bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Combining Plasma Exchange with Plasma Perfusion in Acute Fatty Liver of Pregnancy: A Retrospective Analysis
Authors: Ding Juan , Han Li-Ping , Lou Xiao-Ping , Geng Li-Na , Liu Dong , Yang Qin , Gao Shan
Published: January 2015

Background/Aims: Acute fatty liver of pregnancy (AFLP) is a severe liver failure condition that has limited therapeutic approaches. We aimed to evaluate the efficacy of combining plasma exchange (PE) and plasma perfusion (PP) with conventional therapy for the treatment of AFLP using a retrospective analysis. Methods: Among 22 patients with AFLP, 16 cases were treated with conventional treatment (CT group), while the other 6 cases were treated with PE and PP in addition to conventional therapy (CT+PE+PP group). Treatment efficacy was based primarily on survival and secondarily on liver and kidney functions 2 weeks after treatment. Adverse effects were also assessed at the same time point. Results: In the CT+PE+PP group, 5 (83.3%) patients improved, while 1 (16.7%) patient died of multiple organ dysfunction syndrome. In the CT group, 3 (18.75%) patients improved, while 13 (81.2%) patients died of complications. Liver and kidney functions and survival were significantly improved in the CT+PE+PP group (p < 0.05) compared to the CT group. Conclusions: Timely application of PE and PP in the early phase of AFLP may be a promising treatment to halt or reverse the progression of AFLP.
Concomitant Mycosis Fungoides and Vitiligo: How Mycosis Fungoides May Contribute to Melanocyte Destruction
Authors: Herrmann Jennifer L. , Syklawer Erica , Tarrillion Madeline , Duvic Madeleine , Hughey Lauren C.
Published: January 2015

Background: Few reports have described vitiligo developing in patients with cutaneous T-cell lymphoma (CTCL). Objective: We sought to identify possible factors that might predispose patients with CTCL to vitiligo. Methods: Patient demographics, CTCL disease characteristics and treatments were analyzed in 25 patients with CTCL who developed vitiligo. Cox proportional hazards modeling was used to identify associations of risk factors with the development of vitiligo. Results: Younger age, later CTCL disease stage (stages IIB-IV) and presence of a CD8+CD4- mycosis fungoides phenotype were associated with the development of vitiligo. After adjusting for disease stage, increased risk of vitiligo was associated with methotrexate and CD4 antibody therapies (although the total number of patients with these was small), while decreased risk was associated with nitrogen mustard and PUVA therapies. Conclusions: No single feature was common to all of our patients, suggesting that multiple factors may contribute to the development of vitiligo in a patient-specific fashion.
Endobronchialventile im Management der rezidivierenden Hämoptyse
Authors: Koegelenberg Coenraad F.N. , Bruwer Johannes W. , Bolliger Chris T.
Published: January 2015

Minimalinvasive Optionen für die Behandlung der lebensbedrohlichen Hämoptyse bei Patienten, die nicht auf medikamentöse Maßnahmen ansprechen und/oder als inoperabel eingestuft wurden, sind begrenzt. Wir beschreiben den Fall eines Patienten mit rezidivierender Hämoptyse, dem endobronchiale Ventile eingesetzt wurden, und stellen damit sowohl ein neues Anwendungsgebiet für diese Ventile als auch eine neue Behandlungsoption bei Hämoptyse vor. Der Patient ist ein 30-jähriger Mann mit bilateralen Aspergillomen in den Oberlappen, die sich nach einer Lungentuberkulose entwickelten. Der Patient war in seiner Vorgeschichte wegen lebensbedrohlicher Hämoptyse trotz wiederholter Embolisation von Bronchialarterien mehrfach stationär behandelt worden. Aufgrund der Bilateralität der Erkrankung und seiner sehr geringen Atemreserve wurde der Patient als inoperabel eingestuft. Wir identifizierten die betroffenen Segmente mittels Computertomographie-Rekonstruktion und implantierten 3 Endobronchialventile. Unser Patient blieb für 6 Monate hämoptysefrei, und es traten keine implantatassoziierten Komplikationen auf. Darüber hinaus nahm er eine mit körperlicher Arbeit verbundene Angestelltentätigkeit auf und zeigte signifikante Verbesserungen seiner funktionellen Leistungsfähigkeit. Endobronchialventile könnten daher eine gangbare mittelfristige Behandlungsoption zur Atemwegsblockade bei Patienten darstellen, die nicht auf medikamentöse Maßnahmen ansprechen und/oder als funktionell inoperabel eingestuft wurden. Prospektive Studien sind angezeigt, um die Rolle der Endobronchialventile in diesem Setting genauer zu klären.
Predictors of Hyperkalemia Risk after Hypertension Control with Aldosterone Blockade according to the Presence or Absence of Chronic Kidney Disease
Authors: Gwoo Sangeon , Kim Ye Na , Shin Ho Sik , Jung Yeon Soon , Rim Hark
Published: January 2015

Background/Aims: Aldosterone antagonists have been proven to be efficient in the management of hypertension and the reduction of proteinuria; however, they are not widely used because of the risk of hyperkalemia. We assessed the predictors of hyperkalemia risk following hypertension control using aldosterone blockade in the presence or absence of chronic kidney disease (CKD). Methods: A total of 6,575 patients with hypertension treated between January 1, 2000, and November 30, 2012, were evaluated for the safety of an aldosterone-blocking agent (spironolactone) added to preexisting blood pressure-lowering regimens. Hyperkalemia was defined as a serum potassium level ≥5.0 mEq/l. All patients used 3 mechanistically complementary antihypertensive agents, including a diuretic and a RAAS blocker. Patients were evaluated after 4 and 8 weeks of treatment. The incidence of hyperkalemia, significant renal dysfunction [a reduction of the estimated glomerular filtration rate (eGFR) ≥30%], and adverse effects was assessed. Results: The incidence of hyperkalemia in the presence or absence of CKD was 50.4 and 42.6% after 4 weeks (p = 0.001) and 3.8 and 3.0% after 8 weeks, respectively (p = 0.371). A logistic regression analysis revealed that medication, CKD, basal hyperkalemia, reduction in eGFR, and diabetes were all predictive of a hyperkalemia risk following spironolactone use. Conclusion: Spironolactone was well tolerated by selected CKD patients. The risk of serious hyperkalemia or a significant reduction of eGFR appears to be low. Strict monitoring over the first month of treatment followed by standard surveillance for angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers is suggested.
Correction of Hyper- and Hyponatraemia during Continuous Renal Replacement Therapy
Authors: Dangoisse Carole , Dickie Helen , Tovey Linda , Ostermann Marlies
Published: January 2015

Background: Severe hyper- and hyponatraemia is associated with significant risks, yet its correction can also have serious consequences when implemented too fast or inadequately. The safe correction of serum sodium levels is particularly challenging when renal replacement therapy (RRT) is required. Methods: Using 2 case scenarios, we aim to illustrate a simple method of correcting hyper- and hyponatraemia safely by step-wise manipulation of the dialysate/replacement fluid. Results: During continuous RRT, hypernatraemia can be corrected effectively and safely by adding small pre-calculated amounts of 30% NaCl to the dialysate/replacement fluid bags aiming for a [Na+] in the fluid that allows safe equilibration and correction of the serum [Na+]. To correct hyponatraemia safely, pre-calculated amounts of sterile water can be added in a step-wise manner to achieve a fluid [Na+] that equals the desired target serum [Na+]. Conclusion: During continuous RRT, the step-wise adjustment of [Na+] of dialysate/replacement fluids offers a safe and reliable method to correct sodium disorders.
A Low-Salt Diet Increases the Estimated Net Endogenous Acid Production in Nondiabetic Chronic Kidney Disease Patients Treated with Angiotensin Receptor Blockade
Authors: Baek Seon Ha , Kim Sejoong , Kim Dong Ki , Park Jung Hwan , Shin Sung Joon , Lee Sang Ho , Choi Bum Soon , Chin Ho Jun , Kim Suhnggwon , Lim Chun Soo
Published: January 2015

Background/Aims: An acid-base imbalance precedes renal disease progression in patients with chronic kidney disease (CKD). Little is known about the effects of a low-salt diet (LSD) on net endogenous acid production (NEAP) levels in CKD patients using angiotensin receptor blockade. Methods: We enrolled a total of 202 nondiabetic CKD patients who underwent an 8-week treatment with olmesartan from the original trial [Effects of Low Sodium Intake on the Antiproteinuric Efficacy of Olmesartan in Hypertensive Patients with Albuminuria (ESPECIAL) trial: NCT01552954]. The patients were divided into good- and poor-LSD-compliance groups. Results: During the interventional 8 weeks, the NEAP in the good-compliance group increased compared to the control group (12.9 ± 32.0 vs. -2.0 ± 35.0 mmol/day, p = 0.002). NEAP was positively associated with the good-LSD-compliance group in the fully adjusted analyses (r = 0.135, p = 0.016). The additional reduction of 2.39 g/day of protein intake with a reduction of 1 g/day of salt intake did not increase the NEAP under angiotensin II receptor blockade (ARB) treatment with an LSD (r = 0.546, p < 0.001). Conclusion: We found that an LSD may increase the NEAP in nondiabetic CKD patients using ARB, which suggests that additional acid producing-protein restriction should be required to prevent the NEAP from rising.
Beta-1-Adrenergic Receptors Mediate Nrf2-HO-1-HMGB1 Axis Regulation to Attenuate Hypoxia/Reoxygenation-Induced Cardiomyocytes Injury in Vitro
Authors: Wang Jichun , Hu Xiaorong , Xie Jing , Xu Weipan , Jiang Hong
Published: January 2015

Backgroud/Aims: The aim of the study was to evaluate the effects of beta1-adrenergic receptors (β1-ARs) -mediated nuclear factor erythroid 2-related factor 2 (Nrf2)-heme oxygenase-1 (HO-1)-high mobility group box 1 protein (HMGB1) axis regulation in hypoxia/reoxygenation (H/R)-induced neonatal rat cardiomyocytes. Methods: The neonatal cultured cardiomyocytes were concentration-dependently pretreated by dobutamine (DOB), a selective β1-adrenergic receptor agonist, in the absence and/or presence of LY294002 (a phosphatidylinositol 3-kinase (PI3K) inhibitor), SB203580 (a p38mitogen-activated-protein kinase (p38MAPK) inhibitor), Nrf2siRNA and HO-1siRNA, respectively, and then treated by H/R. The effects and mechanisms by which H/R-induced cardiomyocytes injury were evaluated. Results: Significant increase of HO-1 was found in neonatal cultured cardiomyocytes treated with DOB, when compared to the control group. Significant change for Nrf2 translocation was also revealed in neonatal cultured cardiomyocytes treated with DOB. Insignificant decreases of NF-kappaB p65 activation and HMGB1 release were observed in H/R-induced neonatal cultured cardiomyocytes treated with DOB, when compared to the control group. Importantly, DOB treatment significantly increased the cell viability and decreased the levels of LDH and MDA in H/R-induced cardiomyocytes injury. However, DOB failed to increase HO-1, inhibit NF-kappaB p65 activation, prevent HMGB1 release and attenuate H/R-induced cardiomyocytes injury when the cultured cardiomyocytes were pretreated by Nrf2siRNA, HO-1siRNA, PI3K inhibitor (LY294002) and p38MAPK inhibitor (SB203580), respectively. Conclusions: β1-ARs-mediated Nrf2-HO-1-HMGB1 axis regulation plays a critical protective role in H/R-induced neonatal rat cardiomyocytes injury in vitro via PI3K/p38MAPK signaling pathway.
Short-Term Nose-Only Water-Pipe (Shisha) Smoking Exposure Accelerates Coagulation and Causes Cardiac Inflammation and Oxidative Stress in Mice
Authors: Nemmar Abderrahim , Yuvaraju Priya , Beegam Sumaya , Ali Badreldin H
Published: January 2015

Background/Aim: Water-pipe smoking (WPS) has acquired worldwide popularity, and is disseminating particularly rapidly in Europe and North America. However, little is known about the short-term cardiovascular effects of WPS. Methods: Presently, we assessed the short-term cardiovascular effects of nose-only exposure to mainstream WPS in BALB/c mice for 30 min/day for 5 consecutive days. Control mice were exposed to air. At the end of the exposure period, several cardiovascular endpoints were measured. Results: WPS did not affect the number of leukocytes and the plasma concentrations of C-reactive protein, tumor necrosis factor α (TNFα) and interleukin-6 (IL-6). Likewise, plasma levels of lipid peroxidation (LPO), reduced glutathione (GSH) and catalase were not affected by WPS. By contrast, WPS aggravated in vivo thrombosis by shortening the thrombotic occlusion time in pial arterioles and venules. The number of circulating platelets was reduced by WPS suggesting the occurrence of platelet aggregation in vivo. Elevated concentrations of fibrinogen and plasminogen activator inhibitor-1 were seen after the exposure to WPS. Blood samples taken from mice exposed to WPS and exposed to adenosine diphosphate showed more platelet aggregation. The heart concentrations of IL-6 and TNFα were augmented by WPS. Likewise, heart levels of LPO, reactive oxygen species and the antioxidants catalase and GSH were increased by WPS. However, the systolic blood pressure and heart rate were not affected by WPS. Conclusion: It can be concluded that short-term exposure to WPS exerts procoagulatory effects and induce cardiac inflammation and oxidative stress. At the time point investigated, there was no evidence for blood inflammation or oxidative stress.
Uremic Toxins and Their Effects on Multiple Organ Systems
Authors: Lisowska-Myjak Barbara
Published: January 2015

Nearly all body organs and systems are affected by the toxicity of uremic compounds retained in the course of renal dysfunction. Knowledge about the origin, chemical structure and composition of the retained endogenous substances responsible for these symptoms is far from complete. Organic retention solutes present a great variety of properties which makes their accurate classification extremely difficult. Their potential toxicity remains to be elucidated with meticulous observation of clearly formulated rules guiding the process. Toxicity assessment is a complex process because not just one but several retained compounds may be simultaneously involved in the same biological and metabolic processes. The search for new uremic compounds and combining them into panels of substances involved in the same pathophysiological processes seems to offer a novel approach to identifying and explaining any so far unexplored specific effects of endogenous compounds on the body organs and systems.
Dynamic Changes in the Myometrium during the Third Stage of Labor, Evaluated Using Two-Dimensional Ultrasound, in Women with Normal and Abnormal Third Stage of Labor and in Women with Obstetric Complications
Authors: Patwardhan Manasi , Hernandez-Andrade Edgar , Ahn Hyunyoung , Korzeniewski Steven J. , Schwartz Alyse , Hassan Sonia S. , Romero Roberto
Published: January 2015

Objective: To investigate dynamic changes in myometrial thickness during the third stage of labor. Methods: Myometrial thickness was measured using ultrasound at one-minute time intervals during the third stage of labor in the mid-region of the upper and lower uterine segments in 151 patients including: women with a long third stage of labor (n = 30), postpartum hemorrhage (n = 4), preterm delivery (n = 7) and clinical chorioamnionitis (n = 4). Differences between myometrial thickness of the uterine segments and as a function of time were evaluated. Results: There was a significant linear increase in the mean myometrial thickness of the upper uterine segments, as well as a significant linear decrease in the mean myometrial thickness of the lower uterine segments until the expulsion of the placenta (p < 0.001). The ratio of the measurements of the upper to the lower uterine segments increased significantly as a function of time (p < 0.0001). In women with postpartum hemorrhage, preterm delivery, and clinical chorioamnionitis, an uncoordinated pattern among the uterine segments was observed. Conclusion: A well-coordinated activity between the upper and lower uterine segments is demonstrated in normal placental delivery. In some clinical conditions this pattern is not observed, increasing the time for placental delivery and the risk of postpartum hemorrhage.
The Association between Vitamin D Levels and Urinary Tract Infection in Children
Authors: Tekin Mehmet , Konca Capan , Celik Velat , Almis Habip , Kahramaner Zelal , Erdemir Aydin , Gulyuz Abdulgani , Uckardes Fatih , Turgut Mehmet
Published: January 2015

Aim: We aimed to examine whether there is any association between serum levels of 25-hydroxyvitamin D [25(OH)D3] and urinary tract infection (UTI) among children. Methods: White blood cell count, serum C-reactive protein, calcium, phosphorus, alkaline phosphatase, parathormone, and serum 25(OH)D3 levels were measured in 82 children experiencing a ﬁrst episode of UTI, with no risk factors for UTI, and 64 healthy control children. Results: The mean serum levels of 25(OH)D3 among children with UTI were significantly lower than those of controls (11.7 ± 3.3 vs. 27.6 ± 4.7 ng/ml; p < 0.001). The serum levels of 25(OH)D3 were significantly lower in patients with acute pyelonephritis compared to patients with lower UTI (8.6 ± 2.8 vs. 14.2 ± 3.0 ng/ml; p < 0.001). Within the study group, mean serum levels of 25(OH)D3 among girls were lower than those of boys (10.9 ± 3.4 ng/ml vs. 13.2 ± 4.4 ng/ml; p < 0.001). Multivariate analysis showed that a serum 25(OH)D3 level of <20 ng/ml (odds ratio 3.503, 95% confidence interval 1.621-7.571; p = 0.001) was associated with UTI in children. Conclusions: Our results suggest that vitamin D deficiency may be a risk factor for UTI in children.
Clinical Outcome: A Monosomy 18p is Better than a Tetrasomy 18p
Authors: Wei Jun , Xie Yingjun , He Wenyin , Liu Weiqiang , Jian Wei , Chen Min , Wang Ding , Wang Xiaoman , Sun Xiaofang
Published: January 2015

We report the clinical and laboratory data of 2 patients with different rearrangements involving the short arm of chromosome 18, one with an isochromosome 18p (tetrasomy 18p) and the other with an 18p deletion (monosomy 18p by translocation t(15;18)). Based on molecular cytogenetic findings including high-resolution SNP array, FISH, and multiplex fluorescence PCR, we compared the clinical phenotypes of the 2 patients with other reported patients with 18p deletion, trisomy 18, and isochromosome 18p syndromes to obtain genotype/phenotype correlations. Our findings suggest that a partial monosomy 18p has the better clinical outcome than a tetrasomy 18p.
Two New Cases of 1p21.3 Deletions and an Unbalanced Translocation t(8;12) among Individuals with Syndromic Obesity
Authors: D'Angelo Carla S. , Moller dos Santos Mauren F. , Alonso Luis G. , Koiffmann Celia P.
Published: January 2015

Obesity is a highly heritable but genetically heterogeneous disorder. Various well-known microdeletion syndromes (e.g. 1p36, 2q37, 6q16, 9q34, 17p11.2) can cause this phenotype along with intellectual disability (ID) and other findings. Chromosomal microarrays have identified ‘new' microdeletion/duplication syndromes often associated with obesity. We report on 2 unrelated patients with an overlapping region of deletion at 1p21.3p21.2, and a third patient with a de novo recurrent unbalanced translocation der(8)t(8;12)(p23.1;p13.31), detected by 180K array CGH in a prospective cohort of syndromic obesity patients. Deletion of 1p21.3 is a rare condition, and there have been only 11 cases of the same recurrent translocation between chromosomes 8 and 12 [t(8;12)] reported to date. The former has been associated with ID, autistic spectrum disorder (ASD) and mild dysmorphic features, and in 4 patients who were obese or had a tendency to obesity, a minimal overlapping region of 2 genes, DPYD and MIR137, was detected; t(8;12) has recently been recognized to cause a childhood obesity syndrome due to duplication of the GNB3 gene. Thus, our findings add to the existing literature on the clinical description of these new syndromes, providing additional support that these loci are associated with syndromic obesity. We suggest that heterozygous loss of MIR137 may contribute to obesity as well as ID and ASD.
Instability of Isochromosome 4p in a Child with Pure Trisomy 4p Syndrome Features and Entire 4q-Arm Translocation
Authors: Pota Pruthvi , Grammatopoulou Vasiliki , Torti Erin , Braddock Stephen , Batanian Jacqueline R.
Published: January 2015

Constitutional chromosome instability so far has mainly been associated with ring formation. In addition, isochromosome formation involving the short arm with translocation of the entire long arm is rarely observed. This type of rearrangement has been reported for chromosomes 4, 5, 7, 9, 10, 12, and 20. Here, we present the third patient having an isochromosome 4p with 4q translocation, but showing for the first time chromosome instability detected by FISH following chromosome microarray analysis.
SH2B3
Is a Genetic Determinant of Cardiac Inflammation and Fibrosis
Authors: Flister Michael J. , Hoffman Matthew J. , Lemke Angela , Prisco Sasha Z. , Rudemiller Nathan , O’Meara Caitlin C. , Tsaih Shirng-Wern , Moreno Carol , Geurts Aron M. , Lazar Jozef , Adhikari Neeta , Hall Jennifer L. , Jacob Howard J.
Published: January 2015

Background—

Genome-wide association studies are powerful tools for nominating pathogenic variants, but offer little insight as to how candidate genes affect disease outcome. Such is the case for SH2B adaptor protein 3 (
SH2B3
), which is a negative regulator of multiple cytokine signaling pathways and is associated with increased risk of myocardial infarction (MI), but its role in post-MI inflammation and fibrosis is completely unknown.

Methods and Results—

Using an experimental model of MI (left anterior descending artery occlusion/reperfusion injury) in wild-type and
Sh2b3
knockout rats (Sh2b3
em2Mcwi
), we assessed the role of
Sh2b3
in post-MI fibrosis, leukocyte infiltration, angiogenesis, left ventricle contractility, and inflammatory gene expression. Compared with wild-type, Sh2b3
em2Mcwi
rats had significantly increased fibrosis (2.2-fold;
P
<0.05) and elevated leukocyte infiltration (>2-fold;
P
<0.05), which coincided with decreased left ventricle fractional shortening (−Δ11%;
P
<0.05) at 7 days post left anterior descending artery occlusion/reperfusion injury. Despite an increased angiogenic potential in Sh2b3
em2Mcwi
rats (1.7-fold;
P
<0.05), we observed no significant differences in left ventricle capillary density between wild-type and Sh2b3
em2Mcwi
rats. In total, 12 genes were significantly elevated in the post left anterior descending artery occluded/reperfused hearts of Sh2b3
em2Mcwi
rats relative to wild-type, of which 3 (
NLRP12
,
CCR2
, and
IFNγ
) were significantly elevated in the left ventricle of heart failure patients carrying the MI-associated rs3184504 [T]
SH2B3
risk allele.

Conclusions—

These data demonstrate for the first time that
SH2B3
is a crucial mediator of post-MI inflammation and fibrosis.
Self‐Reported Cardiorespiratory Fitness: Prediction and Classification of Risk of Cardiovascular Disease Mortality and Longevity—A Prospective Investigation in the Copenhagen City Heart Study
Authors: Holtermann Andreas , Marott Jacob Louis , Gyntelberg Finn , Søgaard Karen , Mortensen Ole Steen , Prescott Eva , Schnohr Peter
Published: January 2015

Background

The predictive value and improved risk classification of self‐reported cardiorespiratory fitness (
SRCF
), when added to traditional risk factors on cardiovascular disease (
CVD
) and longevity, are unknown.

Methods and Results

A total of 3843 males and 5093 females from the Copenhagen City Heart Study without
CVD
in 1991–1994 were analyzed using multivariate Cox hazards regression to assess the predictive value and survival benefit for
CVD
and all‐cause mortality from
SRCF
. The category‐free net reclassification improvement from
SRCF
was calculated at 15‐year follow‐up on
CVD
and all‐cause mortality. Overall, 1693 individuals died from
CVD
. In the fully adjusted Cox model, those reporting the same (hazard ratio [
HR],
1.17; 95% confidence interval [
CI],
1.04 to 1.32) and lower (
HR,
1.91; 95%
CI,
1.62 to 2.24)
SRCF
than peers had an increased risk of
CVD
mortality, compared with individuals with higher
SRCF
. Compared with individuals with higher
SRCF
, those with the same and lower
SRCF
had 1.8 (95%
CI,
1.0 to 2.5) and 5.1 (95%
CI,
4.1 to 6.2) years lower life expectancy, respectively. Individuals with lower
SRCF
had a significantly increased risk of
CVD
mortality, compared with individuals with higher
SRCF,
within each strata of leisure time physical activity and self‐rated health, and
SRCF
significantly predicted
CVD
mortality independently of self‐rated health and walking pace. A net reclassification improvement of 30.5% (95%
CI,
22.1% to 38.9%) for
CVD
mortality was found when adding
SRCF
to traditional risk factors. Comparable findings were found for all‐cause mortality.

Conclusions

SRCF
has independent predictive value, is related to a considerable survival benefit, and improves risk classification when added to traditional risk factors of
CVD
and all‐cause mortality.
SRCF
might prove useful in improved risk stratification in primary prevention.
Isolated MCA Disease in Patients Without Significant Atherosclerotic Risk Factors
Authors: Ahn Sung-Ho , Lee Jookyung , Kim Yeon-Jung , Kwon Sun U. , Lee Deokhee , Jung Seung-Chai , Kang Dong-Wha , Kim Jong S.
Published: January 2015

Background and Purpose—

Diagnosis of intracranial artery atherosclerosis remains often uncertain. The high-resolution magnetic resonance imaging (HR-MRI) enables vessel wall assessment for more precise diagnoses. The aim of the present study was to investigate the etiologies of middle cerebral artery steno-occlusive disease in young adult patients with few atherosclerotic risk factors using HR-MRI.

Methods—

We prospectively studied patients who visited a tertiary hospital in Seoul, Korea, and had (1) unilateral middle cerebral artery disease (≥50% stenosis or occlusion), (2) were ≤55 years old and had no or minimal (≤1) atherosclerotic risk factors. We excluded patients with a confirmed diagnosis of Moyamoya disease, vasculitis, or dissection and those having emboligenic sources. A presumptive diagnosis was made based on HR-MRI findings, and patients were categorized as HR-athero (atherosclerotic disease), HR-MMD (Moyamoya disease), HR-dissection, or HR-vasculitis.

Results—

Among 95 patients analyzed, 26 (27.4%) had HR-athero who were more often male (
P
=0.004), smokers (
P
=0.018), and had focal stenosis (
P
=0.003) than others. As compared with the HR-athero patients, 29 HR-MMD patients were more often female (
P
<0.001) and more often had occlusive lesions (
P
=0.001) and nonfocal stenosis (
P
<0.001). The 22 HR-dissection patients tended to have hypertension less often, and the 13 HR-vasculitis patients were younger (
P
=0.004) and tended to have nonfocal stenosis.

Conclusions—

In our cohort of young patients with minimal risk factors, atherosclerosis seems to be an uncommon pathology of middle cerebral artery stenosis. HR-MRI aids us to make a more reliable diagnosis.
A molecular reappraisal of Abrothallus species growing on lichens of the order Peltigerales
Authors: Suija Ave , De los RÍOS ASUNCIÓN , PÉREZ-ORTEGA SERGIO
Published: January 2015

Species of the genus Abrothallus (Abrothallales, Dothideomycetes) are obligately lichenicolous (lichen-inhabiting) and grow on a wide variety of foliose and fruticose lichens. Bayesian Interference (BI) and Maximum Likelihood (ML) analyses of two gene loci—rDNA ITS and TEF-α—were used in order to infer the phylogenetic relationships among lineages of Abrothallus associated with hosts from the order Peltigerales (Lecanoromycetes). We found that the clade is subdivided into 13 lineages each of which can be delimited also by phenotypic criteria. Seven new species (Abrothallus boomii, A. canariensis, A. doliiformis, A. eriodermae, A. ertzii, A. etayoi and A. nephromatis) are described, two of which are known only by their asexual stage. Abrothallus welwitschii is lectotypified, and the original description is complemented. Vouauxiomyces brattii and Epinephroma kamchatica are combined within Abrothallus.
Verification of the New Nonhydrostatic Multiscale Model on the B Grid (NMMB): A View on Global Predictability of Surface Parameters
Authors: Müller Mathias D. , Janjic Zavisa
Published: January 2015

A global verification of temperature, dewpoint temperature, and wind speed for the new Nonhydrostatic Multiscale Model on the B Grid (NMMB) is computed for a 3-yr period (2010–12) using over 9000 weather stations. The raw model forecasts, as well as bias-removed MOS forecasts, are analyzed and compared to NOAA’s operational GFS. In comparison to the GFS, the NMMB forecasts of temperature, dewpoint temperature, and wind speed are about 10% better, even though the NMMB is run at much coarser resolution and does not yet have its own data assimilation system. However, as a result of several changes in the GFS during the 3-yr period, the MOS computations for GFS are not optimal. Using unbiased MOS forecasts, the global distribution of spatial predictability can be analyzed. Clear spatial patterns emerge, which are partly dependent on the variable. For temperature, the best forecasts can be made for small islands and coastlines, and a clear gradient of decreasing skill with increasing distance from the sea is visible on the continents. For wind speed, this pattern is almost reversed. Dewpoint temperature shows the largest patterns, mainly controlled by the humidity of the climate. Combining temperature, wind speed, and dewpoint temperature in a gross predictability index reveals a clear large-scale pattern. Remarkably, smaller-scale features like mountain ranges are not readily apparent in the bias-free predictability pattern, indicating that the spatial pattern of the gross predictability is controlled at the very large scales.
Serum markers in alkaptonuria: simultaneous analysis of homogentisic acid, tyrosine and nitisinone by liquid chromatography tandem mass spectrometry
Authors: Hughes Andrew T , Milan Anna M , Davison Andrew S , Christensen Peter , Ross Gordon , Gallagher James A , Dutton John J , Ranganath Lakshminarayan R
Published: January 2015

Background

Alkaptonuria is a rare debilitating autosomal recessive disorder of tyrosine metabolism, where deficiency of homogentisate 1,2-dioxygenase results in increased homogentisic acid. Homogentisic acid is deposited as an ochronotic pigment in connective tissues, especially cartilage, leading to a severe early onset form of osteoarthritis, increased renal and prostatic stone formation and hardening of heart vessels. Treatment with the orphan drug, nitisinone, an inhibitor of 4-hydroxyphenylpyruvate dioxygenase has been shown to reduce urinary excretion of homogentisic acid.

Method

A reverse phase liquid chromatography tandem mass spectrometry method has been developed to simultaneously analyse serum homogentisic acid, tyrosine and nitisinone. Using matrix-matched calibration standards, two product ion transitions were identified for each compound (homogentisic acid, tyrosine, nitisinone) and their respective isotopically labelled internal standards (13C6-homogentisic acid, d2-tyrosine, 13C6-nitisinone).

Results

Intrabatch accuracy was 94–108% for homogentisic acid, 95–109% for tyrosine and 89–106% for nitisinone; interbatch accuracy (n = 20) was 88–108% for homogentisic acid, 91–104% for tyrosine and 88–103% for nitisinone. Precision, both intra- and interbatch were <12% for homogentisic acid and tyrosine, and <10% for nitisinone. Matrix effects observed with acidified serum were normalized by the internal standard (<10% coefficient of variation). Homogentisic acid, tyrosine and nitisinone proved stable after 24 h at room temp, three freeze–thaw cycles and 24 h at 4℃. The assay was linear to 500μmol/L homogentisic acid, 2000μmol/L tyrosine and 10μmol/L nitisinone; increased range was not required for clinical samples and no carryover was observed.

Conclusions

The method developed and validated shows good precision, accuracy and linearity appropriate for the monitoring of alkaptonuria patients, pre- and post-nitisinone therapy.
A path model of smoking behaviour among senior high school students in Taiwan
Authors: Chen Yi-Chun , Huang Hui-Wen , Cheng Chung-Ping , Hsieh Hsin-Chin , Huang Chih-Ling
Published: January 2015

Objective:

The purpose of this study was to explore the ways in which social smoking expectations mediate the relationship between adolescent smoking behaviour and the smoking behaviour of family and peers.

Design:

Descriptive, cross-sectional survey.

Setting:

Taiwan, Republic of China.

Method:

The participants were 921 senior high school students who completed a questionnaire to measure smoking status, family and peer smoking and social smoking expectations. The survey was conducted from November to December in 2009. Structural equation modelling was performed to test a mediation model. Analysis was performed using PRELIS 2 and LISREL 8.7 software.

Results:

After adjusting for students’ gender, age and school type, it is clear that social expectations mediate the relationship between sibling smoking, peer smoking and adolescent smoking. The path coefficients of sibling and peer smoking on social expectations in the mediator model were moderate, β = .15–.41, p < .05, but the coefficient of social expectations on adolescent smoking was strong, β = .95, p < .001. The total indirect effects between exogenous latent variables and adolescent smoking were .54, indicating a strong association that, in this model, is explained by the mediation of social expectations.

Conclusion:

Determining the mechanisms that influence adolescent smoking is of scientific interest because knowledge of these mechanisms is a prerequisite for the development of recommendations aimed at prevention. With this knowledge, health professionals can develop smoking-prevention policies and education programmes based on reducing the mediating effect of social smoking expectations on the relationship of family smoking and peer smoking with adolescent smoking.
Sudden cardiac death with stress and restraint: The association with sudden adult death syndrome, cardiomyopathy and coronary artery disease
Authors: Krexi Lydia , Georgiou Roxani , Krexi Dimitra , Sheppard Mary N
Published: January 2015

Objective

The aim of this study was to report on sudden cardiac death (SCD) during or immediately after a stressful event in a predominately young cohort.

Methods

This study used retrospective non-case-controlled analysis. A total of 110 cases of SCD in relation to a stressful event such as altercation (45%), physical restraint (31%) in police custody (10%), exams/school/job stress (7.27%), receiving bad news (4%), or a car accident without injuries (2.73%) were retrospectively investigated. The majority of the subjects experiencing SCD were male (80.91%). The mean age was 36 ± 16 years (range 5–82 years). Twenty-three cases (20.91%) were psychiatric patients on antipsychotic medication.

Results

Fifty-three per cent of cases died with a negative autopsy and a morphologically normal heart, indicating sudden adult death which is linked to cardiac channelopathies predisposing to stress-induced SCD. Cardiomyopathy was found in 16 (14.5%) patients and coronary artery pathology in 19 (17%) patients, with atherosclerosis predominating in older patients.

Conclusions

This study highlights SCD during psychological stress, mostly in young males where the sudden death occurred in the absence of structural heart disease. This may reflect the proarrhythmic potential of high catecholamines on the structurally normal heart in those genetically predisposed because of cardiac channelopathy. Structural cardiomyopathies and coronary artery disease also feature prominently. Cases of SCD associated with altercation and restraint receive mass media attention especially when police/other governmental bodies are involved. This study highlights the rare but important risk of SCD associated with psychological stress and restraint in morphologically normal hearts and the importance of an expert cardiac opinion where prolonged criminal investigations and medico-legal issues often ensue.
Shear Wave Wavefront Mapping Using Ultrasound Color Flow Imaging
Authors: Yamakoshi Yoshiki , Kasahara Toshihiro , Iijima Tomohiro , Yuminaka Yasushi
Published: January 2015

A wavefront reconstruction method for a continuous shear wave is proposed. The method uses ultrasound color flow imaging (CFI) to detect the shear wave’s wavefront. When the shear wave vibration frequency satisfies the required frequency condition and the displacement amplitude satisfies the displacement amplitude condition, zero and maximum flow velocities appear at the shear wave vibration phases of zero and π rad, respectively. These specific flow velocities produce the shear wave’s wavefront map in CFI. An important feature of this method is that the shear wave propagation is observed in real time without addition of extra functions to the ultrasound imaging system. The experiments are performed using a 6.5 MHz CFI system. The shear wave is excited by a multilayer piezoelectric actuator. In a phantom experiment, the shear wave velocities estimated using the proposed method and those estimated using a system based on displacement measurement show good agreement.
Crawling Waves Speed Estimation Based on the Dominant Component Analysis Paradigm
Authors: Rojas Renán , Ormachea Juvenal , Salo Arthur , Rodríguez Paul , Parker Kevin J. , Castaneda Benjamin
Published: January 2015

A novel method for estimating the shear wave speed from crawling waves based on the amplitude modulation–frequency modulation model is proposed. Our method consists of a two-step approach for estimating the stiffness parameter at the central region of the material of interest. First, narrowband signals are isolated in the time dimension to recover the locally strongest component and to reject distortions from the ultrasound data. Then, the shear wave speed is computed by the dominant component analysis approach and its spatial instantaneous frequency is estimated by the discrete quasi-eigenfunction approximations method. Experimental results on phantoms with different compositions and operating frequencies show coherent speed estimations and accurate inclusion locations.
Racial Identity and Well-Being among African Americans
Authors: Hughes Michael , Kiecolt K. Jill , Keith Verna M. , Demo David H.
Published: January 2015

How racial identity influences self-esteem and psychological well-being among African Americans remains unresolved due to unexplained inconsistencies in theoretical predictions and empirical findings. Using data from the National Survey of American Life (N = 3,570), we tested hypotheses derived from social identity theory and the internalized racism perspective. Findings support social identity theory in showing that African Americans strongly identify with their group and view it very positively. In addition, those who identify more with their group and evaluate it more positively have greater self-esteem, greater mastery, and fewer depressive symptoms. However, findings also support the internalized racism perspective by showing that when group evaluation is relatively negative, racial identification is related to lower mastery and higher depressive symptoms. We conclude that both social identity theory and the internalized racism perspective are necessary for understanding how racial identity is related to self-attitudes and mental health among African Americans.
Validity arguments for diagnostic assessment using automated writing evaluation
Authors: Chapelle Carol A. , Cotos Elena , Lee Jooyoung
Published: January 2015

Two examples demonstrate an argument-based approach to validation of diagnostic assessment using automated writing evaluation (AWE). Criterion®, was developed by Educational Testing Service to analyze students’ papers grammatically, providing sentence-level error feedback. An interpretive argument was developed for its use as part of the diagnostic assessment process in undergraduate university English for academic purposes (EAP) classes. The Intelligent Academic Discourse Evaluator ( IADE) was developed for use in graduate EAP university classes, where the goal was to help students improve their discipline-specific writing. The validation for each was designed to support claims about the intended purposes of the assessments. We present the interpretive argument for each and show some of the data that have been gathered as backing for the respective validity arguments, which include the range of inferences that one would make in claiming validity of the interpretations, uses, and consequences of diagnostic AWE-based assessments.
Getting on with the rest of your life following stroke: a randomized trial of a complex intervention aimed at enhancing life participation post stroke
Authors: Mayo Nancy E , Anderson Sharon , Barclay Ruth , Cameron Jill I , Desrosiers Johanne , Eng Janice J , Huijbregts Maria , Kagan Aura , MacKay-Lyons Marilyn , Moriello Carolina , Richards Carol L , Salbach Nancy M , Scott Susan C , Teasell Robert , Bayley Mark
Published: January 2015

Objective:

To enhance participation post stroke through a structured, community-based program.

Design:

A controlled trial with random allocation to immediate or four-month delayed entry.

Setting:

Eleven community sites in seven Canadian cities.

Subjects:

Community dwelling persons within five years of stroke onset, cognitively intact, able to toilet independently.

Interventions:

Evidence-based program delivered in three 12-week sessions including exercise and project-based activities, done as individuals and in groups.

Main measures:

Hours spent per week in meaningful activities outside of the home and Reintegration to Normal Living Index; Stroke-Specific Geriatric Depression Scale, Apathy Scale, gait speed, EuroQuol EQ-5D, and Preference-Based Stroke Index. All measures were transformed to a scale from 0 to 100. Assessments prior to randomization, after the first session at three months, six months, 12 months, and 15 months.

Results:

A total of 186 persons were randomized. The between-group analysis showed no disadvantage to waiting and so groups were combined and a within-person analysis was carried out at three time points. There were statistically significant increases in all study outcomes on average over all persons. Over 45% of people met or exceeded the pre-specified target of a three hour per week increase in meaningful activity and this most often took a full year of intervention to achieve. Greatest gains were in satisfaction with community integration (mean 4.78; 95% CI: 2.01 to 7.55) and stroke-specific health-related quality of life (mean 4.14; 95% CI: 2.31 to 5.97).

Conclusions:

Community-based programs targeting participation are feasible and effective, but stroke survivors require time to achieve meaningful gains.
Both Process and Outcome Are Essential to Planning
Authors: Christensen Karen S.
Published: January 2015

The research addresses practitioners’ perspective on the theoretical debate over process versus outcome. Analysis of 119 structured interviews of exemplary planners on their roles, goals, constraints, and strategies finds support for both sides. Planners are process-oriented facilitators who use communication and networking strategies. Ninety-five percent are outcome oriented, either toward their own goals, such as equity, or their agencies’, such as affordable housing. They plan in institutionally constrained practice settings of unequal power. They tailor strategies to constraints of politics, bureaucracy, or limited resources. Thus, planners reconcile the debate, using processes to achieve valued outcomes.
Calcium polyphosphate as an additive to zinc-silicate glass ionomer cements
Authors: Valliant Esther Mae , Gagnier David , Dickey Brett Thomas , Boyd Daniel , Joseph Filiaggi Mark
Published: January 2015

Aluminum-free glass ionomer cements (GICs) are under development for orthopedic applications, but are limited by their insufficient handling properties. Here, the addition of calcium polyphosphate (CPP) was investigated as an additive to an experimental zinc-silicate glass ionomer cement. A 50% maximum increase in working time was observed with CPP addition, though this was not clinically significant due to the short working times of the starting zinc-silicate GIC. Surprisingly, CPP also improved the mechanical properties, especially the tensile strength which increased by ∼33% after 30 days in TRIS buffer solution upon CPP addition up to 37.5 wt%. This strengthening may have been due to the formation of ionic crosslinks between the polyphosphate chains and polyacrylic acid. Thus, CPP is a potential additive to future GIC compositions as it has been shown to improve handling and mechanical properties. In addition, CPP may stimulate new bone growth and provide the ability for drug delivery, which are desirable modifications for an orthopedic cement.
In vivo evaluation of bioactive PMMA-based bone cement with unchanged mechanical properties in a load-bearing model on rabbits
Authors: Fottner Andreas , Nies Berthold , Kitanovic Denis , Steinbrück Arnd , Hausdorf Jörg , Mayer-Wagner Susanne , Pohl Ulrich , Jansson Volkmar
Published: January 2015

Polymethylmethacrylate-based bone cements are widely used for fixation of joint replacements. To improve the long-term outcome, bioactive bone cements are aspired to advance the bone–cement interface. This study evaluated the in vivo properties of a new polymethylmethacrylate-based bioactive bone cement with addition of amphiphilic phosphorylated 2-hydroxyethylmethacrylate. Previous in vitro studies confirmed bioactive properties in cell culture, as well as unchanged mechanical properties are tests according to ISO 5833:2002.

Three different variations of the cement (polymethylmethacrylate + phosphorylated 2-hydroxyethylmethacrylate, polymethylmethacrylate + phosphorylated 2-hydroxyethylmethacrylate + CaCl2 and polymethylmethacrylate + phosphorylated 2-hydroxyethylmethacrylate + CaCl2 + Na2CO3) were compared to conventional polymethylmethacrylate cement. To evaluate the properties under load-bearing conditions, a spacer prosthesis was implanted into the femoral diaphysis of 24 rabbits. Additionally, a cement plug was installed into the proximal tibia. After three months, polished sections with Giemsa surface staining were prepared. The bioactivity was determined using the bone affinity index.

The sections showed a good osseointegration of the bioactive bone cement without cement cracks under load-bearing conditions. Regarding the bone affinity index, the bioactive bone cement revealed a significantly higher value in the proximal tibia (25.9–37.7%) and around the spacer prosthesis (36.8–58.9%) compared to the conventional polymethylmethacrylate cement (12.8–17.0%).

The results confirm the in vivo bioactivity of this bone cement. The absence of cement cracks indicates a sufficient mechanical stability to fix prostheses with this bioactive cement, but for a final assessment long-term tests are necessary.