bluuebunny/crossref_metadata_2025 huggingface dataset:
Perfil e percepção de diabéticos sobre a relação entre diabetes e doença periodontal
Authors: SOUSA João Nilton Lopes de , NÓBREGA Danúbia Roberta de Medeiros , ARAKI Ângela Toshie
Published: July 2014

INTRODUÇÃO: A periodontite é considerada um dos principais problemas de saúde em pacientes com diabetes e sua presença pode induzir resistência à insulina.OBJETIVO: avaliar o perfil e a percepção de pacientes com diabetes sobre a relação bidirecional entre diabetes e doença periodontal, assim como a integralidade da atenção primária à saúde destes pacientes.MÉTODO: Foi realizado um estudo epidemiológico de corte transversal, com 154 usuários cadastrados no programa HIPERDIA, em Unidades de Saúde da Família (USF), utilizando-se um questionário estruturado. Os dados foram registrados no SPSS e analisados por meio de estatística descritiva e inferencial, considerando-se um nível de significância de 5%.RESULTADO: A maioria dos pacientes pertencia ao gênero feminino (71,1%), apresentava baixa renda (73,2%) e escolaridade (42,5%), era não fumante (87,6%), com mais de 12 dentes perdidos (73,2%), escovavam os dentes duas vezes por dia (54,9%) e não utilizavam o fio dental (79,1%). Verificou-se associação estatisticamente significativa entre: gênero e número de escovações (pCONCLUSÃO: Os pacientes com diabetes apresentam elevada prevalência de dentes perdidos, carência de informações sobre os cuidados de higiene bucal e acerca da relação entre a doença periodontal e diabetes, o que evidencia a necessidade uma maior integração entre o Cirurgião-Dentista e a equipe médica.
Avaliação do conhecimento de Cirurgiões-Dentistas e acadêmicos de Odontologia na cidade de Aracaju, Sergipe, a respeito da adequada prescrição de antimicrobianos
Authors: TRENTO Cleverson Luciano , MENEZES JÚNIOR Laerte Ribeiro , SIQUEIRA Allancardi dos Santos , TAKESHITA Wilton Mitsunari
Published: July 2014

INTRODUÇÃO: Os antimicrobianos são caracterizados como um dos mais notáveis exemplos do avanço da Medicina moderna. Contudo, a adaptabilidade dos microrganismos propicia resistência a determinados antimicrobianos.OBJETIVO: Apresentar, por meio de pesquisa realizada com alunos do curso de Odontologia e Cirurgiões-Dentistas na cidade de Aracaju-SE, um perfil do conhecimento destes sobre antibioticoterapia, propondo oferecer uma oportunidade de identificar e reconhecer os riscos relacionados à administração incorreta destes fármacos.MATERIAL E MÉTODO: Investigação observacional, transversal, com base em um questionário respondido por 80 alunos do curso de Odontologia e 50 Cirurgiões-Dentistas, escolhidos de forma aleatória, para verificar o conhecimento sobre o tema proposto.RESULTADO: Dentre os entrevistados, aproximadamente 40% eram profissionais e 60% acadêmicos de Odontologia; destes, cerca de 40% relataram que prescrevem utilizando como critério de seleção que o antimicrobiano seja seletivo e bactericida, enquanto que 90% dos entrevistados afirmam prescrever antibiótico somente quando necessário, como forma de evitar a resistência bacteriana.CONCLUSÃO: De acordo com a metodologia empregada, pode-se concluir que os dois grupos mostraram desconhecimento sobre a diferença entre antibioticoterapia, profilaxia antimicrobiana e terapêutica medicamentosa.
Relações empíricas entre características dendrométricas da Caatinga brasileira e dados TM Landsat 5
Authors: Almeida André Quintão de , Mello Anabel Aparecida de , Neto Antônio Luiz Dória , Ferraz Raphael Cavalcanti
Published: July 2014

O objetivo deste trabalho foi ajustar modelos para estimar características dendrométricas da Caatinga brasileira a partir de dados do sensor TM do Landsat 5. Medidas de diâmetro e altura das árvores foram obtidas de 60 parcelas de inventário (400 m2), em dois municípios do Estado de Sergipe. A área basal e o volume de madeira foram estimados com uso de equação alométrica e de fator de forma (f = 0,9). As variáveis explicativas foram obtidas do sensor TM, após correção radiométrica e geométrica, tendo-se considerado, na análise, seis bandas espectrais, com resolução espacial de 30 m, além dos índices de razão simples (SR), de vegetação por diferença normalizada (NDVI) e de vegetação ajustado ao solo (Savi). Na escolha das melhores variáveis explicativas, foram considerados coeficiente de determinação (R2), raiz do erro quadrático médio (RMSE) e critério bayesiano de informação (CBI). A área basal por hectare não apresentou correlação significativa com nenhuma das variáveis explicativas utilizadas. Os melhores modelos foram ajustados à altura média das árvores por parcela (R2 = 0,4; RMSE = 13%) e ao volume de madeira por hectare (R2 = 0,6; RMSE = 42%). As métricas derivadas do sensor TM do Landsat 5 têm grande potencial para explicar variações de altura média das árvores e do volume de madeira por hectare, em remanescentes de Caatinga situados no Nordeste brasileiro.
Soybean Sensitivity to Drift Rates of Imazosulfuron
Authors: Rana Sandeep S. , Norsworthy Jason K. , Scott Robert C.
Published: July 2014

Imazosulfuron is a sulfonylurea herbicide recently labeled in U.S. rice at a maximum rate of 336 g ai ha−1. Soybean is prone to drift of herbicides from rice fields in the southern United States because these crops are often grown in close proximity. Field trials were conducted to determine the effect of low rates of imazosulfuron applied to nonsulfonylurea-resistant soybean at different growth stages. Soybean was treated at the vegetative cotyledonary (VC); vegetative second trifoliate (V2); vegetative sixth trifoliate (V6); and reproductive full bloom (R2) growth stages with 1/256 (1.3 g ha−1) to 1/4 (84.1 g ha−1) times (X) the maximum labeled rate of imazosulfuron. Soybean was injured regardless of application rate or timing. At 2 wk after treatment (WAT), imazosulfuron injured soybean 23 to 79, 44 to 76, 32 to 68, and 14 to 50% when applied at the VC, V2, V6, and R2 growth stages, respectively, where the highest injury was caused by the highest imazosulfuron rate (1/4X). However, by 20 wk after planting (WAP), soybean treated with imazosulfuron at the VC and V2 growth stages had only 0 to 17% and 8 to 53% injury, respectively. At higher rates [1/8 (42 g ha−1) and 1/4X] of imazosulfuron, soybean treated at the VC growth stage recovered more from injury than did soybean treated at the V2 growth stage. Soybean treated with imazosulfuron at the V6 and R2 growth stages had better recovery from the injury at the lower two rates [1/256 and 1/128X (2.6 g ha−1)] than at the higher rates [1/64 (5.3 g ha−1) to 1/4X]. Imazosulfuron, at all rates tested, delayed soybean maturity by 1 to 4, 2 to 6, 1 to 12, and 3 to 16 d for the VC, V2, V6, and R2 growth stages, respectively. Yield loss was greater when imazosulfuron was applied at V6 and R2 compared to applications at VC and V2. Results from this research indicate that imazosulfuron can severely injure soybean regardless of the growth stage at which drift occurs; however, soybean injured by imazosulfuron at early growth stages (VC and V2) has a better chance of recovery over time compared to drift at later growth stages (V6 and R2).
A simple Bayesian method of inferring extinction
Authors: Alroy John
Published: July 2014

Determining whether a species has gone extinct is a central problem in both paleobiology and conservation biology. Past literature has mostly employed equations that yield confidence intervals around the endpoints of temporal ranges. These frequentist methods calculate the chance of not having seen a species lately given that it is still alive (a conditional probability). However, any reasonable person would instead want to know the chance that a species is extinct given that it has not been seen (the posterior probability). Here, I present a simple Bayesian equation that estimates posteriors. It uninterestingly assumes that the sampling probability equals the frequency of sightings within the range. It interestingly sets the prior probability of going extinct during any one time interval (E) by assuming that extinction is an exponential decay process and there is a 50% chance a species has gone extinct by the end of its observed range. The range is first adjusted for undersampling by using a routine equation. Bayes' theorem is then used to compute the posterior for interval 1 (ε1), which becomes the prior for interval 2. The following posterior ε2again incorporates E because extinction might have happened instead during interval 2. The posteriors are called “creeping-shadow-of-a-doubt values” to emphasize the uniquely iterative nature of the calculation. Simulations show that the method is highly accurate and precise given moderate to high sampling probabilities and otherwise conservative, robust to random variation in sampling, and able to detect extinction pulses after a short lag. Improving the method by having it consider clustering of sightings makes it highly resilient to trends in sampling. Example calculations involving recently extinct Costa Rican frogs and Maastrichtian ammonites show that the method helps to evaluate the status of critically endangered species and identify species likely to have gone extinct below some stratigraphic horizon.
Characterisation and simulation of highly dispersed carbon nanofibre-reinforced cement materials
Authors: Wang Bao-Min , Zhang Yuan , Ge Shu-Kui , Zhu Yu
Published: July 2014

In this work, carbon nanofibres (CNFs) were incorporated into ordinary Portland cement matrices. The mechanical behaviour of these composites and the effect of CNFs on cement hydration and microstructure of cement paste were compared with a plain cement sample by means of mercury intrusion porosimetry, X-ray diffraction, thermal analysis and scanning electron microscopy. The random distribution of CNFs in cement matrices was simulated by three-dimensional Monte Carlo method. The results showed that the added 0·1 wt% CNFs increased the maximum flexural, compressive strength, toughness and impermeability performance of blended cement compared with the samples. The incorporation of CNFs into cement paste accelerated the rate of the hydration reaction and increased the amount of hydration products. The use of CNFs also improved pore parameters, and the pore size distribution of these composites shifted towards smaller pore size scope. In addition, scanning electron micrographs showed that good interaction between CNFs and the cement matrix occurs, with CNFs acting as fillers, resulting in a denser microstructure.
Experimental tests on SSTT-confined HSC columns
Authors: Ma Chau-Khun , Awang Abdullah Zawawi , Omar Wahid , Maybelle Liang
Published: July 2014

The steel-strapping tensioning technique (SSTT) has been widely accepted as an effective method for enhancing the performance of high-strength concrete (HSC) columns. Previous experimental tests showed that SSTT can increase the ductility of HSC by up to twice that of unconfined HSC. However, most of the tests performed on SSTT-confined HSC columns have focused on concentrically loaded short specimens. In reality, however, columns with a length/diameter ratio greater than three and subjected to eccentric loading are very common. Against this background, experiments were carried out to investigate the slenderness effect of SSTT-confined HSC columns subjected to eccentric loads. It was found that SSTT increases both the strength and deformability of slender HSC columns, although the confining effects are reduced proportionally with an increase in slenderness ratio. The effects of the eccentricities and the eccentricity ratio are also presented in this paper.
Long‐term climate change mitigation potential with organic matter management on grasslands
Authors: Ryals Rebecca , Hartman Melannie D. , Parton William J. , DeLonge Marcia S. , Silver Whendee L.
Published: July 2014

Compost amendments to grasslands have been proposed as a strategy to mitigate climate change through carbon (C) sequestration, yet little research exists exploring the net mitigation potential or the long‐term impacts of this strategy. We used field data and the DAYCENT biogeochemical model to investigate the climate change mitigation potential of compost amendments to grasslands in California, USA. The model was used to test ecosystem C and greenhouse gas responses to a range of compost qualities (carbon to nitrogen [C:N] ratios of 11.1, 20, or 30) and application rates (single addition of 14 Mg C/ha or 10 annual additions of 1.4 Mg C·ha−1·yr−1). The model was parameterized using site‐specific weather, vegetation, and edaphic characteristics and was validated by comparing simulated soil C, nitrous oxide (N2O), methane (CH4), and carbon dioxide (CO2) fluxes, and net primary production (NPP) with three years of field data. All compost amendment scenarios led to net greenhouse gas sinks that persisted for several decades. Rates of climate change mitigation potential ranged from 130 ± 3 g to 158 ± 8 g CO2‐eq·m−2·yr−1 (where “eq” stands for “equivalents”) when assessed over a 10‐year time period and 63 ± 2 g to 84 ± 10 g CO2‐eq·m−2·yr−1 over a 30‐year time period. Both C storage and greenhouse gas emissions increased rapidly following amendments. Compost amendments with lower C:N led to higher C sequestration rates over time. However, these soils also experienced greater N2O fluxes. Multiple smaller compost additions resulted in similar cumulative C sequestration rates, albeit with a time lag, and lower cumulative N2O emissions. These results identify a trade‐off between maximizing C sequestration and minimizing N2O emissions following amendments, and suggest that compost additions to grassland soils can have a long‐term impact on C and greenhouse gas dynamics that contributes to climate change mitigation.
Projecting boreal bird responses to climate change: the signal exceeds the noise
Authors: Stralberg D. , Matsuoka S. M. , Hamann A. , Bayne E. M. , Sólymos P. , Schmiegelow F. K. A. , Wang X. , Cumming S. G. , Song S. J.
Published: July 2014

For climate change projections to be useful, the magnitude of change must be understood relative to the magnitude of uncertainty in model predictions. We quantified the signal‐to‐noise ratio in projected distributional responses of boreal birds to climate change, and compared sources of uncertainty. Boosted regression tree models of abundance were generated for 80 boreal‐breeding bird species using a comprehensive data set of standardized avian point counts (349 629 surveys at 122 202 unique locations) and 4‐km climate, land use, and topographic data. For projected changes in abundance, we calculated signal‐to‐noise ratios and examined variance components related to choice of global climate model (GCM) and two sources of species distribution model (SDM) uncertainty: sampling error and variable selection. We also evaluated spatial, temporal, and interspecific variation in these sources of uncertainty. The mean signal‐to‐noise ratio across species increased over time to 2.87 by the end of the 21st century, with the signal greater than the noise for 88% of species. Across species, climate change represented the largest component (0.44) of variance in projected abundance change. Among sources of uncertainty evaluated, choice of GCM (mean variance component = 0.17) was most important for 66% of species, sampling error (mean = 0.12) for 29% of species, and variable selection (mean = 0.05) for 5% of species. Increasing the number of GCMs from four to 19 had minor effects on these results. The range of projected changes and uncertainty characteristics across species differed markedly, reinforcing the individuality of species' responses to climate change and the challenges of one‐size‐fits‐all approaches to climate change adaptation. We discuss the usefulness of different conservation approaches depending on the strength of the climate change signal relative to the noise, as well as the dominant source of prediction uncertainty.
Hydrologic filtering of fish life history strategies across the United States: implications for stream flow alteration
Authors: McManamay Ryan A. , Frimpong Emmanuel A.
Published: July 2014

Lotic fish have developed life history strategies adapted to the natural variation in stream flow regimes. The natural timing, duration, and magnitude of flow events has contributed to the diversity, production, and composition of fish assemblages over time. Studies evaluating the role of hydrology in structuring fish assemblages have been more common at the local or regional scale with very few studies conducted at the continental scale. Furthermore, quantitative linkages between natural hydrologic patterns and fish assemblages are rarely used to make predictions of ecological consequences of hydrologic alterations. We ask two questions: (1) what is the relative role of hydrology in structuring fish assemblages at large scales? and (2) can relationships between fish assemblages and natural hydrology be utilized to predict fish assemblage responses to hydrologic disturbance? We developed models to relate fish life histories and reproductive strategies to landscape and hydrologic variables separately and then combined. Models were then used to predict the ecological consequences of altered hydrology due to dam regulation. Although hydrology plays a considerable role in structuring fish assemblages, the performance of models using only hydrologic variables was lower than that of models constructed using landscape variables. Isolating the relative importance of hydrology in structuring fish assemblages at the continental scale is difficult since hydrology is interrelated to many landscape factors. By applying models to dam‐regulated hydrologic data, we observed some consistent predicted responses in fish life history strategies and modes of reproduction. In agreement with existing literature, equilibrium strategists are predicted to increase following dam regulation, whereas opportunistic and periodic species are predicted to decrease. In addition, dam regulation favors the selection of reproductive strategies with extended spawning seasons and preference for stable conditions.
Older Jail Inmates and Community Acute Care Use
Authors: Chodos Anna H. , Ahalt Cyrus , Cenzer Irena Stijacic , Myers Janet , Goldenson Joe , Williams Brie A.
Published: July 2014

Objectives. We examined older jail inmates’ predetainment acute care use (emergency department or hospitalization in the 3 months before arrest) and their plans for using acute care after release.

Methods. We performed a cross-sectional study of 247 jail inmates aged 55 years or older assessing sociodemographic characteristics, health, and geriatric conditions associated with predetainment and anticipated postrelease acute care use.

Results. We found that 52% of older inmates reported predetainment acute care use and 47% planned to use the emergency department after release. In modified Poisson regression, homelessness was independently associated with predetainment use (relative risk = 1.42; 95% confidence interval = 1.10, 1.83) and having a primary care provider was inversely associated with planned use (relative risk = 0.69; 95% confidence interval = 0.53, 0.89).

Conclusions. The Affordable Care Act has expanded Medicaid eligibility to all persons leaving jail in an effort to decrease postrelease acute care use in this high-risk population. Jail-to-community transitional care models that address the health, geriatric, and social factors prevalent in older adults leaving jail, and that focus on linkages to housing and primary care, are needed to enhance the impact of the act on acute care use for this population.
Prevalence of Undiagnosed Acute and Chronic HIV in a Lower-Prevalence Urban Emergency Department
Authors: Moschella Phillip C. , Hart Kimberly W. , Ruffner Andrew H. , Lindsell Christopher J. , Wayne D. Beth , Sperling Matthew I. , Trott Alexander T. , Fichtenbaum Carl J. , Lyons Michael S.
Published: July 2014

Objectives. We estimated the seroprevalence of both acute and chronic HIV infection by using a random sample of emergency department (ED) patients from a region of the United States with low-to-moderate HIV prevalence.

Methods. This cross-sectional seroprevalence study consecutively enrolled patients aged 18 to 64 years within randomly selected sampling blocks in a Midwestern urban ED in a region of lower HIV prevalence in 2008 to 2009. Participants were compensated for providing a blood sample and health information. After de-identification, we assayed samples for HIV antibody and nucleic acid.

Results. There were 926 participants who consented and enrolled. Overall, prevalence of undiagnosed HIV was 0.76% (95% confidence interval [CI] = 0.30%, 1.56%). Three participants (0.32%; 95% CI = 0.09%, 0.86%) were nucleic acid–positive but antibody-negative and 4 (0.43%; 95% CI = 0.15%, 1.02%) were antibody-positive.

Conclusions. Even when the absolute prevalence is low, a considerable proportion of undetected HIV cases in an ED population are acute. Identification of acute HIV in ED settings should receive increased priority.
The Promise of Community-Based Participatory Research for Health Equity: A Conceptual Model for Bridging Evidence With Policy
Authors: Cacari-Stone Lisa , Wallerstein Nina , Garcia Analilia P. , Minkler Meredith
Published: July 2014

Insufficient attention has been paid to how research can be leveraged to promote health policy or how locality-based research strategies, in particular community-based participatory research (CBPR), influences health policy to eliminate racial and ethnic health inequities. To address this gap, we highlighted the efforts of 2 CBPR partnerships in California to explore how these initiatives made substantial contributions to policymaking for health equity. We presented a new conceptual model and 2 case studies to illustrate the connections among CBPR contexts and processes, policymaking processes and strategies, and outcomes. We extended the critical role of civic engagement by those communities that were most burdened by health inequities by focusing on their political participation as research brokers in bridging evidence and policymaking.
Caloric Beverage Intake Among Adult Supplemental Nutrition Assistance Program Participants
Authors: Todd Jessica E. , Ver Ploeg Michele
Published: July 2014

Objectives. We compared sugar-sweetened beverage (SSB), alcohol, and other caloric beverage (juice and milk) consumption of Supplemental Nutrition Assistance Program (SNAP) participants with that of low-income nonparticipants.

Methods. We used 1 day of dietary intake data from the 2005–2008 National Health and Nutrition Examination Survey for 4594 adults aged 20 years and older with household income at or below 250% of the federal poverty line. We used bivariate and multivariate methods to compare the probability of consuming and the amount of calories consumed for each beverage type across 3 groups: current SNAP participants, former participants, and nonparticipants. We used instrumental variable methods to control for unobservable differences in participant groups.

Results. After controlling for observable characteristics, SNAP participants were no more likely to consume SSBs than were nonparticipants. Instrumental variable estimates showed that current participants consumed fewer calories from SSBs than did similar nonparticipants. We found no differences in alcoholic beverage consumption, which cannot be purchased with SNAP benefits.

Conclusions. SNAP participants are not unique in their consumption of SSBs or alcoholic beverages. Purchase restrictions may have little effect on SSB consumption.
Assessing the Connection Between Health and Education: Identifying Potential Leverage Points for Public Health to Improve School Attendance
Authors: Gase Lauren N. , Kuo Tony , Coller Karen , Guerrero Lourdes R. , Wong Mitchell D.
Published: July 2014

Objectives. We examined multiple variables influencing school truancy to identify potential leverage points to improve school attendance.

Methods. A cross-sectional observational design was used to analyze inner-city data collected in Los Angeles County, California, during 2010 to 2011. We constructed an ordinal logistic regression model with cluster robust standard errors to examine the association between truancy and various covariates.

Results. The sample was predominantly Hispanic (84.3%). Multivariable analysis revealed greater truancy among students (1) with mild (adjusted odds ratio [AOR] = 1.57; 95% confidence interval [CI] = 1.22, 2.01) and severe (AOR = 1.80; 95% CI = 1.04, 3.13) depression (referent: no depression), (2) whose parents were neglectful (AOR = 2.21; 95% CI = 1.21, 4.03) or indulgent (AOR = 1.71; 95% CI = 1.04, 2.82; referent: authoritative parents), (3) who perceived less support from classes, teachers, and other students regarding college preparation (AOR = 0.87; 95% CI = 0.81, 0.95), (4) who had low grade point averages (AOR = 2.34; 95% CI = 1.49, 4.38), and (5) who reported using alcohol (AOR = 3.47; 95% CI = 2.34, 5.14) or marijuana (AOR = 1.59; 95% CI = 1.06, 2.38) during the past month.

Conclusions. Study findings suggest depression, substance use, and parental engagement as potential leverage points for public health to intervene to improve school attendance.
The Effect of Cognitive Therapy on Structural Social Capital: Results From a Randomized Controlled Trial Among Sexual Violence Survivors in the Democratic Republic of the Congo
Authors: Hall Brian J. , Bolton Paul A. , Annan Jeannie , Kaysen Debra , Robinette Katie , Cetinoglu Talita , Wachter Karin , Bass Judith K.
Published: July 2014

Objectives. We evaluated changes in social capital following group-based cognitive processing therapy (CPT) for female survivors of sexual violence.

Methods. We compared CPT with individual support in a cluster-randomized trial in villages in South Kivu province, Democratic Republic of the Congo. Local psychosocial assistants delivered the interventions from April through July 2011. We evaluated differences between CPT and individual support conditions for structural social capital (i.e., time spent with nonkin social network, group membership and participation, and the size of financial and instrumental support networks) and emotional support seeking. We analyzed intervention effects with longitudinal random effects models.

Results. We obtained small to medium effect size differences for 2 study outcomes. Women in the CPT villages increased group membership and participation at 6-month follow-up and emotional support seeking after the intervention compared with women in the individual support villages.

Conclusions. Results support the efficacy of group CPT to increase dimensions of social capital among survivors of sexual violence in a low-income conflict-affected context.
Project HOPE: Online Social Network Changes in an HIV Prevention Randomized Controlled Trial for African American and Latino Men Who Have Sex With Men
Authors: Young Sean D. , Holloway Ian , Jaganath Devan , Rice Eric , Westmoreland Drew , Coates Thomas
Published: July 2014

Objectives. We examined whether and how an HIV prevention diffusion-based intervention spread throughout participants’ online social networks and whether changes in social network ties were associated with increased HIV prevention and testing behaviors.

Methods. We randomly assigned 112 primarily racial/ethnic minority men who have sex with men (MSM) to receive peer-delivered HIV (intervention) or general health (control) information over 12 weeks through closed Facebook groups. We recorded participants’ public Facebook friend networks at baseline (September 2010) and follow-up (February 2011), and assessed whether changes in network growth were associated with changes in health engagement and HIV testing.

Results. Within-group ties increased in both conditions from baseline to follow-up. Among the intervention group, we found a significant positive relation between increased network ties and using social media to discuss sexual behaviors. We found a positive trending relationship between increased network ties and likelihood of HIV testing, follow-up for test results, and participation in online community discussions. No significant differences were seen within control groups.

Conclusions. Among high-risk MSM, peer-led social media HIV prevention interventions can increase community cohesion. These changes appear to be associated with increased HIV prevention and testing behaviors.
Assessment of Hepatitis C Risk Factors and Infection Prevalence in a Jail Population
Authors: Wenger Philip J. , Rottnek Fred , Parker Todd , Crippin Jeffrey S.
Published: July 2014

Objectives. We sought to validate previous reports of HCV prevalence in jails, identify HCV risk factors prevalence, and identify risk factors associated with HCV infection in this population.

Methods. Inmates at the Buzz Westfall Justice Center (BWJC) in St. Louis, Missouri, were offered risk factor screening for HCV and anti-HCV antibody testing from December 2012 through May 2013. Demographic and risk factor information were assessed for significant associations with positive HCV antibody results. Risk factors that were significantly associated in univariate analysis were assessed using binary logistic regression to model the relationship between positive HCV results and the risk factors and demographics.

Results. Fifty of 304 inmates were positive for HCV, with a prevalence of 16.4%. The risk factors significantly associated with increased risk for positive HCV antibody were age (odds ratio [OR] = 1.09; 95% confidence interval [CI] = 1.04, 1.15 for each year), injection drug use (OR = 53.87; 95% CI = 17.78, 163.21), sex with HCV-positive partner (OR = 7.35; 95% CI = 1.41, 38.20), and tattoos by a nonlicensed provider (OR = 2.62; 95% CI = 1.09, 6.33). Prevalence for women was 3 times that of men (38% vs 12%).

Conclusions. Prevalence of HCV at BWJC was similar to previous jail studies, which is lower than reported prison rates and higher than the general population.
Determinants of Mental Health and Self-Rated Health: A Model of Socioeconomic Status, Neighborhood Safety, and Physical Activity
Authors: Meyer Oanh L. , Castro-Schilo Laura , Aguilar-Gaxiola Sergio
Published: July 2014

Objectives. We investigated the underlying mechanisms of the influence of socioeconomic status (SES) on mental health and self-rated health (SRH), and evaluated how these relationships might vary by race/ethnicity, age, and gender.

Methods. We analyzed data of 44 921 adults who responded to the 2009 California Health Interview Survey. We used a path analysis to test effects of SES, neighborhood safety, and physical activity on mental health and SRH.

Results. Low SES was associated with greater neighborhood safety concerns, which were negatively associated with physical activity, which was then negatively related to mental health and SRH. This model was similar across different racial/ethnic and gender groups, but mean levels in the constructs differed across groups.

Conclusions. SES plays an important role in SRH and mental health, and this effect is further nuanced by race/ethnicity and gender. Identifying the psychological (neighborhood safety) and behavioral (physical activity) factors that influence mental health and SRH is critical for tailoring interventions and designing programs that can improve overall health.
The Effect of a “Maintain, Don’t Gain” Approach to Weight Management on Depression Among Black Women: Results From a Randomized Controlled Trial
Authors: Steinberg Dori M. , Askew Sandy , Lanpher Michele G. , Foley Perry B. , Levine Erica L. , Bennett Gary G.
Published: July 2014

Objectives. We evaluated the effect of a weight gain prevention intervention (Shape Program) on depression among socioeconomically disadvantaged overweight and obese Black women.

Methods. Between 2009 and 2012, we conducted a randomized trial comparing a 12-month electronic health–based weight gain prevention intervention to usual primary care at 5 central North Carolina community health centers. We assessed depression with the Patient Health Questionnaire (PHQ-8). We analyzed change in depression score from baseline to 12- and 18-month follow-up across groups with mixed models. We used generalized estimating equation models to analyze group differences in the proportion above the clinical threshold for depression (PHQ-8 score ≥ 10).

Results. At baseline, 20% of participants reported depression. Twelve-month change in depression scores was larger for intervention participants (mean difference = −1.85; 95% confidence interval = −3.08, −0.61; P = .004). There was a significant reduction in the proportion of intervention participants with depression at 12 months with no change in the usual-care group (11% vs 19%; P = .035). All effects persisted after we controlled for weight change and medication use. We saw similar findings at 18 months.

Conclusions. The Shape Program, which includes no mention of mood, improved depression among socioeconomically disadvantaged Black women.
Insurance Continuity and Human Papillomavirus Vaccine Uptake in Oregon and California Federally Qualified Health Centers
Authors: Cowburn Stuart , Carlson Matthew , Lapidus Jodi , Heintzman John , Bailey Steffani , DeVoe Jennifer
Published: July 2014

Objectives. We examined the association between insurance continuity and human papillomavirus (HPV) vaccine uptake in a network of federally qualified health clinics (FQHCs).

Methods. We analyzed retrospective electronic health record data for females, aged 9–26 years in 2008 through 2010. Based on electronic health record insurance coverage information, patients were categorized by percent of time insured during the study period (0%, 1%–32%, 33%–65%, 66%–99%, or 100%). We used bilevel multivariable Poisson regression to compare vaccine-initiation prevalence between insurance groups, stratified by race/ethnicity and age. We also examined vaccine series completion among initiators who had at least 12 months to complete all 3 doses.

Results. Significant interactions were observed between insurance category, age, and race/ethnicity. Juxtaposed with their continuously insured peers, patients were less likely to initiate the HPV vaccine if they were insured for less than 66% of the study period, aged 13 years or older, and identified as a racial/ethnic minority. Insurance coverage was not associated with vaccine series completion.

Conclusions. Disparities in vaccine uptake by insurance status were present in the FQHCs studied here, despite the fact that HPV vaccines are available to many patients regardless of ability to pay.
The Cost-Effectiveness of School-Based Eating Disorder Screening
Authors: Wright Davene R. , Austin S. Bryn , LeAnn Noh H. , Jiang Yushan , Sonneville Kendrin R.
Published: July 2014

Objectives. We aimed to assess the value of school-based eating disorder (ED) screening for a hypothetical cohort of US public school students.

Methods. We used a decision-analytic microsimulation model to model the effectiveness (life-years with ED and quality-adjusted life-years [QALYs]), total direct costs, and cost-effectiveness (cost per QALY gained) of screening relative to current practice.

Results. The screening strategy cost $2260 (95% confidence interval [CI] = $1892, $2668) per student and resulted in a per capita gain of 0.25 fewer life-years with ED (95% CI = 0.21, 0.30) and 0.04 QALYs (95% CI = 0.03, 0.05) relative to current practice. The base case cost-effectiveness of the intervention was $9041 per life-year with ED avoided (95% CI = $6617, $12 344) and $56 500 per QALY gained (95% CI = $38 805, $71 250).

Conclusions. At willingness-to-pay thresholds of $50 000 and $100 000 per QALY gained, school-based ED screening is 41% and 100% likely to be cost-effective, respectively. The cost-effectiveness of ED screening is comparable to many other accepted pediatric health interventions, including hypertension screening.
Utilitarian Walking, Neighborhood Environment, and Risk of Outdoor Falls Among Older Adults
Authors: Li Wenjun , Procter-Gray Elizabeth , Lipsitz Lewis A. , Leveille Suzanne G. , Hackman Holly , Biondolillo Madeleine , Hannan Marian T.
Published: July 2014

Objectives. We examined the roles of utilitarian and recreational walking in relation to occurrence of outdoor falls in older adults.

Methods. We analyzed data on walking habits, falls, and fall injuries among participants of MOBILIZE Boston, a prospective cohort study of 765 community-dwelling women and men, mainly aged 70 years or older, in Boston, Massachusetts. Neighborhood socioeconomic status (SES) indicators were assessed at census block group level. Falls were recorded during a total of 2066.5 person-years of follow-up (September 2005–December 2009), and the median length of follow-up was 2.9 years (range = 0.04–4.3).

Results. Lower neighborhood SES indicators were associated with more utilitarian walking and higher rates of falls on sidewalks, streets, and curbs. Falls on sidewalks and streets were more likely to result in an injury than were falls in recreational areas. Utilitarian-only walkers tended to live in neighborhoods with the lowest neighborhood SES and had the highest rate of outdoor falls despite walking 14 and 25 fewer blocks per week than the recreational-only and dual walkers, respectively.

Conclusions. Improving the safety of walking environments in areas where older adults shop and do other errands of necessity is an important component of fall prevention.
Presence of a chelydrid turtle in the late Pliocene Camp dels Ninots locality (Spain)
Authors: Claude Julien , de Soler Bruno Gomez , Campeny Gerard , Agusti Jordi , Oms Oriol
Published: July 2014

The late Pliocene locality Camp dels Ninots is a fossil Lagerstätte that yielded an exceptionally well preserved vertebrate fauna. Several turtles were reported from this locality and were all assigned to the living species Mauremys leprosa. We describe here a second turtle taxon based on carapace material. This new taxon is identified as Chelydropsis cf. pontica. It is the first report of a chelydrid turtle in the Pliocene of the Iberian peninsula. This discovery extends the range of the species to the southwest of Europe and thereby better documents the space and time distribution of snapping turtles before their supposedly rapid disappearance in Europe.
Tectonic accretion and recycling of the continental lithosphere during the Alpine orogeny along the Pyrenees
Authors: Vanderhaeghe Olivier , Grabkowiak Alexia
Published: July 2014

The goal of this paper is to identify the fate of the continental lithosphere along the Iberia-Eurasia convergent plate boundary marked by the formation of the Pyrenean orogenic belt. The present-day volumes of crust and lithosphere beneath the Pyrenees and the volume of eroded crust redistributed in neighbo ring basins are evaluated based on a synthesis of available geological and geophysical data. The volumes that are expected to have transited across the former plate boundary are modeled taking into account Iberia-Eurasia convergence and making assumptions regarding the initial lithospheric and crustal structure of the Iberia-Eurasia plate boundary at the onset of continental collision (~83 Ma).

Despite large uncertainties, the difference between the initial and present-day lithospheric structures suggests that at 83 Ma, either the Iberia-Eurasia plate boundary was marked by a zone of thinned lithosphere (oceanic and/or continental), or the lithosphere having transited across the plate boundary has for the most part been recycled into the mantle.

At the crustal-scale, the volume of tectonically accreted crust is estimated by adding the volume of crust currently present in the Pyrenean orogenic belt to the volume of sediments deposited in neighboring basins, and by subtracting the initial volume of crust at the onset of continental collision considering two end-members, namely (i) a continental rift or (ii) a 35 km wide oceanic basin. In both cases, this tectonically accreted crustal volume is not enough to match the calculated volume of crust that has potentially transited across the plate boundary as a consequence of convergence since 83 Ma. As a result, our computation suggests that at least 30% (and as much as 63%) of the continental crust has subducted with the Iberian lithospheric slab and has been recycled into the mantle.

In addition, the synthesis of topographic and geophysical (gravity and seismic tomography) reveals a peculiar crustal and lithospheric scale structure for the current day Pyrenees characterized by (i) an elliptical-cone-shape Pyrenean mountain range underlain by an elliptical-cone-shaped crustal root pointing down, and (ii) two tongues of lithospheric mantle in the central part of the belt. These features are interpreted as reflecting redistribution of the lithospheric mantle and of the orogenic crust by ductile flow after subduction and tectonic accretion. We propose that following a period of subduction/collision from 83 to 35 Ma, the decrease in the convergence rate between Iberia-Eurasia favored thermal relaxation of the Iberian slab promoting ductile flow and the development of gravitational instabilities. We suggest that the orogenic root has been dragged down by the dense lithospheric root and that part of it has been recycled into the mantle. In this view, the current-day lithospheric tongues represent the remnants of the lithospheric root after thermal relaxation and recycling by convective removal.
Negative Pressure Wound Therapy – A Review of its Uses in Orthopaedic Trauma
Authors: Putnis Sven , Khan Wasim S , Wong James M.-L
Published: July 2014

The use of Negative Pressure Wound Therapy (NPWT) for complex and large wounds has increased in popularity over the past decade. Modern NPWT systems consisting of an open pore foam sponge, adhesive dressing and a vacuum pump producing negative pressure have been used as an adjunct to surgical debridement to treat tissue defects around open fractures and chronic, contaminated wounds. Other uses include supporting skin grafts and protecting wounds at risk of breaking down. This review outlines the current and emerging indications for negative pressure wound therapy in Orthopaedic trauma and the existing preclinical and clinical evidence base for its use.
Bite Injuries to the Hand: Microbiology, Virology and Management
Authors: Malahias M. , Jordan D. , Hughes O. , Khan Wasim S. , Hindocha S.
Published: July 2014

Bites to the human hand, be it from a pet, a stray animal or even a fellow human, may often have dire consequences for the person suffering the insult. Bites by mammals are a common problem and they account for up to 1% of all visits to hospital emergency rooms, in the UK. Clenched fist injuries to the mouth (‘fight bite’) are notorious for being the worst human bites. Bite injuries of the hand and their related infections must be monitored vigilantly and managed proactively, by experts in this field of surgery. In this review article we discuss the associated microbiology and virology of these injuries as well as their management.
Controversies in the Management of Open Fractures
Authors: C.L O’Brien , M Menon , N.M Jomha
Published: July 2014

Open fractures are a common problem encountered by orthopaedic surgeons and comprise a broad spectrum of trauma. Management is guided by principle-based steps aimed at reducing the risk of gas gangrene or suppurative infections, whilst maintaining viability in a favourable soft tissue environment to reduce the risk of delayed or non-union of bone. Aspects of these principles, however, create discussion around several areas of controversy. The specific antimicrobial regimen and its duration are questions that have been evaluated for decades. Like the ever-evolving nature of the bacterial pathogens, the answer to this is dynamic and changing. The “six-hour rule” is a hotly debated topic with fervent perseverance of this dogma despite a gross lack of support from the literature. The most appropriate soft tissue management approach for open fractures – immediate definitive soft tissue closure versus leaving wounds open for delayed closure or definitive management – is also an area of debate. Exploration of these controversies and consideration for the historical context of the supporting literature furthers our understanding of the critical elements.
The Pathophysiology, Diagnosis and Current Management of Acute Compartment Syndrome
Authors: Donaldson James , Haddad Behrooz , Khan Wasim S
Published: July 2014

Acute compartment syndrome (ACS) is a surgical emergency warranting prompt evaluation and treatment. It can occur with any elevation in interstitial pressure in a closed osseo-fascial compartment. Resultant ischaemic damage may be irreversible within six hours and can result in long-term morbidity and even death. The diagnosis is largely clinical with the classical description of ‘pain out of proportion to the injury’. Compartment pressure monitors can be a helpful adjunct where the diagnosis is in doubt. Initial treatment is with the removal of any constricting dressings or casts, avoiding hypotension and optimizing tissue perfusion by keeping the limb at heart level. If symptoms persist, definitive treatment is necessary with timely surgical decompression of all the involved compartments. This article reviews the pathophysiology, diagnosis and current management of ACS.
Peripheral Nerve Injury: Principles for Repair and Regeneration
Authors: M.F Griffin , M Malahias , S Hindocha , Khan Wasim S
Published: July 2014

Peripheral Nerve Injuries are one of the most common causes of hand dysfunction caused by upper limb trauma but still current management has remained suboptimal. This review aims to explain the traditional view of pathophysiology of nerve repair and also describe why surgical management is still inadequate in using the new biological research that has documented the changes that occur after the nerve injury, which, could cause suboptimal clinical outcomes. Subsequently presentation and diagnosis will be described for peripheral nerve injuries. When traditional surgical repair using end-to-end anastomosis is not adequate nerve conduits are required with the gold standard being the autologous nerve. Due to associated donor site morbidity and poor functional outcome documented with autologous nerve repair several new advancements for alternatives to bridge the gap are being investigated. We will summarise the new and future advancements of non-biological and biological replacements as well as gene therapy, which are being considered as the alternatives for peripheral nerve repair.
Who are Lonely? Loneliness in Different Age Groups (18–81 Years Old), Using Two Measures of Loneliness
Authors: Nicolaisen Magnhild , Thorsen Kirsten
Published: July 2014

This study asks if the prevalence of loneliness in the population varies depending on the measures used, with special focus on loneliness among the elderly. The study compares loneliness in different age groups between 18 and 81 years old ( N = 14,743) using two measures of loneliness: the (indirect) six-item De Jong Gierveld Loneliness Scale and a single-item, direct question about loneliness. Data are from the Norwegian LOGG (Life Course, Generation, and Gender) study. We compare the findings on loneliness according to age, gender, health, and partner status. Overall, the two loneliness measures indicate a similar prevalence of loneliness, but attribute loneliness to somewhat different people. When using a direct measure, loneliness is more prevalent among women; when using the (indirect) De Jong Gierveld Scale, loneliness is more prevalent among men. Also, the association between age and loneliness differed when using the direct and the indirect measure.