bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevention of Right Heart Failure After Left Ventricular Assist Device Implantation by Phosphodiesterase 5 Inhibitor
Authors: Hamdan Righab , Mansour Hassan , Nassar Pierre , Saab Mohamad
Published: April 2014

Right ventricular (RV) function immediately after left ventricular assist device (LVAD) implantation is a crucial prognostic factor. RV failure is linked to increased mortality and worse outcome. A phosphodiesterase 5 inhibitor, sildenafil, was shown to decrease pulmonary vascular resistance and pulmonary artery pressure post‐LVAD. We report on a series of heart failure patients, and the effect of sildenafil on the incidence of RV failure after LVAD implantation. We retrospectively analyzed the data of end‐stage heart failure patients who underwent LVAD implantation with pulmonary hypertension and RV dysfunction prior to surgery. Patients were divided into two groups; group 1: patients who received sildenafil perioperatively, and group 2: patients who did not receive sildenafil. Hemodynamic and echographic data were collected before and after surgery. Fourteen patients were included, 8 patients in group 1 and 6 in group 2. Sildenafil was administered with a mean dose of 56.2 ± 9.4 mg in group 1 and was able to significantly reduce right heart failure incidence, and to demonstrate a significant reduction in pulmonary vascular resistance, pulmonary artery pressure, transpulmonary gradient, and a significant increase in cardiac output. In conclusion, sildenafil seems to have a promising role perioperatively in preventing acute RV failure postsurgery in patients with RV dysfunction and pulmonary hypertension, requiring LVAD therapy.
NOTCH1 mutations are associated with favourable long‐term prognosis in paediatric T‐cell acute lymphoblastic leukaemia: a retrospective study of patients treated on BCH‐2003 and CCLG‐2008 protocol in China
Authors: Gao Chao , Liu Shu‐Guang , Zhang Rui‐Dong , Li Wei‐Jing , Zhao Xiao‐Xi , Cui Lei , Wu Min‐Yuan , Zheng Hu‐Yong , Li Zhi‐Gang
Published: April 2014

Activating mutations of NOTCH1 are a common occurrence in T‐cell acute lymphoblastic leukaemia (T‐ALL), but its impact on T‐ALL treatment is still controversial. In this study, the incidence, clinical features, and prognosis of 92 Chinese children with T‐ALL treated using the Beijing Children's Hospital‐2003 and Chinese Childhood Leukaemia Group‐2008 protocols were analysed. NOTCH1 mutations were found in 42% of T‐ALL patients and were not associated with clinical features, prednisone response, and minimal residual disease (MRD) at day 33 and 78. However, proline, glutamate, serine, threonine (PEST)/transactivation domain (TAD) mutations were associated with younger age (15/16 mutant vs. 48/76 wild‐type, P = 0·018) and more central nervous system involvement (4/16 mutant vs. 3/76 wild‐type, P = 0·016); while heterodimerization domain (HD) mutations were associated with KMT2A‐MLLT1 (MLL‐ENL; 4/30 mutant vs. 1/62 wild‐type, P = 0·037). Furthermore, prognosis was better in patients with NOTCH1 mutations than in those with wild‐type NOTCH1 (5‐year event‐free survival [EFS] 92·0 ± 4·5% vs. 64·0 ± 7·1%; P = 0·003). Long‐term outcome was better in patients carrying HD mutations than in patients with wild‐type HD (5‐year EFS 89·7 ± 5·6% vs. 69·3 ± 6·2%; P = 0·034). NOTCH1 mutations and MRD at day 78 were independent prognostic factors. These findings indicate that NOTCH1 mutation predicts a favourable outcome in Chinese paediatric patients with T‐ALL on the BCH‐2003 and CCLG‐2008 protocols, and may be considered a prognostic stratification factor.
Charcot–Marie–Tooth disease and pathways to molecular based therapies
Authors: Harel T. , Lupski J.R.
Published: April 2014

The discovery in 1991 that chromosome 17p12 duplication is associated with Charcot–Marie–Tooth (CMT) disease marked the beginning of an era of molecular insight into this disorder, which encompasses the peripheral motor and sensory neuropathies. A mere two decades later, over 40 subtypes of CMT have been molecularly defined and many have been extensively studied in vitro and in animal models, providing the framework for a more comprehensive understanding of the biological pathways dictating myelination, axonal dynamics, and axon–glia interactions. The advent of next‐generation sequencing technologies offers opportunities in both research and clinical settings for gene discovery, further molecular understanding and diagnosis, and calls for modifications of the existing algorithms guiding genetic testing. Although treatment is mainly supportive at this time, advances in this field are anticipated as the molecular basis of CMT is unraveled.
Purulent pericarditis, multi‐site abscesses and ketoacidosis in a patient with newly diagnosed diabetes: a rare case report
Authors: Lee H.‐H. , Chu C.‐Y. , Su H.‐M. , Lin T.‐H. , Voon W.‐C. , Lai W.‐T. , Sheu S.‐H. , Hsu P.‐C.
Published: April 2014

Background

Purulent pericarditis is an acute and fulminant disease characterized by pus accumulation in the pericardial space. Its incidence has declined substantially and the common pathogen has changed since the beginning of the antibiotic era; however, it is still found in some patients with immunocompromised conditions.

Case report

We report a rare case in which the onset of diabetes mellitus presented as extremely high HbA1c concentration, ketoacidosis, multi‐site abscesses and purulent pericarditis. After antibiotic therapy and pericardiocentesis, the purulent pericarditis still did not resolve and further intrapericardial thrombolytic therapy also failed. Finally, this patient was treated successfully by surgical debridement and pericardiectomy.

Conclusion

In the immunocompromised state of severe hyperglycaemia, purulent pericarditis is a possible complication of uncontrolled infection. If purulent pericarditis cannot be cured using non‐surgical treatments, such as antibiotic therapy, pericardiocentesis and intrapericardial thrombolytic therapy, a surgical pericardiectomy should be considered to avoid morbidity and mortality.
Aging is associated with increased HbA1c levels, independently of glucose levels and insulin resistance, and also with decreased HbA1c diagnostic specificity
Authors: Dubowitz N. , Xue W. , Long Q. , Ownby J. G. , Olson D. E. , Barb D. , Rhee M. K. , Mohan A. V. , Watson‐Williams P. I. , Jackson S. L. , Tomolo A. M. , Johnson T. M. , Phillips L. S.
Published: April 2014

Aim

To determine whether using HbA1c for screening and management could be confounded by age differences, whether age effects can be explained by unrecognized diabetes and prediabetes, insulin resistance or postprandial hyperglycaemia, and whether the effects of aging have an impact on diagnostic accuracy.

Methods

We conducted a cross‐sectional analysis in adults without known diabetes in the Screening for Impaired Glucose Tolerance (SIGT) study 2005–2008 (n=1573) and the National Health and Nutrition Examination Survey (NHANES) 2005–2006 (n=1184).

Results

Both glucose intolerance and HbA1c levels increased with age. In univariate analyses including all subjects, HbA1c levels increased by 0.93 mmol/mol (0.085%) per 10 years of age in the SIGT study and by 1.03 mmol/mol (0.094%) per 10 years in the NHANES; in both datasets, the HbA1c increase was 0.87 mmol/mol (0.08%) per 10 years in subjects without diabetes, and 0.76 mmol/mol (0.07%) per 10 years in subjects with normal glucose tolerance, all P<0.001. In multivariate analyses of subjects with normal glucose tolerance, the relationship between age and HbA1c remained significant (P<0.001) after adjustment for covariates including race, BMI, waist circumference, sagittal abdominal diameter, triglyceride/HDL ratio, and fasting and 2‐h plasma glucose and other glucose levels, as assessed by an oral glucose tolerance test. In both datasets, the HbA1c of an 80‐year‐old individual with normal glucose tolerance would be 3.82 mmol/mol (0.35%) greater than that of a 30‐year‐old with normal glucose tolerance, a difference that is clinically significant. Moreover, the specificity of HbA1c‐based diagnostic criteria for prediabetes decreased substantially with increasing age (P<0.0001).

Conclusions

In two large datasets, using different methods to measure HbA1c, the association of age with higher HbA1c levels: was consistent and similar; was both statistically and clinically significant; was unexplained by features of aging; and reduced diagnostic specificity. Age should be taken into consideration when using HbA1c for the diagnosis and management of diabetes and prediabetes.
Accuracy of Conventional Transthoracic Echocardiography for the Diagnosis of Intracardiac Right‐to‐Left Shunt: A Meta‐Analysis of Prospective Studies
Authors: Mojadidi Mohammad Khalid , Winoker Jared S. , Roberts Scott C. , Msaouel Pavlos , Zaman Muhammad Omer , Gevorgyan Rubine , Tobis Jonathan M.
Published: April 2014

Background

Paradoxical embolization through a right‐to‐left shunt (RLS), often from a patent foramen ovale (PFO), has been associated with cryptogenic stroke. While transesophageal echo (TEE) bubble study is the current standard reference for diagnosing PFO, transthoracic echo (TTE) remains the most commonly used screening test for RLS due to its noninvasiveness and easy availability. The aim of this meta‐analysis was to determine the accuracy of TTE compared to TEE as the reference.

Methods and Results

A systematic review of Medline, Cochrane, and Embase was done to look for all the prospective studies assessing for intracardiac RLS using conventional TTE compared to TEE as the reference; both TTE and TEE were performed with a contrast agent and a maneuver to provoke RLS in all studies. A total of 13 studies with 1436 patients fulfilled the inclusion criteria. The weighted mean sensitivity and specificity for TTE were 46% and 99%, respectively. Likewise, the positive likelihood ratio and negative likelihood ratio were 20.85 and 0.57, respectively. Using different contrast agents, different microbubble cutoffs for a positive TTE/TEE, and different cardiac cycle cutoffs for a positive TTE/TEE did not affect the accuracy of TTE. In a population of patients with cryptogenic stroke, a TTE that tests positive for RLS has a 95% probability of being a true positive.

Conclusion

Transthoracic echocardiogram has a low sensitivity and extremely high specificity, making it a poor rule out test but an excellent rule in test for the detection of intracardiac RLS.
Personality dimensions in persons symptomatically at risk of psychosis: pronounced but lacking a characteristic profile
Authors: Schultze‐Lutter Frauke , Klosterkötter Joachim , Nikolaides Alexandra , Ruhrmann Stephan
Published: April 2014

Aim

Personality dimensions are frequently abnormal in psychosis. We examined if these abnormalities form a personality profile that is characteristic for patients symptomatically at risk of psychosis.

Methods

Four higher order personality dimensions were assessed in 104 at‐risk patients, 67 clinical and 97 healthy controls with the ‘Dimensional Assessment of Personality Pathology’, and analysed by two‐step cluster procedure to detect personality profiles. Logistic regression was used to test for predictors of profile assignment.

Results

Low and high scorers were distinguished by two profiles. Patients were more likely high scorers. The presence of clinically relevant depression, though equally frequent in clinical groups, best predicted high scorers among patients.

Conclusions

Though at‐risk patients were significantly more often high scorers, this seemed to be a general reflection of the level of psychopathology rather than a group characteristic. Thus, personality dimensions might be of little value for facilitating early detection but might be important to consider in early intervention approaches.
Isolated anti‐β2‐glycoprotein I antibodies in neurology: a frontier syndrome between multiple sclerosis and antiphospholipid syndrome?
Authors: Renaud M. , Aupy J. , Uring‐Lambert B. , Chanson J.‐B. , Collongues N. , Blanc F. , De Sèze J.
Published: April 2014

Background and purpose

Anti‐β2‐glycoprotein I (anti‐β2‐GPI) antibodies are part of the heterogeneous family of antiphospholipid antibodies and seem to be present in various neurological manifestations in addition to antiphospholipid syndrome (APS). Our objective was to analyse the clinical, radiological and therapeutic characteristics of neurological patients with positive anti‐β2‐GPI antibodies and without the Sapporo criteria for APS.

Methods

The medical records were retrospectively reviewed of 28 consecutive patients hospitalized in the Neurology Department of Strasbourg University Hospital, France, in whom anti‐β2‐GPI antibodies (immunoglobulin G and/or immunoglobulin M) were positive and other antiphospholipid antibodies negative, from November 2005 to July 2011. Clinical, radiological, biological and therapeutic data and clinical course were studied.

Results

Positive anti‐β2‐GPI antibodies were present in 28 patients. The predominant physiopathological process was mainly inflammatory (25% with myelitis, 14.3% with optic neuritis) or vascular (14.3% with cerebral ischaemia, 7.1% with cerebral vasculitis). Brain magnetic resonance imaging was performed in 89.3% of patients: atypical lesions were observed in 44% and typical inflammatory and vascular lesions in 16% and 12%, respectively.

Conclusion

The anti‐β2‐GPI antibody seems to be involved in two types of neurological disease: vascular or inflammatory ‘multiple sclerosis‐like’ disease. These two types of patients frequently develop an autoimmune disease (multiple sclerosis, systemic lupus erythematosus, APS). However, a large proportion of the patients had an undefined profile with aspecific cerebral lesions and required monitoring. This study raises questions about a separate entity at the border between APS and multiple sclerosis which remains to be better defined in a larger cohort.
Multilocus analysis of hormonal, neurotransmitter, inflammatory pathways and genome‐wide associated variants in migraine susceptibility
Authors: Ghosh J. , Pradhan S. , Mittal B.
Published: April 2014

Background and purpose

Migraine pathophysiology involves a complex interplay of processes wherein the hormonal, neurotransmitter and inflammatory pathways interact to influence the migraine phenotype. However, all studies pertaining to the role of genetic variants in migraine have been restricted to a specific pathway and none of the studies has looked into inter‐pathway genetic analysis. Our aim was to combine all the genetic variants from our previously reported studies to conduct higher order gene–gene interaction analysis using different multi‐analytical approaches.

Methods

The study group included 324 migraine patients and 134 healthy controls. The study included 20 polymorphisms from hormonal, neurotransmitter, inflammatory and genome‐wide associated variants from our published reports. Univariate and multivariate analyses were carried out by logistic regression. Classification and regression tree (CART) analysis was performed to build a decision tree via recursive partitioning. The high order genetic interactions associated with migraine risk were analyzed using multifactor dimensionality reduction (MDR).

Results

Univariate analysis revealed significant associations of polymorphisms in CYP19A1, ESR1, TNFA and PRDM16 genes with migraine susceptibility. Multiple regression analysis found significant results for four markers in CYP19A1, TNFA, ESR1 and LRP1 genes. In CART, the most prominent splitting variable was CYP19A1 polymorphism followed by TNFA, ESR1 and PRDM16 markers. The MDR analysis identified markers of CYP19A1, CYP19A1‐ TNFA, CYP19A1‐ ESR1‐ TNFA and CYP19A1‐ ESR1‐ TRPM8‐ PRDM16 as best models for one, two, three and four factors, respectively.

Conclusions

The present study suggests interactions amongst hormonal, inflammatory and genome‐wide associated variants but not with neurotransmitter pathway variants in migraine susceptibility.
Iron deposits in post‐mortem brains of patients with neurodegenerative and cerebrovascular diseases: a semi‐quantitative 7.0 T magnetic resonance imaging study
Authors: De Reuck J. L. , Deramecourt V. , Auger F. , Durieux N. , Cordonnier C. , Devos D. , Defebvre L. , Moreau C. , Caparros‐Lefebvre D. , Leys D. , Maurage C. A. , Pasquier F. , Bordet R.
Published: April 2014

Background and purpose

Accumulation of iron (Fe) is often detected in brains of people suffering from neurodegenerative diseases. However, no studies have compared the Fe load between these disease entities. The present study investigates by T2*‐weighted gradient‐echo 7.0 T magnetic resonance imaging (MRI) the Fe content in post‐mortem brains with different neurodegenerative and cerebrovascular diseases.

Methods

One hundred and fifty‐two post‐mortem brains, composed of 46 with Alzheimer's disease (AD), 37 with frontotemporal lobar degeneration (FTLD), 11 with amyotrophic lateral sclerosis, 13 with Lewy body disease, 14 with progressive supranuclear palsy, 16 with vascular dementia (VaD) and 15 controls without a brain disease, were examined. The Fe load was determined semi‐quantitatively on T2*‐weighted MRI serial brain sections in the claustrum, caudate nucleus, putamen, globus pallidus, thalamus, subthalamic nucleus, hippocampus, mamillary body, lateral geniculate body, red nucleus, substantia nigra and dentate nucleus. The disease diagnosis was made on subsequent neuropathological examination.

Results

The Fe load was significantly increased in the claustrum, caudate nucleus and putamen of FTLD brains and to a lesser degree in the globus pallidus, thalamus and subthalamic nucleus. In the other neurodegenerative diseases no Fe accumulation was observed, except for a mild increase in the caudate nucleus of AD brains. In VaD brains no Fe increase was detected.

Conclusions

Only FTLD displays a significant Fe load, suggesting that impaired Fe homeostasis plays an important role in the pathogenesis of this heterogeneous disease entity.
Bullying Victimization at School and Headache: A Meta‐Analysis of Observational Studies
Authors: Gini Gianluca , Pozzoli Tiziana , Lenzi Michela , Vieno Alessio
Published: April 2014

Background and objectives

Being bullied at school is a risk factor for a variety of negative consequences, including somatic problems. The purpose of this meta‐analysis is to determine the association between peer victimization and headache in the school‐age population.

Methods

A systematic literature search was conducted in September 2013 to identify observational studies that examined the association between being bullied and headache in children and adolescents. Odds ratios (OR) were pooled by using a random‐effects model. Moderator and sensitivity analyses were conducted.

Results

Twenty studies, including a total of 173,775 participants, satisfied the pre‐stated inclusion criteria. Fourteen studies reported data on the prevalence of headache, which was on average 32.7% (range: 9.1‐71.7%) in the bullied group and 19.1% (range: 5.3‐46.1%) in the control group. Two separate meta‐analyses of the association between being bullied and headache were performed on 3 longitudinal studies (OR = 2.10, 95% confidence interval = 1.19‐3.71) and 17 cross‐sectional studies (OR = 2.00, 95% confidence interval = 1.70‐2.35), respectively. Results showed that bullied children and adolescents have a significantly higher risk for headache compared with non‐bullied peers. In the cross‐sectional studies, the magnitude of effect size significantly decreased with the increase of the proportion of female participants in the study sample. No further moderators were statistically significant.

Conclusions

The positive association between bullying victimization and headache was confirmed. Further research on the environmental factors that may influence this symptom is needed.
Does the preoperative alpha‐fetoprotein predict the recurrence and mortality after hepatectomy for hepatocellular carcinoma without macrovascular invasion in patients with normal liver function?
Authors: Kudo Atsushi , Matsumura Satoshi , Ban Daisuke , Irie Takumi , Ochiai Takanori , Tanaka Shinji , Arii Shigeki , Tanabe Minoru
Published: April 2014

Aim

It has been highly controversial whether elevated serum α‐fetoprotein (AFP) level before hepatectomy predicts recurrence and mortality of patients with hepatocellular carcinoma (HCC) or not. This study is to identify whether the index predicts recurrence and mortality after hepatectomy in HCC.

Methods

Of 568 consecutive patients, 342 with normal liver function (Child–Pugh score, 5) and no macrovascular invasion were enrolled between April 2000 and March 2013. Multivariate analysis was performed to identify risk factors for disease‐free survival (DFS) and overall survival (OS).

Results

In multivariate analysis, the elevated serum AFP level was an independent risk factor for DFS (hazard ratio [HR], 1.9; P < 0.0001) and OS (HR, 2.0; P < 0.0001). Histological hepatic venous tumor thrombus was also an independent risk factor for DFS (HR, 2.6; P < 0.0001) and OS (HR, 2.5; P = 0.001). Anatomical resection decreases the risk factor for recurrence after hepatectomy (HR, 0.6; P = 0.003), though it did not decrease the risk for OS (P = 0.3). At 5 years, DFS rates were 42% and 21% (P < 0.0001) and OS rates were 75% and 46% among patients with low and high AFP levels, respectively (P < 0.0001). The area under the receiver–operator curves (AUROC) of serum AFP and des‐γ‐carboxy prothrombin were 0.65 and 0.58 for DFS and 0.65 and 0.57 for OS, respectively. Tumor size was the best predictor of microvascular invasion (AUROC, 0.70, P < 0.0001).

Conclusion

Serum AFP was a highly reliable index for DFS and OS.
Interferon lambda 4 polymorphism affects on outcome of telaprevir, pegylated interferon and ribavirin combination therapy for chronic hepatitis C
Authors: Nagaoki Yuko , Imamura Michio , Kawakami Yoshiiku , Kan Hiromi , Fujino Hatsue , Fukuhara Takayuki , Kobayashi Tomoki , Ono Atsushi , Nakahara Takashi , Naeshiro Noriaki , Urabe Ayako , Yokoyama Satoe , Miyaki Daisuke , Murakami Eisuke , Kawaoka Tomokazu , Tsuge Masataka , Hiramatsu Akira , Aikata Hiroshi , Takahashi Shoichi , Hayes C. Nelson , Ochi Hidenori , Chayama Kazuaki ,   Hiroshima Liver Study Group
Published: April 2014

Aim

The predictive value of the recently identified interferon‐λ (IFNL)4 polymorphism on the outcome of telaprevir (TVR), pegylated interferon (PEG IFN) plus ribavirin (RBV) combination therapy for chronic hepatitis C is unknown.

Methods

We assessed predictive factors for sustained virological response (SVR) for TVR, PEG IFN plus RBV combination therapy in 283 genotype 1 chronic hepatitis C patients. IFNL4 polymorphism ss469415590 was analyzed by Invader assay.

Results

SVR rates for patients with IFNL4 TT/TT genotype were significantly higher than for those with the IFNL4 TT/ΔG or ΔG/ΔG genotypes (93% and 59%, respectively, P < 0.0001). In a multivariate regression analysis, prior treatment history (treatment‐naïve patients or patients who relapsed during prior treatment) (odds ratio [OR], 2.385; P = 0.028), rapid virological response (OR, 6.800; P < 0.0001) and ss469415590 TT/TT genotype (OR, 8.064; P < 0.0001) were identified as significant independent predictors for SVR. In patients with IFNL4 TT/ΔG or ΔG/ΔG genotypes, SVR rates for non‐RVR patients were significantly lower than RVR patients (22% and 75%, respectively, P < 0.0001).

Conclusion

Analysis of IFNL4 polymorphism is a valuable predictor in patients receiving TVR triple therapy.
The ‘Robust’ roster: exploring the nurse rostering process
Authors: Drake Robert G.
Published: April 2014

Aim

To identify and explore the relationships between stages of the rostering process and the robustness of the worked roster.

Background

Once published, a nurse roster is often subject to many changes. However, post‐approval changes and their implications are rarely examined. Consequently, there is little evidence to determine whether a ‘worked’ roster was safe, efficient or fair. Electronic rostering systems provide greater transparency of the rostering process allowing postapproval changes to be examined more thoroughly.

Design

Using quantitative data, this study compares the outcomes from different stages of the roster process with the shifts breaking roster rules.

Methods

This study covered the period November 2009–January 2013 and included forty‐two roster periods from fifteen wards. For each of the rosters, data specifying the type of shift assignment (request, manual and automatic) and number of shifts changed after approval (response variables) were captured. Linear regression analysis was then used to identify and explore the relationships between these response variables and the number of shifts breaking rules.

Findings

Roster robustness is unaffected by the number of staff requests, Yet, how shifts are assigned before approval and the number of changes postapproval have a marked effect on the robustness of the roster.

Conclusions

Roster ‘robustness’ is determined by the quality of the approved roster and subsequent postapproval demand‐ and supply‐driven changes. Despite evidence that e‐rostering can improve roster robustness, many Ward Managers prefer to roster manually. On some wards, rosters are approved, regardless of the number of rule breakages occurring.
A quantitative systematic review of the efficacy of mobile phone interventions to improve medication adherence
Authors: Park Linda G. , Howie‐Esquivel Jill , Dracup Kathleen
Published: April 2014

Aims

To evaluate the characteristics and efficacy of mobile phone interventions to improve medication adherence. Secondary aims are to explore participants’ acceptability and satisfaction with mobile phone interventions and to evaluate the selected studies in terms of study rigour, impact, cost and resource feasibility, generalizability and implications for nursing practice and research.

Background

Medication non‐adherence is a major global challenge. Mobile phones are the most commonly used form of technology worldwide and have the potential to promote medication adherence.

Design

Guidelines from the Centre for Reviews and Dissemination were followed for this systematic review.

Data Sources

A comprehensive search of databases (PubMed, Web of Science, CINAHL, PsycInfo, Google Chrome and Cochrane) and bibliographies from related articles was performed from January 2002–January 2013 to identify the included studies.

Review Methods

A quantitative systematic review without meta‐analysis was conducted and the selected studies were critically evaluated to extract and summarize pertinent characteristics and outcomes.

Results

The literature search produced 29 quantitative research studies related to mobile phones and medication adherence. The studies were conducted for prevention purposes as well as management of acute and chronic illnesses. All of the studies used text messaging. Eighteen studies found significant improvement in medication adherence.

Conclusion

While the majority of investigators found improvement in medication adherence, long‐term studies characterized by rigorous research methodologies, appropriate statistical and economic analyses and the test of theory‐based interventions are needed to determine the efficacy of mobile phones to influence medication adherence.
Effect of Light on Biodegradation of Estrone, 17β‐Estradiol, and 17α‐Ethinylestradiol in Stream Sediment
Authors: Bradley Paul M. , Writer Jeffrey H.
Published: April 2014

Biodegradation of [A‐ring 14C] Estrone (E1), 17β‐estradiol (E2), and 17α‐ethinylestradiol (EE2) to 14CO2 was investigated under light and dark conditions in microcosms containing epilithon or sediment collected from Boulder Creek, Colorado. Mineralization of the estrogen A‐ring was observed in all sediment treatments, but not epilithon treatments. No difference in net mineralization between light and dark treatments was observed for 14C‐E2. Net mineralization of 14C‐E1 and 14C‐EE2 was enhanced in light treatments. Extents of 14CO2 accumulation and rates of mineralization were significantly greater for E2 than E1 under dark conditions, but were comparable under light conditions. These results indicate substantial differences in the uptake and metabolism of E1 and E2 in the environment and suggest biorecalcitrance of E1 relative to E2 in light‐limited environments. The extent of 14CO2 accumulation and rate of mineralization for EE2 in dark treatments were less than half of that observed for E2 and generally lower than for E1, consistent with previous reports of EE2 biorecalcitrance. However, 14CO2 accumulation and rates of mineralization were comparable for EE2, E2, and E1 under light conditions. These results indicate photoactivation and/or phototransformation/photodegradation processes can substantially enhance heterotrophic biodegradation of estrogens in sunlit environments and may play an important role in estrogen transport and attenuation.
Comparing Contaminant Removal Costs for Aquifer Recharge with Wastewater with Water Supply Benefits
Authors: Bloetscher Frederick , Pleitez Fernando , Hart James , Stambaugh David , Cooper Jon , Kennedy Karl , Sher Burack Lauren
Published: April 2014

The use of waters of impaired quality has been suggested as a means to expand available water resources supply for water‐limited communities. An ongoing concern is the safety of supplies that use wastewater because of the potential for introduction of emerging contaminants such as pharmaceuticals into drinking water supplies. Prior research into contaminants of emerging concerns (CECs) have included a variety of methods, but the only consistent removal is with reverse osmosis (RO) membranes, ultraviolet light (UV), and advanced oxidation processes (AOP). However, few of these prior studies have measurable quantities of these contaminants in the influent wastewater, so determining actual removal percentages is difficult. This project was designed to evaluate the removal of CECs to verify that a 3‐log removal of common constituents was realized. Spike testing was used to compare to prior research and to evaluate whether the project costs were competitive with other forms of reuse or other water supplies. The combination of RO/UV/AOP was effective at obtaining a 3‐log removal of CECs, but the RO and UV/AOP processes alone were not capable of removing all substances. However, despite the extensive treatment, the proposed process was both competitive cost‐wise and met the water quality goals.
Assessment of Endocrine‐Disrupting Chemicals Attenuation in a Coastal Plain Stream Prior to Wastewater Treatment Plant Closure
Authors: Bradley Paul M. , Journey Celeste A.
Published: April 2014

The U.S. Geological Survey is conducting a combined pre/post‐closure assessment at a long‐term wastewater treatment plant (WWTP) site at Fort Gordon near Augusta, Georgia. Here, we assess select endocrine‐active chemicals and benthic macroinvertebrate community structure prior to closure of the WWTP. Substantial downstream transport and limited instream attenuation of endocrine‐disrupting chemicals (EDCs) was observed in Spirit Creek over a 2.2‐km stream segment downstream of the WWTP outfall. A modest decline (less than 20% in all cases) in surface water detections was observed with increasing distance downstream of the WWTP and attributed to partitioning to the sediment. Estrogens detected in surface water in this study included estrone (E1), 17β‐estradiol (E2), and estriol (E3). The 5 ng/l and higher mean estrogen concentrations observed in downstream locations indicated that the potential for endocrine disruption was substantial. Concentrations of alkylphenol ethoxylate (APE) metabolite EDCs also remained statistically elevated above levels observed at the upstream control site. Wastewater‐derived pharmaceutical and APE metabolites were detected in the outflow of Spirit Lake, indicating the potential for EDC transport to aquatic ecosystems downstream of Fort Gordon. The results indicate substantial EDC occurrence, downstream transport, and persistence under continuous supply conditions and provide a baseline for a rare evaluation of ecosystem response to WWTP closure.
Assessing the Potential Effects of Fungicides on Nontarget Gut Fungi (Trichomycetes) and Their Associated Larval Black Fly Hosts
Authors: Wilson Emma R. , Smalling Kelly L. , Reilly Timothy J. , Gray Elmer , Bond Laura , Steele Lance , Kandel Prasanna , Chamberlin Alison , Gause Justin , Reynolds Nicole , Robertson Ian , Novak Stephen , Feris Kevin , White Merlin M.
Published: April 2014

Fungicides are moderately hydrophobic and have been detected in water and sediment, particularly in agricultural watersheds, but typically are not included in routine water quality monitoring efforts. This is despite their widespread use and frequent application to combat fungal pathogens. Although the efficacy of these compounds on fungal pathogens is well documented, little is known about their effects on nontarget fungi. This pilot study, a field survey in southwestern Idaho from April to December 2010 on four streams with varying pesticide inputs (two agricultural and two reference sites), was conducted to assess nontarget impact of fungicides on gut fungi, or trichomycetes. Tissues of larval black flies (Diptera: Simuliidae), hosts of gut fungi, were analyzed for pesticide accumulation. Fungicides were detected in hosts from streams within agricultural watersheds but were not detected in hosts from reference streams. Gut fungi from agricultural sites exhibited decreased percent infestation, density and sporulation within the gut, and black fly tissues had elevated pesticide concentrations. Differences observed between the sites demonstrate a potential effect on this symbiotic system. Future research is needed to parse out the details of the complex biotic and abiotic relationships; however, these preliminary results indicate that impacts to nontarget organisms could have far‐reaching consequences within aquatic ecosystems.
Contaminants of Emerging Concern in Fish from Western U.S. and Alaskan National Parks — Spatial Distribution and Health Thresholds
Authors: Flanagan Pritz Colleen M. , Schrlau Jill E. , Massey Simonich Staci L. , Blett Tamara F.
Published: April 2014

Remote national parks of the western U.S. and Alaska are not immune to contaminants of emerging concern. Semivolatile organic compounds (SOCs) such as pesticides and PCBs can selectively deposit from the atmosphere at higher rates in cold, high‐elevation and high‐latitude sites, potentially increasing risk to these ecosystems. In the environment, SOCs magnify up food chains and are known to increase health risks such as cancer and reproductive impairment. One hundred twenty‐eight fish in 8 national parks in Alaska and the western U.S. were analyzed for contaminant concentrations, assessed by region, and compared to human and wildlife health thresholds. SOC concentrations from an additional 133 fish from a previous study were also included, for a total of 31 water bodies sampled. PCBs, endosulfan sulfate, and p,p′‐DDE were among the most frequently detected contaminants. Concentrations of historic‐use pesticides dieldrin, p,p′‐DDE, and/or chlordanes in fish exceeded USEPA guidelines for human subsistence fish consumers and wildlife (kingfisher) health thresholds at 13 of 14 parks. Average concentrations in fish ranged from 0.6‐280 ng/g lipid (0.02‐7.3 μg/g ww). Contaminant loading was highest in fish from Alaskan and Sierra Nevada parks. Historic compounds were highest in Alaskan parks, while current‐use pesticides were higher in the Rockies and Sierra Nevada. This study provides a rigorous analysis of CECs in fish from national parks and identifies regions at potential risk.
Fathead Minnow and Bluegill Sunfish Life‐Stage Responses to 17β‐Estradiol Exposure in Outdoor Mesocosms
Authors: Elliott Sarah M. , Kiesling Richard L. , Jorgenson Zachary G. , Rearick Daniel C. , Schoenfuss Heiko L. , Fredricks Kim T. , Gaikowski Mark P.
Published: April 2014

Developmental and reproductive effects of 17β‐estradiol (E2) exposure on two generations of fathead minnows and one generation of bluegill sunfish were assessed. Fish were exposed to E2 for six continuous weeks in outdoor mesocosms simulating natural lake environments. First generation fish were exposed while sexually mature. Second generation fathead minnows were exposed either during early development, sexual maturity, or both stages. Multiple endpoints were measured to assess effects of E2 exposure on fecundity and fish health and development. Plasma vitellogenin concentrations were highly variable in all fish. Differences in egg production timing for both species indicate differences in fecundity between females exposed to E2 and controls. First generation fathead minnows exposed to E2 had lower body condition factors and reduced secondary sexual characteristic expression by males. Only a difference in relative liver weight was observed in second generation fathead minnows. First generation bluegill males exposed to E2 had significantly smaller testes compared to controls. Although fish response was highly variable, results indicate that exposure to E2 at environmentally relevant concentrations affect fathead minnow and bluegill sunfish health and development, which may have implications for the health and sustainability of fish populations. Furthermore, exposure timing and environmental factors affect fish response to E2 exposure.
Paraliparis hawaiiensis, a new species of snailfish (Scorpaeniformes: Liparidae) and the first described from the Hawaiian Archipelago
Authors: Stein D. L. , Drazen J. C.
Published: April 2014

Paraliparis hawaiiensis n.sp. is described from the north‐western Hawaiian Islands from two specimens collected at 2196 and 3055 m. It differs from other North Pacific Ocean species in its chin pore arrangement, tooth pattern and body proportions. Although liparid specimens have previously been collected from Hawaii, they were undescribed and are now lost. Therefore, this is the first liparid species described from the archipelago. In situ photographs of Hawaiian snailfishes are also shown and discussed here.
We Could Have Done a Better Job: A Qualitative Study of Medical Student Reflections on Safe Hospital Discharge
Authors: Block Lauren , Morgan‐Gouveia Melissa , Levine Rachel B. , Cayea Danelle
Published: April 2014

Because safe transitions of care are critical to patient safety, it is important to prepare physician trainees to assist in patient transitions from the hospital. As part of a discharge skills workshop for medical students, a brief reflective exercise was used to understand student perceptions of discharge problems and encourage application of classroom learning. Written reflections completed before and after the workshop were analyzed qualitatively to identify barriers to discharge observed on clinical clerkships and evaluate how the discharge skills workshop influenced student understanding of safe discharges. Students also completed a quantitative evaluation of the workshop. Seventy‐eight of the 96 students (81%) at the Johns Hopkins University School of Medicine who participated in the discharge skills workshop volunteered to submit their written reflections. Eighteen themes were identified within two domains (barriers to safe discharges and solutions to improve discharges). The most commonly cited barrier was the sense that the discharge was rushed or premature. Three of the barrier themes and six of the solution themes were related to the importance of communication and collaboration in safe discharges. Students reported that the reflective exercise personalized the learning experience (mean 3.27 ± 0.86 on a scale of 1 (not at all) to 4 (a lot)). Students observed barriers to safe discharges on their clerkships related to poor communication, insufficient time spent planning discharges, and lack of patient education. Brief reflection encouraged students to apply lessons learned in a didactic session to consider solutions for providing safer patient care.
Is There Cash in That Trash?
Authors: Paquin Raymond L. , Tilleman Suzanne G. , Howard‐Grenville Jennifer
Published: April 2014

Past work on industrial symbiosis (IS) includes a wealth of case studies across diverse settings, including industrial estates, economic regions, and IS networks. Though this work provides needed insight into factors shaping IS, much of it has been descriptive in nature. Relatively few findings have been subjected to hypothesis development and testing. In this study, we develop and empirically test a number of hypotheses on factors influencing IS exchange development, using a unique national‐level IS data set of 1,322 individual material resource‐based exchanges facilitated through the United Kingdom's National Industrial Symbiosis Programme. Our findings affirm and extend the literature in a number of ways. In particular, we found that a firm's number of identified waste streams decreased the likelihood of initiating an exchange, but increased the likelihood of completing it once initiated. We also found, counter to the literature, that diversity among partnering firms reduced the likelihood of both initiating and completing an IS exchange. Finally, we found that higher economic value exchanges were more likely to be initiated, but less likely to be completed. We discuss implications and conclude with a number of avenues for future research.
Menadione‐induced caspase‐dependent programmed cell death in the green chlorophyte Chlamydomonas reinhardtii
Authors: Sirisha V. L. , Sinha Mahuya , D'Souza Jacinta S.
Published: April 2014

Menadione, a quinone that undergoes redox cycles leading to the formation of superoxide radicals, induces programmed cell death (PCD) in animals and plants. In this study, we investigated whether the unicellular green alga Chlamydomonas reinhardtii P.A.Dangeard is capable of executing PCD upon exposure to menadione stress. We report here, the morphological, molecular, and biochemical changes after menadione exposure of C. reinhardtii cells. The effect of menadione on cell death has been shown to be dose‐dependent; 5–100 μM menadione causes 20%–46% cell death, respectively. It appears that growth is inhibited with the concomitant degradation of the photosynthetic pigments and by a decrease in the photosynthetic capacity. Being an oxidative stress, we found an H2O2 burst within 15 min of menadione exposure, followed by an increase in antioxidant enzyme (superoxide dismutase [SOD], catalase [CAT], and ascorbate peroxidase [APX]) activities. In parallel, RT‐PCR was performed for transcript analyses of Mn‐SOD, CAT, and APX. Our results clearly revealed that expression of these genes were up‐regulated upon menadione exposure. Furthermore, classical hallmarks of PCD such as alteration of mitochondrial membrane potential, significant increase in caspase‐3‐like DEVDase activity, cleavage of poly (ADP) ribose polymerase (PARP)‐1‐like enzyme, and DNA fragmentation as detected by terminal deoxynucleotidyl transferase‐mediated dUTP nick end‐labeling (TUNEL) assay and oligosomal DNA fragmentation were observed. Moreover, antibodies against a mammalian active caspase‐3 shared epitopes with a caspase‐3‐like protein of ~17 kDa; its pattern of expression and activity correlated with the onset of cell death. To the best of our knowledge, this is the first report on menadione‐induced PCD through a mitochondrian‐caspase protease pathway in an algal species.
Trochlear calcification with coexisting orbital foreign bodies: case report and literature review
Authors: Salha R. , Shah J. , Sidebottom A.J.
Published: April 2014

Asymptomatic radiodense opacities are commonly found on orbital computed tomography, and one of the causes is calcification of the trochlear apparatus. Distinction between anatomical calcifications and foreign bodies is particularly important in orbital trauma cases where misdiagnosis could lead to an inappropriate procedure. This case reports the coexistence of bilateral trochlear calcification and foreign body close to the orbit.
Spinal clearance in unconscious children following traumatic brain injury
Authors: Cullen Aidan , Terris Mark , Ford Ruth
Published: April 2014

Spinal clearance in unconscious children following traumatic brain injury is an area of controversy. The risk of significant injury in this high‐risk group needs to be balanced against that of prolonged spinal immobilization and all its implications. No national or international guideline exists to aid clinicians faced with such a scenario. This article reviews traumatic spinal injury in children looking at prevalence, risk factors, anatomical considerations, and radiological investigation. Spinal immobilization is discussed along with the use of appropriate and targeted radiological investigations to aid clearance.
Biogenic volatile organic compound emissions from vegetation fires
Authors: CICCIOLI PAOLO , CENTRITTO MAURO , LORETO FRANCESCO
Published: April 2014

The aim of this paper was to provide an overview of the current state of the art on research into the emission of biogenic volatile organic compounds (BVOCs) from vegetation fires. Significant amounts of VOCs are emitted from vegetation fires, including several reactive compounds, the majority belonging to the isoprenoid family, which rapidly disappear in the plume to yield pollutants such as secondary organic aerosol and ozone. This makes determination of fire‐induced BVOC emission difficult, particularly in areas where the ratio between VOCs and anthropogenic NOx is favourable to the production of ozone, such as Mediterranean areas and highly anthropic temperate (and fire‐prone) regions of the Earth. Fire emissions affecting relatively pristine areas, such as the Amazon and the African savannah, are representative of emissions of undisturbed plant communities. We also examined expected BVOC emissions at different stages of fire development and combustion, from drying to flaming, and from heatwaves coming into contact with unburned vegetation at the edge of fires. We conclude that forest fires may dramatically change emission factors and the profile of emitted BVOCs, thereby influencing the chemistry and physics of the atmosphere, the physiology of plants and the evolution of plant communities within the ecosystem.
UV‐B and temperature enhancement affect spring and autumn phenology in Populus tremula
Authors: STRØMME C. B. , JULKUNEN‐TIITTO R. , KRISHNA U. , LAVOLA A. , OLSEN J. E. , NYBAKKEN L.
Published: April 2014

Perennial plants growing at high latitudes synchronize growth and dormancy to appropriate seasons by sensing environmental cues. Autumnal growth cessation, bud set and dormancy induction are commonly driven by the length of photoperiod and light quality, and the responses are modified by temperature. However, although ultraviolet (UV)‐B radiation is well known to affect plant growth and development, information on the effects on bud phenology is scarce. We examined the separate and combined effects of enhanced temperature and UV‐B on autumnal bud set and spring bud break in female and male clones of Populus tremula in an outdoor experiment in Joensuu, Eastern Finland. Enhancements of UV‐B and temperature were modulated to +30% and +2 °C, respectively, from June to October 2012. Enhanced UV‐B accelerated bud set, while increased temperature delayed it. For both UV‐B and temperature, we found sex‐related differences in responsiveness. Temperature increase had a stronger delaying effect on bud maturation in male compared with female clones. Also, male clones were more responsive to UV‐B increase than female clones. Increasing autumnal temperature enhanced bud break in spring for both sexes, while UV‐B enhanced bud break in male clones. In conclusion, we found that UV‐B affected phenological shifts in P. tremula, and that temperature and UV‐B affected genders differently.