investigated the mechanism associated with the lack of organ toxicity when 1.75 mM 3-BrPA was administered systemically using radiolabeled (14C)-3-BrPA in Sprague–Dawley rats.

Findings

Data obtained from tissue-autoradiography of rats infused with 14C-3-BrPA showed strong 14C-signal in tissue sections of various organs except the brain corroborating that 3-BrPA does not cross the blood–brain barrier. Significantly, Hematoxylin & Eosin staining and apoptosis assay of tissue sections positive for 14C-signal showed no signs of toxicity or apoptosis. Convincingly, the 14C-signal observed in tissue-autoradiography emanates from 3-BrPA that is non-reactive or non-toxic, hence we further investigated whether the lack of toxicity is due to its interaction or alkylation with serum components. Analysis of serum proteins by 1D and 2D-gel electrophoretic autoradiography showed that 14C-BrPA selectively binds to peptides of molecular mass ~50-60 kDa. Mass spectrometry data suggested that 14C-BrPA could interact with alpha1-antitrypsin and a peptide of albuminoid-family.

Conclusion

Our data indicate that selective interaction of 3-BrPA with serum proteins could contribute to the apparent lack of tissue-toxicity at the indicated close when the drug is given systematically in Sprague–Dawley rats.