bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ectopic sebaceous glands in the oesophagus: a case report and review of literature
Authors: Lee Seung-Hwa , Lee Duck-Joo , Kim Kwang-Min , Kim Kyu-Nam , Kang Joon-Koo 
Published: June 2014

Introduction Most ectopic sebaceous glands have been reported in the tissues of ectodermal origin. However, there are relatively a few reports of ectopic sebaceous glands in the oesophagus, an organ of endodermal origin. Case presentation We report the case of an asymptomatic 54-year-old man with ectopic oesophageal sebaceous glands. These lesions were incidentally observed in the distal oesophagus during screening endoscopy of gastric neoplasm and confirmed by histologic analysis. Conclusion Surveillance or resection with regard to ectopic sebaceous glands in the oesophagus is generally not required since there is no known malignant potential. However, anti-reflux treatment may be sometimes needed, if such symptoms are present in patients. Also, these lesions should be differentiated from other pathologic lesions of oesophagus that need to be treated. Thus, greater attention of endoscopists is required for detection and differential diagnosis of these lesions. The narrow-band imaging mode and/or endoscopic biopsy may be helpful.
Development and Evaluation of a Pediatric Diabetes Program by a Single Provider
Authors: Ahern Jo Ann , Arguello Raul 
Published: June 2014

Purpose Although the use of a team approach is ideal for a pediatric population, such an approach is expensive, with programs running at a negative balance of $400,000 to $800,000 per year. To address the problem, a “state of the art” pediatric diabetes program was implemented that was cost neutral and did not compromise patient care. Methods Four years after starting a pediatric diabetes program run by a single provider, diabetes goals were evaluated by checking A1C levels while keeping costs in check. A1C levels were obtained every 2 to 3 months and analyzed over several months. Two hundred patients with type 1 diabetes were managed in the program. The cost of the program was analyzed on the basis of rental fees, staff salaries, and basic equipment and supplies required. A1C levels were performed using the Siemens HbA1c DCA Vantage Analyzer. Patients are able to call, fax, text, and e-mail between visits. This has resulted in excellent control and high satisfaction. Results The mean A1C level was 7.2% to 7.4%. The pediatric diabetes program is now cost neutral. Survey results indicated that patients were satisfied with the care they received. Conclusions Children with type 1 diabetes can be managed by a single provider and achieve treatment goals that far exceed those obtained in most pediatric diabetes programs. This can be done at a fiscally responsible cost.
Comparison of clinical prediction scores for the diagnosis of deep vein thrombosis in unselected population of outpatients and inpatients
Authors: Sermsathanasawadi N , Suparatchatpun P , Pumpuang T , Hongku K , Chinsakchai K , Wongwanit C , Ruangsetakit C , Mutirangura P 
Published: June 2014

Objectives The aim of this research was to compare the accuracy of the modified Wells, the Wells, the Kahn, the St. André, and the Constans score for the diagnosis of deep vein thrombosis of the lower limb in unselected population of outpatients and inpatients. Method The pretest of probability score was employed in consecutive 500 outpatients and inpatients with suspicion of deep vein thrombosis. All patients were examined with compression ultrasonography. Results Deep vein thrombosis was confirmed in 26.4%. In the unselected population of outpatients and inpatients, the accuracy of the modified Wells score and the Constans score was higher than other scores. Both scores were more accurate for the outpatients. There was no accurate score for the inpatient subgroup. Conclusions The modified Wells and the Constans score appear to be useful in the unselected population of outpatients and inpatients and particularly in the outpatient subgroup.
Comparison of body weight-supported treadmill training versus body weight-supported overground training in people with incomplete tetraplegia: a pilot randomized trial
Authors: Senthilvelkumar Thangavelu , Magimairaj Henry , Fletcher Jebaraj , Tharion George , George Jacob 
Published: June 2014

Objective: To compare the effectiveness of body weight-supported treadmill training and body weight-supported overground training for improving gait and strength in people with traumatic incomplete tetraplegia. Design: Assessor blinded randomized trial. Setting: Rehabilitation institute of a tertiary care teaching hospital in India. Participants: Sixteen participants with traumatic motor incomplete tetraplegia and within two years of injury. Interventions: Participants were randomised to one of two groups: body weight-supported overground training on level ground and body weight-supported treadmill training. Both groups received 30 minutes of gait training per day, five days a week for eight weeks. In addition, both groups received regular rehabilitation which included flexibility, strength, balance, self care and functional training. Outcome measures: The primary outcome measure was the Walking Index for Spinal Cord Injury (/20 points) and the secondary outcome was the Lower Extremity Muscle Score (/50 points). Results: There was no statistically significant between group differences in the Walking Index for Spinal Cord Injury [mean difference=0.3points; 95% CI (-4.8 to 5.4); p=0.748] or the Lower Extremity Muscle Score [mean difference=0.2 points; 95% CI (-3.8 to 5.1); p=0.749]. Conclusions: Gait training with body weight-supported overground training is comparable to treadmill training for improving locomotion in people with traumatic incomplete tetraplegia.
Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial
Authors: Natour Jamil , Cazotti Luciana de Araujo , Ribeiro Luiza Helena , Baptista Andréia Salvador , Jones Anamaria 
Published: June 2014

Objective: To assess the effectiveness of pilates method on patients with chronic non-specific low back pain (LBP). Method: A randomized controlled trial was carried out in sixty patients with a diagnosis of chronic non-specific LBP. Patients were randomly assigned to one of two groups: Experimental Group (EG) that maintained medication treatment with use of NSAID and underwent treatment with the pilates method and Control Group (CG) that continue medication treatment with use of NSAID and did not undergo any other intervention. A blinded assessor performed all evaluations at baseline (T0), after 45, 90, and 180 days (T45, T90 and T180) for: pain (VAS), function (Roland Morris questionnaire), quality of life (SF-36), satisfaction with treatment (Likert scale), flexibility (sit and reach test) and NSAID intake. Results: The groups were homogeneous at baseline. Statistical differences favoring the EG were found with regard to pain ( P < 0.001), function ( P < 0.001) and the quality of life domains of functional capacity ( P < 0.046), pain ( P < 0.010) and vitality ( P < 0.029). Statistical differences were also found between groups regarding the use of pain medication at T45, T90 and T180 ( P < 0.010), with the EG taking fewer NSAIDs than the CG. Conclusions: The pilates method can be used by patients with LBP to improve pain, function and aspects related to quality of life (functional capacity, pain and vitality). Moreover, this method has no harmful effects on such patients.
Influence of variation of pipe diameter on pressure drop predictions of the new modified three-fluid model inside condensing vertical pipes
Authors: Dalir Nemat , Saffari Hamid 
Published: June 2014

When a loss of coolant accident occurs in the primary system of a water-cooled nuclear reactor, a large amount of steam is released into the reactor containment. Therefore, there is the possibility of over-pressurization of the reactor containment. In such a condition, the released steam is often condensed using a passive containment cooling system. This system consists of condensing vertical pipes with diameters of 30–50 mm. Thus, condensation inside vertical pipes with annular flow happens, which is usually analyzed using the three-fluid models. In the present work, the effect of variation of condensing vertical pipe diameter on pressure drop predictions in downward condensing annular flow of steam is studied using the new modified three-fluid model. In a new pipe diameter, D = 0.03 m, the pressure drops are calculated using the new modified three-fluid model and the correlation of Stevanovic et al. for steam–liquid film interfacial friction coefficient and compared.
Korean nurses’ ethical dilemmas, professional values and professional quality of life
Authors: Kim Kyunghee , Han Yonghee , Kim Ji-su 
Published: June 2014

Background: In the changing medical environment, professional stress continuously increases as the individual’s quality of life suffers. Of all the healthcare professions, nursing is especially prone to burnout, compassion fatigue and reduced compassion satisfaction, due to the tensions resulting from the physical and psychological stress of caring for extremely ill patients. Objectives: This study examined the professional quality of life of clinical nurses in Korea and the relationship between their experiences in ethical dilemmas and professional values. Methods: This was a cross-sectional study of a convenience sample consisting of 488 clinical nurses. We used four questionnaires to measure the participants’ demographic characteristics, experiences in ethical dilemmas, professional nursing values and professional quality of life (ProQOL assessment, Version 5). Ethical considerations: This study received approval from the Institutional Review Board of Bronco Memorial Hospital. Written informed consent was given by all participants. Results: The nurses’ professional quality of life was affected by ethical dilemmas and professional nursing values. The factors influencing compassion satisfaction were age, client domain of ethical dilemmas, social awareness, professionalism of nursing and the roles of nursing services in professional values. The factors influencing burnout were marital status (married), religion (yes), human life domain, professional work domain of ethical dilemmas, social awareness and the role of nursing services in nursing professional values. The factors influencing secondary traumatic stress were human life domain, client domain and the professional work domain of ethical dilemmas. Conclusion: Intervention to help nurses increase their professional quality of life will have a greater chance of success if they are based on the nurses’ values and beliefs about the ethical dilemmas they face and foster the establishment of positive professional values.
“Peter? He comes and goes…”: First Graders' Perspectives on a Part-Time Mainstream Student
Authors: Schnorr Roberta F. 
Published: June 2014

Part-time integration of students with moderate and severe disabilities into regular classes has become a common feature of special education programs. How regular education students think about their school experience, including part-time mainstreaming, can be a source of information for integration efforts, but these perceptions have received little attention in the special education literature. Participant observation and in-depth interviews were employed over a 7-month period to study a first grade class in which a student described as “moderately mentally retarded” participated on a part-time basis. This student spent most of his school day in a self-contained special education class. The findings reveal that these first graders had a common framework for defining their school experience. Their descriptions centered around themes of “where you belong,” “what you do,” and “with whom you play.” Data collected about Peter, the part-time mainstream student, are interpreted according to this student framework. Findings indicate significant discrepancies between the students' definitions of what it means to be part of first grade and the focus of the teacher's efforts to include Peter and present him as a member of the class.
Education and Treatment Needs of Students with Profound, Multiply Handicapping, and Medically Fragile Conditions: A Survey of Teachers' Perceptions
Authors: Izen Cornelia Lively , Brown Fredda 
Published: June 2014

This investigation assessed perceptions of special educators regarding the education and treatment needs of students with profound or multiple handicaps or medically fragile conditions. A survey was distributed nationally to 500 special educators chosen randomly from the membership list of The Association for Persons with Severe Handicaps. The survey sought to: (a) identify what educators perceived to be important variables in delivering quality educational programs, (b) determine current classroom practices, and (c) identify what educators perceived to be strengths and weaknesses of their university teacher training programs. A total of 148 surveys were returned (29.6%) and 123 were included in the final data analysis. Results indicate that respondents did not feel adequately trained by university teacher training programs to work with many individuals having profoundly handicapping conditions. Some teachers did not include certain curricular areas (e.g., vocational skills, community living skills) because they felt they would not benefit students. For a variety of reasons, instructional techniques such as integration strategies, application of technology, and use of van Dijk, neurodevelopmental, and Piagetian procedures also are not implemented by some teachers. In general, as class size and the proportion of students with profound disabilities increases, teachers find implementation of some best practices to be less important.
A Qualitative Study of the Process of Facilitated Communication
Authors: Sabin Laural A. , Donnellan Anne M. 
Published: June 2014

Qualitative research methods were used to investigate facilitated communication as it was implemented with two sixth-grade students in a general education setting. The areas of interest in this study focused on (a) the process of facilitated communication and (b) the role or roles facilitators played in this process. Participant observations occurred in a variety of school and community settings and interviews were conducted with students, their primary facilitators, and other involved teachers and teaching assistants. The findings revealed that a wide variety of physical accommodations were used to support students during the process of facilitated communication. It appeared that each student used a unique combination of support tailored to his or her individualized needs. Additionally, findings showed that complex and detailed functions were performed by facilitators. These functions included providing physical support, decision-making, and negotiating meaning during interactions. A brief discussion of the implications of these findings is included.
Family history of Alzheimer’s disease limits improvement in cognitive function after bariatric surgery
Authors: Alosco Michael L , Spitznagel Mary Beth , Strain Gladys , Devlin Michael , Crosby Ross D , Mitchell James E , Gunstad John 
Published: June 2014

Background/Objective: Bariatric surgery can reverse cognitive impairments associated with obesity. However, such benefits may be attenuated in individuals with a predisposing risk for cognitive impairment such as family history of Alzheimer’s disease. Methods: In all, 94 bariatric surgery participants completed a computerized cognitive test battery before and 12 weeks after surgery. Family history of Alzheimer’s disease was obtained through self-report. Results: In the overall sample, cognitive function improved in memory and attention/executive function 12 weeks post-surgery. Repeated measures showed similar rates of improvements in attention/executive function between patients with and without a family history of Alzheimer’s disease. In contrast, only individuals without a family history of Alzheimer’s disease exhibited post-operative improvements in memory. A family history of Alzheimer’s disease was associated with greater post-surgery rates of cognitive impairment. Conclusions: Family history of Alzheimer’s disease may limit post-surgery cognitive benefits. Future studies should examine whether weight loss can modify the course of cognitive decline in patients at-risk for Alzheimer’s disease.
Predictors of Nonadherence to Antiretroviral Therapy among HIV-Infected Adults in Dar es Salaam, Tanzania
Authors: Muya Aisa N. , Geldsetzer Pascal , Hertzmark Ellen , Ezeamama Amara E. , Kawawa Hawa , Hawkins Claudia , Sando David , Chalamilla Guerino , Fawzi Wafaie , Spiegelman Donna 
Published: June 2014

Background: Adherence rates of ≥95% to antiretroviral therapy (ART) are necessary to maintain viral suppression in HIV-infected individuals. We identified predictors of nonadherence to scheduled antiretroviral drug pickup appointments in a large HIV care and treatment program in Tanzania. Methods: We performed a prospective cohort study of 44, 204 HIV-infected adults on ART between November 2004 and September 2012. Multivariate generalized estimating equation for repeated binary data was used to estimate the relative risk and 95% confidence intervals of nonadherence. Results: Nonadherence was significantly greater among patients with high CD4 counts, high body mass indices, males, younger patients, patients with longer durations on ART, and those with perceived low social support. Conclusions: Targeted interventions should be developed to improve ART adherence among healthier, younger, and more experienced patients who are on ART for longer durations within HIV care and treatment programs. Social support for patients on ART should be emphasized.
Multiphoton imaging to identify grana, stroma thylakoid, and starch inside an intact leaf
Authors: Chen Mei-Yu , Zhuo Guan-Yu , Chen Kuan-Chieh , Wu Pei-Chun , Hsieh Tsung-Yuan , Liu Tzu-Ming , Chu Shi-Wei 
Published: June 2014

Abstract

Background
Grana and starch are major functional structures for photosynthesis and energy storage of plant, respectively. Both exhibit highly ordered molecular structures and appear as micrometer-sized granules inside chloroplasts. In order to distinguish grana and starch, we used multiphoton microscopy, with simultaneous acquisition of two-photon fluorescence (2PF) and second harmonic generation (SHG) signals. SHG is sensitive to crystallized structures while 2PF selectively reveals the distribution of chlorophyll.

Result
Three distinct microstructures with different contrasts were observed, i.e. “SHG dominates”, “2PF dominates”, and “SHG collocated with 2PF”. It is known that starch and grana both emit SHG due to their highly crystallized structures, and no autofluorescence is emitted from starch, so the “SHG dominates” contrast should correspond to starch. The contrast of “SHG collocated with 2PF” is assigned to be grana, which exhibit crystallized structure with autofluorescent chlorophyll. The “2PF dominates” contrast should correspond to stroma thylakoid, which is a non-packed membrane structure with chrolophyll. The contrast assignment is further supported by fluorescence lifetime measurement.

Conclusion
We have demonstrated a straightforward and noninvasive method to identify the distribution of grana and starch within an intact leaf. By merging the 2PF and SHG images, grana, starch and stroma thylakoid can be visually distinguished. This approach can be extended to the observation of 3D grana distribution and their dynamics in living plants.
Association of MRC-1 and IL-28Bwith the treatment outcome of hepatitis C: a case control study
Authors: Peng Cheng-Yuan , Chen Ter-Hsin , Lim Yun-Ping , Tsai Fuu-Jen , Lin Wei-Yong , Liao Wen-Ling , Wan Lei 
Published: June 2014

Abstract

Background
The aim of this study was to evaluate whether polymorphisms of the mannose receptor C type 1 (MRC-1) and interleukin 28B (IL-28B) genes are associated with the treatment outcome of patients infected with hepatitis C virus genotypes 1 and 2 (HCV-1 and HCV-2, respectively) who are treated with peginterferon plus ribavirin (PEG-IFNα-RBV).

Methods
We analyzed the association of the patients’ sustained viral responses (SVRs) to PEG-IFNα-RBV therapy with 2 single nucleotide polymorphisms (SNPs) in MRC-1 and 3 SNPs in IL-28B. We selected patients infected with either HCV-1 (n = 265) or HCV-2 (n = 195) with or without SVR.

Results
Among the MRC-1 SNPs, rs691005 was found to be associated with SVR in HCV-1-infected patients (P < 0.0001). The IL-28B rs8099917 SNP was found to be associated with SVR in HCV-1- and HCV-2-infected patients (HCV-1, P < 0.0001; HCV-2, P = 0.002), while IL-28B rs955155 and rs10853728 SNPs were found to be associated with SVR in HCV-1-infected patients (P = 0.003) and HCV-2-infected patients (P = 0.02), respectively. We also identified an interaction between MRC-1 rs691005 and IL-28B rs8099917 (P = 0.001). The C-T haplotype was shown to have a positive effect on SVR in HCV-1-infected patients (OR = 1.77, 95% CI = 1.2, 2.62), whereas the T-G haplotype was shown to have a negative effect on SVR in HCV-1-infected patients (OR = 0.28, 95% CI = 0.14, 0.58).

Conclusions
These results suggest that SNPs of IL-28B and MRC-1 can be used as genetic markers for predicting the outcome of PEG-IFNα-RBV treatment of HCV infections.
Is concomitant splenectomy beneficial for the long-term survival of patients with gastric cancer undergoing curative gastrectomy? A single-institution study
Authors: Zhang Hao , Pang Deyan , Xu Huanming , Ren Yuan , Liu Caigang 
Published: June 2014

Abstract

Background
Curative resection is the treatment of choice for gastric cancer, but it is unclear whether gastrectomy should also include splenectomy. We retrospectively analyzed long-term survival in patients in our hospital who underwent gastrectomy plus splenectomy (G + S) or gastrectomy alone (G-A) for gastric cancer.

Methods
We identified 214 patients who underwent surgery with curative intent between 1980 and 2003. Of these, 100 underwent G + S, and 114 underwent G-A. The primary endpoint was 5-year overall survival (OS).

Results
Median follow-up was 18 months in patients who underwent G + S, and 26.5 months in patients who underwent G-A. The 5-year OS rate was significantly higher in patients who underwent G-A (33.8%; 95% CI 24.2 to 43.4%) than in those who underwent G + S (28.8%; 95% CI 19.6 to 38.0%) (log-rank test, P = 0.013).

Conclusions
Splenectomy does not benefit patients undergoing gastrectomy for gastric cancer. Routine splenectomy should be abandoned in patients undergoing radical resections for gastric cancer.
Design of local roadway infrastructure to service sustainable energy facilities
Authors: AbdelWarith Karim A , Anastasopoulos Panagiotis Ch , Richardson Wayne , Fricker Jon D , Haddock John E 
Published: June 2014

Abstract

Background
This paper aims to identify specific local roadway infrastructure design guidelines associated with the construction and operation of sustainable energy source facilities, such as ethanol plants, biomass plants, and wind farm facilities.

Methods
Data associated with sustainable energy facility traffic in Indiana were collected to develop Excel-based tools (worksheets) and assist local agencies in the design of pavements in the proximity of ethanol plants, biomass plants, and wind farms.

Results
To that end, a simple procedure is presented, which provides a design capable of withstanding heavy traffic loads, while, at the same time, quantifies the effects that new sustainable energy source facilities may have on local road networks. The procedure is accompanied by two MS Excel-based software tools that can be used in the design of local roads adjacent to such sustainable energy facilities.

Conclusions
The developed worksheets can serve as a hands-on tool to assist local government engineers in evaluating and in quantifying the probable effects of the construction and operation of a sustainable energy facility in their jurisdiction.