bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of perforating vein surgery in patients with venous ulceration
Authors: van Gent WB , Wittens CHA 
Published: December 2013

Objectives The exact role of perforating vein surgery is still unclear. The aim of this study is to analyze the influence of perforating vein surgery in patients with venous ulceration. Methods This study was part of a randomized controlled trial in which conservative and surgical treatment of venous ulceration was compared. It is a secondary analysis of prospectively gathered data. Ninety-seven active leg ulcers were surgically treated with a subfascial endoscopic perforating vein surgery (SEPS) procedure. Concomitant superficial venous incompetence was treated with flush saphenopopliteal ligation and/or saphenofemoral ligation and limited stripping of the great saphenous vein. All patients were also treated with ambulatory compression therapy. Ulcer healing and recurrences are described in detail. To measure the completeness of the SEPS procedure duplex ultrasonography was performed on each patient before and 6 weeks and 12 months after surgery. Also newly formed perforators after surgery were scored and their influence was analyzed. Results Analyses were performed on 94 ulcerated legs with a mean follow-up of 29 months. In all treated legs, only 45% all perforators were treated. In 55% one (29%) or more (26%) perforators were missed. Healing was not significantly influenced by the number of remaining incompetent perforating veins, but recurrence was significantly higher in patients who had incomplete SEPS procedure ( p = 0.007 log-rank). New incompetent perforating veins did not affect ulcer healing or recurrence. The plotted location of new perforators did not show a pattern. Deep vein incompetence and treatment of superficial venous incompetence had no significant influence on healing or recurrence rates in a complete or incomplete SEPS procedure. Conclusion In this series a well-performed SEPS procedure lowers the venous ulcer recurrence rate significantly, indicating the clinical importance of incompetent perforating veins in patients with an active venous ulcer.
Investigating railway track asset management using a Markov analysis
Authors: Prescott Darren , Andrews John 
Published: December 2013

A railway track asset management strategy must ensure that the condition of the track stays at an acceptable level, ensuring passenger comfort and safety. The determination of an efficient and effective strategy is a complex problem that requires consideration of the interrelated processes of deterioration, inspection, maintenance and renewal. Railway traffic causes the track’s geometry to deteriorate through time. When the track’s geometry has been assessed and seen to have deteriorated, maintenance is scheduled to restore the track’s geometry using a tamping machine. Tamping involves lifting the track to the required position before inserting vibrating tines into the ballast either side of the sleepers and using them to pack the ballast below. This process causes damage to the ballast, causing a relative acceleration in future track geometry deterioration and decreasing the time between subsequent maintenance interventions. This paper describes a Markov model that can be used to investigate the asset management strategy applied to a railway track section. The model predicts the way that the track section’s condition changes with time for a given asset management strategy, which is defined through the specification of a number of model parameters. The model is applied to a track section with a specified maintenance strategy and is used to investigate the track’s performance for that strategy. Parameters corresponding to asset management decisions that relate to inspection, maintenance and renewal are then changed in order to illustrate the effects of the decisions on the track’s life cycle. The Markov model provides a simple yet powerful means of investigating the effects of an asset management strategy on a railway track section.
The cost of care of systemic lupus erythematosus (SLE) in the UK: annual direct costs for adult SLE patients with active autoantibody-positive disease
Authors: Khamashta MA , Bruce IN , Gordon C , Isenberg DA , Ateka-Barrutia O , Gayed M , Donatti C , Guillermin A-L , Foo J , Perna A 
Published: December 2013

Objectives The aim of the Systemic LUpus Erythematosus Cost of Care In Europe (LUCIE) study was to evaluate the annual direct medical costs of managing adults with active autoantibody-positive disease on medication for SLE in secondary care. This paper presents the UK analyses only. Methods A cost-of-illness study was conducted from the perspective of the National Health Service. Health resource utilization data were retrieved over a two-year period from four centres in England and unit cost data were taken from published sources. Results At baseline, 86 patients were included, 38 (44.2%) had severe SLE and 48 (55.8%) had non-severe SLE. The mean (SD) SELENA-SLEDAI score was 7.7 (5.7). The mean (SD) annual direct medical cost of was estimated at £3231 (£2333) per patient and was 2.2 times higher in patients with severe SLE compared with patients with non-severe SLE ( p < 0.001). Multivariate model analyses showed that renal disease involvement ( p = 0.0016) and severe flares ( p = 0.0001) were associated with higher annual direct costs. Conclusions Improvement of the overall stability of SLE and early intervention to minimize the impact of renal disease may be two approaches to mitigate the long-term direct cost of managing SLE patients in the UK.
Dipeptidyl peptidase-4 inhibitor reduces infarct size and preserves cardiac function via mitochondrial protection in ischaemia–reperfusion rat heart
Authors: Chinda Kroekkiat , Sanit Jantira , Chattipakorn Siriporn , Chattipakorn Nipon 
Published: December 2013

Aim: We hypothesized that dipeptidyl peptidase (DPP)-4 inhibitor (vildagliptin) reduces fatal arrhythmias, cardiac dysfunction and infarct size caused by ischaemia–reperfusion (I/R) injury via its attenuation of cardiac mitochondrial dysfunction. Methods: In total, 26 rats were randomized to receive either 1 mL normal saline solution or 2.0 mg/kg vildagliptin intravenously ( n = 13/group) 30 min prior to a 30-min left anterior descending coronary artery occlusion, followed by a 120-min reperfusion. Arrhythmia scores, cardiac functions, infarct size and mitochondrial function were evaluated. Results: Vildagliptin reduced the infarct size by 44% and mitigated cardiac dysfunction by preserving cardiac function without altering the incidence of cardiac arrhythmias. Vildagliptin increased expression of Bcl-2 and pro-caspase3 in the ischaemic area, whereas Bax and phosphorylated-connexin43/total-connexin43 were not altered. Vildagliptin attenuated cardiac mitochondrial dysfunction by reducing the reactive oxygen species level and mitochondrial swelling. Conclusions: DPP-4 inhibitor provides cardioprotection by reducing the infarct size and ameliorating cardiac dysfunction in I/R hearts by attenuating cardiac mitochondrial dysfunction and cardiomyocyte apoptosis.
Reliability, Validity, and Interpretation of the Dependence Scale in Mild to Moderately Severe Alzheimer’s Disease
Authors: Lenderking William R. , Wyrwich Kathleen W. , Stolar Marilyn , Howard Kellee A. , Leibman Chris , Buchanan Jacqui , Lacey Loretto , Kopp Zoe , Stern Yaakov 
Published: December 2013

Introduction: The Dependence Scale (DS) was designed to measure dependence on others among patients with Alzheimer’s disease (AD). The objectives of this research were primarily to strengthen the psychometric evidence for the use of the DS in AD studies. Methods: Patients with mild to moderately severe AD were examined in 3 study databases. Within each data set, internal consistency, validity, and responsiveness were examined, and structural equation models were fit. Results: The DS has strong psychometric properties. The DS scores differed significantly across known groups and demonstrated moderate to strong correlations with measures hypothesized to be related to dependence (| r| ≥ .31). Structural equation modeling supported the validity of the DS concept. An anchor-based DS responder definition to interpret a treatment benefit over time was identified. Discussion: The DS is a reliable, valid, and interpretable measure of dependence associated with AD and is shown to be related to—but provides information distinct from—cognition, functioning, and behavior.
Gross Violations of Duverger’s Law in India
Authors: Mayer Peter 
Published: December 2013

In his famous study of the impact of electoral regimes on party systems, Duverger suggested that two-party systems are always found to be associated with single-member constituencies where candidates are elected by a plurality of votes ( Duverger, 1964 ). Many studies of what Rae called the political consequences of electoral laws have tended to confirm this well-known electoral ‘law’. A few studies ( Betz, 2006 ; Chhibber and Murali, 2006 ; Diwakar, 2007 , 2010 ), however, have drawn attention to India’s exceptionalism in terms of party aggregation. This article explores a relatively minor—and thus less-examined but nonetheless puzzling—aspect of Indian exceptionalism: the spectacular failure overall of candidates (and of minor parties) to conform to Duverger’s law. Since 1957, the first national election after States Reorganisation, the average number of candidates standing in Lok Sabha constituencies in all states has tended to rise. In 2004, for example, in all but four states there were more than 10 candidates per constituency in over 90 per cent of constituencies. In this article I explore why neither the mechanical nor the psychological processes commonly understood to be so compelling elsewhere exert significant influence in India. This suggests that there are hitherto unrecognized presuppositions to Duverger’s law.
Book Review: Security and Development in India’s Northeast, Confronting the State: ULFA’s Quest for Sovereignty and Perilous Journey: Debates on Security and Development in Assam
Authors: Singh Deepak K. 
Published: December 2013

Gurudas Das, Security and Development in India’s Northeast. New Delhi: Oxford University Press India. 2012. 181 pages. ₹ 595. Nani Gopal Mahanta, Confronting the State: ULFA’s Quest for Sovereignty. New Delhi: SAGE Publications. 2013. 348 pages. ₹ 750. Rakhee Bhattacharya and Sanjay Pulipaka, eds, Perilous Journey: Debates on Security and Development in Assam. New Delhi: Manohar Publications. 2011. 257 pages. ₹ 695.
Meta-analysis of low-molecular-weight heparin to prevent recurrent placenta-mediated pregnancy complications
Authors: Rodger Marc A. , Carrier Marc , Le Gal Grégoire , Martinelli Ida , Perna Annalisa , Rey Évelyne , de Vries J. I. P. , Gris Jean-Christophe 
Published: December 2013

AbstractA 35-year-old woman with recurrent severe placenta-mediated pregnancy complications in her 2 pregnancies asks: Will low-molecular-weight heparin help prevent recurrent placenta-mediated pregnancy complications in my next pregnancy? We performed a meta-analysis of randomized controlled trials (RCTs) comparing low-molecular-weight heparin (LMWH) vs no LMWH for the prevention of recurrent placenta-mediated pregnancy complications. We identified six RCTs that included a total of 848 pregnant women with prior placenta-mediated pregnancy complications. The primary outcome was a composite of pre-eclampsia (PE), birth of a small-for-gestational-age (SGA) newborn (<10th percentile), placental abruption, or pregnancy loss >20 weeks. Overall, 67 (18.7%) of 358 of women being given prophylactic LMWH had recurrent severe placenta-mediated pregnancy complications compared with 127 (42.9%) of 296 women with no LMWH (relative risk reduction, 0.52; 95% CI, 0.32 to 0.86; P = .01; I2, 69%, indicating moderate heterogeneity). We identified similar relative risk reductions with LMWH for individual outcomes, including any PE, severe PE, SGA <10th percentile, SGA <5th percentile, preterm delivery <37 weeks, and preterm delivery <34 weeks with minimal heterogeneity. LMWH may be a promising therapy for recurrent, especially severe, placenta-mediated pregnancy complications, but further research is required.
Distinct roles for hepcidin and interleukin-6 in the recovery from anemia in mice injected with heat-killed Brucella abortus
Authors: Gardenghi Sara , Renaud Tom M. , Meloni Alessandra , Casu Carla , Crielaard Bart J. , Bystrom Laura M. , Greenberg-Kushnir Noa , Sasu Barbra J. , Cooke Keegan S. , Rivella Stefano 
Published: December 2013

Key Points
Investigation of the distinct roles of hepcidin and interleukin 6 on iron metabolism and inflammation in the onset and resolution of AI.
Abiotic stress-induced accumulation of raffinose in Arabidopsis leaves is mediated by a single raffinose synthase (RS5, At5g40390)
Authors: Egert Aurélie , Keller Felix , Peters Shaun 
Published: December 2013

Abstract

Background
The sucrosylgalactoside oligosaccharide raffinose (Raf, Suc-Gal1) accumulates in Arabidopsis leaves in response to a myriad of abiotic stresses. Whilst galactinol synthases (GolS), the first committed enzyme in Raf biosynthesis are well characterised in Arabidopsis, little is known of the second biosynthetic gene/enzyme raffinose synthase (RS). Conflicting reports suggest the existence of either one or six abiotic stress-inducible RSs (RS-1 to -6) occurring in Arabidopsis. Indirect evidence points to At5g40390 being responsible for low temperature-induced Raf accumulation in Arabidopsis leaves.

Results
By heterologously expressing At5g40390 in E.coli, we demonstrate that crude extracts synthesise Raf in vitro, contrary to empty vector controls. Using two independent loss-of-function mutants for At5g40390 (rs 5–1 and 5–2), we confirm that this RS is indeed responsible for Raf accumulation during low temperature-acclimation (4°C), as previously reported. Surprisingly, leaves of mutant plants also fail to accumulate any Raf under diverse abiotic stresses including water-deficit, high salinity, heat shock, and methyl viologen-induced oxidative stress. Correlated to the lack of Raf under these abiotic stress conditions, both mutant plants lack the typical stress-induced RafS activity increase observed in the leaves of wild-type plants.

Conclusions
Collectively our findings point to a single abiotic stress-induced RS isoform (RS5, At5g40390) being responsible for Raf biosynthesis in Arabidopsis leaves. However, they do not support a single RS hypothesis since the seeds of both mutant plants still contained Raf, albeit at 0.5-fold lower concentration than seeds from wild-type plants, suggesting the existence of at least one other seed-specific RS. These results also unambiguously discount the existence of six stress-inducible RS isoforms suggested by recent reports.
Guidelines for the use and management of long-acting injectable antipsychotics in serious mental illness
Authors: Llorca Pierre Michel , Abbar Mocrane , Courtet Philippe , Guillaume Sebastien , Lancrenon Sylvie , Samalin Ludovic 
Published: December 2013

Abstract

Background
Long-acting injectable (LAI) formulations are not widely used in routine practice even though they offer advantages in terms of relapse prevention. As part of a process to improve the quality of care, the French Association for Biological Psychiatry and Neuropsychopharmacology (AFPBN) elaborated guidelines for the use and management of antipsychotic depots in clinical practice.

Methods
Based on a literature review, a written survey was prepared that asked about 539 options in 32 specific clinical situations concerning 3 fields: target-population, prescription and use, and specific populations. We contacted 53 national experts, 42 of whom (79%) completed the survey. The options were scored using a 9-point scale derived from the Rand Corporation and the University of California in the USA. According to the answers, a categorical rank (first-line/preferred choice, second-line/alternate choice, third-line/usually inappropriate) was assigned to each option. The first-line option was defined as a strategy rated as 7–9 (extremely appropriate) by at least 50% of the experts. The following results summarize the key recommendations from the guidelines after data analysis and interpretation of the results of the survey by the scientific committee.

Results
LAI antipsychotics are indicated in patients with schizophrenia, schizoaffective disorder, delusional disorder and bipolar disorder. LAI second-generation antipsychotics are recommended as maintenance treatment after the first episode of schizophrenia. LAI first-generation antipsychotics are not recommended in the early course of schizophrenia and are not usually appropriate in bipolar disorder. LAI antipsychotics have long been viewed as a treatment that should only be used for a small subgroup of patients with non-compliance, frequent relapses or who pose a risk to others. The panel considers that LAI antipsychotics should be considered and systematically proposed to any patients for whom maintenance antipsychotic treatment is indicated. Recommendations for medication management when switching oral antipsychotics to LAI antipsychotics are proposed. Recommendations are also given for the use of LAI in specific populations.

Conclusion
In an evidence-based clinical approach, psychiatrists, through shared decision-making, should be systematically offering to most patients that require long-term antipsychotic treatment an LAI antipsychotic as a first-line treatment.
The process of recovery in women who experienced psychosis following childbirth
Authors: McGrath Laura , Peters Sarah , Wieck Angelika , Wittkowski Anja 
Published: December 2013

Abstract

Background
Psychosis following childbirth affects 1–2 mothers per 1000 deliveries. Onset is rapid and functioning is severely affected. Although prognosis in terms of symptom remission is generally good, long-term disability can persist. The study’s aim was to develop a theoretical understanding of recovery from psychosis following childbirth.

Methods
Semi-structured interviews were conducted with 12 women with experience of psychosis following childbirth. Interview transcripts were analysed using grounded theory methodology.

Results
A theory of four superordinate themes was developed from the data, including: (i) the process of recovery; (ii) evolving an understanding; (iii) strategies for recovery; and (iv) sociocultural context. The process of recovery and women’s understanding of their experience were conceptualised as parallel processes, which informed one another. Women found that a diagnosis facilitated their use of particular strategies.

Conclusions
This study highlighted a complex and ongoing process of recovery from psychosis following childbirth. Sensitivity to a woman’s position in the process of recovery has the potential to facilitate professionals in assessing readiness for different interventions which will be likely to result in women feeling more understood, accepted and supported.
Association between shift work and obesity among female nurses: Korean Nurses’ Survey
Authors: Kim Min-Ju , Son Kuk-Hui , Park Hyun-Young , Choi Dong-Ju , Yoon Chang-Hwan , Lee Hea-Young , Cho Eun-Young , Cho Myeong-Chan 
Published: December 2013

Abstract

Background
Shift work has been hypothesized as a risk factor for obesity. In this study, we investigated the association between current shift work and body mass index (BMI) among female nurses in Korea. The relationship between duration of shift work and BMI of the participants was also evaluated.

Methods
This cross-sectional survey evaluated participants in the Korean Nurses’ Survey, conducted from October to December 2011, using web-based self-administered questionnaires. A total of 9,989 nurses were included among 10,000 who registered on the survey web site (5,287 shift workers and 4,702 non-shift workers). Current shift workers were divided into tertiles of shift work duration (0.08–3.00 years, n = 1,732; 3.08–6.75 years, n = 1,731; and 6.83–38.00 years, n = 1,686). The BMI thresholds of overweight and obesity were ≥23 kg/m2 and ≥25 kg/m2, respectively. Data were analyzed using SPSS software.

Results
Mean participant age was 33.2 ± 8.6 years and the mean BMI was 20.9 ± 2.5 kg/m2. There were statistically significant differences in current smoking status, regular drinking habit, dietary habits, regular exercise, sleep problems and self-perceived health status according to duration of shift work. The overall prevalence of overweight/obesity (18.6%) and obesity (7.4%) increased significantly as shift work duration increased from the lowest to highest tertile (P for trend <0.001). Multivariate logistic regression analysis revealed no association between current shift work and BMI. However, after adjusting for potential confounders, the participants with the longest duration of shift work were 1.63 (95% CI, 1.22–2.17) times more likely to be overweight or obese than those with the shortest duration. There was a significant positive association between obesity and shift work duration in the unadjusted analysis; however, it was attenuated and no longer significant in the multivariate model.

Conclusions
The duration of shift work was positively associated with prevalence of overweight/obesity in nurses in Korea. Although these findings need to be confirmed in prospective studies, they suggest that special attention should be paid to female nurses with a long duration of shift work.
Awareness of breast cancer among adolescent girls in Colombo, Sri Lanka: a school based study
Authors: Ranasinghe Hasanthika M , Ranasinghe Nilakshika , Rodrigo Chaturaka , Seneviratne Rohini De A , Rajapakse Senaka 
Published: December 2013

Abstract

Background
Breast cancer is the commonest cancer in women worldwide. Although programmes promoting breast cancer awareness are being carried out throughout Sri Lanka, few have targeted school students. We conducted this study to assess the knowledge, attitudes and practices regarding breast cancer with reference to screening, services available, breast self-examination, and sources of information, among adolescent schoolgirls in the Colombo District of Sri Lanka.

Methods
The knowledge, attitudes and practices related to breast cancer were assessed among 859 adolescent girls in schools within the Colombo District, using a self-administered questionnaire. Classes and students were selected using multi-stage stratified cluster sampling.

Results
Of the total sample, approximately 60% of respondents identified ‘history of breast lump’, ‘family history of breast cancer’ & ‘exposure to irradiation’ as risk factors for breast cancer. Although most were aware that the presence of a breast lump was an important warning sign, awareness of other warning signs was poor. Only 35.6% identified mammogram as an effective screening method. One third of the sample maintained that they are unaware of symptoms, diagnostics and treatment of breast cancer. Of those who were aware, 90.6% named surgery as a treatment option for breast cancer, 79.4% were unaware that chemotherapy is used. Of the total sample, 17.1% knew how to perform breast self-examination, and only 9.4% were aware of currently available breast cancer screening services. Knowledge was significantly better among students who had a relative with breast cancer.

Conclusions
There were significant deficiencies in knowledge, attitudes and practices on breast cancer in the study population. In particular, knowledge on breast self examination was poor. There is a need for awareness programs aimed specifically at this important target group.