bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Mental Health Act. vs the Mental Capacity Act. Is the MHA losing its edge?
Authors: Watts John , Mackenzie Robin 
Published: December 2013

Purpose
– The purpose of this paper is to explore the clinical implications of the case of AM and the ruling that the Mental Health Act no longer has primacy over other legislation in certain treatment situations.

Design/methodology/approach
– Critical case analysis and discussion.

Findings
– The Mental Capacity Act Deprivation of Liberty Safeguards could be used more widely, and in preference to the Mental Health Act, but this may cause problems to clinicians and other decision makers such as Mental Health Tribunals.

Originality/value
– This case and its findings have not been widely discussed in academic or clinical practice literature.
Destination leadership and the issue of power
Authors: Stilling Blichfeldt Bodil , Hird John , Kvistgaard Peter 
Published: December 2013

Purpose
– Studies of destination management and leadership may over-emphasize unity and collaboration, thus producing romanticized accounts for such processes. This paper discusses destination leadership from a less romanticized perspective – pointing to the various ways in which it intertwines with power.

Design/methodology/approach
– The authors focus on the relationship between destination leadership and power networks offering a fresh look at the reality of collaborative processes in destinations. By exposing the latent or manifest networks of complex power relations in destinations, the authors disentangle the analysis of destination management and leadership from romanticized perspectives. A non-conventional vignettes approach is applied.

Findings
– The concept of power offers more realistic descriptions and “thick” conceptualizations of destination leadership. Moreover, the predominance of more inclusive and bottom-up approaches to destination development necessitates advances in understandings of power relations at work at the destination. Furthermore, if DMOs are to successfully establish themselves as destination leaders, they need to position themselves in the midst of the power networks entailing relationships and interactions with and between destination stakeholders.

Originality/value
– The paper demonstrates that power is not a characteristic of individual actors, but is instead a characteristic of relations. Moreover, power is defined as a potential and might therefore be latent and only occasionally be activated. Furthermore, in a destination multiple power-relations co-exist, effecting attempts to lead the destination. Therefore, the paper points to the existence of a series of bases of power and effects hereof on destination leadership.
The Financial Crisis and the Hegemony of Urban Neoliberalism: Lessons from Frankfurt am Main
Authors: Schipper Sebastian 
Published: December 2013

AbstractIn view of debates among critical urban scholars regarding the relationship between the current economic crisis and the stability of neoliberal hegemony on the urban scale, this article analyzes (1) the impact of the economic recession on the city of Frankfurt am Main, and (2) whether urban politics in the German financial center will witness a new phase of post‐neoliberalization. Statistical analyses of the local labor and property markets and of municipal budget trends reveal that the implications of the current crisis are relatively limited, especially when compared to the dot.com crisis in the early 2000s. Furthermore, a discourse analysis of the debates in the Frankfurt City Council between 2008 and 2010, supplemented by interviews with local political elites, shows that neoliberal hegemony remains stable and powerful regardless of the deep economic decline and a short period of uncertainty and intensive hegemonic struggles. In my analysis I focus on the power of neoliberal subjectivity and knowledge production in order to try and explain the deepening of the general consensus among local elites by demonstrating that a broad majority of actors from different political parties interprets the crisis within a neoliberal rationality.
Soil functional resistance and stability are linked to different ecosystem properties
Authors: Wakelin Steven A. , Macdonald Lynne M. , O'Callaghan Maureen , Forrester Sean T. , Condron Leo M. 
Published: December 2013

AbstractThe functional resistance and resilience of soils from across the South Island of New Zealand were assessed. Soils were collected from under varying land‐uses (pasture, pine forest, native forest) at each of four different locations (Hokitika, Craigieburn, Eyrewell, Orton Bradley Park). Soil function was measured using carbon utilization profiles (MicroResp technique), and responses to freeze‐thaw disturbance assessed in a multivariate approach. Resistance was defined as the amount of change in functional profiles (multivariate distance) before, and then 10 h after, disturbance. Resilience was defined as the stability in ecosystem function over time (6 sample points spanning 17 days after initial freeze‐thaw disturbance). The functional resistance of soils was not linked to land‐use nor sampling location (permanova P > 0.05) but was negatively correlated with soil Olsen‐P levels (biological‐environmental matching (BIO‐ENV test); ρ = 0.604, P = 0.04). Secondary factors associated with soil organic matter status were associated with functional resistance in soil of low Olsen‐P. This was explicitly tested by repeating the experiment in soils collected from a long‐term P fertilizer management trial; functional resistance remained linked to the underlying P status of the soils (P = 0.002). The functional stability of soil (post‐disturbance) was associated with long‐term rainfall (canonical analysis on principal coordinates – CAP analysis; P = 0.039); soils from high rainfall sites were more stable after disturbance. The results show that variables linked to functional resistance and resilience in soils are different. Furthermore, resilience was not correlated with resistance, or with measures of functional diversity (e.g. evenness of substrate mineralization). Alteration of the P status of soils is likely to impact on the capacity of soils to rapidly respond to disturbance, whereas drivers of climate, such as global warming, may impact soil functional resilience.
Adverse circulatory effects of passive smoking during infancy: surprisingly strong, manifest early, easily avoided
Authors: Cohen G , Vardavas C , Patelarou E , Kogevinas M , Katz‐Salamon M 
Published: December 2013

AbstractAimTo compare blood pressure reactions (BPR) of infants to mild stress for evidence of adverse cardiovascular effects of passive exposure to tobacco smoke during pregnancy and early infancy.MethodsAn observational field study conducted in Crete. We compared 4‐ to 6‐month olds of lifelong nonsmokers minimally (controls, n = 9) or frequently exposed to tobacco smoke (passive smokers; n = 10) with those born to habitual smokers (n = 6). Smoke exposure was verified biochemically (urine cotinine each trimester and at study). We recorded beat‐to‐beat blood pressure (BP) during brief repositioning manoeuvres performed during a daytime nap and analysed BPR (% change in BP during head‐up tilt) for associations with maternal and infant cotinine.ResultsWe observed a 20‐fold difference between BPR of infants of controls versus passive smokers – exceptional given number of infants (α error/confidence level <10% i.e. power >90%). The BPR declined linearly as the infant's (but not mother's) cotinine level rose (p = 0.04), indicating abnormal BPR was caused mainly by postnatal smoke exposure. Infants of active smokers differed from those of passive smokers.ConclusionCardiovascular effects of passive smoking by a newborn infant manifest early on and are exceptionally strong. They can be largely avoided by keeping the home smoke rigorously free.
Tryptophan breakdown is increased in euthymic overweight individuals with bipolar disorder: a preliminary report
Authors: Reininghaus Eva Z , McIntyre Roger S , Reininghaus Bernd , Geisler Simon , Bengesser Susanne A , Lackner Nina , Hecht Karen , Birner Armin , Kattnig Fabian , Unterweger Renate , Kapfhammer Hans‐Peter , Zelzer Sieglinde , Fuchs Dietmar , Mangge Harald 
Published: December 2013

ObjectivesIndividuals with bipolar disorder (BD) are disproportionately affected by symptoms of being overweight and metabolic syndrome when compared to the general population. The pertinence of this observation is underscored by observations that excess weight is associated with a more complex illness presentation, course, and outcome in BD. We present the first preliminary report of our BIPFAT study, which explored shared hypothesized pathophysiological pathways between being overweight and having BD.MethodsWe investigated the tryptophan–kynurenine metabolism pathway as a proxy of dysregulated inflammatory homeostasis in euthymic, overweight individuals with BD (n = 78) compared to healthy controls (n = 156).ResultsBoth blood kynurenine concentrations and the kynurenine to tryptophan ratio [(Kyn:Trp); an estimate of tryptophan breakdown] were significantly higher in the total sample of euthymic patients with BD, with greater increases noted in both parameters in the subsample of overweight patients with BD. When compared to controls, peripheral neopterin concentrations were significantly lower. Within the BD group, there were also significant between‐group differences in neopterin concentrations, with higher levels in those who were overweight and in subjects with BD in the later stages of illness compared to earlier stages.ConclusionsIncreased tryptophan breakdown, as well as neopterin levels in BD, may be an indirect mediator of immune‐mediated inflammation. In BD, this may account for the high prevalence of medical comorbidities and increased mortality. The observation of increased kynurenine levels and Kyn:Trp, and altered circulating neopterin levels provides indirect evidence of increased activity of tryptophan‐degrading indoleamine 2,3‐dioxygenase in euthymic individuals with BD, underscoring the role of inflammatory mediators as a causative and/or consequent factor. More robust abnormalities in the overweight subsample underscore the additional inflammatory burden of medical comorbidity and suggest a shared pathophysiology as well as a mechanism mediating BD and cardiovascular disease.
Haemoglobinuria is associated with chronic kidney disease and its progression in patients with sickle cell anaemia
Authors: Saraf Santosh L. , Zhang Xu , Kanias Tamir , Lash James P. , Molokie Robert E. , Oza Bharvi , Lai Catherine , Rowe Julie H. , Gowhari Michel , Hassan Johara , DeSimone Joseph , Machado Roberto F. , Gladwin Mark T. , Little Jane A. , Gordeuk Victor R. 
Published: December 2013

SummaryTo evaluate the association between haemoglobinuria and chronic kidney disease (CKD) in sickle cell anaemia (SCA), we analysed 356 adult haemoglobin SS or Sβo thalassaemia patients from the University of Illinois at Chicago (UIC) and 439 from the multi‐centre Walk‐Treatment of Pulmonary Hypertension and Sickle Cell Disease with Sildenafil Therapy (Walk‐PHaSST) cohort. CKD was classified according to National Kidney Foundation Kidney Disease Outcomes Quality Initiatives guidelines. Haemoglobinuria, defined as positive haem on urine dipstick with absent red blood cells on microscopy, was confirmed by enzyme‐linked immunosorbent assay in a subset of patients. The prevalence of CKD was 58% in the UIC cohort and 54% in the Walk‐PHaSST cohort, and haemoglobinuria was observed in 36% and 20% of the patients, respectively. Pathway analysis in both cohorts indicated an independent association of lactate dehydrogenase with haemoglobinuria and, in turn, independent associations of haemoglobinuria and age with CKD (P < 0·0001). After a median of 32 months of follow‐up in the UIC cohort, haemoglobinuria was associated with progression of CKD [halving of estimated glomerular filtration rate or requirement for dialysis; Hazard ratio (HR) 13·9, 95% confidence interval (CI) 1·7–113·2, P = 0·0012] and increasing albuminuria (HR 3·1, 95% CI: 1·3–7·7; logrank P = 0·0035). In conclusion haemoglobinuria is common in SCA and is associated with CKD, consistent with a role for intravascular haemolysis in the pathogenesis of renal dysfunction in SCA.
El Niño, Host Plant Growth, and Migratory Butterfly Abundance in a Changing Climate
Authors: Srygley Robert B. , Dudley Robert , Oliveira Evandro G. , Riveros Andre J. 
Published: December 2013

AbstractIn the wet forests of Panama, El Niño typically brings a more prolonged and severe dry season. Interestingly, many trees and lianas that comprise the wet forests increase their productivity as a response to El Niño. Here, we quantify the abundance of migratingMarpesia chironbutterflies over 17 yr and the production of new leaves of their hostplants over 9 yr to test the generality of the El Niño migration syndrome,i.e., whether increased abundance of migrating insects and productivity of their food plants are associated with El Niño and La Niña events. We find that the quantity ofM. chironmigrating across the Panama Canal was directly proportional to the sea surface temperature (SST) anomaly of the Pacific Ocean, which characterizes El Niño and La Niña events. We also find that production of new leaves by its larval host trees, namelyBrosimum alicastrum,Artocarpus altilis, andFicus citrifolia, was directly proportional to theSSTanomaly, with greater leaf flushing occurring during the period of the annual butterfly migration that followed an El Niño event. Combining these and our previously published results for the migratory butterflyAphrissa statiraand its host lianas, we conclude that dry season rainfall and photosynthetically active radiation can serve as primary drivers of larval food production and insect population outbreaks in Neotropical wet forests, with drier years resulting in enhanced plant productivity and herbivore abundance. Insect populations should closely track changes in both frequency and amplitude of the El Niño Southern Oscillation with climate change.
Posttraumatic stress symptoms and structure among orphan and vulnerable children and adolescents in Zambia
Authors: Familiar Itziar , Murray Laura , Gross Alden , Skavenski Stephanie , Jere Elizabeth , Bass Judith 
Published: December 2013

BackgroundScant information exists on posttraumatic stress disorder (PTSD) symptoms and structure in youth from developing countries.MethodsWe describe the symptom profile and exposure to trauma experiences among 343 orphan and vulnerable children and adolescents from Zambia. We distinguished profiles of posttraumatic stress symptoms using latent class analysis.ResultsAverage number of trauma‐related symptoms (21.6; range 0–38) was similar across sex and age. Latent class model suggested three classes varying by level of severity: low (31% of the sample), medium (45% of the sample), and high (24% of the sample) symptomatology.ConclusionsResults suggest that PTSD is a continuously distributed latent trait.
Acute angle closure: qualitative and quantitative evaluation of the anterior segment using anterior segment optical coherence tomography
Authors: Moghimi Sasan , Zandvakil Narges , Vahedian Zakieh , Mohammadi Massood , Fakhraie Ghasem , Coleman Anne L , Lin Shan C 
Published: December 2013

AbstractBackgroundTo evaluate different mechanisms of acute angle closure and to compare it with unaffected fellow eyes and primary angle closure suspects using anterior segment optical coherence tomography.DesignProspective, cross‐sectional.Participants116 eyes (76 patients) with angle closure disease were included.MethodsEyes were categorized into three groups: (i) acute angle closure (40 eyes); (ii) fellow eyes of acute angle closure (40 eyes); and (iii) primary angle closure suspect (36 eyes). Complete ophthalmic examinations including gonioscopy, A‐scan biometry and anterior segment optical coherence tomography were performed.Main Outcome MeasureBased on the anterior segment optical coherence tomography images, four mechanisms of primary angle closure including pupil block, plateau iris configuration, thick peripheral iris roll and exaggerated lens vault were evaluated among the three subtypes of angle closure disease.ResultsThere was a statistically significant difference in the mechanism of angle closure disease among the three groups (P < 0.001). Although the majority of fellow and primary angle closure suspect eyes had pupil block mechanism (77.5% and 75%, respectively), only 37.5% of acute angle closure eyes had dominant pupil block mechanism. The percentage because of exaggerated lens vault was greatest in acute angle closure eyes (50%). Acute angle closure eyes had the shallowest anterior chamber depth (P < 0.001), least iris curvature (P < 0.001) and greatest lens vault (P = 0.003) compared with the other two groups.ConclusionsA statistically significant difference in the underlying primary angle closure mechanisms among acute angle closure eyes as compared with their fellow eyes and primary angle closure suspect may exist.
The Role of Diffusion Tensor Imaging in Detecting Microstructural Changes in Prodromal Alzheimer's Disease
Authors: Zhang Bing , Xu Yun , Zhu Bin , Kantarci Kejal 
Published: December 2013

SummaryThe MRI technique diffusion tensor imaging (DTI) is reviewed along with microstructural changes associated with prodromal Alzheimer's disease (AD) as a potential biomarker for clinical applications. The prodromal stage of AD is characterized by mild cognitive impairment (MCI), representing a transitional state between normal aging and AD. Microstructural abnormalities on DTI are promising in vivo biomarkers of gray and white matter changes associated with the progression of AD pathology. Elevated mean diffusivity and decreased fractional anisotropy are consistently found in prodromal AD, and even in cognitively normal elderly who progress to MCI. However, quality of parameter maps may be affected by artifacts of motion, susceptibility, and eddy current‐induced distortions. The DTI maps are typically analyzed by region‐of‐interest or voxel‐based analytic techniques such as tract‐based spatial statistics. DTI‐based index of diffusivity is complementary to macrostructural gray matter changes in the hippocampus in detecting prodromal AD. Breakdown of structural connectivity measured with DTI may impact cognitive performance during early AD. Furthermore, assessment of hippocampal connections may help in understanding the cerebral organization and remodeling associated with treatment response.
Investigation of the relationship between serum hormones and pilonidal sinus disease: a cross‐sectional study
Authors: Özkan Z. , Aksoy N. , Emir S. , Kanat B. H. , Gönen A. N. , Yazar F. M. , Çimen A. R. 
Published: December 2013

AbstractAimThe aim of this cross‐sectional study was to determine whether pilonidal sinus is influenced by hormones that stimulate body hair growth. Currently, there are insufficient data on the presence of hormonal abnormalities in pilonidal sinus disease.MethodHormone levels (including those of thyroid‐stimulating hormone, follicular‐stimulating hormone, luteinizing hormone, prolactin, progesterone, oestradiol, testosterone, cortisol and dehydroepiandrosterone) were measured in 39 patients with pilonodal sinus presenting between February 2013 and March 2013. The results were compared with those of 39 volunteers without this disease.ResultsThere was no statistically significant difference between men with pilonidal sinus disease (P > 0.05). The prolactin levels of women with pilonoidal sinus were significantly higher than those of women in the control group (P < 0.05).ConclusionRaised serum prolactin levels in women may be related to the development of pilonidal sinus disease.
A study to demonstrate the use of FNA cytology rather than biopsy in the diagnosis of neonatal biliary atresia
Authors: Mokhtari M. , Kumar P. V. , Salimi A. 
Published: December 2013

ObjectiveTo study the use of fine needle aspiration (FNA) cytology in neonatal biliary atresia (BA).MethodsTwelve female and nine male patients (age range, 3–7 months; mean age, 4.5 months) with a pre‐operative diagnosis of BA, who were scheduled for Kasia portoenterostomy and selected for intraoperative FNA, were studied.ResultsCholestasis, bile deposits, bile infarcts, hepatitic rosettes enclosing bile plugs, feathery degeneration of hepatocytes and inflammatory cells were seen in the cytological slides. Bile infarcts, rosette formation and inflammatory cells were mainly noticed in type 3 BA. Bile infarcts and hepatitic rosettes are surrogate findings for the diagnosis of the obstructive type of cholestasis.ConclusionWith the help of imaging studies, FNA in a multidisciplinary setting can be diagnostic of neonatal BA when cytological features suggest the obstructive nature of cholestasis, but this procedure cannot replace completely liver biopsy for this diagnosis.
A systematic approach to assess the strengths and limitations of cytomorphology in the diagnosis of the follicular variant of papillary thyroid carcinoma
Authors: Manivannan P. , Siddaraju N. , Gopalakrishnan S. 
Published: December 2013

ObjectiveTo identify the most useful cytomorphological features of follicular variant of papillary thyroid carcinoma (FVPTC).MethodsFine needle aspiration cytological features of seven histologically proven FVPTCs were systematically evaluated in a blinded manner for various architectural, nuclear, cytoplasmic and background features with special reference to nuclear morphology.ResultsMost smears were moderate to highly cellular with clustered and/or repetitive microfollicles, rare macrofollicles and minimal thick gummy colloid. Six of seven cases showed significant nuclear crowding/overlapping. Fairly uniform nucleomegaly (mostly three to five times the size of a mature lymphocyte) of intact neoplastic cells and enlarged naked nuclei were prominent features in all seven cases, whereas enlarged ovoid nuclei were seen in two cases. Chromatin was fine to coarsely granular and evenly distributed. Occasional nuclear grooves (NGs) and intranuclear cytoplasmic inclusions (INCIs) were seen in five and three cases, respectively. This refined approach led to a precise diagnosis of FVPTC in six cases, which were earlier interpreted as various follicular lesions. Follicular hyperplasia was excluded by the absence of significant amounts of colloid and atretic naked nuclei, whilst the possibility of follicular adenoma or follicular carcinoma was excluded by the presence of one or more features suggestive of papillary thyroid carcinoma.ConclusionsOur study showed a high cell yield, microfollicular pattern, nuclear overcrowding/overlapping, scanty gummy colloid and enlarged naked nuclei as the most consistent features of FVPTC. Although inconsistent, features such as enlarged ovoid nuclei and syncytial clusters were complementary to the diagnosis in the absence of NGs and INCIs.