bluuebunny/crossref_metadata_2025 huggingface dataset:
An informational diversity framework, illustrated with sexually deceptive orchids in early stages of speciation
Authors: Smouse Peter E. , Whitehead Michael R. , Peakall Rod
Published: April 2015

Reconstructing evolutionary history for emerging species complexes is notoriously difficult, with newly isolated taxa often morphologically cryptic and the signature of reproductive isolation often restricted to a few genes. Evidence from multiple loci and genomes is highly desirable, but multiple inputs require ‘common currency’ translation. Here we deploy a Shannon information framework, converting into diversity analogue, which provides a common currency analysis for maternally inherited haploid and bi‐parentally inherited diploid nuclear markers, and then extend that analysis to construction of minimum‐spanning networks for both genomes. The new approach is illustrated with a quartet of cryptic congeners from the sexually deceptive Australian orchid genus Chiloglottis, still in the early stages of speciation. Divergence is more rapid for haploid plastids than for nuclear markers, consistent with the effective population size differential (Nep < Nen), but divergence patterns are broadly correlated for the two genomes. There are nevertheless intriguing discrepancies between the emerging plastid and nuclear signals of early phylogenetic radiation of these taxa, and neither pattern is entirely consistent with the available information on the sexual cues used by the orchids to lure the pollinators enforcing reproductive isolation. We describe possible extensions of this methodology to multiple ploidy levels and other types of markers, which should increase the range of application to any taxonomic assemblage in the very early stages of reproductive isolation and speciation.
A State‐Price Volatility Index for China's Stock Market
Authors: O'Neill Michael , Wang Kent , Liu Zhangxin (Frank)
Published: April 2015

This study derives a volatility index for China's stock market with similar properties to the Chicago Board Options Exchange Volatility Index (the ‘VIX’). A long‐term benchmark of historic volatility expectations is here presented for China from 1996 to 2011, called the ‘China‐ State‐Price Volatility (SPV)’. Construction of this index involves the use of SPV methodology, using implied volatility calculated from options on the Hang Seng China Enterprise Index (HSCEI). Historic open–high–low–close volatility on the Shanghai Composite Index (SHCI) is also used to extend the benchmark prior to the availability of HSCEI options data. The China‐SPV successfully forecasts realised volatility for the Shanghai Stock Exchange. It also serves as a ‘fear gauge’ in that it monitors daily movements of the SHCI in the same way that the VIX monitors the S&P 500 index (Whaley, 2009). The China‐SPV evidences an increasing relation with the US market in terms of the dynamic correlation of levels and changes with the VIX since 2004.
Investment–cash flow sensitivity measures investment thirst, but not financial constraint
Authors: Deng Kebin , Ding Zhong , Zhu Yushu , Zhou Qing
Published: April 2015

Literature streams disagree about the capacity of investment–cash flow sensitivity (ICFS) to measure both investment thirst and financial constraint. We argue that ICFS measures the former but not the latter. Therefore, we use Fazzari et al.'s study (1988) to develop a model to test the relationship between ICFS and financial constraint, but extend that model using Kornai (1979) to include investment thirst. We demonstrate: because the ICFS–financial constraint relationship varies, ICFS cannot measure financial constraint. Conversely, using a natural experiment of China's Four Trillion Stimulus policy, we show ICFS significantly and positively correlates with investment thirst after controlling for financial constraint.
Comparison of two in situ corneal donation technique: morgue trephination or scleracorneal removal technique
Authors: Yuksel Erdem , Yuksel Nilay , Akata Fikret
Published: April 2015

Purpose

To compare the two different ‘in situ’ methods of corneal trephination technique under morgue condition (morgue trephination technique, MTT) and classic scleracorneal removal technique (SRT).

Methods

A total of 1179 cases were evaluated for cornea donation at Gazi University Faculty of Medicine mortuary between the years 2008 and 2013 and were included to the study. Suitable donor corneas were retrieved with in situ trephination technique under morgue condition (group 1, MTT) or with in situ classic SRT (group 2, SRT). The two different ‘in situ’ methods were compared in terms of donor corneal biological quality (endothelial cell count, ECC) and functional outcome (presence of infection and primary graft failure).

Results

One hundred and fifty‐two of 1179 cases were suitable for corneal donation. Two hundred and twenty‐nine corneas of 152 cases were transplanted, 108 corneas were obtained with MTT and 121 corneas were obtained with SRT. Pretransplant and post‐transplant ECCs were 2402.5 ± 115.6 and 2108.3 ± 108.23 (p = 0.065) in MTT, respectively, and 2512.7 ± 130.4 and 2235.4 ± 201.8 (p = 0.059) in SRT, respectively. The incidence of primary graft failure and infection was not statistically significantly different between two method [2.7% and 1.6% (p = 0.223), 0.9% and 0.8% (p = 0.115)].

Conclusion

The two different ‘in situ’ methods, MTT and SRT, were similar in terms of donor ECC, presence of infection and primary graft failure. Cornea excision performed through the technique described herein may increase the corneal donation rates as result of reduced disfigurement to donor body and offer important contributions during surgery with good anatomic adaptation of tissues.
Elevated circulating Th17 and follicular helper CD4+ T cells in patients with rheumatoid arthritis
Authors: Zhang Yan , Li Yu , Lv Ting‐Ting , Yin Zhen‐Jie , Wang Xin‐Bo
Published: April 2015

It remains not fully elucidated the potential functions of Th17 cells and follicular helper T (Tfh) cells and secreting cytokines in the pathogenesis of rheumatoid arthritis (RA) and their association with disease activity. In this study, the frequencies of Th17 and Tfh cells were determined by flow cytometry, and the levels of interleukin (IL)‐17, IL‐21, and IL‐22 were measured by ELISA in RA patients with different disease activities. The dynamic changes of cell subsets were also detected in response to disease‐modify antirheumatic drugs (DMARDs) therapy. The percentages of CD3+CD4+IL‐17A+ (Th17) cells and CD3+CD4+CXCR5+ICOShigh (Tfh) cells, as well as the concentrations of IL‐17, IL‐21, and IL‐22 were significantly elevated in RA patients than those in healthy individuals. Furthermore, Tfh cells, IL‐21, and IL‐22 in the serum was positively correlated with the values of disease activity score. Concentrations of IL‐21 and IL‐22 in the serum were remarkably reduced following the DMARDs therapies. Our data suggested that Th17 cells, Tfh cells as well as the secreting cytokines may be involved in the pathogenesis of RA. The frequency of circulating Tfh cells and the productions of IL‐21 and IL‐22 were associated with the disease activity of RA patients, and might be potential therapeutic targets for treatment of RA.
Low‐fasting triglyceride levels are associated with non‐invasive markers of advanced liver fibrosis among adults in the United States
Authors: Jiang Z. G. , Tsugawa Y. , Tapper E. B. , Lai M. , Afdhal N. , Robson S. C. , Mukamal K. J.
Published: April 2015

Background

Elevated fasting triglyceride is often associated with metabolic syndrome and non‐alcoholic fatty liver disease (NAFLD), the most common form of chronic liver disease. On the other hand, as liver disease progresses, patients may develop hepatocellular dysfunction that impairs triglyceride production.

Aim

To test the hypothesis that lower fasting triglyceride levels may paradoxically indicate more advanced liver disease.

Methods

A cross‐sectional analysis of 11 947 adults aged 20 years or older without chronic viral hepatitis from the National Health and Nutrition Examination Survey 1999–2010 was performed to analyze the relationships between fasting triglyceride levels and five validated non‐invasive indices of liver fibrosis, including Fibrosis 4 Score (FIB4), NAFLD Fibrosis Score (NFS), Ast‐Platelet Ration Index, AST/ALT ratio and BARD.

Results

Low‐fasting triglyceride levels were consistently associated with elevated liver fibrosis indices. Individuals in the lowest quintile of triglycerides (TG) had an adjusted odds ratio (OR) of 3.0 (95% CI, 1.7–5.2; P < 0.001) for advanced fibrosis estimated by FIB4 score and OR of 1.8 (95% Cl, 1.2–2.7; P = 0.009) estimated by NFS, compared to individuals in the highest quintile. This association remained highly significant when restricted to individuals with abnormal LFTs from suspected NAFLD. This inverse relationship was continuous, and more pronounced among men and whites (P interaction <0.001 and 0.008 respectively), but not modified by age or body mass index. In addition, fasting TG had a stronger, more direct association with liver fibrosis indices than did albumin or total bilirubin.

Conclusions

Fasting triglyceride levels were inversely associated with liver fibrosis indicators in American adults, especially among white men. Our findings suggest that sequential lipid measurements may serve as a useful disease marker in the management of chronic liver disease patients.
Environmental displacement: the common ground of climate change, extraction and conservation
Authors: Lunstrum Elizabeth , Bose Pablo , Zalik Anna
Published: April 2015

In this introduction to a special section on environmental displacement, we introduce the concept and ground it in seemingly distinct processes of climate change, extraction, and conservation. We understand environmental displacement as a process by which communities find the land they occupy irrevocably altered in ways that foreclose or otherwise impede possibilities for habitation or else disrupt access to resources within these spaces of life, work and socio‐cultural reproduction. Such dislocation amounts to environmental displacement on the grounds that it is justified by environmental or ecological rationales, motivated by desires to access natural resources, or else provoked by human‐induced environmental change and attempts to address it. Building from here, we make the case for why climate change and efforts to mitigate and adapt to it, extractive industries, and conservation initiatives should be analysed together as displacement inducing phenomena, as they are empirically connected in consequential ways and materialise from similar logics. We additionally lay out the contributions of the individual articles of the special issue and draw connections across them to help provide a preliminary framework for thinking through environmental displacement, including its causes, logics, and consequences, especially for vulnerable populations.
South Korean Nuclear Energy Policies and the Public Agenda in the 21st Century
Authors: Hermanns Heike
Published: April 2015

Nuclear energy continues to be a major component of South Korean energy policy, despite the nuclear accident in Fukushima and several incidents in domestic nuclear power plants in 2011. There is growing unease among the Korean public regarding the safety of nuclear energy, but these grievances do not translate into demands for policy changes. This article introduces how different actors and their preferences affected the public agenda related to nuclear energy, comparing the protests against a nuclear waste storage facility in Buan County in 2003 and 2004 with the reactions to the Fukushima accident and domestic incidents in more recent years. Using agenda‐setting theory, this article aims to shed light on the dynamics of these events on actors, the decision‐making processes and the reasons for the lack of concerted effort by citizens and civic groups to demand changes in the country's energy policies.
The Multiple Pathways to Trauma Recovery, Vindication, and National Reconciliation in Cambodia
Authors: Hein Patrick
Published: April 2015

Trauma theory has long been confined to the domain of psychology with a concern for clinical situations and vignettes. The framing of trauma as an individual or psychological problem is unable to explain what causes changes in public attitudes toward trauma victims because it fails to recognize the collective dynamics and social dimension of trauma. The collective dynamics of trauma have emerged as a vital theme in recent works including constructivist sociological models of collective trauma representations and of the changing impact of international norms. This article engages with these models in the context of the Cambodian genocide by the Khmer Rouge and explores the shifts in public perceptions of formerly stigmatized survivors, considering that trauma recovery is a never‐ending process with an uncertain outcome. It is argued that the public perception of what constitutes individual trauma and who is acknowledged as victim depends largely on cultural and political contexts. Field interviews with several victims of forced marriages, a mental health expert, and a former judge illustrate what needs to be done to help traumatized survivors find closure and obtain reparations.
Imidazole‐based alkaloid derivative LCB54‐0009 suppresses ocular angiogenesis and lymphangiogenesis in models of experimental retinopathy and corneal neovascularization
Authors: Kim Byung‐Hak , Lee Junyeop , Choi Jun‐Sub , Park Dae Young , Song Ho Young , Park Tae Kyo , Cho Chung‐Hyun , Ye Sang‐Kyu , Joo Choun‐Ki , Koh Gou Young , Kim Tae‐Yoon
Published: April 2015

Background and Purpose

Abnormally induced angiogenesis and lymphangiogenesis are associated with human diseases, including neovascular eye disease. Substances that inhibit these processes may have potential as an attractive therapeutic strategy for these diseases.

Experimental Approach

In vitro and in vivo angiogenesis and/or lymphangiogenesis were assessed in VEGF‐ or hypoxia‐stimulated endothelial and retinal cells and in animal models of oxygen‐induced retinopathy (OIR), streptozotocin‐induced diabetic retinopathy (SIDR), suture‐induced inflammatory corneal neovascularization (SICNV) and silver nitrate‐induced corneal neovascularization. HUVECs and retinal cells were cultured under hypoxic conditions or incubated with VEGF to identify the molecular mechanisms involved.

Key Results

The imidazole‐based alkaloid derivative LCB54‐0009 inhibited capillary‐like tube formation in VEGF‐induced HUVECs without inducing cytotoxic effects. Intravitreal injection of LCB54‐0009 into retinas suppressed the formation of the pathological neovascular tufts and increased vascular permeability in both OIR of mice and SIDR of rats. Furthermore, subconjunctival injection of LCB54‐0009 into the cornea suppressed corneal inflammation and inflammation‐associated angiogenesis and lymphangiogenesis in SICNV of mice and silver nitrate cauterization of rats. These pharmacological activities were associated with effects on HIF‐1α protein stability and HIF‐1α/NF‐κB redox sensitivity through its antioxidant activities. LCB54‐0009 also inhibited the hypoxia‐induced expression of angiopoietin‐2, and VEGF‐induced VEGFR‐2 activation and downstream signalling, resulting in the down‐regulation of the expression of pro‐angiogenic factors and pro‐inflammatory mediators and an up‐regulation of the expression of anti‐angiogenic factors.

Conclusions and Implications

LCB54‐0009 is a potential candidate molecule for blocking pathological angiogenesis and lymphangiogenesis mediated by HIF‐1α‐ angiopoietin‐2 expression and VEGFR‐2 activation.
Sympathetic activation and endothelial dysfunction in polycystic ovary syndrome are not explained by either obesity or insulin resistance
Authors: Lambert Elisabeth A. , Teede Helena , Sari Carolina Ika , Jona Eveline , Shorakae Soulmaz , Woodington Kiri , Hemmes Robyn , Eikelis Nina , Straznicky Nora E. , De Courten Barbora , Dixon John B. , Schlaich Markus P. , Lambert Gavin W.
Published: April 2015

Objective

Polycystic ovary syndrome (PCOS) is a common endocrine condition underpinned by insulin resistance and associated with increased risk of obesity, type 2 diabetes and adverse cardiovascular risk profile. Previous data suggest autonomic imbalance [elevated sympathetic nervous system (SNS) activity and decreased heart rate variability (HRV)] as well as endothelial dysfunction in PCOS. However, it is not clear whether these abnormalities are driven by obesity and metabolic disturbance or whether they are independently related to PCOS.

Participants and methods

We examined multiunit and single‐unit muscle SNS activity (by microneurography), HRV (time and frequency domain analysis) and endothelial function [ischaemic reactive hyperaemia index (RHI) using the EndoPAT device] in 19 overweight/obese women with PCOS (BMI: 31·3 ± 1·5 kg/m2, age: 31·3 ± 1·6 years) and compared them with 21 control overweight/obese women (BMI: 33·0 ± 1·4 kg/m2, age: 28·2 ± 1·6 years) presenting a similar metabolic profile (fasting total, HDL and LDL cholesterol, glucose, triglycerides, insulin sensitivity and blood pressure).

Results

Women with PCOS had elevated multiunit muscle SNS activity (41 ± 2 vs 33 ± 3 bursts per 100 heartbeats, P < 0·05). Single‐unit analysis showed that vasoconstrictor neurons were characterized by elevated firing rate and probability and incidence of multiple spikes (P < 0·01 for all parameters). Women with PCOS also had impaired endothelial function (RHI: 1·77 ± 0·14 vs 2·18 ± 0·14, P < 0·05). HRV did not differ between the groups.

Conclusion

Women with PCOS have increased sympathetic drive and impaired endothelial function independent of obesity and metabolic disturbances. Sympathetic activation and endothelial dysfunction may confer greater cardiovascular risk in women with PCOS.
Long‐Term Follow‐Up of 2.5‐mm Narrow‐Diameter Implants Supporting a Fixed Prostheses
Authors: Anitua Eduardo , Saracho Juan , Begoña Leire , Alkhraisat Mohammad Hamdan
Published: April 2015

Background

The use of narrow‐diameter implants (NDIs; <3.75 mm) constitutes an alternative to bone augmentation procedure. Long‐term evaluation of NDIs with a diameter <3.0 mm is still lacking.

Purpose

Analyze the long‐term outcomes of 2.5‐mm NDIs splinted to regular‐sized implants for supporting partial and complete fixed prostheses.

Materials and Methods

Patients charts were retrospectively analyzed to select patients treated by the insertion of at least one 2.5‐mm two‐piece implant before July 2005. The study was based on the available charts (no patient was recalled). Patient's demographic data were described. The known implant length was used as a reference to calibrate the linear measurements of marginal bone loss on digital periapical radiograph. Implant details, survival and prosthetic complications were analyzed.

Results

Thirty‐seven 2.5‐mm implants placed in 20 patients (mean age at surgery: 54.05 ± 9.7 years) in maxilla and mandible were included and evaluated. The implants' mean follow‐up time since insertion was 6.5 ± 3.2 years (range 0 to 9.7 years). The follow‐up time was more than 7 years for 22 implants. One implant failed due to lack of osseointegration. Two prosthetic complications (connector and porcelain fracture) occurred. The survival rate was 97.3% for implants and 92.0% for prostheses. The mean marginal bone loss at the mesial and distal aspect was 0.70 ± 0.55 and 0.72 ± 0.56 mm, respectively.

Conclusions

When dental implants of 2.5 mm in diameter are splinted by a fixed prosthesis, long‐term favorable outcomes could be obtained.
Evaluation of tubomanometry as a routine diagnostic tool for chronic obstructive Eustachian tube dysfunction
Authors: Schröder S. , Lehmann M. , Korbmacher D. , Sauzet O. , Sudhoff H. , Ebmeyer J.
Published: April 2015

Objective

The objective of this study was to demonstrate the reliability of tubomanometry (TMM) described by Estéve in the diagnosis of chronic obstructive Eustachian tube (ET) dysfunction.

Study design

Combined prospective and retrospective clinical study.

Setting

Tertiary referral centre, affiliated to university.

Methods

Two hundred and fifteen healthy subjects were examined once, 25 healthy subjects underwent TMM weekly for 6 weeks, and six healthy subjects were tested three times a day on at least three different days. The results of tubomanometry in healthy subjects were compared to data obtained from 171 patients with chronic obstructive ET dysfunction.

Results

In healthy subjects, there was an immediate opening of the ET at 30–50 mbar with an R‐value ≤1 in at least 94% of the cases. In patients with chronic ET dysfunction, an opening of the ET could be registered in only 42% of patients at 30 mbar and in 58% at 50 mbar. The average of the R‐value in these subjects always indicated towards a delayed opening (R > 1). When measurements are repeated in the same subject with a weekly interval, the intraclass correlation (ICC) was 0.49 for the TMM with 30 mbar, 0.51 for the TMM with 40 mbar and 0.52 for the TMM with 50 mbar in healthy people. For the patients with symptoms of ET dysfunction, the ICC for up to four repeated measures was 0.50 for the TMM with 30 mbar, 0.53 for the TMM with 40 mbar and 0.54 for the TMM with 50 mbar. A complete agreement of the results in repeated measurements within seconds was present in 86% for 30 and 40 mbar and in 79% for 50 mbar. The ICC was 0.61 for the TMM with 50 mbar, 0.62 for the TMM with 40 mbar and 0.68 for the TMM with 30 mbar.

Conclusions

Tubomanometry can support the diagnosis of ET dysfunction. An R‐value ≤1 indicates a regular function of the ET, an R‐value >1 indicates a delayed opening of the ET, and no definable R‐value means no detectable opening of the ET. TMM is a reliable and valid instrument to support the diagnosis of chronic obstructive ET dysfunction.
Myocardial deformation and total atrial conduction time in the prediction of cardiac involvement in patients with pulmonary sarcoidosis
Authors: Değirmenci Hüsnü , Demirelli Selami , Arısoy Arif , Ermiş Emrah , Araz Ömer , Bakırcı Eftal Murat , Hamur Hikmet , Büyüklü Mutlu , Topal Ergün
Published: April 2015

Aims

In this study, we aim to evaluate the left atrial global longitudinal strain (LAGLS), total atrial conduction time (TACT) and left ventricle (LV) functions in recently diagnosed pulmonary sarcoidosis (PS) patients.

Method

Fifty recently diagnosed PS patients (group 1) and a control group of 50 healthy individuals (group 2) were evaluated in the study. Two‐dimensional echocardiography images were obtained from LV apical 4‐chamber (4C), long‐axis (L) and 2‐chamber (2C) views. Peak longitudinal strain and strain rate (SR) were obtained from 4C, L and 2C views. Mean values of the three views were calculated. LV global longitudinal strain and LV‐SR torsion were determined as the net differences in the mean rotation between the apical and basal levels. LAGLS and TACT values were calculated.

Results

The study found that LAGLS was significantly lower in group 1 than in group 2 (P < 0.05). TACT was also significantly longer in group 1 than in group 2 (respectively group 1: 111.6 ± 15.1 ms; group 2: 103.4 ± 5.8 ms, P < 0.001). There was a significant moderate negative correlation between LAGLS and TACT (r = −0.36, P < 0.05). Patients with sarcoidosis had significantly lower LV longitudinal strain and SR measurements than the control group. Although LV basal rotation (LVR) values were similar in both groups, LVR‐apical and LV‐torsion (LVTR) values were significantly higher in the patient group (group 1).

Conclusion

The identification of left atrial and left ventricular myocardial deformation using speckle tracking echocardiography in patients with PS allows subclinical LV dysfunction and subclinical electrophysiologic changes to be detected earlier.
Endothelial dysfunction in patients with pulmonary thromboembolism: neutrophil to lymphocyte ratio and platelet to lymphocyte ratio
Authors: Kurtipek Ercan , Büyükterzi Zafer , Büyükterzi Meral , Alpaydın Mehmet Sertaç , Erdem Said Sami
Published: April 2015

Background and Aims

Pulmonary thromboembolism (PTE) is a common cardiovascular emergency. Activated leukocytes may produce free oxygen radicals and endothelial damage, and, thereby, increased inflammation and thrombogenesis. In this study, we aimed to investigate endothelial dysfunction in patients with PTE.

Methods

Between May 2012 and July 2013, a total of 71 patients with acute PTE (32 males, 39 females; mean age: 64.94 ± 15.27 years; range: 33 to 87 years) who were admitted to the Emergency and Thoracic Diseases Departments and 56 healthy controls (44 males, 12 females; mean age: 62.52 ± 9.80 years; range: 46 to 79 years) were included. Brachial artery flow‐mediated dilation (BFMD) was performed. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were calculated.

Results

Significantly higher BFMD values were observed in patients with PTE (P < 0.05). Patients with PTE also had significantly higher NLR and PLR values, compared with the healthy control group (P < 0.05).

Conclusion

The results of our study suggest that using non‐invasive method such as ultrasonography combined with NLR and PLR in endothelial dysfunction diagnosis in PTE patients are both effective and inexpensive. We believe in PTE patients endothelial dysfunction may play a role in the development of probable cardiovascular events in future.
Clinical characteristics and survival of patients with pulmonary hypertension: a 40‐month mean follow‐up
Authors: López Reyes Raquel , Nauffal Manzur Dolores , Garcia Ortega Alberto , Menéndez Salinas Maria Angeles , Ansotegui Barrera Emilio , Balerdi Perez Begoña
Published: April 2015

Background and Aims

The aim of our study was to describe the characteristics and clinical outcomes of pulmonary hypertension (PH) patients who underwent their follow‐up at a single centre.

Methods

We included patients who fulfilled the criteria for the diagnosis of PH by right heart catheterisation. A detailed clinical history and complete physical examination were recorded for each patient. Demographic data, laboratory testing, haemodynamic values and treatment records were also collected. A 6‐min walk test was used to evaluate exercise capacity. Survival analysis was performed using the Kaplan–Meier method, and a log‐rank test was used to compare survival curves among groups. A multivariate Cox's proportional hazards model was used in order to identify independent predictors of mortality in the overall PH population.

Results

A total of 93 patients (64 women and 29 men) were studied. The patients were distributed across the groups as follows: 50.5% in group 1, 20.4% in group 2, 9.7% in group 3, 14% in group 4 and 5.4% in group 5. The most common type of PH in our population was portopulmonary hypertension followed by PH associated with left heart disease, and idiopathic and chronic thromboembolic disease. Nineteen deaths, constituting 20.5% of the sample population, were reported. The Kaplan–Meier estimates of the 1‐, 2‐ and 3‐year survival rates were 91%, 89% and 85%, respectively. There were no statistically significant differences in survival among the groups (P = 0.18). A multivariate analysis revealed that the cardiac index (CI) was an independent predictor of death.

Conclusions

The survival rates of PH patients are higher than previously reported. In our study, the largest number of deaths occurred in groups 1 and 2, and CI was found to be an independent predictor of mortality.
A decade in diabetes specialist services, 2000 to 2011, in England: the views of consultant diabetologists and diabetes specialist nurses amidst persistent healthcare delivery change
Authors: Gosden C. A. , Barnard K. , Williams D. R. R. , Tinati T. , Turner B. , Holt R. I. G.
Published: April 2015

Aims

To assess the impact of continual major National Health Service reorganization on commissioning, organizational and delivery arrangements for secondary care diabetes services. To explore how consultant diabetologists and diabetes specialist nurses perceive the issues facing diabetes specialist services in 2011 and how these have changed in the preceding decade.

Methods

We used a longitudinal case study approach that combined quantitative and qualitative methods. Five locations in England were purposively selected to represent the wider diabetes specialist community, and seven semi‐structured interviews were conducted. Interviews were recorded, transcribed verbatim and analysed using Framework analysis. Findings were compared with and contrasted to results from national quantitative surveys of diabetes specialist services undertaken in 2000 and 2006.

Results

Clinicians viewed positively the expertise and commitment of multidisciplinary teams and their ability to adapt to new situations. Negative perceptions persisted throughout the decade, relating to the continual change that threatens to dismantle relationships and services which had taken many years to establish. Lack of resources, inadequate manpower planning and poor access to psychological support for people with diabetes remained constant themes from 2000 to 2011.

Conclusions

A willingness to innovate and work differently to improve services was identified; however, clinicians must be supported through organizational changes to ensure people with diabetes receive high‐quality care. The disruptive nature of organizational change was a recurrent theme throughout the decade. Periods of stability must exist within commissioning to allow relationships, which are key to integration, to be maintained and permit service improvements to develop.
Lifestyle‐related risk factors and trajectories of work disability over 5 years in employees with diabetes: findings from two prospective cohort studies
Authors: Virtanen M. , Kivimäki M. , Zins M. , Dray‐Spira R. , Oksanen T. , Ferrie J. E. , Okuloff A. , Pentti J. , Head J. , Goldberg M. , Vahtera J.
Published: April 2015

Aims

To examine work disability trajectories among employees with and without diabetes and identify lifestyle‐related factors associated with these trajectories.

Methods

We assessed work disability using records of sickness absence and disability pension among participants with diabetes and age‐ sex‐, socio‐economic status‐ and marital status‐matched controls in the Finnish Public Sector Study (1102 cases; 2204 controls) and the French GAZEL study (500 cases; 1000 controls), followed up for 5 years. Obesity, physical activity, smoking and alcohol consumption were assessed at baseline and the data analysed using group‐based trajectory modelling.

Results

Five trajectories described work disability: ‘no/very low disability’ (41.1% among cases and 48.0% among controls); ‘low–steady’ (35.4 and 34.7%, respectively); ‘high–steady’ (13.6 and 12.1%, respectively); and two ‘high–increasing’ trajectories (10.0 and 5.2%, respectively). Diabetes was associated with a ‘high–increasing’ trajectory only (odds ratio 1.90, 95% CI 1.47–2.46). Obesity and low physical activity were similarly associated with high work disability in people with and without diabetes. Smoking was associated with ‘high–increasing’ trajectory in employees with diabetes (odds ratio 1.88, 95% CI 1.21–2.93) but not in those without diabetes (odds ratio 1.32, 95% CI 0.87–2.00). Diabetes was associated with having multiple ( ≥ 2) risk factors (21.1 vs. 11.4%) but the association between multiple risk factors and the ‘high–increasing’ trajectory was similar in both groups.

Conclusions

The majority of employees with diabetes have low disability rates, although 10% are on a high and increasing disability trajectory. Lifestyle‐related risk factors have similar associations with disability among employees with and without diabetes, except smoking which was only associated with poorer prognosis in diabetes.
Influence of bed rest on plasma galanin and adrenomedullin at presyncope
Authors: O'Shea Daniel , Lackner Helmut K. , Rössler Andreas , Green David A. , Gauger Peter , Mulder Edwin , Tamma Grazia , Hinghofer‐Szalkay Helmut , Valenti Giovanna , Goswami Nandu
Published: April 2015

Background

The role of hormones in reduced orthostatic tolerance following long‐term immobilization remains uncertain. We have previously shown that plasma concentrations of adrenomedullin and galanin, two peptides with vasodepressor properties, rise significantly during orthostatic challenge. We tested the hypothesis that bedrest immobilization increases the rise in adrenomedullin and galanin during orthostatic challenge leading to presyncope.

Materials and methods

We measured baseline (supine), presyncope and recovery (10 min postpresyncope, supine) levels of adrenomedullin and galanin in 8 healthy men, before and after 21 days of −6° head‐down bed rest (HDBR). Presyncope was elicited using a combined head‐up tilt and graded lower body negative pressure protocol. Orthostatic tolerance was defined as the time taken from the commencement of head‐up tilt to the development of presyncope.

Results

Orthostatic tolerance time after HDBR reduced by 8·36 ± 5·39 min (P = 0·0032). HDBR increased plasma adrenomedullin concentration to orthostatic challenge (P = 0·0367). Compared to pre‐HDBR, a significant rise in post‐HDBR presyncopal (P < 0·001) and recovery adrenomedullin concentration (P < 0·01) was demonstrated. In contrast, we observed no change in pre‐ and post‐HDBR galanin levels to orthostatic challenge.

Conclusions

Bedrest immobilization appears to affect adrenomedullin levels in that greater increases in adrenomedullin occur at presyncope following bedrest immobilization. Due to its peripheral vasculature hypotensive effect, the greater levels of adrenomedullin at presyncope following bedrest immobilization may have contributed to the reduced orthostatic capacity postbedrest.
Mild chronic graft‐versus‐host disease may alleviate poor prognosis associated with FLT3 internal tandem duplication for adult acute myeloid leukemia following allogeneic stem cell transplantation with myeloablative conditioning in first complete remission: a retrospective study
Authors: Nasilowska‐Adamska Barbara , Czyz Anna , Markiewicz Miroslaw , Rzepecki Piotr , Piatkowska‐Jakubas Beata , Paluszewska Monika , Dzierzak‐Mietla Monika , Solarska Iwona , Borg Katarzyna , Prochorec‐Sobieszek Monika , Szydlo Richard , Lewandowski Krzysztof , Skotnicki Aleksander , Jedrzejczak Wieslaw Wiktor , Kyrcz‐Krzemien Slawomira , Komarnicki Mieczyslaw , Warzocha Krzysztof
Published: April 2015

Internal tandem duplication (ITD) of the FLT3 gene (Fms‐like tyrosine kinase 3) is the most commonly found mutation in acute myeloid leukemia (AML). The significance of FLT3‐ITD at diagnosis was retrospectively estimated for allo‐HSCT (allogeneic hematopoietic stem cell transplantation) outcomes in 140 patients, median age of 38, undergoing allo‐HSCT after myeloablative conditioning in first complete remission of AML. FLT3‐ITD was detected at AML diagnosis in 42/140 (30%) of included into this study patients. At 3 years, relapse incidence (RI) following allo‐HSCT in AML patients with intermediate or normal karyotype was significantly higher in those FLT3‐ITD positive than FLT3‐ITD negative [52.9 vs. 20.4%, P = 0.002]. Additionally, patients with mild chronic graft‐versus‐host disease (cGvHD) had significantly lower RI compared to patients with moderate or severe grade cGvHD or those not experiencing cGvHD, respectively, 4.8 vs. 36.0 vs. 27.8%, P = 0.032. FLT3‐ITD was harboring a poor prognosis in AML with intermediate or normal karyotype and significantly increased risk of relapse following allo‐HSCT. It appears that allo‐HSCT does not cure patients with FLT3‐ITD, unless they develop symptoms of mild cGvHD and graft versus leukemia, which may decrease RI.
From mice to elephants: overturning the ‘one size fits all’ paradigm in marine plankton food chains
Authors: Boyce Daniel G. , Frank Kenneth T. , Leggett William C.
Published: April 2015

It is widely believed that consumer control is a weak regulator of marine phytoplankton communities. It remains unclear, however, why this should be the case when marine consumers routinely regulate their prey at higher trophic levels. One possibility is that the weak consumer control of phytoplankton communities results from the inability of field researchers to effectively account for consumer–prey trophic relationships operating at the scale of the plankton. We explored this issue by reviewing studies of trophic control in marine plankton. Experimental studies indicate that size is a critical determinant of feeding relationships among plankton. In sharp contrast, of the 51 field studies reviewed, 78% did not distinguish among the sizes or species of phytoplankton and their consumers, but instead assumed a general bulk phytoplankton–zooplankton trophic connection. Such an approach neglects the possibility that several trophic connections may separate the smallest phytoplankton (0.2 μm) from the larger zooplankton (~ 1000 μm), a remarkable size differential exceeding that between a mouse (~10 cm) and an elephant (~2500 cm). The size‐based approach we propose integrates theory, experiments and field observations and has the potential to greatly enhance our understanding of the causes and consequences of recently documented restructuring of plankton communities.
What can and can't we say about indirect land‐use change in Brazil using an integrated economic – land‐use change model?
Authors: Verstegen Judith A. , van der Hilst Floor , Woltjer Geert , Karssenberg Derek , de Jong Steven M. , Faaij André P. C.
Published: April 2015

It is commonly recognized that large uncertainties exist in modelled biofuel‐induced indirect land‐use change, but until now, spatially explicit quantification of such uncertainties by means of error propagation modelling has never been performed. In this study, we demonstrate a general methodology to stochastically calculate direct and indirect land‐use change (dLUCandiLUC) caused by an increasing demand for biofuels, with an integrated economic – land‐use change model. We use the global Computable General Equilibrium model MAGNET, connected to the spatially explicit land‐use change modelPLUC. We quantify important uncertainties in the modelling chain. Next,dLUCandiLUCprojections for Brazil up to 2030 at different spatial scales and the uncertainty herein are assessed. Our results show that cell‐based (5 × 5 km2) probabilities ofdLUCrange from 0 to 0.77, and ofiLUCfrom 0 to 0.43, indicating that it is difficult to project exactly wheredLUCandiLUCwill occur, with more difficulties foriLUCthan fordLUC. At country level,dLUCarea can be projected with high certainty, having a coefficient of variation (cv) of only 0.02, whileiLUCarea is still uncertain, having a cv of 0.72. The latter means that, considering the 95% confidence interval, theiLUCarea in Brazil might be 2.4 times as high or as low as the projected mean. Because this confidence interval is so wide that it is likely to straddle any legislation threshold, our opinion is that threshold evaluation foriLUCindicators should not be implemented in legislation. For future studies, we emphasize the need for provision of quantitative uncertainty estimates together with the calculatedLUCindicators, to allow users to evaluate the reliability of these indicators and the effects of their uncertainty on the impacts of land‐use change, such as greenhouse gas emissions.
Fabrication of Gd2O2S: Pr, Ce, F Scintillation Ceramics by Pressureless Sintering in Nitrogen Atmosphere
Authors: Wang Wei , Li Yongsheng , Kou Huamin , Liu Shuping , Liu Wanpeng , Shi Yun , Li Jiang , Feng Xiqi , Pan Yubai , Guo Jingkun
Published: April 2015

Gd2O2S: Pr, Ce, F ceramics with good scintillation properties were fabricated by pressureless sintering in nitrogen atmosphere. The effects of annealing temperature on the intensity of X‐ray excited luminescence and light output were investigated. The light output strongly depends on the thickness of Gd2O2S: Pr, Ce, F ceramics. Thermoluminescence properties of the samples were studied after X‐ray irradiation in the temperature range of 77–438 K.
Sex differences in the association between body mass index and hypertension – a cross‐sectional study in 717 812 adolescents
Authors: Gordon B. , Shamiss A. , Derazne E. , Tzur D. , Afek A.
Published: April 2015

In order to examine sex‐specific differences in the association of body mass index (BMI) and hypertension, we conducted a retrospective, cross‐sectional study of 717 812 (402 914 men and 314 898 women) Israeli Jewish adolescents aged 16.0–19.99 years medically screened for military service. A diagnosis of hypertension was established per history or if a mean of 10 separate blood pressure measurements exceeded 140/90, following an initial measurement higher than 140/90. Weight and height were measured. Prevalence of hypertension was 0.42% in men and 0.05% in women. In men, BMI was significantly associated with hypertension from the third decile (odds ratio [OR] 1.67, 1.06–2.65) up to the 10th decile (OR 30.17, 20.83–43.69). In women, we observed a significantly increased risk for hypertension in the ninth decile (OR 3.82, 1.42–10.22) and in the 10th decile (OR 18.92, 7.7–46.51), with no visible trend in lower deciles. BMI effects on hypertension prevalence are different in male and female adolescents.
Failure of eruption of permanent molars: a diagnostic dilemma
Authors: Sharma Geetanjali , Kneafsey Louise , Ashley Paul , Noar Joseph
Published: April 2015

Background

Limited studies have proposed protocols for the management of failure of eruption (FOE) of permanent molars with no clear consensus or guidelines. Accurate diagnosis is challenging but key for successful management.

Aims

Confirm key diagnostic criteria that will aid diagnostic differentiation between primary failure of eruption (PFE) and mechanical failure of eruption (MFE) of permanent molars and identify successful management strategies.

Design

Retrospective descriptive study. Patients diagnosed with FOE of permanent molars (excluding impaction) between January 2003 and December 2013 were identified. Patient details and clinical and radiological features of FOE were recorded. Two examiners analysed the data. A diagnosis of PFE or MFE was made based on a combination of current protocols. Management strategies for each were identified and reported as satisfactory/unsatisfactory.

Results

Thirty‐one patients met the inclusion criteria. Fifteen were classified as PFE and 14 as MFE. One patient was too young to confirm diagnosis, and one patient had delayed eruption. A total of 26% of cases were misdiagnosed which led to unsuccessful orthodontic management.

Conclusion

We propose a protocol based on the results of this study coupled with existing protocols in the form of a simple flow diagram to aid accurate diagnosis and management of this rare and challenging clinical problem.
The perceptions of homeless people regarding their healthcare needs and experiences of receiving health care
Authors: Rae Bernadette Emma , Rees Sharon
Published: April 2015

Aims

To understand the perspective of the homeless about their healthcare encounters and how their experiences of receiving healthcare influence their health‐seeking behaviour.

Background

A phenomenological study was undertaken because of the increasing levels of homelessness in the United Kingdom. Most of the current literature is American or Canadian.

Design

An interpretive phenomenological inquiry.

Method

An opportunistic sample of fourteen single homeless adults was recruited from one male hostel and one non‐residential day centre. Data collection was done in 2013. Semi‐structured audio‐recorded interviews were conducted one‐to‐one. Colaizzi's method for data analysis was used.

Findings

Three major themes were identified. Expressed Health Need, Healthcare Experiences and Attitudes to health care. Health problems are recognized by the homeless but the need for intervention is not always prioritised. Obstacles in access to health care in the UK are both perceived (attitudes towards the homeless; previous bad experience) and actual (difficulty in registering with a general practitioner, difficulty travelling to services, being forced to move to new area). Some homeless people feel that they are treated with prejudice and receive substandard care. Positive healthcare experiences were also reported.

Conclusions

Positive and negative healthcare encounters can profoundly affect the homeless. Recommendations: Address apparent inconsistency of care; promote greater interdisciplinary communication and referrals to homeless services from prisons and hospitals; increase the availability of intermediate services; reduce obligation of homeless to move area; research experiences of homeless families.
Satisfied or not satisfied: pain experiences of patients with sickle cell disease
Authors: Ezenwa Miriam O. , Molokie Robert E. , Wang Zaijie Jim , Suarez Marie L. , Yao Yingwei , Wilkie Diana J.
Published: April 2015

Aims

To examine the relationship between pain and satisfaction in patients with sickle cell disease.

Background

Frequency and severity of unrelieved sickle cell pain are positively associated with mortality. Yet, information is scarce on whether sickle cell patients are satisfied with their pain level.

Design

A cross‐sectional, correlational analysis of baseline data from a randomized clinical trial.

Methods

A randomized sample of adult outpatients was recruited between February 2007–March 2011. Patients completed the PAINReportIt®, containing measures of pain, satisfaction and socio‐demographics. We analysed data using Kendall's rank correlations, analysis of variance, Tukey–Kramer post hoc tests, Fisher's tests and proportional odds logistic regression.

Results

There were statistically significant correlations between pain outcomes and satisfaction with pain level, but average pain intensity more strongly discriminated groups based on satisfaction with pain level. Among pain variables bivariately associated with patient satisfaction with pain level, only pain expectation maintained its significant relationship with satisfaction with pain level when average pain intensity was controlled. A smaller percentage of our sickle cell patients reported moderate to severe pain intensity (28%) or high composite pain index (39%), while reporting being satisfied with pain their level than reported in earlier studies using different measures and populations (70‐94%).

Conclusion

Satisfaction with pain level was an unambiguous measure of patient satisfaction and a promising indicator of pain that did not show the paradoxical relationship between satisfaction and pain seen with past measures.
Peer Interactions among Children with Profound Intellectual and Multiple Disabilities during Group Activities
Authors: Nijs Sara , Penne Anneleen , Vlaskamp Carla , Maes Bea
Published: April 2015

Background

Children with profound intellectual and multiple disabilities (PIMD) meet other children with PIMD in day care centres or schools. This study explores the peer‐directed behaviours of children with PIMD, the peer interaction‐influencing behaviour of the direct support workers and the children's positioning.

Method

Group activities for children with PIMD initiated by a direct support worker were video‐recorded. The behaviour and positioning of the children and the behaviour of the direct support workers were coded.

Results

Limited peer‐directed behaviour of the children with PIMD and peer interaction‐influencing behaviour of the direct support workers are observed. Weak associations were found between the positioning or peer interaction‐influencing behaviours and the behaviour of children with PIMD.

Conclusions

Children with PIMD show social interest in each other during group activities. More knowledge is needed to create an environment which facilitates peer‐directed behaviours of persons with PIMD.