bluuebunny/crossref_metadata_2025 huggingface dataset:
Korean–Chinese Migrant Workers and the Politics of Korean Nationalism
Authors: Lee Byoungha , Choi Jun Young , Seo Jungmin
Published: December 2014

Why has Korean migration policy been ethnicized? This research mainly aims to explain ethnic preference in Korea's immigration policy through the lens of Korean nationalism. The influx of ethnic Koreans in China (or Joseonjok) since the early 1990s has created a new dilemma for the South Korean government, which has long claimed to be the only legitimate polity of the Korean nation. The discrepancy between the legal citizenship and ethnicity of the Korean–Chinese workers in Korean society has forced the Korean state to redefine both legal and discursive national boundaries. This study analyzes the bifurcation of the Korean state discourses regarding Korean–Chinese workers in Korean society.
Development of disease‐resistant rice by optimized expression of WRKY45
Authors: Goto Shingo , Sasakura‐Shimoda Fuyuko , Suetsugu Mai , Selvaraj Michael Gomez , Hayashi Nagao , Yamazaki Muneo , Ishitani Manabu , Shimono Masaki , Sugano Shoji , Matsushita Akane , Tanabata Takanari , Takatsuji Hiroshi
Published: December 2014

The rice transcription factor WRKY45 plays a central role in the salicylic acid signalling pathway and mediates chemical‐induced resistance to multiple pathogens, including Magnaporthe oryzae and Xanthomonas oryzae pv. oryzae. Previously, we reported that rice transformants overexpressing WRKY45 driven by the maize ubiquitin promoter were strongly resistant to both pathogens; however, their growth and yield were negatively affected because of the trade‐off between the two conflicting traits. Also, some unknown environmental factor(s) exacerbated this problem. Here, we report the development of transgenic rice lines resistant to both pathogens and with agronomic traits almost comparable to those of wild‐type rice. This was achieved by optimizing the promoter driving WRKY45 expression. We isolated 16 constitutive promoters from rice genomic DNA and tested their ability to drive WRKY45 expression. Comparisons among different transformant lines showed that, overall, the strength of WRKY45 expression was positively correlated with disease resistance and negatively correlated with agronomic traits. We conducted field trials to evaluate the growth of transgenic and control lines. The agronomic traits of two lines expressing WRKY45 driven by the OsUbi7 promoter (POsUbi7 lines) were nearly comparable to those of untransformed rice, and both lines were pathogen resistant. Interestingly, excessive WRKY45 expression rendered rice plants sensitive to low temperature and salinity, and stress sensitivity was correlated with the induction of defence genes by these stresses. These negative effects were barely observed in the POsUbi7 lines. Moreover, their patterns of defence gene expression were similar to those in plants primed by chemical defence inducers.
Extracorporeal membrane oxygenation for congenital diaphragmatic hernia in Japan
Authors: Inamura Noboru , Usui Noriaki , Okuyama Hiroomi , Nagata Kouji , Kanamori Yutaka , Fujino Yuji , Takahashi Shigehiro , Hayakawa Masahiro , Taguchi Tomoaki
Published: December 2014

Background

The aim of this study was to clarify how extracorporeal membrane oxygenation (ECMO) is used to treat congenital diaphragmatic hernia (CDH) in Japan.

Methods

We completed a nationwide survey of CDH involving 614 infants. The subjects included 43 patients who underwent ECMO. We compared the clinical data of the patients who did and did not survive ≥90 days, and analyzed the 24 h blood gas data in isolated CDH cases in both groups.

Results

Of the 43 CDH patients, non‐isolated CDH associated with other life‐threatening or chromosomal anomalies was diagnosed in six patients. Only one of these six patients was able to discontinue ECMO and survived, and the other five died shortly after birth. The other 37 patients all had isolated CDH. The reason for initiating ECMO in 31 of these patients was persistent pulmonary hypertension of the newborn (PPHN). In the 37 patients with isolated CDH, ECMO was initiated within 24 h after birth. Sixteen patients (37%) survived ≥90 days, and intact discharge was possible in eight cases. Among the isolated CDH patients, on ROC analysis of the lowest oxygenation index (OI) to predict 90 day survival, the cut‐off was 15.

Conclusions

ECMO is used to treat PPHN starting from an early period after birth, but the mortality and morbidity are not favorable. For lowest OI, the index used to predict survival following ECMO, the cut‐off was 15.
Gut hormones of preterm infants with abdominal symptoms and hypothyroxinemia
Authors: Kawamata Ryou , Suzuki Yume , Yada Yukari , Koike Yasunori , Kono Yumi , Takahashi Naoto
Published: December 2014

Background

The pathogenesis of abdominal symptoms in premature infants with hypothyroxinemia is not understood; therefore, we investigated changes in gut hormones before and after levothyroxine sodium (T4‐Na) supplementation in preterm infants with abdominal symptoms and hypothyroxinemia.

Methods

In eight preterm study subjects and 14 gestational age‐matched controls, fasting serum concentration of leptin, glucose‐dependent insulinotropic polypeptide (GIP), glucagon‐like peptide‐1 (GLP‐1), peptide YY (PYY), pancreatic polypeptide, insulin, amylin and ghrelin was measured using a bead array system.

Results

Serum GLP‐1, GIP and PYY in the subjects before T4‐Na supplementation were lower than in controls at age 2 weeks. After improvement of abdominal symptoms and free thyroxine, serum levels of the three gut hormones in the subjects were increased and were not different from those in the control patients.

Conclusions

In preterm infants with abdominal symptoms, serum GLP‐1, GIP and PYY might be related to thyroid function.
Total antioxidant and total oxidant states, and serum paraoxonase‐1 in neonatal sepsis
Authors: Annagür Ali , Örs Rahmi , Altunhan Hüseyin , Kurban Sevil , Ertuğrul Sabahattin , Konak Murat , Uygun Saime Sündüz , Pekcan Sevgi , Erbay Ekrem , Mehmetoğlu İdris
Published: December 2014

Background

Paraoxonase‐1 (PON‐1) is an enzyme with a glycoprotein structure that depends on calcium and which is located in serum high‐density lipoprotein (HDL). The aim of this study was to evaluate PON‐1, and oxidant/antioxidant state, before and after treatment for neonatal sepsis, and to determine the usability of PON‐1 in neonatal sepsis treatment.

Methods

A total of 35 neonatal sepsis patients and 35 healthy controls were included in the study. Activity of PON‐1, total oxidant state (TOS) and total antioxidant state (TAS) were measured and oxidative stress index (OSI) was calculated.

Results

In the neonatal sepsis patients, pre‐treatment TAS, TOS and OSI were significantly higher than the post‐treatment levels (P < 0.0001, P < 0.0001 and P < 0.0001, respectively), and PON‐1 was significantly lower (P < 0.0001). Similarly, pre‐treatment TAS, TOS and OSI in the sepsis group were also significantly higher than in the control group (P < 0.0001, P < 0.0001 and P < 0.0001, respectively) and PON‐1 was significantly lower (P < 0.0001). Post‐treatment TAS in the sepsis group was significantly higher than in the control group (P = 0.009), whereas post‐treatment TOS, OSI and PON‐1 in the sepsis group were not significantly different to the control group (P = 0.078, P = 0.597 and P = 0.086, respectively).

Conclusion

Low serum PON‐1 was found in neonatal sepsis. Serum PON‐1 is thought to be a useful biomarker to evaluate the effectiveness of treatment and recovery in neonatal sepsis.
Longitudinal renal function in pediatric heart transplant recipients: 20‐years experience
Authors: Gupta Punkaj , Rettiganti Mallikarjuna , Gossett Jeffrey M. , Gardner Megan , Bryant Janet C. , Noel Tommy R. , Knecht Kenneth R.
Published: December 2014

This study was initiated to assess the temporal trends of renal function, and define risk factors associated with worsening renal function in pediatric heart transplant recipients in the immediate post‐operative period. We performed a single‐center retrospective study in children ≤18 yr receiving OHT (1993–2012). The AKIN's validated, three‐tiered AKI staging system was used to categorize the degree of WRF. One hundred sixty‐four patients qualified for inclusion. Forty‐seven patients (28%) were classified as having WRF after OHT. Nineteen patients (11%) required dialysis after heart transplantation. There was a sustained and steady improvement in renal function in children following heart transplantation in all age groups, irrespective of underlying disease process. The significant factors associated with risk of WRF included body surface area (OR: 1.89 for 0.5 unit increase, 95% CI: 1.29–2.76, p = 0.001) and use of ECMO prior to and/or after heart transplantation (OR: 3.50, 95% CI: 1.51–8.13, p = 0.004). Use of VAD prior to heart transplantation was not associated with WRF (OR: 0.50, 95% CI: 0.17–1.51, p = 0.22). On the basis of these data, we demonstrate that worsening renal function improves early after orthotopic heart transplantation.
Application of CdTe/ZnSe Quantum Dots in In Vitro Imaging of Chicken Tissue and Embryo
Authors: Moulick Amitava , Blazkova Iva , Milosavljevic Vedran , Fohlerova Zdenka , Hubalek Jaromir , Kopel Pavel , Vaculovicova Marketa , Adam Vojtech , Kizek Rene
Published: December 2014

The present work is aimed to synthesize CdTe/ZnSe core/shell quantum dots (QDs) in an easy way and to explore the possibilities of its application in in vitro imaging of chicken tissue and embryo. The QDs were prepared using microwave irradiation with different temperatures, which is a very easy and less time‐consuming method. Subsequently, these QDs were characterized by spectrofluorimetry, Transmission Electron Microscopy, X‐ray fluorescence analysis and Dynamic Light Scattering measurement. A blueshifting of the emission was found when ZnSe was deposited on CdTe QDs. The QDs showed its fluorescence emission quantum yields up to 25%. They were applied into chicken embryos and breast muscle tissues to study their efficiency in in vitro imaging. All the QDs of different color were able to visualize in in vitro imaging. The highest fluorescence intensity was detected in the case of red QDs prepared at 100°C. The green and red QDs were possible to detect up to the depth of 3 and 4 mm of the tissue, respectively.
Nobiletin, a Polymethoxy Flavonoid, Reduced Endothelin‐1 Plus SCF‐Induced Pigmentation in Human Melanocytes
Authors: Kim Hyo Jung , Yonezawa Takayuki , Teruya Toshiaki , Woo Je‐Tae , Cha Byung‐Yoon
Published: December 2014

Nobiletin is a unique flavonoid having polymethoxy groups and has exhibited anti‐inflammatory and antiobesity effects. Here, we examined the inhibition of nobiletin on melanogenesis induced by endothelin‐1 (ET) and stem cell factor (SCF) in normal human melanocytes. Nobiletin dose dependently reduced ET plus SCF‐stimulated tyrosinase activity without causing cytotoxicity. Nobiletin reduced cAMP‐response element‐binding protein (CREB) phosphorylation and microphthalmia‐associated transcription factor (MITF) expression, which is a key transcription factor for tyrosinase expression in pigmentation induced by ET plus SCF stimulation. Nobiletin treatment effectively decreased ET plus SCF‐induced Raf‐1, MEK and ERK1/2 phosphorylation and also downregulated the forskolin‐induced phosphorylation of CREB. Furthermore, nobiletin inhibited ET plus SCF‐triggered production of melanin and expression of MITF/tyrosinase in a three‐dimensional human epidermal model. In accordance with protein expression, the expression of genes related to the pigmentation was also increased in the cells stimulated with ET plus SCF and the cotreatment with nobiletin decreased obviously the ET plus SCF‐triggered gene expressions of tyrosinase, PMEL, TRP1 and MITF. Nobiletin contributes to hypopigmentation by downregulating MITF and tyrosinase expression through reduced Raf‐1 phosphorylation. Our findings implicate nobiletin as a potential new whitening agent.
Secreted effectors inToxoplasma gondiiand related species: determinants of host range and pathogenesis?
Authors: English E. D. , Adomako‐Ankomah Y. , Boyle J. P.
Published: December 2014

Recent years have witnessed the discovery of a number of secreted proteins inToxoplasma gondiithat play important roles in host–pathogen interactions and parasite virulence, particularly in the mouse model. However, the role that these proteins play in driving the unique features ofT. gondiicompared to some of its nearest apicomplexan relatives (Hammondia hammondiandNeospora caninum) is unknown. These unique features include distinct dissemination characteristicsin vivoand a vast host range. In this review we comprehensively survey what is known about disease outcome, the host response and host range forT. gondii,H. hammondi, andN. caninum. We then review what is presently known about recently identified secreted virulence effectors in these three genetically related, but phenotypically distinct, species. Finally we exploit the existence of genome sequences for these three organisms and discuss what is known about the presence, and functionality, of keyT. gondiieffectors in these three species.
The Varied Effects of Policy Cues on Partisan Opinions
Authors: Grossmann Matt
Published: December 2014

Although citizens often arrive at the same views as their political party's leaders, they also respond to information about policy targets and effects. Accounting for political context, even in the United States, encourages a variable view of how partisanship shapes opinions in policy debates. In three survey experiments associated with policies supported by both Democrats and Republicans, I find that both aspects of policy argumentation and the actors making the arguments can enable partisanship to affect public opinion. This process is highly conditional, however: sometimes polarization occurs only with the presence of a single politician; in other areas, polarization is likely following presentation of evidence by either partisan side. The effect of policy information on partisan polarization is variable across political and policy contexts.
Capacity Sharing and Cost Allocation among Independent Firms with Congestion
Authors: Yu Yimin , Benjaafar Saif , Gerchak Yigal
Published: December 2014

We analyze the benefit of production/service capacity sharing for a set of independent firms. Firms have the choice of either operating their own production/service facilities or investing in a facility that is shared. Facilities are modeled as queueing systems with finite service rates. Firms decide on capacity levels (the service rate) to minimize delay costs and capacity investment costs possibly subject to service‐level constraints on delay. If firms decide to operate a shared facility they must also decide on a scheme for sharing the capacity cost. We formulate the problem as a cooperative game and identify settings under which capacity sharing is beneficial and there is a cost allocation that is in the core under either the first‐come, first‐served policy or an optimal priority policy. We show that capacity sharing may not be beneficial in settings where firms have heterogeneous work contents and service variabilities. In such cases, we specify conditions under which capacity sharing may still be beneficial for a subset of the firms.
Supply Chain Consequences of Subsidies for Corporate Social Responsibility
Authors: Arya Anil , Mittendorf Brian
Published: December 2014

The use of government incentives tied to market prices as means of boosting corporate social responsibility (CSR) has expanded notably in recent decades. Enhanced business tax deductions for charitable donations and credits for conservation easements are notable cases. While providing incentives for socially desirable behavior to achieve legislative goals has intuitive appeal, the broader economic consequences are not always fully understood. In this study, we examine such wider consequences for supply chains when subsidies for CSR are offered. One effect we identify is that since incentives are typically tied to market value, firms have not only an added incentive to achieve societal objectives (say by donating inventory) but also an incentive to raise output (retail) market prices. A second consequence is that since firms forgo potential revenues by engaging in socially desired behavior, they become increasingly sensitive to supplier pricing; in an uncoordinated supply chain this leads to input (wholesale) price concessions. Among other things, the results underscore that incentives put in place to meet broader societal objectives also have notable ramifications for suppliers, retailers, and consumers in primary markets.
Fusarium species and chemotypes associated with fusarium head blight and fusarium root rot on wheat in Sardinia
Authors: Balmas V. , Scherm B. , Marcello A. , Beyer M. , Hoffmann L. , Migheli Q. , Pasquali M.
Published: December 2014

Environmental conditions in Sardinia (Tyrrhenian Islands) are conducive to fusarium root rot (FRR) and fusarium head blight (FHB). A monitoring survey on wheat was carried out from 2001 to 2013, investigating relations among these diseases and their causal agents. FHB was more frequently encountered in the most recent years while FRR was constantly present throughout the monitored period. By assessing the population composition of the causal agents as well as their genetic chemotypes and EF‐1α polymorphisms, the study examined whether the two diseases could be differentially associated to a species or a population. Fusarium culmorum chemotypes caused both diseases and were detected at different abundances (88% 3‐ADON, 12% NIV). Fusarium graminearum (15‐ADON genetic chemotype) appeared only recently (2013) and in few areas as the causal agent of FHB. In F. culmorum, two haplotypes were identified based on an SNP mutation located 34 bp after the first exon of the EF‐1α partial sequence (60% adenine, 40% thymine); the two populations did not segregate with the chemotype but the A‐haplotype was significantly associated with FRR in the Sardinian data set (P = 0·001), suggesting a possible fitness advantage of the A‐haplotype in the establishment of FRR that was neither dependent on the sampling location nor the sampling year. The SNP determining the Sardinian haplotype is distributed worldwide. The question whether the A‐haplotype segregates with characters facilitating FRR establishment will require further validation on a specifically sampled international data set.
Does Late Childbearing Increase the Risk for Behavioural Problems in Children? A Longitudinal Cohort Study
Authors: Tearne Jessica E. , Robinson Monique , Jacoby Peter , Li Jianghong , Newnham John , McLean Neil
Published: December 2014

Background

This study aimed to examine the relationship between advanced parental age and behavioural outcomes in offspring in a longitudinal cohort of children in Western Australia.

Methods

The Western Australian Pregnancy Cohort (Raine) is a prospective study of 2900 pregnancies. Offspring were followed up at ages 2, 5, 8, 10, 14, and 17 years, and 1754 adolescents were available for follow‐up at 17 years. The Child Behaviour Checklist was used to measure child behaviour, including internalising (e.g. anxious/withdrawn) and externalising (e.g. aggressive/destructive) behaviours.

Results

There was a significant linear relationship between maternal age and total internalising and externalising behaviour outcomes, but not paternal age. Increasing maternal age was associated with decreasing risk for problem behaviours in offspring. In the categorical models, young maternal age (20–24 years) was associated with significantly increased risk for problem behaviours in offspring relative to offspring of parents in the reference group (25–29 years), and a paternal age of 35–39 years was associated with decreased risk for total behaviour morbidity in offspring.

Conclusions

This study showed no evidence that late fatherhood is associated with adverse behavioural outcomes in offspring. Increasing maternal age was found to be a protective factor for child behaviour morbidity.
The Roles of Local Government Managers in Theory and Practice: A Centennial Perspective
Authors: Nelson Kimberly L. , Svara James H.
Published: December 2014

The standard narrative to explain the evolution of roles filled by city managers suggests that managers originally served as administrative technicians who carried out the policy directives of city councils, but, over time, they became more involved in policy advice and community leadership. This article documents enduring involvement in policy and the recent expansion of community leadership, analyzing definitions of the manager's roles offered by practitioners and scholars since the beginning of the city manager profession 100 years ago. In addition, measurements of the manager's role performance at various points in time are examined, along with trends in the preparation of managers and the context in which they work. Ignoring the evidence that the policy role is integral to professional management can lead to unfounded questions about the legitimacy of city and county managers and impairs our understanding of the council‐manager form of government and political–administrative relations.
Can carbon credits fund riparian forest restoration?
Authors: Matzek Virginia , Puleston Cedric , Gunn John
Published: December 2014

Ecological restoration is increasingly called on to provide ecosystem services (ES) valuable to humans, as well as to benefit biodiversity and improve wildlife habitat. Where mechanisms to pay for ES exist, they may serve as incentives to embark on habitat restoration projects. We evaluated the potential of newly established carbon markets in the United States to incentivize afforestation along riparian corridors, by comparing the income earnable by carbon offset credits with the costs of planting, maintaining, and registering such a restoration project in California. We used a 20‐year chronosequence of riparian forest sites along the Sacramento River as our model project. We found that carbon credits can repay more than 100% of costs after two decades of regrowth, if sufficient effort is put into sampling intensity in the first post‐restoration decade. However, carbon credits alone are unlikely to entice landowners currently engaged in agricultural activities to switch from farming crops to farming habitat.
Diverse responses across soil parent materials during ecological restoration
Authors: Abella Scott R. , Crouse Joseph E. , Covington W. Wallace , Springer Judith D.
Published: December 2014

A major challenge to advancing the science and practice of ecological restoration is working across large landscapes containing diverse sites that may respond differently to restoration. We conducted a 5‐year restoration experiment, replicated across 9 sites spanning 3 soil parent material types within a 9,000‐ha Pinus ponderosa forest landscape. We evaluated plant community response to restoration Pinus thinning, grazing, and aqueous smoke application. We measured vegetation before (2003) and 3 (2006) and 5 (2008) years after treatment. Plant community responses of species richness, cover, and composition were diverse, ranging from increases, decreases, or no change depending on soil parent material, tree thinning, and presence or exclusion of grazing. Restoration outcomes were under hierarchical control: soil parent material constrained response to Pinus thinning, which in turn influenced grazing effects. On limestone‐derived soil, responses included no change in species richness but increased plant cover with Pinus thinning. Both plant richness and cover increased on benmorite soil after thinning, and cover generally increased more without grazing. On rocky, basalt soil, plant richness increased but cover did not after any treatment. Diversity of responses to restoration has implications for: (1) setting goals or monitoring indicators tailored to inherent soil capability; (2) identifying where grazing most affects restoration outcomes; and (3) forecasting responses to restoration across landscapes. Diverse responses to restoration along physiographic gradients such as soil parent material warrant consideration when developing restoration across degraded landscapes.
A collaborative model for large‐scale riparian restoration in the western United States
Authors: Oppenheimer J. Daniel , Beaugh Stacy K. , Knudson Julie A. , Mueller Peter , Grant‐Hoffman Nikki , Clements Amanda , Wight Mike
Published: December 2014

In 2009, a group of practitioners took action to restore 175 miles of riparian habitat impaired by invasive plants along the Dolores River in southwestern Colorado and eastern Utah. Recognizing the magnitude of ecological, jurisdictional, and management challenges associated with this large‐scale initiative, this group of managers built trust and relationships with key partners to foster collaboration across boundaries and cultivate consensus of a variety of perspectives and forms of knowledge. What emerged was a network of individuals, organizations, and agencies dedicated to restoring the Dolores River riparian corridor while sharing information and learning from one another. This public–private collaboration, called the Dolores River Restoration Partnership (DRRP), has been successful in creating a process by which financial, technical, and human resources are shared across boundaries to restore a riparian corridor. Specifically, theDRRPdeveloped effective planning documents, a responsive governance structure, monitoring protocols, and a shared mindset for extracting lessons learned that have been instrumental in making progress toward its shared restoration goals and addressing a wide variety of restoration challenges. The tools developed by the partnership and lessons learned from their utility are outlined in this case study as a means to inform other collaborative restoration efforts.
Pleuroscopic cryoprobe biopsies of the pleura: A feasibility and safety study
Authors: Thomas Rajesh , Karunarathne Shanka , Jennings Barton , Morey Sue , Chai Siaw Ming , Lee Y.C. Gary , Phillips Martin J.
Published: December 2014

Background and objective

Flexi‐rigid pleuroscopy is a useful tool in the work‐up of pleural effusions, but pleural biopsy using flexible forceps can be difficult in some patients. This study evaluated the feasibility, safety and diagnostic value of using a flexible cryoprobe to obtain parietal pleural biopsies during pleuroscopy.

Methods

This was a single‐centre retrospective study. In patients undergoing diagnostic pleuroscopy, pleural biopsy using flexible forceps, followed by a flexible cryoprobe introduced through the pleuroscope, were performed. A pathologist independently reviewed all biopsies. Any complications, particularly bleeding, were recorded. All patients were followed up for ≥6 months (median 12 months (range 7–26)).

Results

Twenty‐two patients (21 males; median age 72 years; 14 right‐sided effusions) were included. All underwent flexible forceps biopsies (FFB) and cryoprobe biopsies (CB) of pleura. FFB and CB established a definitive diagnosis in 20/22 (90%). CB successfully obtained pleural tissue suitable for histopathological analysis in all patients. CB was larger than FFB (median, 25–75 IQR of 10, 7–15.8mm vs 4, 3–8mm), and had better preserved cellular architecture and tissue integrity. Crush artefacts were less common with CB (2/22) compared with FFB (21/22). No significant bleeding was reported.

Conclusions

CB during flexi‐rigid pleuroscopy is feasible, safe and effective. Its routine use during flexi‐rigid pleuroscopy requires further evaluation.
Endobronchial ultrasound‐guided transbronchial needle aspiration for diagnosis of sarcoidosis in clinically unselected study populations
Authors: Trisolini Rocco , Lazzari Agli Luigi , Tinelli Carmine , De Silvestri Annalisa , Scotti Valeria , Patelli Marco
Published: December 2014

Literature suggests that ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) has excellent performance characteristics for diagnosis of sarcoidosis. However, many authors challenge the external validity of EBUS‐TBNA results, as most studies were performed in referral centres by highly experienced investigators, and included populations with very high sarcoidosis prevalence.

We performed a systematic review and meta‐analysis to estimate the role of EBUS‐TBNA for diagnosis of sarcoidosis in studies enrolling consecutive patients with lymphadenopathy detected at imaging studies, regardless of the suspected underlying clinical aetiology. The Pubmed, Embase, Cinahl, Web of Science and Cochrane Library databases were screened to identify the pertinent literature. Quality of eligible studies was assessed by Quality Assessment, Data Abstraction and Synthesis‐2 criteria. Pooled diagnostic yield, sensitivity and specificity were calculated, and a summary receiver operating characteristic curve was constructed. Subgroup analysis was planned to identify possible sources of study heterogeneity. Fourteen studies, collectively involving 2097 patients, fulfilled eligibility criteria. The median prevalence of sarcoidosis was 15%. EBUS‐TBNA had a pooled diagnostic yield of 0.79 (standard deviation, 0.24), a pooled sensitivity of 0.84 (95% confidence interval (CI), 0.79–0.88) and a pooled specificity of 1.00 (95% CI, 0.99–1.00). Only subgroup analysis exploring the influence of study design seemed to influence the observed inter‐study heterogeneity for sensitivity, retrospective studies showing worst sensitivity than prospective ones. The results of EBUS‐TBNA for diagnosis of sarcoidosis in clinically unselected populations are excellent and compare favourably with published results from studies conducted in selected populations. High‐quality trials would be needed to evaluate factors possibly explaining the observed heterogeneity in sensitivity.
Endobronchial ultrasound learning curve in interventional pulmonary fellows
Authors: Stather David R. , Chee Alex , MacEachern Paul , Dumoulin Elaine , Hergott Christopher A. , Gelberg Jacob , Folch Eric , Majid Adnan , Gonzalez Anne V. , Tremblay Alain
Published: December 2014

Background and objective

Little published data exist regarding the learning curve for endobronchial ultrasound‐transbronchial needle aspiration (EBUS‐TBNA). We sought to assess the improvement in skill as trainees learned EBUS‐TBNA in a clinical setting.

Methods

This is a multicentre cohort study of EBUS‐TBNA technical skill of interventional pulmonology (IP) fellows as assessed with EBUS‐TBNA computer simulator testing every 25 clinical cases throughout IP fellowship training.

Results

Nine fellows from three academic centres in the United States and Canada were enrolled in the study. Ongoing improvements were seen for EBUS‐TBNA efficiency score and percentage of lymph nodes correctly identified on ultrasound exam, even after 200 clinical cases. Expert‐level technical skill was obtained for EBUS efficiency score and for percentage of lymph nodes correctly identified on ultrasound exam at a median of 212 and 164 procedures, respectively; however, 33% of fellows did not achieve expert‐level technical skill for either metric during their fellowship training. Significant variation in learning curves of the fellows was observed.

Conclusions

Significant variation is seen in the EBUS‐TBNA learning curves of individual IP fellows and for individual procedure components, with ongoing improvement in EBUS‐TBNA skill even after 200 clinical cases. These results highlight the need for validated, objective measures of individual competence, and can assist training programmes in ensuring adequate procedure volumes required for a majority of trainees to successfully complete these assessments.
Analysis of Forensic DNA Mixtures with Artefacts
Authors: Cowell R. G. , Graversen T. , Lauritzen S. L. , Mortera J.
Published: December 2014

DNA is now routinely used in criminal investigations and court cases, although DNA samples taken at crime scenes are of varying quality and therefore present challenging problems for their interpretation. We present a statistical model for the quantitative peak information obtained from an electropherogram of a forensic DNA sample and illustrate its potential use for the analysis of criminal cases. In contrast with most previously used methods, we directly model the peak height information and incorporate important artefacts that are associated with the production of the electropherogram. Our model has a number of unknown parameters, and we show that these can be estimated by the method of maximum likelihood in the presence of multiple unknown individuals contributing to the sample, and their approximate standard errors calculated; the computations exploit a Bayesian network representation of the model. A case example from a UK trial, as reported in the literature, is used to illustrate the efficacy and use of the model, both in finding likelihood ratios to quantify the strength of evidence, and in the deconvolution of mixtures for finding likely profiles of the individuals contributing to the sample. Our model is readily extended to simultaneous analysis of more than one mixture as illustrated in a case example. We show that the combination of evidence from several samples may give an evidential strength which is close to that of a single-source trace and thus modelling of peak height information provides a potentially very efficient mixture analysis.
A Hybrid Model for Combining Case–Control and Cohort Studies in Systematic Reviews of Diagnostic Tests
Authors: Chen Yong , Liu Yulun , Ning Jing , Cormier Janice , Chu Haitao
Published: December 2014

Systematic reviews of diagnostic tests often involve a mixture of case–control and cohort studies. The standard methods for evaluating diagnostic accuracy focus only on sensitivity and specificity and ignore the information on disease prevalence that is contained in cohort studies. Consequently, such methods cannot provide estimates of measures related to disease prevalence, such as population-averaged or overall positive and negative predictive values, which reflect the clinical utility of a diagnostic test. We propose a hybrid approach that jointly models the disease prevalence along with diagnostic test sensitivity and specificity in cohort studies, and sensitivity and specificity in case–control studies. To overcome the potential computational difficulties in the standard full likelihood inference of the hybrid model proposed, we propose an alternative inference procedure based on composite likelihood. Such composite-likelihood-based inference does not suffer computational problems and maintains high relative efficiency. In addition, it is more robust to model misspecifications compared with standard full likelihood inference. We apply our approach to a review of the performance of contemporary diagnostic imaging modalities for detecting metastases in patients with melanoma.
Optimal Marker-Adaptive Designs for Targeted Therapy Based on Imperfectly Measured Biomarkers
Authors: Zang Yong , Liu Suyu , Yuan Ying
Published: December 2014

Targeted therapy revolutionizes the way that physicians treat cancer and other diseases, enabling them to select individualized treatment adaptively according to the patient's biomarker profile. The implementation of targeted therapy requires that the biomarkers are accurately measured, which may not always be feasible in practice. We propose two optimal marker-adaptive trial designs in which the biomarkers are subject to measurement errors. The first design focuses on a patient's individual benefit and minimizes the treatment assignment error so that each patient has the highest probability of being assigned to the treatment that matches his or her true biomarker status. The second design focuses on the group benefit, which maximizes the overall response rate for all the patients enrolled in the trial. We develop a Wald test to evaluate the treatment effects for marker subgroups at the end of the trial and derive the corresponding asymptotic power function. Simulation studies and an application to a lymphoma cancer trial show that the optimal designs proposed achieve our design goal and obtain desirable operating characteristics.
Future Directions for Vascular Access for Hemodialysis
Authors: Roy‐Chaudhury Prabir , Kruska Lindsay
Published: December 2014

Hemodialysis vascular access is at the same time both the “Lifeline” and the “Achilles Heel” of hemodialysis. This review will initially summarize the vascular biology of dialysis vascular access dysfunction and then use this information to describe some novel and innovative ways (including advances in the process of care for vascular access) to prevent this problem.
Low Dialysate Potassium Concentration: An Overrated Risk Factor for Cardiac Arrhythmia?
Authors: Abuelo J. Gary
Published: December 2014

Serum potassium concentrations rise with dietary potassium intake between dialysis sessions and are often at hyperkalemic levels by the next session. Conversely, potassium concentrations fall during each hemodialysis, and sometimes reach hypokalemic levels by the end. Low potassium dialysate, which rapidly decreases serum potassium and often brings it to hypokalemic levels, is almost universally considered a risk factor for life‐threatening arrhythmias. While there is little doubt about the threat of lethal arrhythmias due to hyperkalemia, convincing evidence for the danger of low potassium dialysate and rapid or excess potassium removal has not been forthcoming. The original report of more frequent ventricular ectopy in early dialysis that was improved by reducing potassium removal has received very little confirmation from subsequent studies. Furthermore, the occurrence of ventricular ectopy during dialysis does not appear to predict mortality. Studies relating sudden deaths to low potassium dialysate are countered by studies with more thorough adjustment for markers of poor health. Dialysate potassium concentrations affect the excursions of serum potassium levels above or below the normal range, and have the potential to influence dialysis safety. Controlled studies of different dialysate potassium concentration and their effect on mortality and cardiac arrests have not been done. Until these results become available, I propose interim guidelines for the setting of dialysate potassium levels that may better balance risks and benefits.
Action orientation overcomes the ego depletion effect
Authors: Dang Junhua , Xiao Shanshan , Shi Yucai , Mao Lihua
Published: December 2014

It has been consistently demonstrated that initial exertion of self‐control had negative influence on people's performance on subsequent self‐control tasks. This phenomenon is referred to as the ego depletion effect. Based on action control theory, the current research investigated whether the ego depletion effect could be moderated by individuals' action versus state orientation. Our results showed that only state‐oriented individuals exhibited ego depletion. For individuals with action orientation, however, their performance was not influenced by initial exertion of self‐control. The beneficial effect of action orientation against ego depletion in our experiment results from its facilitation for adapting to the depleting task.
Massage induces an immediate, albeit short‐term, reduction in muscle stiffness
Authors: Eriksson Crommert M. , Lacourpaille L. , Heales L. J. , Tucker K. , Hug F.
Published: December 2014

Using ultrasound shear wave elastography, the aims of this study were: (a) to evaluate the effect of massage on stiffness of the medial gastrocnemius (MG) muscle and (b) to determine whether this effect (if any) persists over a short period of rest. A 7‐min massage protocol was performed unilaterally on MG in 18 healthy volunteers. Measurements of muscle shear elastic modulus (stiffness) were performed bilaterally (control and massaged leg) in a moderately stretched position at three time points: before massage (baseline), directly after massage (follow‐up 1), and following 3 min of rest (follow‐up 2). Directly after massage, participants rated pain experienced during the massage. MG shear elastic modulus of the massaged leg decreased significantly at follow‐up 1 (−5.2 ± 8.8%, P = 0.019, d = −0.66). There was no difference between follow‐up 2 and baseline for the massaged leg (P = 0.83) indicating that muscle stiffness returned to baseline values. Shear elastic modulus was not different between time points in the control leg. There was no association between perceived pain during the massage and stiffness reduction (r = 0.035; P = 0.89). This is the first study to provide evidence that massage reduces muscle stiffness. However, this effect is short lived and returns to baseline values quickly after cessation of the massage.
Pineal gland function is required for colon antipreneoplastic effects of physical exercise in rats
Authors: Frajacomo F. T. T. , de Paula Garcia W. , Fernandes C. R. , Garcia S. B. , Kannen V.
Published: December 2014

Light‐at‐night exposure enhances the risk of cancer. Colon cancer is among the most dangerous tumors affecting humankind. Physical exercise has shown positive effects against colon cancer. Here, we investigated whether pineal gland modulates antipreneoplastic effects of physical exercise in the colon. Surgical and non‐surgical pineal impairments were performed to clarify the relationship between the pineal gland activity and manifestation of colonic preneoplastic lesions. Next, a progressive swimming training was applied in rats exposed or not to either non‐surgical pineal impairment or carcinogen treatment for 10 weeks. Both surgical and non‐surgical pineal impairments increased the development of colon preneoplasia. It was further found that impairing the pineal gland function, higher rates of DNA damage were induced in colonic epithelial and enteric glial cells. Physical exercise acted positively against preneoplasia, whereas impairing the pineal function with constant light exposure disrupts its positive effects on the development of preneoplastic lesions in the colon. This was yet related to increased DNA damage in glial cells and enteric neuronal activation aside from serum melatonin levels. Our findings suggest that protective effects of physical exercise against colon cancer are dependent on the pineal gland activity.
Helping Children Help: The Relation between Maternal Scaffolding and Children's Early Help
Authors: Hammond Stuart I. , Carpendale Jeremy I. M.
Published: December 2014

Theory and empirical research suggest that parental scaffolding of children's participation in chores may contribute to the development of early helping. Sixty mother–child dyads with toddlers between 18 and 24 months of age were assessed on two measures of scaffolding (during a cleanup chore; reading an emotionally laden book together). Children's helping was assessed in five tasks with an experimenter, and children were also assessed for social approach to an unfamiliar adult as a measure of sociability, and for internal state language as a measure of social understanding. Both mothers' scaffolding of everyday helping and children's sociability uniquely predicted individual differences in children's helping. Thus, individual differences in children's helping appear early, and are associated with both temperament and with parents' efforts to support and encourage young children's helpfulness.
LOOSE FLOWER, a WUSCHEL‐like Homeobox gene, is required for lateral fusion of floral organs in Medicago truncatula
Authors: Niu Lifang , Lin Hao , Zhang Fei , Watira Tezera W. , Li Guifen , Tang Yuhong , Wen Jiangqi , Ratet Pascal , Mysore Kirankumar S. , Tadege Million
Published: December 2014

The Medicago truncatula WOX gene, STENOFOLIA (STF), and its orthologs in Petunia, pea, and Nicotiana sylvestris are required for leaf blade outgrowth and floral organ development as demonstrated by severe phenotypes in single mutants. But the Arabidopsis wox1 mutant displays a narrow leaf phenotype only when combined with the prs/wox3 mutant. In maize and rice, WOX3 homologs are major regulators of leaf blade development. Here we investigated the role of WOX3 in M. truncatula development by isolating the lfl/wox3 loss‐of‐function mutant and performing genetic crosses with the stf mutant. Lack of WOX3 function in M. truncatula leads to a loose‐flower (lfl) phenotype, where defects are observed in sepal and petal development, but leaf blades are apparently normal. The stf lfl double mutant analysis revealed that STF and LFL act mainly independently with minor redundant functions in flower development, but LFL has no obvious role in leaf blade outgrowth in M. truncatula on its own or in combination with STF. Interestingly, LFL acts as a transcriptional repressor by recruiting TOPLESS in the same manner as STF does, and can substitute for STF function in leaf blade and flower development if expressed under the STF promoter. STF also complements the lfl mutant phenotype in the flower if expressed under the LFL promoter. Our data suggest that the STF/WOX1 and LFL/WOX3 genes of M. truncatula employ a similar mechanism of action in organizing cell proliferation for lateral outgrowth but may have evolved different cis elements to acquire distinct functions.
Increased hospital costs associated with red blood cell transfusion
Authors: Trentino Kevin M. , Farmer Shannon L. , Swain Stuart G. , Burrows Sally A. , Hofmann Axel , Ienco Rinaldo , Pavey Warren , Daly Frank F.S. , Van Niekerk Anton , Webb Steven A.R. , Towler Simon , Leahy Michael F.
Published: December 2014

Background

Red blood cell (RBC) transfusion is independently associated in a dose‐dependent manner with increased intensive care unit stay, total hospital length of stay, and hospital‐acquired complications. Since little is known of the cost of these transfusion‐associated adverse outcomes our aim was to determine the total hospital cost associated with RBC transfusion and to assess any dose‐dependent relationship.

Study Design and Methods

A retrospective cohort study of all multiday acute care inpatients discharged from a five hospital health service in Western Australia between July 2011 and June 2012 was conducted. Main outcome measures were incidence of RBC transfusion and mean inpatient hospital costs.

Results

Of 89,996 multiday, acute care inpatient discharges, 4805 (5.3%) were transfused at least 1 unit of RBCs. After potential confounders were adjusted for, the mean inpatient cost was 1.83 times higher in the transfused group compared with the nontransfused group (95% confidence interval, 1.78‐1.89; p < 0.001). The estimated total hospital‐associated cost of RBC transfusion in this study was AUD $77 million (US $72 million), representing 7.8% of total hospital expenditure on acute care inpatients. There was a significant dose‐dependent association between the number of RBC units transfused and increased costs after adjusting for confounders.

Conclusion

RBC transfusions were independently associated with significantly higher hospital costs. The financial implication to hospital budgets will assist in prioritizing areas to reduce the rate of RBC transfusions and in implementing patient blood management programs.