bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐term Outcomes of Infants and Children Undergoing Percutaneous Endoscopy Gastrostomy Tube Placement
Authors: McSweeney Maireade E. , Jiang Hongyu , Deutsch Amanda J. , Atmadja Melissa , Lightdale Jenifer R.
Published: July 2013

Objectives:

Little is known about long‐term outcomes of patients undergoing percutaneous endoscopic gastrostomy (PEG) placement. The purpose of this study was to examine tube‐related major complications in pediatric patients undergoing PEG placement during a 10‐year follow‐up period.

Methods:

A retrospective chart review of patients undergoing PEG placement from April 1999 through December 2000 at Boston Children's Hospital was performed. Cumulative incident rates of major complications (defined by additional hospitalization, surgical or interventional radiology procedures) as well as time between PEG placement and major complications were evaluated using Kaplan‐Meier survival analysis. Time to elective tube removal and patient mortality was also assessed.

Results:

One hundred thirty‐eight patients (59% [n = 82] boys [median age 22.5 months] [interquartile range, IQR 9–72.5], weight 9.2 kg [IQR 6.1–15.8]), underwent PEG placement during the study period and were followed at our hospital for a median of 4.98 years (IQR 1.5–8.7) years. Median time to elective tube removal was 10.2 years, with approximately half of the patients estimated to still have an indwelling enteral tube 10 years after placement. Fifteen patients (11%) had at least 1 major complication related to their gastrostomy tubes during the examined time period. The cumulative incidence of patients having a major complication was 15% (95% confidence interval 8.9–24.5) by 5.4 years.

Conclusions:

Children undergoing PEG placement have a long‐term high risk of morbidity related to enteral tubes. Major complications can occur many years after PEG placement. Larger prospective studies may be useful to assess risk factors for PEG‐related complications in pediatrics.
Changes in Prescription Patterns of Acid‐Suppressant Medications by Belgian Pediatricians
Authors: De Bruyne Pauline , Christiaens Thierry , Stichele Robert Vander , Van Winckel Myriam
Published: July 2013

Objective:

The aim of this study was to examine the trend in the prescribing of proton pump inhibitors (PPIs) and histamine 2‐receptor antagonists (H2‐RAs) for children in Belgium from 1997 to 2009 to encourage discussion regarding appropriate clinical use.

Methods:

Monthly claim–based data for PPIs and H2‐RAs were obtained from the national health insurance database (Pharmanet 1997–2009).

Results:

The total monthly volume of all reimbursed antireflux medications, prescribed by Belgian pediatricians, increased 7‐fold from 20,782 daily defined doses (DDDs) in January 1997 to 142,912 DDDs in June 2009. During this study period, reimbursed volume of H2‐RAs increased from 2575 to 38,996 DDDs and of PPIs from 3472 to 103,926 DDDs per month.

Conclusions:

PPI use has increased substantially in children. Its use does not seem to be commensurate with the prevalence of gastroesophageal reflux disease in children. This study encourages clinical discussion regarding well‐considered use of these drugs in children.
The impact of latent confounders in directed network analysis in neuroscience
Authors: Ramb Rebecca , Eichler Michael , Ing Alex , Thiel Marco , Weiller Cornelius , Grebogi Celso , Schwarzbauer Christian , Timmer Jens , Schelter Björn
Published: July 2013

In the analysis of neuroscience data, the identification of task-related causal relationships between various areas of the brain gives insights about the network of physiological pathways that are active during the task. One increasingly used approach to identify causal connectivity uses the concept of Granger causality that exploits predictability of activity in one region by past activity in other regions of the brain. Owing to the complexity of the data, selecting components for the analysis of causality as a preprocessing step has to be performed. This includes predetermined—and often arbitrary—exclusion of information. Therefore, the system is confounded by latent sources. In this paper, the effect of latent confounders is demonstrated, and paths of influence among three components are studied. While methods for analysing Granger causality are commonly based on linear vector autoregressive models, the effects of latent confounders are expected to be present also in nonlinear systems. Therefore, all analyses are also performed for a simulated nonlinear system and discussed with regard to applications in neuroscience.
Evolution of cardiorespiratory interactions with age
Authors: Iatsenko D. , Bernjak A. , Stankovski T. , Shiogai Y. , Owen-Lynch P. J. , Clarkson P. B. M. , McClintock P. V. E. , Stefanovska A.
Published: July 2013

We describe an analysis of cardiac and respiratory time series recorded from 189 subjects of both genders aged 16–90. By application of the synchrosqueezed wavelet transform, we extract the respiratory and cardiac frequencies and phases with better time resolution than is possible with the marked events procedure. By treating the heart and respiration as coupled oscillators, we then apply a method based on Bayesian inference to find the underlying coupling parameters and their time dependence, deriving from them measures such as synchronization, coupling directionality and the relative contributions of different mechanisms. We report a detailed analysis of the reconstructed cardiorespiratory coupling function, its time evolution and age dependence. We show that the direct and indirect respiratory modulations of the heart rate both decrease with age, and that the cardiorespiratory coupling becomes less stable and more time-variable.
Estimating coupling directions in the cardiorespiratory system using recurrence properties
Authors: Marwan Norbert , Zou Yong , Wessel Niels , Riedl Maik , Kurths Jürgen
Published: July 2013

The asymmetry of coupling between complex systems can be studied by conditional probabilities of recurrence, which can be estimated by joint recurrence plots. This approach is applied for the first time on experimental data: time series of the human cardiorespiratory system in order to investigate the couplings between heart rate, mean arterial blood pressure and respiration. We find that the respiratory system couples towards the heart rate, and the heart rate towards the mean arterial blood pressure. However, our analysis could not detect a clear coupling direction between the mean arterial blood pressure and respiration.
Unified asymptotic theory for all partial directed coherence forms
Authors: Baccalá L. A. , de Brito C. S. N. , Takahashi D. Y. , Sameshima K.
Published: July 2013

This paper presents a unified mathematical derivation of the asymptotic behaviour of the three main forms of partial directed coherence (PDC). Numerical examples are used to contrast PDC,
g
PDC (generalized PDC) and
i
PDC (information PDC) as to meaning and applicability and, more importantly, to show their essential statistical equivalence insofar as connectivity inference is concerned.
Cardiovascular and cardiorespiratory coupling analyses: a review
Authors: Schulz Steffen , Adochiei Felix-Constantin , Edu Ioana-Raluca , Schroeder Rico , Costin Hariton , Bär Karl-Jürgen , Voss Andreas
Published: July 2013

Recently, methods have been developed to analyse couplings in dynamic systems. In the field of medical analysis of complex cardiovascular and cardiorespiratory systems, there is growing interest in how insights may be gained into the interaction between regulatory mechanisms in healthy and diseased persons. The couplings within and between these systems can be linear or nonlinear. However, the complex mechanisms involved in cardiovascular and cardiorespiratory regulation very likely interact with each other in a nonlinear way. Recent advances in nonlinear dynamics and information theory have allowed the multivariate study of information transfer between time series. They therefore might be able to provide additional diagnostic and prognostic information in medicine and might, in particular, be able to complement traditional linear coupling analysis techniques. In this review, we describe the approaches (Granger causality, nonlinear prediction, entropy, symbolization, phase synchronization) most commonly applied to detect direct and indirect couplings between time series, especially focusing on nonlinear approaches. We will discuss their capacity to quantify direct and indirect couplings and the direction (driver–response relationship) of the considered interaction between different biological time series. We also give their basic theoretical background, their basic requirements for application, their main features and demonstrate their usefulness in different applications in the field of cardiovascular and cardiorespiratory coupling analyses.
Temporal dynamics of recovery from extinction shortly after extinction acquisition
Authors: Archbold Georgina E. , Dobbek Nick , Nader Karim
Published: July 2013

Evidence suggests that extinction is new learning. Memory acquisition involves both short-term memory (STM) and long-term memory (LTM) components; however, few studies have examined early phases of extinction retention. Retention of auditory fear extinction was examined at various time points. Shortly (1–4 h) after extinction acquisition spontaneous recovery was high compared to that after longer delays (8–24 h). Recall of a consolidated extinction trace was also impaired if it was preceded 1 h by extinction of a novel CS; propranolol did not attenuate this effect. These results suggest poor extinction retention reflects a retrieval impairment caused by the aversive experience of extinction training.
Steroid hormone (20-hydroxyecdysone) modulates the acquisition of aversive olfactory memories in pollen forager honeybees
Authors: Geddes Lisa H. , McQuillan H. James , Aiken Alastair , Vergoz Vanina , Mercer Alison R.
Published: July 2013

Here, we examine effects of the steroid hormone, 20-hydroxyecdysone (20-E), on associative olfactory learning in the honeybee, Apis mellifera. 20-E impaired the bees’ ability to associate odors with punishment during aversive conditioning, but did not interfere with their ability to associate odors with a food reward (appetitive learning). The steroid had a significant impact also on the expression of amine-receptor genes in centers of the brain involved in the formation and recall of associative olfactory memories (mushroom bodies). 20-E increased expression of the dopamine receptor gene, Amdop2, and reduced the expression of the putative dopamine/ecdysone receptor gene, Amgpcr19. Interestingly, Amgpcr19 tended to be highly expressed in the brains of foragers that exhibited strong aversive learning, but expressed at lower levels in bees that performed well in appetitive learning assays. In 2-d-old bees, transcript levels of the same gene could be reduced by queen mandibular pheromone, a pheromone that blocks aversive learning in young worker bees. As ecdysteroid levels rise to a peak ∼2 d after adult emergence and then fall to low levels in foragers, we examined aversive learning also in young worker bees. Aversive learning performance in 2-d-old bees was consistently poor. The results of this study indicate that learning in honeybees can be modulated by ecdysteroids. They highlight, in addition, a potential involvement of the putative dopamine/ecdysone receptor, AmGPCR19, in hormonal regulation of associative olfactory learning in the honeybee.
Transcriptional Dynamics of Two Seed Compartments with Opposing Roles in Arabidopsis Seed Germination
Authors: Dekkers Bas J.W. , Pearce Simon , van Bolderen-Veldkamp R.P. , Marshall Alex , Widera Paweł , Gilbert James , Drost Hajk-Georg , Bassel George W. , Müller Kerstin , King John R. , Wood Andrew T.A. , Grosse Ivo , Quint Marcel , Krasnogor Natalio , Leubner-Metzger Gerhard , Holdsworth Michael J. , Bentsink Leónie
Published: July 2013

Seed germination is a critical stage in the plant life cycle and the first step toward successful plant establishment. Therefore, understanding germination is of important ecological and agronomical relevance. Previous research revealed that different seed compartments (testa, endosperm, and embryo) control germination, but little is known about the underlying spatial and temporal transcriptome changes that lead to seed germination. We analyzed genome-wide expression in germinating Arabidopsis (Arabidopsis thaliana) seeds with both temporal and spatial detail and provide Web-accessible visualizations of the data reported (vseed.nottingham.ac.uk). We show the potential of this high-resolution data set for the construction of meaningful coexpression networks, which provide insight into the genetic control of germination. The data set reveals two transcriptional phases during germination that are separated by testa rupture. The first phase is marked by large transcriptome changes as the seed switches from a dry, quiescent state to a hydrated and active state. At the end of this first transcriptional phase, the number of differentially expressed genes between consecutive time points drops. This increases again at testa rupture, the start of the second transcriptional phase. Transcriptome data indicate a role for mechano-induced signaling at this stage and subsequently highlight the fates of the endosperm and radicle: senescence and growth, respectively. Finally, using a phylotranscriptomic approach, we show that expression levels of evolutionarily young genes drop during the first transcriptional phase and increase during the second phase. Evolutionarily old genes show an opposite pattern, suggesting a more conserved transcriptome prior to the completion of germination.
Sporothrix schenckii (sensu strict S. globosa) mating type 1‐2 (MAT1‐2) gene
Authors: Kano Rui , Anzawa Kazushi , Mochizuki Takashi , Nishimoto Katsutaro , Hiruma Masataro , Kamata Hiroshi , Hasegawa Atsuhiko
Published: July 2013

Sporotix schenckii is a pathogenic fungus that causes human and animal sporotrichosis, and based on morphology of the sessile conidia and molecular analysis, it was recently recognized as a species complex comprising at least the following six sibling species: S. albicans, S. brasiliensis, S. globosa, S. luriei, S. mexicana and S. schenckii. However, apart from S. schenckii sensu strict, only S. brasiliensis, S. globosa and S. luriei are associated with human and animal infection. S. globosa has been most commonly isolated in Asia, Europe and the USA; therefore, molecular epidemiological study for S. globosa is important in relation to human sporotrichosis in Japan. To the best of our knowledge, this is the first study to determine the mating type 1‐2 (MAT1‐2) gene of Sporothrix schenckii with the aim of understanding the taxonomy of the genus Sporothrix. The MAT1‐2 gene (1618 bp) encodes a protein sequence of 198 amino acids. Reverse transcription polymerase chain reaction analysis also detected MAT1‐2 gene mRNA expression in all of the S. schenckii strains examined, indicating that this gene is expressed in S. schenckii cells. Phylogenetic analysis of the MAT1‐2 gene fragments of Ophiostoma himal‐ulmi, O. novo‐ulmi, O. ulmi and S. schenckii indicated that these isolates could be classified into four clusters. MAT1‐1 gene‐specific polymerase chain reaction was positive in 15 isolates, but negative in four human isolates and one feline isolate.
Epithelial–mesenchymal transition of the eccrine glands is involved in skin fibrosis in morphea
Authors: Takahashi Masayuki , Akamatsu Hirohiko , Yagami Akiko , Hasegawa Seiji , Ohgo Shiroh , Abe Masamichi , Iwata Yohei , Arima Masaru , Mizutani Hiroshi , Nakata Satoru , Matsunaga Kayoko
Published: July 2013

Morphea is a type of localized scleroderma. It is a skin disease involving the development of fibrosis in the dermis and subcutaneous fat tissue beneath without a visceral lesion, and the cause is still unclear. An involvement of epithelial–mesenchymal transition (EMT) has been reported as a cause of tissue fibrosis, but this was mostly observed in pulmonary and hepatic fibrosis, and the involvement of EMT in a skin disease, morphea, has not been studied . Thus, we analyzed the involvement of EMT in skin fibrosis in morphea patients using pathological techniques. Skin lesions of six morphea patients were analyzed (five female and one male patient). As a control, non‐light‐exposed skin lesions of 11 healthy females were analyzed. Concretely, tissue samples were prepared from these subjects and subjected to immunostaining of transforming growth factor (TGF)‐β1, α‐smooth muscle actin (α‐SMA) and fibronectin, which have been reported to be associated with fibrosis, and Snail1 and E‐cadherin, which are considered to be involved in EMT, and expressions of these were analyzed. In morphea patients, dermal expression of TGF‐β1, α‐SMA and fibronectin, which are involved in fibrosis, was enhanced, and, at the same time, enhanced expression of Snail1 and reduced expression of E‐cadherin, which are involved in EMT, were observed in the dermal eccrine glands. These findings suggested the progression of EMT in the dermal eccrine glands in morphea.
Genus‐wide acid tolerance accounts for the biogeographical distribution of soil Burkholderia populations
Authors: Stopnisek Nejc , Bodenhausen Natacha , Frey Beat , Fierer Noah , Eberl Leo , Weisskopf Laure
Published: July 2013

Bacteria belonging to the genus Burkholderia are highly versatile with respect to their ecological niches and lifestyles, ranging from nodulating tropical plants to causing melioidosis and fatal infections in cystic fibrosis patients. Despite the clinical importance and agronomical relevance of Burkholderia species, information about the factors influencing their occurrence, abundance and diversity in the environment is scarce. Recent findings have demonstrated that pH is the main predictor of soil bacterial diversity and community structure, with the highest diversity observed in neutral pH soils. As many Burkholderia species have been isolated from low pH environments, we hypothesized that acid tolerance may be a general feature of this genus, and pH a good predictor of their occurrence in soils. Using a combination of environmental surveys at trans‐continental and local scales, as well as in vitro assays, we show that, unlike most bacteria, Burkholderia species have a competitive advantage in acidic soils, but are outcompeted in alkaline soils. Physiological assays and diversity analysis based on 16S rRNA clone libraries demonstrate that pH tolerance is a general phenotypic trait of the genus Burkholderia. Our results provide a basis for building a predictive understanding of the biogeographical patterns exhibited by Burkholderia sp.
Video Use and the Student Learning Experience in Politics and International Relations
Authors: Holland Jack
Published: July 2013

This article explores video use and the student learning experience in Politics and International Relations (IR). The study brings together and builds on two extant literatures – on deep learning and visual literacy – in order to explore how students make use of three types of video: lecture summaries, current affairs clips and fictional television. Questionnaire and focus group data generate a nuanced picture, with distinct implications for the learning experience. The article shows how different types of video can be linked to the development of different skills for different students.
Bully/victim problems among Greek pupils with special educational needs: associations with loneliness and self‐efficacy for peer interactions
Authors: Andreou Eleni , Didaskalou Eleni , Vlachou Anastasia
Published: July 2013

This study explores the prevalence of different types of bullying and victimisation among Greek pupils receiving special education support provision. Associations of these types with feelings of loneliness and perceived social efficacy for peer interactions are also examined. The sample consisted of 178 students of fifth and sixth primary school grades who participated in pull‐out special education delivery programmes. Participants were found to be actively involved in both bullying and victimisation, with higher rates in victimisation. Statistically significant gender and disability differences in bullying and loneliness were identified. Both bullying and victimisation were associated with loneliness/social dissatisfaction, and self‐efficacy for peer interactions. Moreover, our data provided evidence that bully/victims may be a distinct group in terms of their increased levels of loneliness. Results are discussed in terms of their implications for promoting children with special educational needs and disabilities social inclusion.
Dissecting Earnings Recognition Timeliness
Authors: BALL RYAN T. , EASTON PETER
Published: July 2013

We dissect the portion of stock price change of the fiscal year that is recognized in reported accounting earnings of the year. We call this portion earnings recognition timeliness (ERT). The emphasis in our dissection is on empirical identification of two fundamental precepts of financial accounting: (1) the matching principle, which is manifested in the recognition of expenses in the same period as the related benefits (i.e., sales revenue) accrue; and (2) recognition of expenses in the current period due to changes in expectations regarding earnings of future periods (we refer to these expenses as the expectations element of expenses). Although the expectations element has implicitly been at the core of much of the recent empirical literature on asymmetry in the earnings/return relation, it has not been explicitly identified. This recent literature is based on the premise that bad news about the future leads to more recognition of expenses in the current period (such as write‐downs) whereas good news about the future tends to have a much lesser effect on expenses of the current period; asymmetry in the expenses/return relation is captured implicitly via the observation of asymmetry in the earnings/return relation (i.e., asymmetry in ERT). Since the ERT reflects the relation between sales revenue and returns, matched expenses and returns, as well as the relation between the expectations element of expenses and returns, a focus on the expectations element may lead to sharper inferences. Our straightforward empirical procedure permits a focus on this element.
Taxonomic review of Mycetophagidae Leach (Coleoptera: Tenebrionoidea) in Korea with their host fungi
Authors: Jung Boo Hee , Park Hae Chul
Published: July 2013

A taxonomic review of the fungivorous Korean Mycetophagidae is presented. Nine species in four genera belonging to two tribes are presented in Korea. Four species, Eulagius ussuriensis Nikitsky, Litargus japonicus Reitter, Mycetophagus irroratus (Reitter), and Mycetophagus pustulosus (Reitter), are newly recorded in Korea. Most species are associated with the fruiting bodies of higher fungi, fungus‐grown bark, and mold contaminated materials. In addition, we provide information on host‐fungi records of Korean mycetophagid species.
Hepatic contrast‐enhanced ultrasound: Impact of its introduction in the Australian context
Authors: Won So Yeun , Singh Neha , Lim Beng Ghee , Stella Damien , Gibson Robert
Published: July 2013

Introduction

Contrast‐enhanced ultrasound (CEUS) is a relatively new imaging modality in Australia. We discuss our early experience with CEUS at Royal Melbourne Hospital in assessment of focal liver lesions and its clinical impact.

Method

Radiology department and hospital computerised information systems were used to identify and collate information regarding the indication, previous and follow‐up imaging, CEUS findings and subsequent final diagnoses of patients who underwent hepatic CEUS from 12/12/2007 to 20/4/2012.

Results

A total of 388 hepatic CEUS were performed, examining 409 lesions. The cases were grouped as either ‘initial study’ or ‘follow‐up’ group, with main focus on the former group. Of the 367 lesions in the ‘initial study’ group, CEUS was able to distinguish benign from malignant pathology in 344 cases (93.8%). This was especially beneficial in setting of known malignancy with indeterminate liver lesions found on CT to confidently exclude metastatic disease. For 124 of 162 patients who had an incidentally detected indeterminate liver lesion, CEUS was the final imaging investigation required to make a diagnosis.

Conclusion

CEUS is a valuable tool in assessment of focal liver lesions in conjunction with other conventional modalities in a variety of clinical settings. In particular, it provided definitive diagnosis in a significant proportion of incidentally identified liver lesions many of which are benign, saving patient anxiety and further unnecessary follow‐up.
Importance of mentoring in Australian radiology training
Authors: Rhodes Alexander
Published: July 2013

Mentoring is widely accepted as a fundamental component of a number of professions; however, mentoring is underutilized, and its practice is poorly instituted in most Australian radiology training programmes. This article highlights the benefits of mentoring within the radiology training context. Potential barriers to successful mentoring are elucidated, and future pathways for improved implementation and application of mentor programmes with radiology training programmes are presented.
Deep resequencing of 17 glutamate system genes identifies rare variants in DISC1 and GRIN2B affecting risk of opioid dependence
Authors: Xie Pingxing , Kranzler Henry R. , Krystal John H. , Farrer Lindsay A. , Zhao Hongyu , Gelernter Joel
Published: July 2013

The N‐methyl‐D‐aspartate (NMDA) glutamate receptors play important roles in the pathophysiology of substance dependence (SD), but no strong genetic evidence has associated common variants in NMDAR‐related genes to SD. We hypothesized that rare variants (RVs) with minor allele frequency <1% in the NMDAR‐related genes might exert large effects on SD risk. We sequenced 34 544 bp of coding and flanking intronic regions of 17 genes involved in the NMDA system in 760 subjects, all with co‐occurring alcohol dependence, cocaine dependence and opioid dependence (OD), and 760 healthy control subjects. One hundred percent of the target regions were sequenced at >1000× coverage. We identified 454 variants, including 380 RVs. Based on case‐control allele count differences, we genotyped 11 exonic RVs in 6751 additional subjects, and the 1520 subjects from the sequencing stage for validation. All alleles of the 11 RVs called in the sequencing stage were confirmed. We found a statistically significant association of the 11 RVs with OD in African Americans (P = 0.00080). Results from gene‐based association tests showed that the association signal derived mostly from DISC1 (P = 0.0010) and GRIN2B (P = 0.00085). DISC1 is a well‐validated schizophrenia risk gene. This is the first demonstration that RVs affect the risk of OD and the first demonstration of biological convergence of schizophrenia and OD risk—via DISC1.
Comparison of the Baska® mask with the single‐use laryngeal mask airway in low‐risk female patients undergoing ambulatory surgery
Authors: Alexiev V. , Ochana A. , Abdelrahman D. , Coyne J. , McDonnell J. G. , O'Toole D. P. , Neligan P. , Laffey J. G.
Published: July 2013

We compared the Baska® mask with the single‐use classic laryngeal mask airway (cLMA) in 150 females at low risk for difficult tracheal intubation in a randomised, controlled clinical trial. We found that median (IQR [range]) seal pressure was significantly higher with the Baska mask compared with the cLMA (40 (34–40 [16–40]) vs 22 (18–25 [14–40]) cmH2O, respectively, p < 0.001), indicating a better seal. In contrast, the first time success rate for insertion of the Baska mask was lower than that seen with the cLMA (52/71 (73%) vs 77/99 (98%), respectively, p < 0.001). There were no differences in overall device insertion success rates (78/79 (99%) vs 68/71 (96%), respectively, p = 0.54). The Baska mask proved more difficult to insert, requiring more insertion attempts, taking longer to insert and had higher median (IQR [range]) insertion difficulty scores (1.6 (0.8–2.2 [0.1–5.6]) vs 0.5 (0.3–1.4 [0.1–4.0]), respectively, p < 0.001). There was also an increased rate of minor blood staining of the Baska mask after removal, but there were no differences in other complication rates, such as laryngospasm, or in the severity of throat discomfort. In conclusion, in clinical situations where the seal with the glottic aperture takes priority over ease of insertion, the Baska mask may provide a useful alternative to the cLMA.
Vascular trauma in Western Australia: a comparison of two study periods over 15 years
Authors: Friend Jikol , Rao Sudhakar , Sieunarine Kishore , Woodroof Paul
Published: July 2013

Background

Royal Perth Hospital (RPH) has become Western Australia's only designated adult major trauma facility since a previous study of vascular trauma was conducted in 2001 at the same facility. The aim of this study is to identify changes in vascular trauma patterns over the two study periods and compare these changes with international literature.

Methods

All individuals presenting to RPH between January 2000 and December 2010 with vascular injury were identified from a prospective trauma database for this descriptive study. Injuries were classified using the Abbreviated Injury Score (AIS).

Results

The incidence of vascular trauma as a percentage of total trauma increased over the two study periods. The current 10‐year study included 45 164 patients on the trauma database, of which 1205 patients (2.6%) sustained 1335 vascular injuries, an increase from 1% in the previous 5‐year study at the same facility. Males aged 20–29 years were more frequently injured. Blunt trauma occurred more frequently than penetrating. The extremities, particularly the upper limbs were most commonly injured. The most common causes of injury for each region were as follows; motorbike crash (MBC), motor vehicle crash (MVC) and stabbing (neck, thorax and abdomen), MBC and MVC (lower limb) and piercing injuries (upper limb). Injury Severity Score (ISS) and mortality 43% (32 of 75) were highest for thoracic injuries, particularly thoracic aorta injury. Mortality rate has decreased.

Conclusion

Vascular injuries in Western Australia are increasing. MVC are the most common cause of life threatening injury. Road safety interventions targeting young males are likely to reduce trauma.
Polymorphisms in the IRF‐4 gene, asthma and recurrent bronchitis in children
Authors: Pinto L. A. , Michel S. , Klopp N. , Vogelberg C. , von Berg A. , Bufe A. , Heinzmann A. , Laub O. , Simma B. , Frischer T. , Genuneit J. , Gorski M. , Illig T. , Kabesch M.
Published: July 2013

Background

Interferon‐regulatory factors (IRFs) play a crucial role in immunity, not only influencing interferon expression but also T cell differentiation. IRF‐4 was only recently recognized as a further major player in T cell differentiation.

Objective

As IRF‐1 polymorphisms were shown to be associated with atopy and allergy, we comprehensively investigated effects of IRF‐4 variants on allergy, asthma and related phenotypes in German children.

Methods

Fifteen tagging single nucleotide polymorphisms (SNPs) in the IRF‐4 gene were genotyped by MALDI‐TOF MS in the cross‐sectional ISAAC phase II study population from Munich and Dresden (age 9–11; N = 3099). Replication was performed in our previously established genome‐wide association study (GWAS) data set (N = 1303) consisting of asthma cases from the Multicenter Asthma Genetic in Childhood (MAGIC) study and reference children from the ISAAC II study.

Results

SNPs were not significantly associated with asthma but with bronchial hyperresponsiveness, atopy and, most interestingly, with recurrent bronchitis in the first data set. The IRF‐4 variant rs9378805 was associated with recurrent bronchitis in the ISAAC population and replicated in the GWAS data set where further SNPs showed associations with recurrent bronchitis and asthma.

Conclusions

We found genetic associations in IRF‐4 to be associated with recurrent bronchitis in our two study populations. Associated polymorphisms are localized in a putative regulatory element in the 3′UTR region of IRF‐4. These findings suggest a putative role of IRF‐4 in the development of bronchitis.
Coring‐out fistulectomy with a newly designed ‘fistulectome’ for complicated perianal fistulae: a retrospective clinical analysis
Authors: Tasci I. , Erturk S. , Alver O.
Published: July 2013

Aim

Conventional surgery for complex anal fistula (AF) is associated with continence disturbance and recurrence. In the hope of reducing these we developed a new mechanical device, the ‘fistulectome’, to excise the entire fistula tract.

Method

Between March 2001 and April 2011, 136 patients underwent surgery for a complex AF using the fistulectome. All fistulae were cryptoglandular in origin. Five patients were lost to follow up and were excluded from the analysis.

Results

Of the 131 fistulae, 76 were trans‐sphincteric, 14 were suprasphincteric and 16 were extrasphincteric. Seven had a horseshoe extension and 18 were unclassified. Of the 131, 108 had recurred after conventional fistulotomy performed at another centre and 23 were primary. The mean duration of follow up was 34.6 months, the mean hospital stay was 5 days and the healing time was 14 days. Recurrence, flatus incontinence and soiling occurred in 17 (12.9%), four (3.5%) and two (1.52%) patients.

Conclusion

The results of this series suggest that coring‐out of a fistula using a fistulectome may be a valid treatment for complicated anal fistula.
Coloration properties and clearability of phthalimide‐derived monoazo disperse dyes containing ester groups
Authors: Choi Jae‐Hong , Choi Jong‐Yoon , Kim Eun‐Mi , Kim Jae‐Pil , Towns Andrew D , Yoon Chun
Published: July 2013

The coloration properties and clearability of disperse dyes prepared from phthalimide‐derived diazo components and a coupling component containing two carboxylic acid ester groups have been investigated. Members of the series featured C2–C4 alkyl substituents on their phthalimidyl nitrogen atom. The nature of the N‐alkyl group made no consistent difference to dye uptake on polyester. No correlation was found between percentage exhaustion and calculated solubility parameters. Wash fastness was extremely good. Comparison with analogues indicated that the diester motif was of significant extra benefit to wash fastness for phthalimide‐derived dyes, but did not increase photostability above the lower range of commercial acceptability. Clearability was compared with that of dyes lacking one or both hydrolysable structural features, as well as with that of some industrial dyes. The novel dyes exhibited a greater tendency to be solubilised, consistent with hydrolysis of their ester and/or phthalimide functionalities.
Multipurpose use of the ‘bear claw’ (over‐the‐scope‐clip system) to treat endoluminal gastrointestinal disorders
Authors: Mönkemüller Klaus , Peter Shajan , Toshniwal Jay , Popa Daniel , Zabielski Marzena , Stahl Richard D. , Ramesh Jayapal , Wilcox C. Mel
Published: July 2013

Background and Aim

The ‘bear‐claw’ or over‐the‐scope‐clip system (OTSC; Ovesco Endoscopy, Tübingen, Germany) is a new clipping device developed for closure of large luminal gastrointestinal (GI) defects. The aim of the present study was to evaluate the clinical outcomes of patients treated with the OTSC.

Methods

The present study was an observational, open‐label, retrospective, single‐arm case series conducted at two hospitals with tertiary care endoscopy. It involved 20 clip applications in 16 patients (median age 65.8 years [range 51–90 years], seven women) with GI defects from fistulas and anastomotic dehiscence and peptic ulcer bleeding.

Results

The range of indications included gastrointestinal bleeding (n = 6), gastrocutaneous fistulas (n = 3), esophagotracheal and/or esophagopleural fistulae (n = 3), resection ofsubmucosal tumor (n = 2), stent fixation (n = 1), and anastomotic leak after esophagectomy (n = 1). The overall success rate for the OTSC device was 75% (12 out of 16 patients). The overall per case success rate was 70% (14 of 20 applications). Mean follow up was 10 months (range 1–10). There were no complications (0%) related to endoscopy, sedation or application of the clipping device.

Conclusions

The OTSC system is a useful device in a variety of clinical scenarios including the management of larger GI leaks and fistulas, GI bleeding, full‐thickness resection of tumors, and stent anchoring, even in very old and frail patients.
Pharmacokinetics, safety and tolerability of empagliflozin, a sodium glucose cotransporter 2 inhibitor, in patients with hepatic impairment
Authors: Macha S. , Rose P. , Mattheus M. , Cinca R. , Pinnetti S. , Broedl U. C. , Woerle H. J.
Published: July 2013

Aims

This open‐label, parallel‐group study investigated the effect of various degrees of hepatic impairment on the pharmacokinetics, safety and tolerability of the sodium glucose cotransporter 2 inhibitor empagliflozin.

Methods

Thirty‐six subjects [8 each with mild, moderate or severe hepatic impairment (Child–Pugh classification), and 12 matched controls with normal hepatic function] received a single 50 mg dose of empagliflozin.

Results

Empagliflozin was rapidly absorbed. After reaching peak levels, plasma drug concentrations declined in a biphasic fashion. Compared with subjects with normal hepatic function, geometric mean ratios (90% confidence interval) of AUC0–∞ and Cmax were 123.15% (98.89–153.36) and 103.81% (82.29–130.95), respectively, in patients with mild hepatic impairment, 146.97% (118.02–183.02) and 123.31% (97.74–155.55), respectively, in patients with moderate hepatic impairment, and 174.70% (140.29–217.55) and 148.41% (117.65–187.23), respectively, in patients with severe hepatic impairment. Adverse events, all mild or moderate in intensity, were reported in three subjects with moderate hepatic impairment, two subjects with severe hepatic impairment and six subjects with normal hepatic function.

Conclusions

Empagliflozin was well tolerated in subjects with hepatic impairment. Increases in empagliflozin exposure were less than twofold in patients with hepatic impairment; therefore no dose adjustment of empagliflozin is required in patients with hepatic impairment.
Unstimulated whole salivary flow rate and anxiolytics intake are independently associated with oral Candida infection in patients with oral lichen planus
Authors: Bokor‐Bratic Marija , Cankovic Milos , Dragnic Natasa
Published: July 2013

Many factors have been proposed to influence oral infection with yeast. The aim of this study was to determine the prevalence of oral yeasts in oral lichen planus (OLP) patients and control subjects, and to perform a multiple logistic regression analysis to identify factors that influence oral Candida infection in OLP patients. In this cross‐sectional study, 90 new patients with OLP and 90 sex‐ and age‐matched control subjects with no mucosal lesions were interviewed about their health status, use of medication, and smoking and alcohol habits. Swab and unstimulated whole saliva samples were collected and salivary pH was measured. A positive Candida culture was more prevalent among OLP patients (48.9%) than among control subjects (26.7%). Candida albicans was the most frequently isolated species in both groups. By logistic regression analysis, unstimulated whole salivary flow rates of 0.11–0.24 ml min−1 (OR = 5.90) and 0.25–0.32 ml min−1 (OR = 3.51) and benzodiazepine anxiolytics intake (OR = 8.30) were independently associated with the presence of Candida among OLP patients. Age, denture wearing, levels of dentition, decreased salivary pH, antihypertensive drugs, and alcohol consumption were not associated with oral Candida infection in OLP patients. The results indicate that data on benzodiazepine anxiolytics intake and evaluation of unstimulated whole salivary flow rate should be considered as part of the clinical evaluation to identify OLP patients at risk for Candida infection.
Image‐driven electronic identification keys for invasive plant species in the Netherlands
Authors: van Valkenburg J. L. C. H. , Duistermaat H. , Boer E.
Published: July 2013

For several years work has been ongoing to compile information to facilitate the identification of non‐native plants that (potentially) pose a threat to the biodiversity of the ecozone comprising Northern Germany, the Netherlands, Belgium and North‐Western France. Such identification information may also be used for species that are regulated by other countries and are likely to be present as contaminants in commercial exports originating from the Netherlands. This information system comprises a set of interactive image‐driven identification keys for invasive plants at various growth stages for use in a range of different situations: seed contaminants in bird feed, weeds in bonsai plants, seedling identification, identification keys of invasive terrestrial plants and invasive aquatic plants. The advantage of image‐driven identification keys using a multiple entry system lies in limiting misunderstandings in terminology and failure in identification, in the absence of certain characters, as is sometimes the case in dichotomous keys. The interactive keys are linked to the species information in the Q‐bank database, including datasheets, worldwide distribution maps, specimen level information, barcodes of selected species, etc. This information is now available at http://www.q-bank.eu/Plants/
Validation of morphological keys for identification of Bursaphelenchus xylophilus (Nematoda, Parasitaphelenchidae) to group and species level
Authors: Sarniguet C. , Buisson A. , Anthoine G.
Published: July 2013

Official analyses undertaken in the framework of an official survey, or import controls need reliable results. This can be achieved by using validated methods. For morphological tests, this validation process is rarely illustrated despite guidance provided in EPPO PM 7/98 (1) Specific requirements for laboratories preparing accreditation for a plant pest diagnostic activity. This paper presents validation for the morphological identification of Bursaphelenchus xylophilus, with the evaluation results of published identification keys and of internally designed identification keys at B. xylophilus group and species levels. For published identification keys some criteria were shown not to be reliable for routine use: excretory pore position and number of caudal papillae. The key designed in the laboratory for xylophilus group identification was shown to be sensitive and specific when one male and one female were observed. The key designed for B. xylophilus species identification is sensitive, specific and reproducible if only one female of B. xylophilus is observed. The tools designed were validated as simple and reliable for routine analysis. The advantages and limitations of the validation process for morphological tools are discussed for process improvement.
Eradication and control of invasive alien plants in the Mediterranean Basin: towards better coordination to enhance existing initiatives
Authors: Brunel S. , Brundu G. , Fried G.
Published: July 2013

The European and Mediterranean Plant Protection Organization (EPPO), in the framework of its activities in the Mediterranean Basin, launched a questionnaire to gather information on eradication actions and control actions for invasive alien plants. Thirty‐four (34) eradication actions were reported, 16 occurring in Spain, 7 in Italy, 7 in France, 1 in Portugal, 1 in Malta, and 2 on the southern rim of the Mediterranean, with 1 in Israel and 1 in Tunisia. Twenty‐two (22) species were targeted, and the habitats where such actions were undertaken most frequently were coastal dunes, sandy shores and aquatic ecosystems. Most of the species that have been the object of an eradication action were known invasive species recorded in the EPPO lists, such as Ailanthus altissima, Buddleia davidii, Carpobrotus spp., Eichhornia crassipes, Ludwigia peploides, Pennisetum setaceum, Pistia stratiotes, Solanum elaeagnifolium and Sicyos angulatus. Other eradicated species have a limited distribution in the EPPO region and may represent emerging invasive plants, such as Ambrosia confertifolia, Cylindropuntia rosea, Leersia oryzoides, Leptochloa fusca subsp. uninervia and Marsilea drummondii. Control actions concerning 90 species were also reported. A large number of eradication actions, as well as management actions, are therefore happening in Mediterranean countries. At present countries appear to operate with complete autonomy, without consulting neighbouring countries or other stakeholders within the country. There is therefore a need for coordination of new eradication actions.
In vitro and in vivo evaluation of a new large animal spirometry device using mainstream CO2 flow sensors
Authors: Ambrisko T. D. , Lammer V. , Schramel J. P. , Moens Y. P. S.
Published: July 2013

Reasons for performing study

A spirometry device equipped with mainstream CO2 flow sensor is not available for large animal anaesthesia.

Objectives

To measure the resistance of a new large animal spirometry device and assess its agreement with reference methods for volume measurements.

Study design

In vitro experiment and crossover study using anaesthetised horses.

Methods

A flow partitioning device (FPD) equipped with 4 human CO2 flow sensors was tested. Pressure differences were measured across the whole FPD and across each sensor separately using air flows (range: 90–720 l/min). One sensor was connected to a spirometry monitor for in vitro volume (3, 5 and 7 l) measurements. These measurements were compared with a reference method. Five anaesthetised horses were used for tidal volume (VT) measurements using the FPD and a horse‐lite sensor (reference method). Bland–Altman analysis, ANOVA and linear regression analysis were used for data analysis.

Results

Pressure differences across each sensor were similar suggesting equal flow partitioning. The resistance of the device increased with flow (range: 0.3–1.5 cmH2O s/l) and was higher than that of the horse‐lite. The limits of agreement for volume measurements were within ‐1 and 2% in vitro and ‐12 and 0% in vivo. Nine of 147 VT measurements in horses were outside of the ± 10% limits of acceptance but most of these erroneous measurements occurred with VTs lower than 4 l. The determined correction factor for volume measurements was 3.97 ± 0.03.

Conclusions

The limits of agreement for volume measurements by the new device were within ± 10% using clinically relevant range of volumes. The new spirometry device can be recommended for measurement of VT in adult Warmblood horses.