bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does take‐home analgesia improve postoperative pain after elective day case surgery? A comparison of hospital vs parent‐supplied analgesia
Authors: Hegarty Mary , Calder Alyson , Davies Kylie , Shave Margaret , Christiansen Elaine , Meyer Tessa , von Ungern‐Sternberg Britta S. 
Published: November 2012

SummaryBackgroundMore children are undergoing same‐day surgery. While advances have been made in pediatric pain management, there have been few studies addressing pain management in the home (Br J Anaesth, 82, 1999 and 319). We wished to investigate whether issuing parents with take‐home analgesia would improve postoperative pain scores and/or parental satisfaction following hospital discharge.MethodsTwo hundred children, and their parents, attending for day case surgery at our institution were randomized into two groups. One group received advice regarding the management of postoperative pain and were given a pack containing discharge medications: group ‘dispensed’. The other group received the same advice, but did not receive any medication: group ‘advised’. Telephone interviews were conducted to assess pain scores, PONV, functional activity, analgesia requirements, and satisfaction rates.ResultsData were available for 181 patients (median age, 4 years; range, 0–12 years): 89 children in group ‘dispensed’ and 92 children in group ‘advised’. Postoperative instructions were followed by 86% in group ‘advised’ and 89% in group ‘dispensed’ (P = 0.68). Although all parents received analgesia advice, only 85/181 (48%) recalled the information. Rates for no/mild pain and moderate/severe pain were similar between the two groups: 59% (group ‘advised’) vs 62% (group ‘dispensed’) and 41% (group ‘advised’) vs 38% (group ‘dispensed’) (P = 0.78).DiscussionOur study did not show any differences in the incidence of pain/parental satisfaction between the two groups. Analgesia advice given to parents was poorly retained, suggesting that other methods for disseminating information should be considered.
Eradication of Gram‐Positive and Gram‐Negative Bacteria by Photosensitizers Immobilized in Polystyrene
Authors: Nakonechny Faina , Pinkus Anna , Hai Smadar , Yehosha Ortal , Nitzan Yeshayahu , Nisnevitch Marina 
Published: November 2012

AbstractImmobilization of photosensitizers in polymers opens prospects for their continuous and reusable application. Methylene blue (MB) and Rose Bengal were immobilized in polystyrene by mixing solutions of the photosensitizers in chloroform with a polymer solution, followed by air evaporation of the solvent. This procedure yielded 15–140 μm polymer films with a porous surface structure. The method chosen for immobilization ensured 99% enclosure of the photosensitizer in the polymer. The antimicrobial activity of the immobilized photosensitizers was tested against Gram‐positive and Gram‐negative bacteria. It was found that both immobilized photosensitizers exhibited high antimicrobial properties, and caused by a 1.5–3 log10 reduction in the bacterial concentrations to their total eradication. The bactericidal effect of the immobilized photosensitizers depended on the cell concentration and on the illumination conditions. Scanning electron microscopy was used to prove that immobilized photosensitizers excited by white light caused irreversible damage to microbial cells. Photosensitizers immobilized on a solid phase can be applied for continuous disinfection of wastewater bacteria.
Social Policy from Olson to Ostrom: A Case Study of Dutch Disability Insurance
Authors: Bannink Duco 
Published: November 2012

AbstractSocial policy development and reform in corporatist welfare states often follows a pattern of subsequent collectivization and de‐collectivization. This has to do, the article argues, with the social problems these phases address. Early social policy development forms a response to Olson‐type collective action problems that organized actors (labour and employers' organizations) in the field experience: state‐obliged benefits solve free rider problems, while bipartite administration allows labour and employers' organizations to organize their constituencies. This solution to Olson‐type collective action problems, however, also constitutes an Ostrom‐type collective action problem. Such a system functions as a common pool resource. Individual benefit take‐up is experienced as free and the costs of benefit take‐up are collectivized in the common pool. The article illustrates this pattern with reference to Dutch disability insurance.
Mammalian target of rapamycin signalling modulates amino acid uptake by regulating transporter cell surface abundance in primary human trophoblast cells
Authors: Rosario Fredrick J. , Kanai Yoshikatsu , Powell Theresa L. , Jansson Thomas 
Published: November 2012

Key points
Inadequate nutrient supply during fetal life results in intrauterine growth restriction (IUGR), which may lead to obesity, diabetes, and cardiovascular disease later in life.
A decreased placental amino acid transporter activity has been implicated in the pathophysiology of IUGR; however, the mechanisms regulating placental amino acid transporters in the human are largely unknown.
We show that inhibition of mammalian target of rapamycin complex 1 or 2 markedly decreases the activity of key placental amino acid transporters in cultured primary human placental cells, mediated by modulating the movement of specific transporter isoforms between the cell interior and the plasma membrane.
Because mTOR signalling is inhibited in the IUGR placenta, these findings identify one possible mechanism by which fetal nutrient supply is reduced in this pregnancy complication.
Our data may help us better understand the regulation of amino acid transporters and the molecular mechanisms underlying IUGR.
Abstract  Abnormal fetal growth increases the risk for perinatal complications and predisposes for the development of obesity, diabetes and cardiovascular disease later in life. Emerging evidence suggests that changes in placental amino acid transport directly contribute to altered fetal growth. However, the molecular mechanisms regulating placental amino acid transport are largely unknown. Here we combined small interfering (si) RNA‐mediated silencing approaches with protein expression/localization and functional studies in cultured primary human trophoblast cells to test the hypothesis that mammalian target of rapamycin complex 1 (mTORC1) and 2 (mTORC2) regulate amino acid transporters by post‐translational mechanisms. Silencing raptor (inhibits mTORC1) or rictor (inhibits mTORC2) markedly decreased basal System A and System L amino acid transport activity but had no effect on growth factor‐stimulated amino acid uptake. Simultaneous inhibition of mTORC1 and 2 completely inhibited both basal and growth factor‐stimulated amino acid transport activity. In contrast, mTOR inhibition had no effect on serotonin transport. mTORC1 or mTORC2 silencing markedly decreased the plasma membrane expression of specific System A (SNAT2, SLC38A2) and System L (LAT1, SLC7A5) transporter isoforms without affecting global protein expression. In conclusion, mTORC1 and mTORC2 regulate human trophoblast amino acid transporters by modulating the cell surface abundance of specific transporter isoforms. This is the first report showing regulation of amino acid transport by mTORC2. Because placental mTOR activity and amino acid transport are decreased in human intrauterine growth restriction our data are consistent with the possibility that dysregulation of placental mTOR plays an important role in the development of abnormal fetal growth.
CLC‐3 chloride channels moderate long‐term potentiation at Schaffer collateral–CA1 synapses
Authors: Farmer Laurel M. , Le Brandy N. , Nelson Deborah J. 
Published: November 2012

Key points
The CLC‐3 chloride channel is expressed on postsynaptic membranes, where it is spatially and functionally linked to the NMDA receptor.
CLC‐3 is phosphorylated by Ca2+/calmodulin kinase II.
Loss of CLC‐3 expression or prevention of CLC‐3 phosphorylation/gating results in excessive induction of long‐term potentiation.
Given that knockout of CLC‐3 results in hippocampal neurodegeneration, our results suggest that CLC‐3 gating may provide a protective limit on plasticity and Ca2+ influx.
Abstract  The chloride channel CLC‐3 is expressed in the brain on synaptic vesicles and postsynaptic membranes. Although CLC‐3 is broadly expressed throughout the brain, the CLC‐3 knockout mouse shows complete, selective postnatal neurodegeneration of the hippocampus, suggesting a crucial role for the channel in maintaining normal brain function. CLC‐3 channels are functionally linked to NMDA receptors in the hippocampus; NMDA receptor‐dependent Ca2+ entry, activation of Ca2+/calmodulin kinase II and subsequent gating of CLC‐3 link the channels via a Ca2+‐mediated feedback loop. We demonstrate that loss of CLC‐3 at mature synapses increases long‐term potentiation from 135 ± 4% in the wild‐type slice preparation to 154 ± 7% above baseline (P < 0.001) in the knockout; therefore, the contribution of CLC‐3 is to reduce synaptic potentiation by ∼40%. Using a decoy peptide representing the Ca2+/calmodulin kinase II phosphorylation site on CLC‐3, we show that phosphorylation of CLC‐3 is required for its regulatory function in long‐term potentiation. CLC‐3 is also expressed on synaptic vesicles; however, our data suggest functionally separable pre‐ and postsynaptic roles. Thus, CLC‐3 confers Cl− sensitivity to excitatory synapses, controls the magnitude of long‐term potentiation and may provide a protective limit on Ca2+ influx.
A preliminary prospective study of nutritional, psychological and combined therapies for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in a private care setting
Authors: Arroll Megan Anne , Howard Alex 
Published: November 2012

BackgroundMyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a condition characterised by severe and persistent fatigue, neurological disturbances, autonomic and endocrine dysfunctions and sleep difficulties that have a pronounced and significant impact on individuals’ lives. Current National Institute for Health and Clinical Excellence guidelines within the UK suggest that this condition should be treated with cognitive behavioural therapy and/or graded exercise therapy, where appropriate. There is currently a lack of an evidence base concerning alternative techniques that may be beneficial to those with ME/CFS.ObjectivesThis study aimed to investigate whether three modalities of psychology, nutrition and combined treatment influenced symptom report measures in those with ME/CFS over a 3-month time period and whether there were significant differences in these changes between groups.Design and settingThis is a preliminary prospective study with one follow-up point conducted at a private secondary healthcare facility in London, UK.Participants138 individuals (110 females, 79.7%; 42 participants in psychology, 44 in nutrition and 52 in combined) participated at baseline and 72 participants completed the battery of measures at follow-up (52.17% response rate; 14, 27 and 31 participants in each group, respectively).Outcome measuresSelf-reported measures of ME/CFS symptoms, functional ability, multidimensional fatigue and perceived control.ResultsBaseline comparisons showed those in the combined group had higher levels of fatigue. At follow-up, all groups saw improvements in fatigue, functional ability and symptomatology; those within the psychology group also experienced a shift in perceived control over time.ConclusionsThis study provides early evidence that psychological, nutritional and combined techniques for the treatment of ME/CFS may influence symptomatology, fatigue, function and perceived control. However, these results must be viewed with caution as the allocation to groups was not randomised, there was no control group and the study suffered from high drop-out rates.
Does mild cognitive impairment affect the occurrence of radiographic knee osteoarthritis? A 3-year follow-up in the ROAD study
Authors: Yoshimura Noriko , Muraki Shigeyuki , Oka Hiroyuki , Kawaguchi Hiroshi , Nakamura Kozo , Tanaka Sakae , Akune Toru 
Published: November 2012

ObjectiveTo determine whether mild cognitive impairment (MCI) increases the risk of occurrence or progression of radiographic knee osteoarthritis (KOA) in a general population.DesignPopulation-based cohort study.SettingResidents in mountain and seaside areas of Wakayama Prefecture, Japan.Participants1690 participants (596 men, 1094 women; mean age 65.2 years old) were enrolled from the large-scale cohort for the Research on Osteoarthritis (OA)/osteoporosis Against Disability (ROAD) study initiated in 2005 to investigate epidemiological features of OA in Japan. Of these, 1384 individuals (81.9%; 466 men, 918 women) completed the second survey including knee radiography 3 years later.Primary outcome measuresRadiographic KOA was defined as Kellgren-Lawrence (KL) grade ≥ 2 using paired x-ray films. Incidence of KOA during follow-up defined on radiographs as KL grade ≥2, progression of KOA defined as a higher KL grade (either knee) at follow-up compared with baseline. MCI defined as a summary mini-mental state examination (MMSE) score ≤23. Associations between MCI and incidence or progression of KOA were analysed.ResultsThe annual cumulative incidence of KOA was 3.3%; for progression of OA it was 8.0%. On logistic regression analysis adjusted for age, gender, regional differences, body mass index, grip strength (worse side), smoking, alcohol consumption, regular exercise and history of knee injury, baseline MMSE summary score was significantly associated with the incidence of KOA (+1 MMSE score; OR 0.83, p=0.010). Baseline MCI was also significantly associated with the incidence of KOA (vs non-occurrence of KOA; OR 4.90, p=0.027). There was no significant association between MMSE scores, the presence of MCI and progression of KOA (+1 MMSE score; OR 0.96, p=0.232; vs non-progression of KOA; OR 1.38, p=0.416).ConclusionsMCI significantly increases the risk of incident radiographic KOA, but not the progression of KOA.
Low income is associated with poor adherence to a Mediterranean diet and a higher prevalence of obesity: cross-sectional results from the Moli-sani study
Authors: Bonaccio Marialaura , Bonanni Americo Ettore , Di Castelnuovo Augusto , De Lucia Francesca , Donati Maria Benedetta , de Gaetano Giovanni , Iacoviello Licia ,   on behalf of the Moli-sani Project Investigators
Published: November 2012

ObjectivesTo examine cross-sectional associations of socioeconomic status (ie, income and education) with an adherence to a Mediterranean dietary pattern and obesity prevalence.DesignCross-sectional study on a sample of Italian subjects enrolled in the Moli-sani Project, a population-based cohort study. The Italian EPIC food frequency questionnaire was used to determine food intake. Adherence to a Mediterranean diet (MD) was appraised according to both the Mediterranean score elaborated by Trichopoulou (MDS) and the novel Italian Mediterranean Index (IMI) and to the a posteriori scores derived from principal component analysis. Four income categories were identified.SettingMolise region, Italy.Participants13 262 subjects (mean age 53±11, 50% men) out of 24 318 citizens (age ≥35) randomly enrolled in the Moli-sani Project.Main outcomesDietary patterns and risk factors for cardiovascular disease.ResultsHousehold higher income were significantly associated with greater adherence to an MD (p<0.0001) and to Olive oil and Vegetables dietary pattern in a multivariable model including age, sex, daily energy intake, body mass index, physical activity, smoking, alcohol consumption, education and marital status. The odds of having the highest adherence to an MD clearly increased according to income levels. People having the highest income had 54% (95% CI 21% to 97%, MDS) or 72% (95% CI 34% to 121%, IMI) higher probability to stick to an MD-like eating pattern than those in the lowest-income group. Obesity prevalence was higher in the lowest-income group (36%) in comparison with the highest-income category (20%, p<0.0001). Income was associated with dietary patterns in all categories of education.ConclusionsA higher income and education are independently associated with a greater adherence to MD-like eating patterns and a lower prevalence of obesity.
HIV incidence among men who have sex with men in Beijing: a prospective cohort study
Authors: Li Dongliang , Li Shuming , Liu Yingjie , Gao Yanjie , Yu Mingrun , Yang Xueying , Li Qingchun , Jiang Shulin , Zhou Zhenhai , Zhang Zheng , Yan Li , Jiang Guiyan , Xiao Dong , Pan Stephen W , Luo Fengji , Ruan Yuhua , Shao Yiming 
Published: November 2012

Objectives(1) To assess the HIV incidence rate among men who have sex with men (MSM) in a large cohort study in Beijing, China and (2) to identify sociodemographic and behavioural risk factors of HIV seroconversion among MSM in Beijing, China.DesignA prospective cohort study.SettingBaseline and follow-up visits were conducted among MSM in Beijing, China.ParticipantsA cohort of 797 HIV-seronegative MSM was recruited from August to December 2009, with follow-up occurring after 6 and 12 months.Primary and secondary outcome measuresAt baseline and follow-up visits, participants reported sociodemographic and sexual behaviour information, and were tested for HIV, herpes simplex virus-2 (HSV-2) and syphilis with whole blood specimens. Cox regression analysis was used to identify factors associated with HIV seroconversion.ResultsMost study participants (86.8%) were retained by the 12-month follow-up. The HIV, HSV-2 and syphilis incidence rates were 8.09 (95% CI 6.92 to 9.26), 5.92 (95% CI 5.44 to 6.40) and 8.06 (95% CI 7.56 to 8.56) cases per 100 person-years, respectively. HIV seroconversion was significantly associated with being <25 years old, having <12 years of education, having >1 male sex partner in the past 6 months, and being syphilis positive or HSV-2 positive.ConclusionsThe HIV incidence among MSM in Beijing is serious. Interventions and treatment of sexually transmitted diseases (STD) should be combined with HIV control and prevention measures among MSM.
Risk factors for stress fracture in female endurance athletes: a cross-sectional study
Authors: Duckham Rachel L , Peirce Nicholas , Meyer Caroline , Summers Gregory D , Cameron Noël , Brooke-Wavell Katherine 
Published: November 2012

ObjectiveTo identify psychological and physiological correlates of stress fracture in female endurance athletes.DesignA cross-sectional design was used with a history of stress fractures and potential risk factors assessed at one visit.MethodsFemale-endurance athletes (58 runners and 12 triathletes) aged 26.0±7.4 years completed questionnaires on stress fracture history, menstrual history, athletic training, eating psychopathology and exercise cognitions. Bone mineral density, body fat content and lower leg lean tissue mass (LLLTM) were assessed using dual-x-ray absorptiometry. Variables were compared between athletes with a history of stress fracture (SF) and those without (controls; C) using χ², analysis of variance and Mann-Whitney U tests.ResultsNineteen (27%) athletes had previously been clinically diagnosed with SFs. The prevalence of current a/oligomenorrhoea and past amenorrhoea was higher in SF than C (p=0.008 and p=0.035, respectively). SF recorded higher global scores on the eating disorder examination questionnaire (p=0.049) and compulsive exercise test (p=0.006) and had higher LLLTM (p=0.029) compared to C. These findings persisted with weight and height as covariates. In multivariate logistic regression, compulsive exercise, amenorrhoea and LLLTM were significant independent predictors of SF history (p=0.006, 0.009 and 0.035, respectively).ConclusionsEating psychopathology was associated with increased risk of SF in endurance athletes, but this may be mediated by menstrual dysfunction and compulsive exercise. Compulsive exercise, as well as amenorrhoea, is independently related to SF risk.
‘Are decisions about discharge of elderly hospital patients mainly about freeing blocked beds?’ A qualitative observational study
Authors: Ekdahl Anne Wissendorff , Linderholm Märit , Hellström I , Andersson Lars , Friedrichsen Maria 
Published: November 2012

ObjectiveTo explore the interactions concerning the frail and elderly patients having to do with discharge from acute hospital wards and their participation in medical decision-making. The views of the patients and the medical staff were both investigated.DesignA qualitative observational and interview study using the grounded theory.Setting and participantsThe setting was three hospitals in rural and urban areas of two counties in Sweden of which one was a teaching hospital. The data comprised observations, healthcare staff interviews and patient interviews. The selected patients were all about to be informed that they were going to be discharged.ResultsThe patients were seldom invited to participate in the decision-making regarding discharge. Generally, most communications regarding discharge were between the doctor and the nurse, after which the patient was simply informed about the decision. It was observed that the discharge information was often given in an indirect way as if other, albeit absent, people were responsible for the decision. Interviews with the healthcare staff revealed their preoccupation with the need to free up beds: ‘thinking about discharge planning all the time’ was the core category. This focus not only failed to fulfil the complex needs of elderly patients, it also generated feelings of frustration and guilt in the staff, and made the patients feel unwelcome.ConclusionsFrail elderly patients often did not participate in the medical decision-making regarding their discharge from hospital. The staff was highly focused on patients getting rapidly discharged, which made it difficult to fulfil the complex needs of these patients.
Identifying and quantifying misclassified and under-reported AIDS deaths in Brazil: a retrospective analysis from 1985 to 2009
Authors: Fazito Erika , Cuchi Paloma , Ma Fat Doris , Ghys Peter Denis , Pereira Mauricio G , Vasconcelos Ana Maria Nogales , Pascom Ana Roberta Pati 
Published: November 2012

BackgroundA retrospective analysis of deaths registered in the Brazilian Mortality System was conducted to quantify the under-reporting of HIV/AIDS deaths and those misclassified to AIDS-related conditions in the 15–49 years old population in Brazil.MethodsDeath rates for AIDS-related diseases were calculated by age and sex for 1985–2009. Changes in the age-sex-specific death rates over time were used to identify conditions likely to be misclassified AIDS deaths and to quantify the corresponding number of misclassified deaths. Deaths due to ill-defined causes were redistributed across all other natural causes of death. The resulting total number of AIDS deaths was further adjusted for incompleteness of the mortality reporting system.ResultsOut of the 28 potential causes of death investigated, five increased in the same distinct age pattern as AIDS: pneumonia, Kaposi's sarcoma, other immunodeficiencies, other septicaemia and toxoplasmosis. 18 490 deaths due to these five causes were recoded to HIV/AIDS from 1985 to 2009. 38 145 deaths due to ill-defined causes were redistributed to AIDS and 15 485 were added to the number of AIDS deaths to correct for completeness of the mortality system in Brazil. Altogether, 72 120 deaths were recoded to AIDS between 1985 and 2009 and added to the reported 194 445 AIDS related deaths in the country, representing 27% misclassification of AIDS deaths in Brazil.ConclusionsThis study demonstrated that AIDS mortality is underestimated by the official mortality information system in Brazil. Efforts need to be made to reduce misclassification of causes of death in the future and identify ways in which the confidentiality of information regarding cause of death can be maintained.