bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and correlates of rest tremor in essential tremor: cross‐sectional survey of 831 patients across four distinct cohorts
Authors: Louis E. D. , Hernandez N. , Michalec M.
Published: March 2015

Background and purpose

Essential tremor (ET) is amongst the most commonly encountered neurological disorders. Its hallmark feature is kinetic tremor. However, other tremors may also occur in ET patients, creating considerable diagnostic confusion amongst treating physicians. Hence, characterizing the prevalence and clinical accompaniments of these other tremors is of value. Surprisingly, there are few data on the prevalence of rest tremor in ET patients, and even fewer data on the clinical correlates of such tremor.

Methods

Eight hundred and thirty‐one patients in four distinct settings (population, genetics study, study of environmental epidemiology, brain bank) underwent a detailed videotaped neurological examination that was reviewed by a senior movement disorders neurologist. Rest tremor was evaluated in several positions (seated, standing, lying down).

Results

The prevalence of rest tremor whilst seated or standing was lowest in the population‐based setting (1.9%), highest in the brain bank study (46.4%) and intermediate in the remaining two settings (9.6% and 14.7%, respectively). Rest tremor was restricted to the arms and was not observed in the legs. Rest tremor was associated with older age, longer disease duration (in some studies), greater tremor severity and, to some extent, the presence of cranial tremors.

Conclusions

Rest tremor can be a common clinical feature of ET. Its prevalence is highly dependent on the setting in which patients are evaluated, ranging from as low as 1% to nearly 50%. Rest tremor seems to emerge as a clinical feature with advancing disease. The anatomical substrates for this type of tremor remain unknown at present.
Subgroups of multiple sclerosis patients with larger treatment benefits: a meta‐analysis of randomized trials
Authors: Signori A. , Schiavetti I. , Gallo F. , Sormani M. P.
Published: March 2015

Background and purpose

No subgroups of patients with higher treatment effects have been clearly detected in multiple sclerosis (MS). The aim of the present work was to evaluate whether there are subgroups of relapsing−remitting MS (RRMS) patients who are more responsive to treatments.

Methods

All published randomized clinical trials in RRMS reporting a subgroup analysis of treatment effect were collected. Two main outcomes, the annualized relapse rate (ARR) and the disability progression, were studied. The treatment effect in each subgroup was reported as a relative effect (RE), defined as the treatment effect in the subgroup relative to the overall effect. A meta‐analysis was run to compare the RE between subgroups.

Results

Six trials (6693 RRMS patients) were included. Treatment effects on ARR were significantly higher in younger than in older subjects (RE = 0.83 vs. RE = 1.30, P < 0.001), in patients with than those without gadolinium activity (RE = 0.86 vs. RE = 1.15, P = 0.005) and in patients with lower than in those with higher Expanded Disability Status Scale (RE = 0.96 vs. RE = 1.23, P = 0.02), and on disability progression in younger than in older subjects (RE = 0.82 vs. RE = 1.28, P = 0.017).

Conclusions

This study formally shows that in RRMS higher treatment effects are associated with characteristics of earlier (lower age and Expanded Disability Status Scale) and more active (higher gadolinium activity) disease.
Susceptibility vessel sign on T2* magnetic resonance imaging and recanalization results of mechanical thrombectomy with stent retrievers: a multicentre cohort study
Authors: Soize S. , Batista A. L. , Rodriguez Regent C. , Trystram D. , Tisserand M. , Turc G. , Serre I. , Ben Hassen W. , Zuber M. , Calvet D. , Mas J.‐L. , Meder J.‐F. , Raymond J. , Pierot L. , Oppenheim C. , Naggara O.
Published: March 2015

Background and purpose

The susceptibility vessel sign (SVS) on T2*‐weighted magnetic resonance imaging has been reported in several studies as a negative predictor of early recanalization after intravenous thrombolysis. The meaning of SVS regarding the results of mechanical thrombectomy with stent retrievers was investigated.

Methods

Susceptibility vessel sign presence and length were studied in 153 acute ischaemic stroke patients (82 men; mean ± SD age 59 ± 17 years, baseline National Institutes of Health Stroke Scale score 17.2 ± 6.5) from three stroke centres, treated with either mechanical thrombectomy alone (n = 84) or bridging therapy (n = 69). Variables were compared between recanalizers, defined as thrombolysis in cerebral infarction (TICI) scores ≥2b, and non‐recanalizers (TICI<2b).

Results

The SVS was present in 113 (73.8%) patients. There was no association between the presence of SVS and recanalization, obtained in 86 (56.2%) patients, in the whole population [odds ratio (OR) 1.24, 95% confidence interval (CI) 0.53–2.92, P = 0.84) and in treatment subgroups (bridging: OR = 0.91, 95% CI 0.29–2.87, P = 1.0; thrombectomy alone: OR = 1.85, 95% CI 0.48–7.16, P = 0.54). However, in SVS+ patients, recanalization decreased with SVS length (OR 0.94 for each additional mm, 95% CI 0.89–0.99; P = 0.02).

Conclusions

The success of recanalization in acute stroke patients treated with stent retrievers was related to thrombus length but not to the presence of SVS.
Epilepsy in Rett syndrome—Lessons from the Rett networked database
Authors: Nissenkorn Andreea , Levy‐Drummer Rachel S. , Bondi Ori , Renieri Alessandra , Villard Laurent , Mari Francesca , Mencarelli Maria A. , Lo Rizzo Caterina , Meloni Ilaria , Pineda Mercedes , Armstrong Judith , Clarke Angus , Bahi‐Buisson Nadia , Mejaski Bosnjak Vlatka , Djuric Milena , Craiu Dana , Djukic Alexsandra , Pini Giorgio , Bisgaard Anne Marie , Melegh Bela , Vignoli Aglaia , Russo Silvia , Anghelescu Cristina , Veneselli Edvige , Hayek Joussef , Ben‐Zeev Bruria
Published: March 2015

Objective

Rett syndrome is an X‐linked dominant neurodevelopmental disorder caused by mutations in the MECP2 gene, and characterized by cognitive and communicative regression, loss of hand use, and midline hand stereotypies. Epilepsy is a core symptom, but literature is controversial regarding genotype–phenotype correlation. Analysis of data from a large cohort should overcome this shortcoming.

Methods

Data from the Rett Syndrome Networked Database on 1,248 female patients were included. Data on phenotypic and genotypic parameters, age of onset, severity of epilepsy, and type of seizures were collected. Statistical analysis was done using the IBM SPSS Version 21 software, logistic regression, and Kaplan‐Meier survival curves.

Results

Epilepsy was present in 68.1% of the patients, with uncontrolled seizures in 32.6% of the patients with epilepsy. Mean age of onset of epilepsy was 4.68 ± (standard deviation) 3.5 years. Younger age of onset was correlated to severity of epilepsy (Spearman correlation r = 0.668, p < 0.01). Patients with late truncating deletions had lower prevalence of epilepsy. Compared to them, the p.R133C mutation, associated with a milder Rett phenotype, increased the risk for epilepsy (odds ratio [OR] 2.46, confidence interval [CI] 95% 1.3–4.66), but not for severe epilepsy. The p.R255X mutation conferred an increased risk for epilepsy (OR 2.07, CI 95% 1.2–3.59) as well as for severe epilepsy (OR 3.4, CI 95% 1.6–7.3). The p.T158M and p.C306C mutations relatively increased the risk for severe epilepsy (OR 3.09 and 2.69, CI 95% 1.48–6.4 and 1.19–6.05, respectively), but not for epilepsy occurrence.

Significance

Various mutations in the MECP2 gene have a different influence on epilepsy, unrelated to the severity of the general Rett phenotype. This might suggest a site‐specific effect of MeCp2 on epileptic pathways. Further investigation of these mechanisms should promote better understanding of epileptogenesis in Rett syndrome.
Active Learning: Qualitative Inquiries Into Vocabulary Instruction in Chinese L2 Classrooms
Authors: Shen Helen H. , Xu Wenjing
Published: March 2015

Active learning emerged as a new approach to learning in the 1980s. The core concept of active learning involves engaging students not only in actively exploring knowledge but also in reflecting on their own learning process in order to become more effective learners. Because the nonalphabetic nature of the Chinese writing system makes learning to read and write Chinese characters extremely time‐consuming for native English speakers, this qualitative study was intended to identify instructional strategies, methods, and activities for promoting active learning among beginning learners of Chinese as a second language and to investigate students' perceptions of the identified strategies, methods, and activities with regard to their effectiveness in engaging students in meaningful learning.
DNA markers for identifying interspecific hybrids between Miscanthus sacchariflorus and Miscanthus sinensis
Authors: Tamura Ken‐ichi , Sanada Yasuharu , Shoji Atsushi , Okumura Kenji , Uwatoko Naohiro , Anzoua Kossonou Guillaume , Sacks Erik J. , Yamada Toshihiko
Published: March 2015

Interspecific hybrids between Miscanthus sacchariflorus and Miscanthus sinensis, such as Miscanthus × giganteus, are promising biomass crops for temperate regions. A set of DNA markers to distinguish both species would be a powerful tool for interspecific hybrid breeding. Out of 85 intron‐flanking primer pairs developed using genomic information from sugarcane (Saccharum hybrid) and Sorghum bicolor, seven were selected that showed polymorphisms between M. sacchariflorus and M. sinensis. Four simple sequence repeat primer pairs were also screened that showed polymorphisms between both species from 44 previously developed primer pairs. Of the polymerase chain reaction (PCR) products generated by the 11 primer pairs, nine amplified fragments were specific to M. sacchariflorus and two were specific to M. sinensis, based on 83 accessions mainly from Japan but also including Chinese and Korean ones. Fragments specific to two species were detected in three known hybrid plants. These results indicate that combinations of these PCR fragments could be good markers for identifying hybrids of M. sacchariflorus and M. sinensis obtained from breeding programs or from natural crosses between wild sympatric populations.
Dual‐Screened Vertical Circulation Wells for Groundwater Lowering in Unconfined Aquifers
Authors: Jin Yulan , Holzbecher Ekkehard , Sauter Martin
Published: March 2015

A new type of vertical circulation well (VCW) is used for groundwater dewatering at construction sites. This type of VCW consists of an abstraction screen in the upper part and an injection screen in the lower part of a borehole, whereby drawdown is achieved without net withdrawal of groundwater from the aquifer. The objective of this study is to evaluate the operation of such wells including the identification of relevant factors and parameters based on field data of a test site and comprehensive numerical simulations. The numerical model is able to delineate the drawdown of groundwater table, defined as free‐surface, by coupling the arbitrary Lagrangian–Eulerian algorithm with the groundwater flow equation. Model validation is achieved by comparing the field observations with the model results. Eventually, the influences of selected well operation and aquifer parameters on drawdown and on the groundwater flow field are investigated by means of parameter sensitivity analysis. The results show that the drawdown is proportional to the flow rate, inversely proportional to the aquifer conductivity, and almost independent of the aquifer anisotropy in the direct vicinity of the well. The position of the abstraction screen has a stronger effect on drawdown than the position of the injection screen. The streamline pattern depends strongly on the separation length of the screens and on the aquifer anisotropy, but not on the flow rate and the horizontal hydraulic conductivity.
Photophobia in Primary Headaches
Authors: Rossi Heather L. , Recober Ana
Published: March 2015

Background

Photophobia is a debilitating feature of many headache disorders.

Overview

Clinical and preclinical research has identified several potential pathways involved in enhanced light sensitivity. Some of these structures include trigeminal afferents in the eye, second‐order neurons in the trigeminal nucleus caudalis, third‐order neurons in the posterior thalamus, modulatory neurons in the hypothalamus, and fourth‐order neurons in the visual and somatosensory cortices. It is unclear to what degree each site plays a role in establishing the different temporal patterns of photophobia across different disorders. Peptides such as calcitonin gene‐related peptide and pituitary adenylate cyclase‐activating polypeptide may play a role in photophobia at multiple levels of the visual and trigeminal pathways.

Conclusion

While our understanding of photophobia has greatly improved in the last decade, there are still unanswered questions. These answers will help us develop new therapies to provide relief to patients with primary headache disorders.
MUC5AC and MUC5B enhance the characterization of mucinous adenocarcinomas of the lung and predict poor prognosis
Authors: Kim Young K , Shin Dong H , Kim Kyung B , Shin Nari , Park Won Y , Lee Jung H , Choi Kyung U , Kim Jee Y , Lee Chang H , Sol Mee Y , Kim Mi H
Published: March 2015

Aims

From the viewpoint of histogenesis, lung adenocarcinoma can be subdivided into two groups: terminal respiratory unit (TRU) and non‐TRU types. We recently reported a non‐TRU type adenocarcinoma designated as ciliated adenocarcinoma (we now prefer central type adenocarcinoma). We suggest reasons that mucinous adenocarcinoma should encompass central type adenocarcinoma to represent its biological characteristics as non‐TRU type adenocarcinoma.

Methods and results

Mucin (MUC)5AC and MUC5B were expressed more significantly in non‐TRU type adenocarcinoma (P < 0.01). Thirty‐five (76.1%) and 45 cases (97.8%) of 46 non‐TRU type adenocarcinoma showed positivity for MUC5AC and MUC5B. Twelve (7.6%) and eight (5.1%) cases of 157 TRU type adenocarainoma showed positivity for MUC5B and MUC5AC. NKX2‐1 gene expression was measured with quantitative reverse transcription–polymerase chain reaction (qRT–PCR). ΔΔCt of NKX2‐1 gene expression was 6.79 for TRU type adenocarcinoma and 0.6 for non‐TRU type adenocarcinoma. Overall survival and disease‐free survival were poorer in non‐TRU type adenocarcinoma (P = 0.02 and P = 0.03). A multivariate test also showed that non‐TRU type adenocarcinoma is an independent prognostic factor (P = 0.04).

Conclusion

MUC5AC and MUC5B were specific makers for non‐TRU adenocarcinoma, including both central type adenocarcinoma and mucinous adenocarcinoma. We suggest that non‐TRU type adenocarcinoma presents a poorer prognosis, so it should be regarded separately from TRU type adenocarcinoma.
Becoming a Hitman
Authors: WILSON DAVID , RAHMAN MOHAMMED
Published: March 2015

This article discusses what might motivate someone to become a hitman. It does this by considering those hitmen identified as ‘Novices’ and ‘Dilettantes’ in the research by MacIntyre et al. () and then uses a critical analysis of a biography of one British hitman not considered in that article to pursue these ideas further. Throughout, we are keen to see how potential hitmen develop a psychological ‘reframing’ of their victim (Levi), so as to be able to achieve their objectives, and how this reframing might thereafter be maintained. Hitmen, it is argued, emerge as an extreme example of Hall's () ‘criminal undertakers’.
Circuit Class Therapy or Seven-Day Week Therapy for Increasing Rehabilitation Intensity of Therapy after Stroke (CIRCIT): A Randomized Controlled Trial
Authors: English Coralie , Bernhardt Julie , Crotty Maria , Esterman Adrian , Segal Leonie , Hillier Susan
Published: March 2015

Background

Increased therapy has been linked to improvements in functional ability of people with stroke.

Aim

To determine the effectiveness of two alternative models of increased physiotherapy service delivery (seven-day week therapy or group circuit class therapy five days a week) to usual care.

Method

Three-armed randomized controlled trial with blinded assessment of outcome. People admitted with a diagnosis of stroke, previously independently ambulant and with a moderate level of disability were recruited. ‘Usual care’ was individual physiotherapy provided five-days a week. Seven-day week therapy was usual care physiotherapy provided seven-days a week. Participants in the circuit class therapy arm of the trial received physiotherapy in group circuit classes in two 90-min sessions, five-days a week. Primary outcome was distance walked on the six-minute walk test at four-weeks post-randomization.

Results

Two hundred eighty-three participants were randomized; primary outcome data were available for 259 (92%). In the seven-day arm participants received an additional three hours of physiotherapy and thosein the circuit class armanadditional 22 h. There were no significant between-group differences at four-weeks in walking distance ( P = 0·72). Length of stay was shorter for seven-day (mean difference −2·9 days, 95% confidence interval −17·9 to 12·0) and circuit class participants (mean difference −9·2 days, 95% confidence interval −24·2 to 5·8) compared to usual care, but this was not significant.

Conclusions

Both seven-day therapy and group circuit class therapy increased physiotherapy time, but walking outcomes were equivalent to usual care.
Female genital mutilation (FGM) and the lower urinary tract
Authors: Creighton Sarah M.
Published: March 2015

Female genital mutilation (FGM) is defined by the World Health Organisation (WHO) as comprising various procedures which remove or damage the external female genital organs for no medical reason. FGM has no health benefits and is recognized to cause severe short and long term damage to both physical and psychological health. Although FGM is primarily performed in Africa, Asia and the Middle East, migration of FGM practising communities means that the health professionals worldwide need to be aware of the impact of FGM on health. FGM is almost always performed on children but the health implications of FGM are life‐long. FGM can cause immediate and long term damage to urinary function. In addition FGM may be detected during investigations for urinary symptoms which may be related or unrelated to the patient's FGM. Health professionals caring for girls and women with urinary symptoms must be aware of the clinical presentation of FGM and management options. They must also understand the legal implications of FGM and the role of health professionals in safeguarding girls from FGM as well as their own responsibilities for recording and reporting information about FGM.
Liberty, Political Rights and Wealth Transfer Taxation
Authors: Braun S. Stewart
Published: March 2015

Libertarians famously contend that the minimal state is the most just social arrangement because it secures individual freedoms and basic political rights. They also oppose wealth transfer taxation, i.e. taxation of inheritances, bequests, and inter vivos gifts, arguing that it violates people's right to use their wealth freely. However, as I argue, libertarian opposition to wealth transfer taxation causes practical problems for their commitment to a minimal state, as there is strong empirical evidence demonstrating that wealth transfer taxation is required to secure the political rights necessary for a free and stable society. In other words, I contend that without an effective wealth transfer tax, it will be difficult to ensure political rights and basic freedoms, thus leaving the libertarian minimal state in peril of collapse.
Evolutionary biogeography of South American weevils of the tribe Naupactini (Coleoptera: Curculionidae)
Authors: del Río M. Guadalupe , Morrone Juan J. , Lanteri Analia A.
Published: March 2015

Aim

Naupactini are highly diverse weevils, widespread in the Neotropical region. Their evolution may have been driven by geological and environmental changes. Our main goals were to explain the biotic diversification of this tribe in South America and to test previous hypotheses on the relationships between distribution areas.

Location

Neotropical South America.

Methods

We compiled geographical records for 165 species of South American Naupactini. We then applied a track analysis and a parsimony analysis of paralogy‐free subtrees to obtain generalized tracks and a general area cladogram, respectively.

Results

We retrieved 11 generalized tracks that coincided broadly with biogeographical areas of Neotropical South America: Northern Venezuelan, Galápagos Islands, Ecuadorian, Yungas, Cerrado, Caatinga, Puna+Pacific coastal deserts, Chacoan, Atlantic+Parana forests, Monte and Pampean. The single general area cladogram obtained showed the following topology: ((Northern Venezuelan–Ecuadorian) (Galápagos Islands–Puna+Pacific coastal deserts) (Yungas (Cerrado (Monte (Pampean (Chacoan–Atlantic+Parana forests)))))).

Main conclusions

The general patterns identified agree with biogeographical provinces of modern regionalizations, assumed to have been caused by vicariance. These biogeographical units form two main components, one from north‐western South America and the other from south‐eastern South America, separated by the barrier of the Andean cordillera. The absence of other discernible geological barriers and the influence of the Plio‐Pleistocene cycles make it difficult to elucidate the historical relationships between most forest areas and nearby open areas of South America. These observations indicate that the taxa under consideration underwent dispersal at different times, contributing to complex biogeographical patterns.
Cardiac Autoantibody Levels Predict Recurrence Following Cryoballoon‐Based Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation Patients
Authors: YALCIN MUHAMMED ULVI , GURSES KADRI MURAT , KOCYIGIT DUYGU , KESIKLI SACIT ALTUG , DURAL MUHAMMET , EVRANOS BANU , YORGUN HIKMET , SAHINER LEVENT , KAYA ERGUN BARIS , OTO MEHMET ALI , GUC DICLE , AYTEMIR KUDRET , OZER NECLA
Published: March 2015

Cardiac Autoantibodies and AF Recurrence

Introduction

Recent evidence has suggested that autoantibodies may play an important role in the development of atrial fibrillation (AF). The predictive value of preprocedural autoantibodies against beta‐1 adrenergic receptor (anti‐β1‐R) and M2‐muscarinic acetylcholine receptor (anti‐M2‐R) for AF recurrence following cryoballoon‐based pulmonary vein isolation (PVI) is still unclear. We aimed to determine the predictive value of preprocedural anti‐β1‐R and anti‐M2‐R levels for AF recurrence.

Methods

Eighty patients (mean age 54.25 ± 7.70 years; 40% female) with paroxysmal AF and preserved left ventricular function who underwent cryoballoon‐based PVI were included in the study. Preprocedural anti‐M2‐R and anti‐β1‐R levels were measured with ELISA.

Results

At 1‐year follow‐up after ablation, late AF recurrence was observed in 17 (21.25%) patients. In the Cox regression model, including number of antiarrhythmic drugs, early AF recurrence, anti‐β1‐R levels >159.88 ng/mL, anti‐M2‐R levels >277.65 ng/mL, AF duration, and left atrial volume index, only anti‐β1‐R levels >159.88 ng/mL (HR: 4.281, P = 0.039) and anti‐M2‐R levels >277.65 ng/mL (HR: 4.313, P = 0.030) were found to be independent predictors of late AF recurrence. Anti‐β1‐R level >159.88 ng/mL was shown to predict late AF recurrence with a sensitivity of 70.59% and specificity of 90.48%. A cut‐off value of 277.65 ng/mL for anti‐M2‐R level predicted AF recurrence with a sensitivity of 70.59% and specificity of 95.24%.

Conclusion

Preprocedural serum anti‐β1‐R and anti‐M2‐R levels are independent predictors of late AF recurrence following cryoballoon‐based PVI in paroxysmal AF patients. Detection of preprocedural anti‐β1‐R and anti‐M2‐R levels may serve as a novel method for determination of paroxysmal AF patients who may not benefit from cryoballoon‐based PVI.
IKs Gain‐ and Loss‐of‐Function in Early‐Onset Lone Atrial Fibrillation
Authors: STEFFENSEN ANNETTE BUUR , REFSGAARD LENA , ANDERSEN MARTIN NYBO , VALLET CECILIA , MUJEZINOVIC AMER , HAUNSØ STIG , SVENDSEN JESPER HASTRUP , OLESEN SØREN‐PETER , OLESEN MORTEN SALLING , SCHMITT NICOLE
Published: March 2015

KCNQ1 Mutations in Early‐Onset Lone AF

Introduction

Atrial fibrillation (AF) is the most frequent cardiac arrhythmia. The potassium current IKs is essential for cardiac repolarization. Gain‐of‐function mutation in KCNQ1, the gene encoding the pore‐forming α‐subunit of the IKs channel (KV7.1), was the first ion channel dysfunction to be associated with familial AF. We hypothesized that early‐onset lone AF is associated with a high prevalence of mutations in KCNQ1.

Methods and Results

We bidirectionally sequenced the entire coding sequence of KCNQ1 in 209 unrelated patients with early‐onset lone AF (<40 years) and investigated the identified mutations functionally in a heterologous expression system. We found 4 nonsynonymous KCNQ1 mutations (A46T, R195W, A302V, and R670K) in 4 unrelated patients (38, 31, 39, and 36 years, respectively). None of the mutations were present in the control group (n = 416 alleles). No other mutations were found in genes previously associated with AF. The mutations A46T, R195W, and A302V have previously been associated with long‐QT syndrome. In line with previous reports, we found A302V to display a pronounced loss‐of‐function of the IKs current, while the other mutants exhibited a gain‐of‐function phenotype.

Conclusions

Mutations in the IKs channel leading to gain‐of‐function have previously been described in familial AF, yet this is the first time a loss‐of‐function mutation in KCNQ1 is associated with early‐onset lone AF. These findings suggest that both gain‐of‐function and loss‐of‐function of cardiac potassium currents enhance the susceptibility to AF.
The Science of Salt: A Systematic Review of Clinical Salt Studies 2013 to 2014
Authors: Johnson Claire , Raj Thout Sudhir , Trudeau Luc , Bacon Simon L. , Padwal Raj , Webster Jacqui , Campbell Norm
Published: March 2015

The authors provided a systematic review of the clinical and population health impact of increased dietary salt intake during 1 year. Randomized controlled trials or cohort studies or meta‐analyses on the effect of sodium intake were examined from Medline searches between June 2013 to May 2014. Quality indicators were used to select studies that were relevant to clinical and public health. A total of 213 studies were reviewed, of which 11 (n=186,357) were eligible. These studies confirmed a causal relationship between increasing dietary salt and increased blood pressure and an association between several adverse health outcomes and increased dietary salt. A new association between salt intake and renal cell cancer was published. No study that met inclusion criteria found harm from lowering dietary salt. The findings of this systematic review are consistent with previous data relating increased dietary salt to increased blood pressure and adverse health outcomes.
Dedifferentiation of patient‐derived glioblastoma multiforme cell lines results in a cancer stem cell‐like state with mitogen‐independent growth
Authors: Olmez Inan , Shen Wangzhen , McDonald Hayes , Ozpolat Bulent
Published: March 2015

Emerging evidence shows that glioblastoma multiforme (GBM) originates from cancer stem cells (CSCs). Characterization of CSC‐specific signalling pathways would help identify new therapeutic targets and perhaps lead to the development of more efficient therapies selectively targeting CSCs. Here; we successfully dedifferentiated two patient‐derived GBM cell lines into CSC‐like cells (induced glioma stem cells, iGSCs) through expression of Oct4, Sox2 and Nanog transcription factors. Transformed cells exhibited significant suppression of epidermal growth factor receptor and its downstream pathways. Compared with parental GBM cells, iGSCs formed large neurospheres even in the absence of exogenous mitogens; they exhibited significant sensitivity to salinomycin and chemoresistance to temozolomide. Further characterization of iGSCs revealed induction of NOTCH1 and Wnt/β‐catenin signalling and expression of CD133, CD44 and ALDH1A1. Our results indicate that iGSCs may help us understand CSC physiology and lead to development of potential therapeutic interventions aimed at differentiating tumour cells to render them more sensitive to chemotherapy or other standard agents.
Rosettes and other white shiny structures in polarized dermoscopy: histological correlate and optical explanation
Authors: Haspeslagh M. , Noë M. , De Wispelaere I. , Degryse N. , Vossaert K. , Lanssens S. , Facchetti F. , Van Den Bossche K. , Brochez L.
Published: March 2015

Background

Rosettes are a specific form of a white shiny structure seen with polarized dermoscopy. The precise morphological correlate and optical explication are not known.

Objective

To estimate the frequency of rosettes in ex vivo dermoscopy and to find explication and morphologic correlate of this dermoscopic feature.

Methods

A series of 6108 consecutive skin biopsies were examined with ex vivo dermoscopy and when rosettes were present serial transverse sections with polarization were examined.

Results

In this series of 6108 consecutive skin biopsies, rosettes were found on ex vivo dermoscopy in 63 cases. When multiple we observed that they are always oriented at the same angle. Transverse sections with polarization of these lesions proved that smaller rosettes are mainly caused by polarizing horny material in adnexal openings, and larger rosettes by concentric perifollicular fibrosis.

Conclusions

Rosettes are an optical effect of crossed polarization by concentric fibrosis or horny material and hence are not lesion‐specific.
Ocular adverse effects after facial cosmetic procedures: a review of case reports
Authors: Ricci Lucas H. , Navajas Samia V. , Carneiro Paula R. , Söderberg Stephanie A. , Ferraz Caroline A.
Published: March 2015

To review indexed literature concerning adverse ocular effects of the most common aesthetic facial procedures (light‐emitting therapy, dermal fillers injection, and botulinum toxin). Literature search using three online databases – PubMed, SciELO, and Capes – selecting case reports, series of cases and reviews, with no language restriction, published in a period of the last twenty years (1995–2015). After reviewing 48 case reports and most recent reviews, the authors found the most common ocular adverse effects of dermal fillers were related to vascular occlusion; light‐emitting therapy was associated with pigmented tissue damage leading to anterior uveitis and iris atrophy, and ptosis presented the higher relative risk associated with botulinum toxin. Even though ocular adverse effects are not very frequent, some of them can lead to permanent ocular dysfunction and visual impairment. Professionals involved in cosmetic procedures should be aware of the risks.
Optic Nerve Sheath Diameter Measurement to Identify High‐Risk Patients for Spinal Ischemia after Endovascular Thoracoabdominal Aortic Aneurysm Repair
Authors: Ertl Michael , Schierling Wilma , Kasprzak Piotr , Schömig Beate , Brückl Corinna , Schlachetzki Felix , Pfister Karin
Published: March 2015

BACKGROUND & PURPOSE

Thoracic endovascular aortic repair (TEVAR) is associated with a reasonable risk of spinal ischemia. As cerebrospinal fluid pressure (CSFP) is correlated with the rate of paraplegia, a non‐invasive method to estimate CSFP could help to estimate the patient's individual risk and guide the therapeutic approach. The quantification of the optic nerve sheath diameter (ONSD) using ocular sonography (OS) could be a suitable technique and was examined in the present study.

METHODS

28 patients with TEVAR were included. Five consecutive measurements of the ONSD were performed in each patient. The first before the intervention (“baseline”), the next immediately postinterventional at the intensive care unit (post1), measurements 3, 4 (post2, post3) on day 1 and 2 after the intervention and number 5 (post4) before discharge. Statistical analysis was done using the Wilcoxon‐test. A p‐value < 0.05 was considered statistically significant.

RESULTS

A significant increase between baseline and post1‐measurements (right eye: p = 0.006; left eye: p = 0.02) could be detected. A significant decrease was detected between post1 and post3 (right eye: p = 0.02; left eye: p < 0.01). A group of 5 patients had an additional increase of ONSD from post1 to post2, one of these patients developed a permanent paraplegia. Patients with spinal catheters had significantly lower ONSDs at nearly all time points.

CONCLUSION

The present study is the first to prospectively examine and prove the possibility to monitor CSFP changes in patients with TEVAR associated transient spinal edema using OS. Systematic factors as artificial ventilation and body positioning did not have a significant effect.
Anatomical Variations in the Posterior Circle of Willis and Vascular Pathologies in Isolated Unilateral Thalamic Infarction
Authors: Goerlitz Johannes , Wenz Holger , Al‐Zghloul Mansour , Kerl Hans U. , Groden Christoph , Förster Alex
Published: March 2015

BACKGROUND AND PURPOSE

To characterize relations between configurations of the posterior part of the Circle of Willis (CoW) and the occurrence of unilateral thalamic infarction.

METHODS

From a magnetic resonance imaging report database, we identified and analyzed 111 patients with acute isolated unilateral thalamic infarction on diffusion‐weighted imaging (DWI). Vascular pathologies were noted on magnetic resonance angiography (MRA) and the diameter of the posterior communicating artery (PComA) and the P1 and P2 segments of the posterior cerebral artery determined.

RESULTS

Most infarctions were observed in the territory of the inferolateral arteries (70.2%), followed by the paramedian (16.3%), tuberothalamic (8.7%), and posterior choroidal arteries (4.8%). Relevant vascular pathologies included stenosis of the basilar artery (4.5%), P1 segment stenosis (4.5%)/occlusion (.9%), and P2 segment stenosis (14.4%)/occlusion (4.5%). Paramedian thalamic infarction was associated with ipsilateral P1 segment hypoplasia/absence (P < .001); tuberothalamic infarction with ipsilateral PComA hypoplasia/absence (P = .08). Furthermore, the diameter of the relevant CoW segment was smaller in patients with ipsilateral thalamic infarction.

CONCLUSIONS

Assessment of CoW configuration on MRA may be helpful to understand the appearance of unilateral thalamic stroke independent from stroke etiology. A smaller diameter of the relevant CoW segment might be a risk factor for ipsilateral thalamic stroke in the corresponding thalamic vascular territory.
Impact of diet on incisor growth and attrition and the development of dental disease in pet rabbits
Authors: Meredith A. L. , Prebble J. L. , Shaw D. J.
Published: March 2015

OBJECTIVES

To assess the impact of four rabbit diets (hay only; extruded diet with hay; muesli with hay; muesli only) on length and curvature of cheek teeth and eruption and attrition rates of incisors.

MATERIALS AND METHODS

Thirty‐two Dutch rabbits, randomly divided into four diet groups, had length and saggital plane curvature of the first cheek teeth measured radiographically at 1, 9 and 17 months. Eruption/attrition of the left upper incisor was directly measured at weeks 30, 32 and 35.

RESULTS

Eruption rates matched attrition rates in all groups, but were higher in the hay only group than in both groups fed muesli. By month 9, a greater degree of tooth curvature was present in rabbits fed muesli only than in those fed hay only and extruded diet with hay. After 17 months, rabbits fed muesli only and muesli with hay had longer lower first cheek teeth and larger interdental spaces between the first two molars than rabbits fed extruded diet and hay and hay only. Three rabbits fed muesli only developed evidence of dental disease.

CLINICAL SIGNIFICANCE

Presence of increased tooth length, curvature and interdental spaces indicated early dental pathology in rabbits fed muesli. Muesli diets cannot be recommended for pet rabbits.
Expansion load: recessive mutations and the role of standing genetic variation
Authors: Peischl Stephan , Excoffier Laurent
Published: March 2015

Expanding populations incur a mutation burden – the so‐called expansion load. Previous studies of expansion load have focused on codominant mutations. An important consequence of this assumption is that expansion load stems exclusively from the accumulation of new mutations occurring in individuals living at the wave front. Using individual‐based simulations, we study here the dynamics of standing genetic variation at the front of expansions, and its consequences on mean fitness if mutations are recessive. We find that deleterious genetic diversity is quickly lost at the front of the expansion, but the loss of deleterious mutations at some loci is compensated by an increase of their frequencies at other loci. The frequency of deleterious homozygotes therefore increases along the expansion axis, whereas the average number of deleterious mutations per individual remains nearly constant across the species range. This reveals two important differences to codominant models: (i) mean fitness at the front of the expansion drops much faster if mutations are recessive, and (ii) mutation load can increase during the expansion even if the total number of deleterious mutations per individual remains constant. We use our model to make predictions about the shape of the site frequency spectrum at the front of range expansion, and about correlations between heterozygosity and fitness in different parts of the species range. Importantly, these predictions provide opportunities to empirically validate our theoretical results. We discuss our findings in the light of recent results on the distribution of deleterious genetic variation across human populations and link them to empirical results on the correlation of heterozygosity and fitness found in many natural range expansions.
Activation of senescence‐associated Dark‐inducible (DIN) genes during infection contributes to enhanced susceptibility to plant viruses
Authors: Fernández‐Calvino Lourdes , Guzmán‐Benito Irene , del Toro Francisco J. , Donaire Livia , Castro‐Sanz Ana B. , Ruíz‐Ferrer Virginia , Llave César
Published: March 2015

Virus infections in plants cause changes in host gene expression that are common to other environmental stresses. In this work, we found extensive overlap in the transcriptional responses between Arabidopsis thaliana plants infected with Tobacco rattle virus (TRV) and plants undergoing senescence. This is exemplified by the up‐regulation during infection of several senescence‐associated Dark‐inducible (DIN) genes, including AtDIN1 (Senescence 1, SEN1), AtDIN6 (Asparagine synthetase 1, AtASN1) and AtDIN11. DIN1, DIN6 and DIN11 homologues were also activated in Nicotiana benthamiana in response to TRV and Potato virus X (PVX) infection. Reduced TRV levels in RNA interference (RNAi) lines targeting AtDIN11 indicate that DIN11 is an important modulator of susceptibility to TRV in Arabidopsis. Furthermore, low accumulation of TRV in Arabidopsis protoplasts from RNAi lines suggests that AtDIN11 supports virus multiplication in this species. The effect of DIN6 on virus accumulation was negligible in Arabidopsis, perhaps as a result of gene or functional redundancy. However, TRV‐induced silencing of NbASN, the DIN6 homologue in N. benthamiana, compromises TRV and PVX accumulation in systemically infected leaves. Interestingly, NbASN inactivation correlates with the appearance of morphological defects in infected leaves. We found that DIN6 and DIN11 regulate virus multiplication in a step prior to the activation of plant defence responses. We hypothesize on the possible roles of DIN6 and DIN11 during virus infection.
Part 2: pressure ulcer assessment: implementation and revision of CALCULATE
Authors: Richardson Annette , Straughan Christine
Published: March 2015

Introduction

Critically ill patients are a vulnerable group at very high risk of developing pressure ulcers, and the incidence varies within critical care.

Methods

A number of strategies were used to implement the pressure ulcer assessment tool CALCULATE across four adult critical care units. Strategies included, nursing leadership, the provision of definitions for each risk factor, information laid out on posters at each patient's bedside, changes to pre‐printed nursing documentation and a 30‐min focused training package. Two local audits were conducted to measure the number and types of risk factors occurring in patients with pressure ulcers, and to assess the frequency of assessments and gain feedback on the usability of the tool in practice.

Findings

Critical care acquired pressure ulcer incidence was 3.4%. The two most commonly occurring risk factors were impaired circulation (82%) and mechanical ventilation (75%). Patients had a mean score of 4, and 65% had 4 or more reported risk factors. Feedback on the usability of the tool was mainly positive.

Discussion

The tool CALCULATE was relatively straightforward to implement and was likely to be due to the design and the various change strategies used to implement the new approach. The seven point tool was revised to an eight point score based on nurses' clinical feedback.

Conclusions

Research is required to further enhance and develop pressure ulcer assessment. Meanwhile CALCULATE offers an easy to use and appropriate tool to assist in the identification of patients at an elevated risk of pressure ulcer damage.

Implications for Practice

Careful choice of change management strategies are needed when implementing a new assessment tool. CALCULATE should be considered for use in critical care for pressure ulcer assessment, but used alongside nurses' clinical judgement and observations of skin.
Functional proteomic biomarkers in cancer
Authors: Larijani Banafshe , Perani Michela , Alburai'si Kholoud , Parker Peter J.
Published: March 2015

Beyond penetrant germline and somatic mutations, there are substantial challenges in extrapolating phenotypes from linear DNA sequences and transcriptomics. This brings a molecular pathology emphasis to the properties of the main players responsible for executing actions, proteins. The proteomic attribute most frequently determined in pathology is (relative) content, but for many candidate biomarkers this is not the most important feature to understand. In keeping pace with the depth of knowledge of the mechanisms underlying pathologies, we need to ask more sophisticated questions about the state of proteins, for example, their oligomerization status, modification status, and location. This demands hitherto nonroutine approaches to proteomics, which we will discuss in this brief perspective.
NUDGING, SHOVING, AND BUDGING: BEHAVIOURAL ECONOMIC‐INFORMED POLICY
Authors: OLIVER ADAM
Published: March 2015

In recent years, behavioural economics has gained considerable traction in the policy discourse, with a particular conceptual framework called libertarian paternalism, which informs nudge policy, dominating. Libertarian paternalism requires policies to protect individual liberty, to be focused specifically upon improving the welfare of those towards whom the intervention is targeted, and to be informed by the findings of behavioural economics. In practice, however, many of the interventions that are being advocated as nudges do not meet all of these criteria. Moreover, libertarian paternalism is not the only framework in which behavioural economics can inform policy. Coercive paternalism and behavioural regulation, frameworks that respectively underpin shove and budge policies, both use behavioural economics to inform public policy, and both face their own set of limitations. This article attempts to bring a degree of intellectual clarity to the potentially important contribution that behavioural economics can make to public policy.
Polycystic Ovary Syndrome: Special Diagnostic and Therapeutic Considerations for Children
Authors: Kamangar Faranak , Okhovat Jean‐Phillip , Schmidt Timothy , Beshay Abram , Pasch Lauri , Cedars Marcelle I. , Huddleston Heather , Shinkai Kanade
Published: March 2015

Polycystic ovary syndrome (PCOS) is an endocrine syndrome with variable phenotypic expression and important systemic associations and sequelae, including obesity, insulin resistance, infertility, risk of endometrial cancer, and possible risk of cardiovascular events. PCOS is recognized as a condition influenced by genetic and environmental factors and distinct manifestations in all stages of life, including the prenatal period, childhood, adolescence, and adulthood. Identification of this disorder in childhood and adolescence has received growing attention, in part because of emerging evidence of the benefit of early intervention, but the diagnosis and management of PCOS in children and adolescents can be challenging. Diagnostic and therapeutic considerations of PCOS in children are reviewed to enhance identification and evaluation of patients suspected of having this disorder. When a diagnosis of PCOS is suspected in a child but cannot be confirmed, a provisional diagnosis is strongly recommended so as to prompt ongoing monitoring with an emphasis on important early interventions such as obesity reduction.
Distinct germination response of endangered and common arable weeds to reduced water potential
Authors: Rühl A. T. , Eckstein R. L. , Otte A. , Donath T. W.
Published: March 2015

Arable weeds are one of the most endangered species groups in Europe. Modern agriculture and intensive land‐use management are the main causes of their dramatic decline. However, besides the changes in land use, climate change may further challenge the adaptability of arable weeds. Therefore, we investigated the response pattern of arable weeds to different water potential and temperature regimes during the phase of germination. We expected that endangered arable weeds would be more sensitive to differences in water availability and temperature than common arable weeds. To this end, we set up a climate chamber experiment where we exposed seeds of five familial pairs of common and endangered arable weed species to different temperatures (5/15, 10/20 °C) and water potentials (0.0 to −1.2 MPa). The results revealed a significant relationship between the reaction of arable weed species to water availability and their Red List status. The effects of reduced water availability on total germination, mean germination time and synchrony were significantly stronger in endangered than in common arable weeds. Therefore, global climate change may present a further threat to the survival of endangered arable weed species.
The Mesopotamian God Enki/Ea
Authors: Galter Hannes D.
Published: March 2015

The traditions and beliefs about the Mesopotamian deity Enki/Ea – the god of water, wisdom, magic, and creation – formed a major part of the Sumerian and Babylonian religious text material. They cover a period from the 3rd to the 1st millennium BCE. This paper traces the history of these traditions focussing on the later periods, reviews the mythological texts representing the ‘Eridu tradition’, and outlines Enki/Ea's change of roles especially during the 1st millennium BCE. It deals in detail with the story of the Great Flood and considers the conditions for a possible influence of the Enki/Ea mythologies on neighboring literatures.