bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical misconduct in Hong Kong: implications for medical education around the world
Authors: Chan Zenobia C Y 
Published: September 2012

Medical Education 2012: 46: 1009–1016Context  Medical educators emphasise responses to medical misconduct, but little is known about medical misconduct and its implications for medical education. This article investigates the nature of medical malpractice in Hong Kong and offers guidance for the inclusion of a curriculum to prevent the occurrence of medical misconduct in medical education around the world.Methods  A comprehensive review of judgements made by the Medical Council of Hong Kong during the period from July 2008 to December 2010 was conducted. Each of the 40 cases of inquiry related to medical misconduct were summarised and analysed according to 14 factors.Results  Of the 40 cases, nearly half involved only one or two charges. The Council found the defendants guilty of professional misconduct on 148 of 169 charges, and ordered the following four types of penalty: removal order, suspension, warning letter, and reprimand. Cases are grouped into three categories involving: improper documentation, inappropriate management or prescription of drugs, and failure to interact appropriately with patients. The relevant ethical codes or legislation for each category are illustrated.Conclusions  Various types of medical misconduct unquestionably caused suffering to the patients involved, their families and society. Hence, it is crucial for medical educators to teach students about the importance of medical ethics and the prevention of misconduct.
The cost of copy number in a selfish genetic element: the 2‐μm plasmid of Saccharomyces cerevisiae
Authors: Harrison E. , Koufopanou V. , Burt A. , MacLean R. C. 
Published: September 2012

AbstractMany autonomously replicating genetic elements exist as multiple copies within the cell. The copy number of these elements is often assumed to have important fitness consequences for both element and host, yet the forces shaping its evolution are not well understood. The 2 μm is a multicopy plasmid of Saccharomyces yeasts, encoding just four genes that are solely involved in plasmid replication. One simple model for the fitness relationship between yeasts and 2 μm is that plasmid copy number evolves as a trade‐off between selection for increased vertical transmission, favouring high copy number, and selection for decreased virulence, favouring low copy number. To test this model, we experimentally manipulated the copy number of the plasmid and directly measured the fitness cost, in terms of growth rate reduction, associated with high plasmid copy number. We find that the fitness burden imposed by the 2 μm increases with plasmid copy number, such that each copy imposes a fitness burden of 0.17% (± 0.008%), greatly exceeding the cost expected for it to be stably maintained in yeast populations. Our results demonstrate the crucial importance of copy number in the evolution of yeast per 2 μm associations and pave the way for future studies examining how selection can shape the cost of multicopy elements.
Improving chronic lung disease management in rural and remote Australia: The Breathe Easy Walk Easy programme
Authors: JOHNSTON CATHERINE L. , MAXWELL LYNDAL J. , BOYLE EILEEN , MAGUIRE GRAEME P. , ALISON JENNIFER A. 
Published: September 2012

ABSTRACTBackground and objective:  To evaluate the impact of a chronic lung disease management training programme, Breathe Easy Walk Easy (BEWE), for rural and remote health‐care practitioners.Methods:  Quasi‐experimental, before and after repeated measures design. Health‐care practitioners (n = 33) from various professional backgrounds who attended the BEWE training workshop were eligible to participate. Breathe Easy Walk Easy, an interactive educational programme, consisted of a training workshop, access to online resources, provision of community awareness‐raising materials and ongoing telephone/email support. Participant confidence, knowledge and attitudes were assessed via anonymous questionnaire before, immediately after and at 3 and 12 months following the BEWE workshop. At 12 months, local provision of pulmonary rehabilitation services and patient outcome data (6‐min walk test results before and after pulmonary rehabilitation) were also recorded.Results:  Measured knowledge (score out of 19) improved significantly after the workshop (mean difference 7.6 correct answers, 95% confidence interval: 5.8–9.3). Participants' self‐rated confidence and knowledge also increased. At 12‐month follow up, three locally run pulmonary rehabilitation programmes had been established. For completing patients, there was a significant increase in 6‐min walk distance following rehabilitation of 48 m (95% confidence interval: 18–70 m).Conclusions:  The BEWE programme increased rural and remote health‐care practitioner knowledge and confidence in delivering management for people living with chronic lung disease and facilitated the establishment of effective pulmonary rehabilitation programmes in regional and remote Australian settings where access to such programmes is limited.
Two‐year evaluation of the MiniArc in obese versus non‐obese patients for treatment of stress urinary incontinence
Authors: Moore Robert D , De Ridder Dirk , Kennelly Michael J 
Published: September 2012

ObjectivesObesity is a well‐established risk factor of stress urinary incontinence, which affects up to 35% of adult women worldwide. We evaluated whether there is a difference in outcomes with MiniArc sling for treatment of stress incontinence in obese women versus non‐obese women at 24 months.MethodsA 2‐year subanalysis of obese (body mass index >30 kg/m2) versus non‐obese patients enrolled into a multicenter, prospective study evaluating the effectiveness of MiniArc sling was carried out. Qualitative (Urogenital Distress Inventory 6 and Incontinence Impact Questionnaire 7) and quantitative measurements, including the cough stress test, were carried out. Secondary outcome measures included procedure time, estimated blood loss, length of stay, perioperative complications, Wong–Baker Faces Pain Scale and adverse events.ResultsOf 188 patients, 62 were obese. The mean procedure time, blood loss and length of stay were no different between groups. Obese patients reported significantly more pain immediately postoperatively (2 vs 1, Wong–Baker, P = 0.042), but there was no difference at postoperative day 7. There was no difference in objective cure using the cough stress test (81% obese vs 86% non‐obese; P = 0.449). Urogenital Distress Inventory 6 and Incontinence Impact Questionnaire 7 median scores showed no difference between groups in improvement (P = 0.126 and P = 0.087, respectively). No serious device‐related complications were reported in either group.ConclusionsThe MiniArc sling represents a safe and effective treatment option for both obese and non‐obese patients with stress incontinence. Comparable outcomes at 2 years can be obtained in terms of cure rates using the cough stress test or questionnaires, as well as complication rates.
Mycobacterium ulcerans infection: evolution in clinical management
Authors: Simpson Candice , O'Brien Daniel P. , McDonald Anthony , Callan Peter 
Published: September 2012

AbstractMycobacterium ulcerans causes significant morbidity in various endemic locations in Australia and West Africa. The commonest presentation is as a necrotic ulcer often with surrounding subcutaneous necrosis and oedema, which can cause significant morbidity, deformity and functional impairment. Traditional treatment was wide excision and debridement with grafting or flap reconstructions further adding to morbidity and with high recurrence rates. Following publication of clinical studies where antibiotics were shown to be effective, treatment has moved towards combination management with systemic antibiotics and limited surgery involving mainly debridement of the ulcers. Identification of the ‘paradoxical’ immune‐reconstitution syndrome has also impacted upon the extent of excision required. This paper will present the evolution in clinical management of M. ulcerans cases on the Bellarine Peninsula, Victoria, Australia.
Peer Network Overlap in Twin, Sibling, and Friend Dyads
Authors: McGuire Shirley , Segal Nancy L. 
Published: September 2012

Research suggests that sibling–peer connections are important for understanding adolescent problem behaviors. Using a novel behavioral genetic design, the current study investigated peer network overlap in 300 child–child pairs (aged 7–13 years) in 5 dyad types: monozygotic (MZ), dizygotic twins, full siblings (FSs), friend pairs, and virtual twins (i.e., same‐aged, genetically unrelated siblings). Genetic relatedness, sex composition, and age differences contributed to peer overlap in sibling dyads. MZ twins showed the highest overlap (82%), opposite‐sex FS pairs showed the lowest overlap (27%), and friend pairs (48%) were close to the mean (53%). Social contact variables and self‐reported relationship intimacy predicted additional variance in peer overlap. The roles of genotype–environment correlational and shared environmental processes in the sibling–peer connections are discussed.
Silicon nutrition increases grain yield, which, in turn, exerts a feed‐forward stimulation of photosynthetic rates via enhanced mesophyll conductance and alters primary metabolism in rice
Authors: Detmann Kelly C. , Araújo Wagner L. , Martins Samuel C. V. , Sanglard Lílian M. V. P. , Reis Josimar V. , Detmann Edenio , Rodrigues Fabrício Á. , Nunes‐Nesi Adriano , Fernie Alisdair R. , DaMatta Fábio M. 
Published: September 2012

Summary

Silicon (Si) is not considered to be an essential element for higher plants and is believed to have no effect on primary metabolism in unstressed plants. In rice (Oryza sativa), Si nutrition improves grain production; however, no attempt has been made to elucidate the physiological mechanisms underlying such responses.

Here, we assessed crop yield and combined advanced gas exchange analysis with carbon isotope labelling and metabolic profiling to measure the effects of Si nutrition on rice photosynthesis, together with the associated metabolic changes, by comparing wild‐type rice with the low‐Si rice mutant lsi1 under unstressed conditions.

Si improved the harvest index, paralleling an increase in nitrogen use efficiency. Higher crop yields associated with Si nutrition exerted a feed‐forward effect on photosynthesis which was fundamentally associated with increased mesophyll conductance. By contrast, Si nutrition did not affect photosynthetic gas exchange during the vegetative growth phase or in de‐grained plants. In addition, Si nutrition altered primary metabolism by stimulating amino acid remobilization.

Our results indicate a stimulation of the source capacity, coupled with increased sink demand, in Si‐treated plants; therefore, we identify Si nutrition as an important target in attempts to improve the agronomic yield of rice.
Is chemotherapy dose intensity adequate in breast cancer management in the Australian healthcare setting: A retrospective analysis
Authors: Bae Susie , Yeung Yvonne , Ng Say , Craike Melinda , Livingston Patricia M , Chirgwin Jacquie 
Published: September 2012

AbstractAimTo determine the adequacy of chemotherapy received dose intensity (RDI) in breast cancer treatment in a general population and to identify factors that influence RDI.MethodsA retrospective analysis of breast cancer patients who commenced a course of i.v. chemotherapy in 2008 was undertaken. Data were collected on patient and tumor characteristics, chemotherapy regimen, dose (including delays, reductions and the reasons for these), granulocyte colony‐stimulating factor (G‐CSF) use and febrile neutropenia incidence. RDI was calculated using the planned and actual dose received and time taken. A level of ≥85% RDI was considered acceptable for treatment given with curative intent.ResultsIn all, 131 patients (aged 28 to 77 years) received chemotherapy in adjuvant (n = 76, 58%), neoadjuvant (n = 11, 8%) and metastatic settings (n = 44, 34%). RDI did not reach 85% for 12% adjuvant, 36% neoadjuvant and 34% metastatic cases (χ2 = 10.55, P = 0.005). Overall, 43% of patients received G‐CSF.ConclusionAcceptable chemotherapy RDI was delivered for most patients in the adjuvant setting but not in the neoadjuvant setting. G‐CSF treatment contributed to the optimization of dose intensity in the adjuvant setting only. Dose intensity in the metastatic setting was considered satisfactory where quality of life is the primary focus. Other factors can be modified to improve RDI.
Differing Associations of White Matter Lesions and Lacunar Infarction with Retinal Microvascular Signs
Authors: Liew Gerald , Baker Michelle L. , Wong Tien Y. , Hand Peter J. , Wang Jie Jin , Mitchell Paul , De Silva Deidre A. , Wong Meng-Cheong , Rochtchina Elena , Lindley Richard I. , Wardlaw Joanna M. , Hankey Graeme J. ,   the Multi-Centre Retinal Stroke Study Group
Published: September 2012

Background White matter lesions (WML) and lacunar infarcts (LI) are believed to have microvascular etiologies but the exact microvascular changes occurring in each is unclear. Aim Using the retina as a proxy, we assessed retinal microvascular changes in WML and LI. Methods We prospectively recruited 1211 acute stroke patients. Four subgroups were identified from neuroimaging: WML alone, LI alone, both WML and LI, neither WML nor LI. Masked retinal photographs identified retinopathy and retinal arteriolar wall signs and measured retinal vascular caliber. Results Compared with 448 controls with neither WML nor LI, 384 patients with only WML were more likely to have retinopathy [odds ratio (OR) 1·5, 95% confidence interval (CI) 1·1 to 2·1] and enhanced arteriolar light reflex (OR 1·6, 95% CI 1·1 to 2·3); 200 patients with only LI were more likely to have arteriolar narrowing (OR 1·6, 95% CI 1·1 to 2·3) and enhanced arteriolar light reflex (OR 1·6, 95% CI 1·0 to 2·4); and 179 patients with both WML and LI were more likely to have arteriovenous nicking (OR 1·7, 95% CI 1·1 to 2·6), enhanced arteriolar light reflex (OR 2·0, 95% CI 1·3 to 3·2) and wider venules (OR 2·3, 95% CI 1·4 to 3·6). All analyses were adjusted for age, gender, study site and cardiovascular risk factors. Conclusion Both WML and LI were associated with retinal microvascular signs, supporting a microvascular etiology. Differing patterns of association suggest different mechanisms may predominate, e.g. greater endothelial permeability in WML, and ischemia associated with arteriolar wall disease in LI.
SOURCE ROCK POTENTIAL OF ORGANIC‐RICH SHALES IN THE TERTIARY BHUBAN AND BOKA BIL FORMATIONS, BENGAL BASIN, BANGLADESH
Authors: Farhaduzzaman Md. , Abdullah Wan Hasiah , Islam Md. Aminul , Pearson M.J. 
Published: September 2012

Sandstones in the Miocene Bhuban and Lower Pliocene Boka Bil Formations contain all of the hydrocarbons so far discovered in the Bengal Basin, Bangladesh. Organic‐rich shale intervals in these formations have source rock potential and are the focus of the present study which is based on an analysis of 36 core samples from wells in eight gasfields in the eastern Bengal Basin. Kerogen facies and thermal maturity of these shales were studied using standard organic geochemical and organic petrographic techniques.Organic matter is dominated by Type III kerogen with lesser amounts of Type II. TOC is 0.16–0.90 wt % (Bhuban Formation) and 0.15–0.55 wt % (Boka Bil Formation) and extractable organic matter (EOM) is 132–2814 ppm and 235–1458 ppm, respectively. The hydrogen index is 20–181 mg HC/g TOC in the Bhuban shales and 35–282 mg HC/ g TOC in the Boka Bil shales. Vitrinite was the dominant maceral group observed followed by liptinite and inertinite. Gas chromatographic parameters including the C/S ratio, n‐alkane CPI, Pr/Ph ratio, hopane Ts/Tm ratio and sterane distribution suggest that the organic matter in both formations is mainly derived from terrestrial sources deposited in conditions which alternated between oxic and sub‐oxic. The geochemical and petrographic results suggest that the shales analysed can be ranked as poor to fair gas‐prone source rocks. The maturity of the samples varies, and vitrinite reflectance ranges from 0.48 to 0.76 %VRr. Geochemical parameters support a maturity range from just pre‐ oil window to mid‐ oil window.
Identification and Quantification of Oligodendrocyte Precursor Cells in Multiple System Atrophy, Progressive Supranuclear Palsy and Parkinson's Disease
Authors: Ahmed Zeshan , Asi Yasmine T. , Lees Andrew J. , Revesz Tamas , Holton Janice L. 
Published: September 2012

AbstractMultiple system atrophy is a neurodegenerative disorder characterized pathologically by abnormal accumulations of α‐synuclein in the cytoplasm of oligodendrocytes, which are termed glial cytoplasmic inclusions (GCIs). Oligodendrocytes are responsible for myelinating axons and providing neurotrophic support, but in MSA, myelin loss, axonal loss and gliosis are consistent features suggesting that GCIs play a central role in disease pathogenesis. Oligodendroglial, myelin and axonal degeneration are also features of multiple sclerosis (MS) in which recent studies have highlighted the robust remyelination capacity of the central nervous system (CNS). The cells responsible for remyelination are called oligodendroglial precursor cells (OPCs). In this study, we investigated the role of OPCs in the pathogenesis of MSA and progressive supranuclear palsy (PSP), a neurodegenerative disease in which neuropathological changes include oligodendroglial inclusions composed of microtubule‐associated protein tau. Despite the lability of OPC‐specific antigens, we successfully identified OPCs and demonstrated that tau and α‐synuclein do not accumulate in OPCs. We also showed that the density of OPCs was increased in a white matter region of the MSA brain, which is also severely affected by GCIs and myelin degeneration. These findings raise the possibility that OPCs could be available to repair disease‐associated damage in MSA, consistent with their biological function.
Peer victimization and school disaffection: Exploring the moderation effect of social support and the mediation effect of depression
Authors: Galand Benoît , Hospel Virginie 
Published: September 2012

BackgroundPeer victimization is associated with increased internalizing problems and reduced school adjustment. Research into the main effect and the buffering effect of social support on these internalizing problems has produced inconsistent findings, and none has tested the buffering effect of social support on school adjustment. Moreover, recent studies have underlined the importance of taking various sources of social support into account.AimsThis study aims to test the relationships between peer victimization and school disaffection, the moderation effect of parental, peer and teacher social support, and the mediation effect of depression.SampleFour hundred seventh and eighth graders participated in this study.MethodStudents filled out a questionnaire assessing peer victimization, depression, academic self‐efficacy, school disaffection, and perceived social support from parents, peers, and teachers.ResultsPeer victimization was negatively associated with self‐efficacy and positively associated with school disaffection. Regression analyses showed a main negative effect of social support (especially teacher support) on depression and school disaffection and a positive effect on self‐efficacy. No significant interactions emerged between victimization and social support or between sources of social support. Path analyses indicated that the effects of victimization on self‐efficacy and school disaffection were fully mediated by depression, but that the effects of social support are partially independent of depression. Multigroup analyses indicated that these relationships were parallel among boys and girls.ConclusionsThe results of this study are consistent with the main effect model of social support. They also highlight the importance of teacher support for school adjustment.
Experiences of young people who have undergone the Lightning Process to treat chronic fatigue syndrome/myalgic encephalomyelitis – a qualitative study
Authors: Reme Silje Endresen , Archer Nicola , Chalder Trudie 
Published: September 2012

ObjectivesChronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a serious condition characterized by debilitating but unexplained fatigue. Treatment alternatives are few, and especially so for young people. The aetiology of CFS/ME is still unclear and controversial, but rehabilitative interventions seem so far most promising. The Lightning Process is a 3‐day training programme that has recently become available, but no outcome studies have yet been published. It is a non‐medical training programme that combines concepts from Neuro‐Linguistic Programming, Life Coaching and Osteopathy. The aim of this study was to explore the experiences of young people with CFS/ME after they had undergone the Lightning Process.DesignQualitative research study.MethodsSemi‐structured interviews were conducted with an opportunistic sample recruited through open advertisements of nine young people, aged 14–26, who had undergone the treatment, and three of their parents. Inductive thematic analysis was used to evaluate the content of the interviews.ResultsMostly positive experiences were reported of the Lightning Process. Two reported dissatisfaction and no improvement, while seven were satisfied and were much improved. Particular helpful aspects were the theoretical rationale, practical exercises, and the technique they learned. Less helpful aspects were the intensity and short duration of the treatment with little follow‐up, the secrecy surrounding it, and feelings of being blamed if the treatment did not work.ConclusionsAs this is the first report of young people's experiences with the Lightning Process, it will be important to consider the helpful and unhelpful treatment components for future refinement of interventions for CFS/ME.Statement of contributionWhat is already known on this subject? Treatment alternatives for people with CFS/ME are few, especially for young people. The Lightning Process is a popular treatment programme that has recently become available, but no studies involving the treatment have yet been published. Feelings of blame or dismissal in CFS/ME patients lead to withdrawal or disengagement from professionals.What does this study add? The Lightning Process for young people with CFS/ME encompasses many positive aspects, particularly the practical aspects of the treatment programme. The more extreme position taken by the Lightning Process in denying the limitations of the illness seem to produce divergent results in various young people; some found it liberating and therapeutic, whilst others did not respond well to it and were left feeling guilty and blamed.
Four‐year‐olds' beliefs about how others regard males and females
Authors: Halim May Ling , Ruble Diane N. , Tamis‐LeMonda Catherine S. 
Published: September 2012

Children's awareness of how others evaluate their gender could influence their behaviours and well‐being, yet little is known about when this awareness develops and what influences its emergence. The current study investigated culturally diverse 4‐year‐olds' (N = 240) public regard for gender groups and whether exposure to factors that convey status and highlight gender influenced it. Children were asked whether most people thought (i) girls or boys, and (ii) women or men, were better. Overall, children thought others more positively evaluated their own gender. However more TV exposure and, among girls only, more traditional parental division of housework predicted children stating that others thought boys were better, suggesting more awareness of greater male status. Children's public regard was distinct from their personal attitudes.