bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptions of dental students in Japanese national universities about studying abroad
Authors: Oka H. , Ishida Y. , Hong G. , Nguyen P. T. T.
Published: June 2016

Purpose

Dental faculties in Japan have organised many short‐term international exchange programs to enable their undergraduates to study abroad. However, not many students apply for those programs. In this present study, we attempted to clarify the factors that discourage undergraduate dental students from studying abroad.

Methods

We administered a questionnaire survey to 512 undergraduate dental students in three national universities located in different areas in Japan.

Results

Although 61.7% of the participants expressed interest in studying abroad, only 19.1% of them had prior experiences of study abroad or plans to do so. Their main worries were about lack of sufficient language ability in academic fields. Comparing those who were interested in studying abroad with those who were not revealed significant differences regarding their concern about lack of language ability and lack of specialised knowledge in dentistry. Participants who did not want to study abroad indicated that they did not perceive a purpose in doing so and cited not having foreign friends as a problem. Household income was significantly correlated with concerns about overall expenses.

Conclusion

Overall, language ability and academic knowledge appeared to be the two strongest factors affecting dental students’ consideration of studying abroad. Dental schools in Japan can use the findings of this study to improve their undergraduate exchange programs in such a way as to stimulate greater interest amongst their students.
Factors associated with the effect of open splenectomy for immune thrombocytopenic purpura
Authors: Li Ying , Zhang Dawei , Hua Fanli , Gao Song , Wu Yangjiong , Xu Jianmin
Published: June 2016

Objective

To assess the effect and complications of open splenectomy (OS) for immune thrombocytopenic purpura (ITP) and determine preoperative factors associated with surgical effect.

Methods

This was a retrospective analysis of ITP patients who failed medical therapy and were treated with OS between 1997 and 2014 at the Jinshan Hospital, China. Follow‐up was 60 months. Surgical effect was determined from platelet counts and bleeding episodes. Complications were assessed including bleeding episodes. Preoperative factors were identified by logistic regression analysis.

Results

Fifty‐six patients (48.2 ± 16.2 yr old; 39 females) were included. Disease course was 31.2 ± 48.2 months; 91.1% patients had preoperative platelet count <20 × 109 /L. OS effect at 1 wk, 1 month, 1 yr, and 5 yrs was in 91.1%, 92.9%, 91.1%, and 89.3% patients, respectively. Pneumonia or lower extremity thrombosis occurred in 7.1% patients. Postoperative mild, moderate, and severe bleeding occurred in 33.9%, 50.0%, and 16.1% patients, respectively. No patients required blood transfusion. Mortality was zero. Larger spleen size associated with surgical effect at 1 wk, 1 month, and 1 yr, and lower preoperative minimum platelet count associated with effect at 5 yrs (P < 0.05).

Conclusions

Open splenectomy is an effective treatment with less complications for the management of ITP. Lower preoperative minimum platelet count associated with successful OS at 5 yrs.
NHE1 expression at wound margins increases time‐dependently during physiological healing
Authors: Haverkampf Sonja , Heider Judith , Weiß Katharina T. , Haubner Frank , Ettl Tobias , Schreml Julia , Hedtrich Sarah , von Süßkind‐Schwendi Marietta , Berneburg Mark , Karrer Sigrid , Dissemond Joachim , Schreml Stephan
Published: June 2016

Wound repair is an orchestrated process, encompassing the phases of inflammation, proliferation and tissue remodeling. In this context, sodium hydrogen exchanger 1 (NHE1) is crucial to epidermal barrier integrity and acidification. Recently, we found that extracellular pH (pHe) on wound surfaces is dramatically increased initially after barrier disruption, and that pHe decreases gradually during physiological healing. Additionally, we have shown that spatial NHE1‐patterns account for pHe‐gradients on surfaces of chronic wounds. Here, we show that NHE1‐expression is very low at margins initially after wounding and that it increases massively during the time‐course of physiolgical healing. This finding is in accordance with the decrease of pHe on wound surfaces, which we reported on in previous works. Thus, we show that NHE1 is an interesting target when it comes to modification of surface pHe on wounds, both acute and chronic, and that NHE1 is time‐dependently regulated in physiological healing.
Inhibited early immunologic response is associated with hypertrophic scarring
Authors: Butzelaar Liselotte , Schooneman Dennis P. M. , Soykan Ezgi A. , Talhout Wendy , Ulrich Magda M. W. , van den Broek Lenie J. , Gibbs Susan , Beelen Robert H. J. , Mink van der Molen Aebele B. , Niessen Frank B.
Published: June 2016

This study aimed to examine changes in the inflammatory response in early hypertrophic compared to normal wound healing. The immune system is thought to be involved in hypertrophic scar formation. However, the exact mechanism and time of onset of the derailment remain unknown. In a prospective observational study, skin biopsies were taken directly postwounding and 3 hours later from patients who had elective cardiothoracic surgery. The skin biopsies were analysed for mRNA, proteins and cells involved in the early inflammatory phase of wound healing. The endpoint was scar outcome (hypertrophic (HTS) or normal (NTS)) at one year after surgery. There were significant differences between the NTS and HTS groups regarding the fold changes of mRNA expression of P‐selectin during surgery. Postoperative skin concentrations of inflammatory proteins IL‐6, IL‐8 and CCL2 were significantly lower in the HTS compared to the NTS group. Also, a trend of higher pre‐operative M2 macrophage numbers was observed in the HTS group. Neutrophil numbers increased equally during surgery in both groups. The increase of P‐selectin mRNA in hypertrophic wound healing could affect leucocyte migration. The decreased concentrations of inflammatory proteins in hypertrophic wound healing indicate a reduced inflammatory response, which has consequences for the treatment of hypertrophic scarring during the early inflammatory phase. In a conclusion, alterations of wound healing associated with hypertrophic scarring are visible as early as 3 hours postwounding and include a reduced rather than increased inflammatory protein response.
Could the obligation to land undersized individuals increase the black market for juveniles: evidence from the Mediterranean?
Authors: Bellido Jose M , García‐Rodriguez Mariano , García‐Jiménez Teresa , González‐Aguilar María , Carbonell‐Quetglas Ana
Published: June 2016

The latest Green Paper on the EU Common Fisheries Policy (CFP) identified the high level of discards in Europe as one of the structural weaknesses of the current CFP. The new CFP introduces a discard ban in European waters, with an obligation to land all regulated species. The fishing management system in the Mediterranean is based on effort control and technical measures, and this is raising some particular concerns about the effective implementation of the discard ban. With the exception of bluefin tuna (Thunnus thynnus, Scombridae), there are no quotas in the Mediterranean and this regulation affects all regulated species with the minimum landing size. Under these circumstances, the discard ban may lead to an increase in the amount of juvenile fish caught, because such catches are not counted against a given quota, as is the case in the Atlantic fisheries, and thus, there is no incentive to avoid catching them. On the contrary, the obligation to land the juveniles that are now discarded and their subsequent fishmeal processing might even become commercially interesting. One possible consequence of the new regulation may be an increase in the illegal marketing of fish below the minimum size. The landing, storage and transportation of juveniles will all be legal, and this may simplify their commercialization via the black market. The discard ban and landing obligation should be accompanied by other measures to ensure their successful implementation, including the agreement of the fishing sector to comply with the rules and regulations.
Factors associated with the severity of obstructive sleep apnea in older adults
Authors: Hongyo Kazuhiro , Ito Norihisa , Yamamoto Koichi , Yasunobe Yukiko , Takeda Masao , Oguro Ryosuke , Takami Yoichi , Takeya Yasushi , Sugimoto Ken , Rakugi Hiromi
Published: June 2016

Aim

Epidemiological studies have shown that severe obstructive sleep apnea (OSA) is associated with higher mortality when compared with mild to moderate OSA. Because aging is a well‐known risk factor for OSA, we aimed to elucidate the underlying factors associated with the severity of OSA in elderly patients.

Methods

Patients who underwent polysomnography were divided into the non‐elderly group (aged <65 years; n = 44) and the elderly group (aged ≥65 years; n = 46). The severity of OSA was determined by the apnea hypopnea index (AHI), and each group was subdivided into two groups: mild to moderate OSA (5 < AHI < 30) and severe OSA (AHI ≥30) . In the elderly group, geriatric assessments to evaluate physical and neuropsychiatric function were carried out.

Results

All patients had OSA as diagnosed by an AHI >5. Whereas body mass index was positively correlated with AHI in both groups, age was correlated with AHI only in the elderly group. Body mass index and age were higher in severe OSA than mild to moderate OSA in the elderly group. Unexpectedly, no significant difference was observed in physical strength, cognitive function, apathy scale, depression scale or activities of daily living between mild to moderate OSA and severe OSA in the elderly group. Binary logistic regression analysis showed that male sex, body mass index and aging were independent risk factors of severe OSA in the elderly group.

Conclusions

Our findings suggest that aging increases the severity of OSA in elderly patients, even if they are physically active and neuropsychiatrically unimpaired. Geriatr Gerontol Int 2017; 17: 614–621.
Early language input and later reading development in Chinese as heritage language (CHL) learners
Authors: Zhang Haomin (Stanley)
Published: June 2016

There is a general tendency to treat heritage language (HL) learners as if they formed a single unitary group with shared linguistic and print experiences. In actuality, however, HL learners vary widely in their early oral and print experiences at home or in other social contexts and as a result, they develop vastly different skills in both oral language and literacy skills. The study aimed to investigate the effect of early oral and print input on later reading development among Chinese as heritage language (CHL) learners. Seventy‐three college‐level CHL learners who participated in this study completed an early language background questionnaire and a series of reading measures inclusive of print vocabulary knowledge, lexical inferencing ability and reading comprehension. The results found that early language input was significantly related to later reading development. Critically, the study identified the significant factors of language experiences predicting later reading skills. Oral language input at home and print input in CHL schools were found to jointly contribute to the later development of word‐level abilities while print input at home predicted later reading comprehension skill among CHL learners. The findings suggest that early oral and print language input at home and in CHL schools could have longitudinal effects on later reading skills.
Editorial: Regulating Audit Quality – Ramifications and Research Opportunities
Authors: Moroney Robyn
Published: June 2016

On taking up the role as an editor of the International Journal of Auditing, I would like to share some thoughts about two current audit quality issues. There is little doubt that audit quality is an issue much discussed and debated by practitioners, regulators and academics. What is less certain is what exactly constitutes a quality audit and how it is best achieved. Regulators, concerned with investor confidence in audited financial statements, have introduced regulations aimed at enhancing audit quality. As audits are unobservable, audit quality is difficult to assess and so evaluating the relative success of different types of regulation can be problematic. With a view to helping readers evaluate research in this area and identify possible research topics, I will focus here on two regulations aimed at enhancing audit quality: partner rotation and audit inspections.
Environmental Audits and Third Party Certification of Management Practices: Firms’ Motives, Audit Orientations, and Satisfaction with Certification
Authors: Prajogo Daniel , Castka Pavel , Yiu Daphne , Yeung Andy C.L. , Lai Kee‐Hung
Published: June 2016

In this study, we investigate the interplay between motives for certification, audit orientations and firms’ benefits and satisfaction with ISO 14001 certification. We demonstrate that firms’ motive for certification is an important determinant in firms’ satisfaction. Firms with internal motivations (such as improvements in their environmental performance) require audits that foster continuous improvement and tend to report greater benefits and satisfaction with the third party certification compared to those that are driven by external motives (such as to match competitors’ actions). Our findings show that only an improvement orientation towards auditing would lead to clients’ satisfaction with ISO 14001. In contrast, external motives for pursuing ISO 14001 certification make firms less focused on environmental improvement through the standard, and, thus, less satisfied with the certification. Our research demonstrates how different motives for seeking certification lead to different satisfaction levels with voluntary standards in an environmental management context.
Apixaban versus enoxaparin in the prevention of venous thromboembolism following total knee arthroplasty: a single‐centre, single‐surgeon, retrospective analysis
Authors: King D. A. L. , Pow R. E. , Dickison D. M. , Vale P. R.
Published: June 2016

Background

There is a high risk of developing venous thromboembolism (VTE) following total knee arthroplasty (TKA). Conventional thromboprophylactic agents have limitations, such as route of administration, the need for monitoring, narrow therapeutic windows and interactions. Apixaban is a new oral anticoagulant with the potential to overcome these limitations.

Aims

To report the efficacy and safety of apixaban and low‐molecular‐weight heparin, enoxaparin, in VTE prophylaxis following TKA.

Methods

This single‐centre, single‐surgeon, retrospective analysis included 506 consecutive patients who underwent TKA between 2009 and 2015 and received enoxaparin or apixaban as thromboprophylaxis. Baseline characteristics of patients, in‐hospital rates of VTE, total DVT, proximal or distal DVT, pulmonary embolism, bleeding outcomes and mortality were compared between the two groups.

Results

In‐hospital VTE occurred in 22 (8.9%) patients in the enoxaparin group and 11 (4.5%) patients in the apixaban group (P = 0.049). Nine (3.6%) patients in the enoxaparin group and one (0.4%) in the apixaban group experienced a postoperative drop in haemoglobin ≥20 g/L that either necessitated transfusion of ≥2 units blood, caused haemodynamic instability or both (P = 0.020). Thirty‐five patients experienced other bleeding events, with 25 (9.9%) in the enoxaparin group and 10 (4.0%) in the apixaban group (P = 0.009). There were no statistically significant differences in rates of total DVT, proximal or distal DVT, pulmonary embolism or mortality between the groups.

Conclusions

Compared with enoxaparin, thromboprophylaxis with apixaban resulted in a lower VTE incidence and fewer haemorrhagic complications.
Differential Association of Exercise Intensity With Risk of Atrial Fibrillation in Men and Women: Evidence from a Meta‐Analysis
Authors: MOHANTY SANGHAMITRA , MOHANTY PRASANT , TAMAKI MEGUMI , NATALE VERONICA , GIANNI CAROLA , TRIVEDI CHINTAN , GOKOGLAN YALCIN , DI BIASE LUIGI , NATALE ANDREA
Published: June 2016

Gender‐Specific Link of Exercise Intensity With AF

Background

Despite widespread interest and extensive research, the association between different levels of physical activity (PA) and risk of atrial fibrillation (AF) is still not clearly defined. Therefore, we systematically evaluated and summarized the evidences regarding association of different intensity of PA with the risk of AF in this meta‐analysis.

Methods and Results

An extensive literature search was performed on databases for studies showing association of exercise with AF risk. Twenty‐two studies were identified that included 656,750 subjects. Meta‐analytic estimates were derived using random‐effects models and pooled odds ratio estimates were obtained. Potential sources of heterogeneity were examined in sensitivity analyses, and publication biases were estimated.

Pooled analysis of 7 studies with 93,995 participants reported high risk of incident AF with sedentary lifestyle (pooled OR 2.47 [95% CI 1.25–3.7], P = 0.005). In 3 trials, 149,048 women involved in moderate PA were 8.6% less likely to develop AF compared to women with sedentary life (OR 0.91 [95% CI 0.78–0.97], P = 0.002). Women performing intense exercise were found to have 28% lower risk of AF (OR 0.72 [95% CI 0.57–0.88], P < 0.001). The overall pooled estimate indicated a protective impact of moderate PA in men (pooled OR 0.8133 [95% CI 0.26–1.004], P = 0.06) whereas vigorous PA was associated with a significantly increased AF risk (pooled OR 3.30 [1.97–4.63], P = 0.0002).

Conclusion

Sedentary lifestyle significantly increases and moderate amount of physical activity reduces the risk of AF in both men and women. However, intense exercise has a gender‐specific association with AF risk.
Acute Sildenafil Use Reduces 24‐Hour Blood Pressure Levels in Patients With Resistant Hypertension: A Placebo‐Controlled, Crossover Trial
Authors: Santa Catharina Arthur , Modolo Rodrigo , Ritter Alessandra Mileni Versuti , Quinaglia Thiago , de Amorim Rivadávio Fernandes Batista , Moreno Heitor , de Faria Ana Paula
Published: June 2016

The authors previously demonstrated that acute administration of sildenafil—a phosphodiesterase 5 (PDE5) inhibitor—improves hemodynamic parameters in patients with resistant hypertensive (RH), but its effect on ambulatory blood pressure monitoring (ABPM) is unknown. This interventional, nonrandomized, single‐blinded, placebo‐controlled, crossover trial included 26 patients with RH. A dose of sildenafil (187.5mg) was given, and after a washout period of 14 days the patients received a single oral dose of placebo and the protocol was repeated. The patients underwent 24‐hour ABPM recordings the day before and immediately after the protocols. The reduction of systolic (−8.8±1.4 vs 1.3±1.2 mm Hg, P=.02), diastolic (−5.3±3.3 vs 1.8±1.1 mm Hg, P=.03), and mean (−7.9±3.6 vs 0.8±0.9 mm Hg, P=.01) 24‐hour BP were found after the use of sildenafil compared with placebo. Improvement in daytime BP levels was also observed (systolic −6.0±4.7 vs 4.4±1.5 mm Hg [P=.02] and mean −4.8±3.9 vs 3.5±1.4 mm Hg [P=.02] for sildenafil vs placebo, respectively). Considering its antihypertensive effect, sildenafil may represent a therapeutic option for RH treatment.
Sluggish cognitive tempo is associated with suicide risk in psychiatrically hospitalized children
Authors: Becker Stephen P. , Withrow Amanda R. , Stoppelbein Laura , Luebbe Aaron M. , Fite Paula J. , Greening Leilani
Published: June 2016

Background

Although identified as a significant public health concern, few studies have examined correlates of suicide risk in school‐aged children. Recent studies show a relation between sluggish cognitive tempo (SCT) symptoms and a range of adverse outcomes linked to suicidal ideation, including depression, emotion dysregulation, lowered self‐esteem, and peer problems/social withdrawal, yet no study to date has examined SCT in relation to suicide risk.

Methods

We tested the hypothesis that SCT would be associated with suicide risk in a sample of 95 psychiatrically hospitalized children (74% male; 62% black) between the ages of 8 and 12 (M = 10.01, SD = 1.50). Parents completed measures of their child's psychiatric symptoms, including SCT and depression, as well as a measure of their own psychopathology. Children completed measures assessing loneliness and depression. Both parents and children completed measures of suicide risk.

Results

White children reported greater suicide risk than nonwhite children. After controlling for demographic characteristics, loneliness, parental psychopathology, and correlated psychiatric symptoms, including both parent‐ and child self‐reported depressive symptoms, SCT remained uniquely associated with children's suicide risk. Results were consistent across both parent and child measures of suicide risk.

Conclusions

This multi‐informant study provides strong preliminary support for an association between SCT symptoms and suicide risk in psychiatrically hospitalized children, above and beyond loneliness, depression, and demographic characteristics. Findings are discussed in the context of the interpersonal theory of suicide. Additional studies are needed to replicate and extend these findings, with a particular need for studies that examine the cognitive processes and daydreaming content of individuals displaying elevated SCT symptomatology.
Biological data from a data‐deficient shark: the Arabian smoothhound Mustelus mosis (Carcharhiniformes: Triakidae)
Authors: Moore A. B. M. , Henderson A. C. , Farrell E. D. , Weekes L. B.
Published: June 2016

The present study provides information on length distribution, reproductive biology and diet of Mustelus mosis based on individuals caught in waters off the eastern Arabian Peninsula. Although ageing of vertebral centra was attempted, band pairs were of low clarity and counts could not be confidently assigned.
Feminist Theory in Family Studies: History, Reflection, and Critique
Authors: Allen Katherine R.
Published: June 2016

In this invited commentary, I address the history and impact of feminist theory in family studies, casting a critical perspective on theorizing in both feminist studies and family studies. I assess indicators of the impact of feminist theory on the study of families, consider the enduring tensions in feminist family theory, and trace 4 generations of feminist theorizing and activism as a prelude to the ways that feminist theory critiques the patriarchal family. Through texts that reflect some of my own educational experiences, I discuss a selection of articles and books that have been influential in establishing the body of knowledge associated with feminist family studies. I conclude with a reflection on the life and work of Alexis J. Walker, to whom this article is dedicated.
Theorizing Family‐Based Nature Activities and Family Functioning: The Integration of Attention Restoration Theory With a Family Routines and Rituals Perspective
Authors: Izenstark Dina , Ebata Aaron T.
Published: June 2016

Time spent in nature has been recognized as beneficial for individuals, but the benefits of nature engagement for families remain significantly underresearched and lack theoretical underpinnings. We draw from the family studies, family leisure, and environmental psychology literature to suggest a new theoretical approach—integrating attention restoration theory and a routines and rituals perspective to study family‐based nature activities. Attention restoration theory shows how certain types of behavioral settings have different effects on restored attention, which may influence interactions between family members, and a family routines and rituals perspective predicts greater developmental benefits from certain types of ritualized activities over onetime experiences. We argue that participation in family‐based nature activities can serve as a pathway for positive family functioning more so than other types of leisure contexts.
A Historical and Empirical Review of Pornography and Romantic Relationships: Implications for Family Researchers
Authors: Rasmussen Kyler
Published: June 2016

This article provides a broad overview of pornography's effects on romantic relationships since the late 1960s, examining the literature through the family impact lens and focusing on pornography's potential influence on relational stability. Pornography's effects are relevant for consumers, public officials, and family scholars concerned with the stability of committed relationships. In particular, findings suggest that pornography can reduce satisfaction with partners and relationships through contrast effects, reduce commitment by increasing the appeal of relationship alternatives, and increase acceptance of infidelity. Evidence connecting pornography to rape or sexual aggression remains mixed, although these effects continue to have important implications for how romantic partners interact. The theoretical perspectives underlying these effects are discussed.
The European Market Abuse Directive: Has it Worked?
Authors: Shahzad Khurram , Mertens Gerard
Published: June 2016

In this paper, we examine whether the Market Abuse Directive (MAD) has been effective in achieving its objectives of deterring the market manipulation activities, increasing the timeliness of information and decreasing the disclosure of inside information to select groups. Our sample consists of firms listed on Frankfurt Stock Exchange. We use stock prices and analysts' forecast‐based proxies to examine the impact and effectiveness of MAD. The analysis based on these two set of proxies provides evidence that the adoption of MAD has been effective. In particular, we find that after the implementation of MAD, on average, (1) the volatility of stock prices around earnings announcement declines, (2) stock prices remain closer to their post earnings announcement level during the period before earnings announcement, (3) the accuracy of analyst forecasts improves, (4) the dispersion of analyst forecasts decreases, and (5) the number of analysts following a company declines.
Tissue kallikrein protects SH‐SY5Y neuronal cells against oxygen and glucose deprivation‐induced injury through bradykinin B2 receptor‐dependent regulation of autophagy induction
Authors: Liu Yanping , Lu Zhengyu , Cui Mei , Yang Qi , Tang Yuping , Dong Qiang
Published: June 2016

Previous studies have demonstrated that tissue kallikrein (TK) protects against cerebral ischemia injury mainly through inhibition of apoptosis via bradykinin B2 receptor (B2R). In this study, we proposed that autophagy induction contributed to the neuroprotective mechanism of TK. To validate this hypothesis, we investigated TK‐induced autophagy and its signaling mechanisms in human SH‐SY5Y cells exposed to oxygen and glucose deprivation (OGD). We found that TK treatment enhanced autophagy induction, reflected by augmented LC3 conversion and Beclin1 expression, decreased p62 levels and increased monomeric red fluorescent protein‐LC3 puncta formation. Green fluorescent protein‐monomeric red fluorescent protein‐LC3 adenovirus assay indicated that TK maintained autophagic flux. Moreover, bafilomycin A1 (Baf.A1) caused obvious LC3‐II accumulation either in the presence or absence of TK. Autophagy inhibition by Beclin1 knockdown or Baf.A1 treatment abrogated the neuroprotective effects of TK. Mitogen‐activated protein kinase kinase 1/2 (MEK1/2)/extracellular signal‐regulated kinase (ERK)1/2 and AMP‐activated protein kinase (AMPK)/tuberous sclerosis complex 2 (TSC2)/mammalian target of rapamycin (mTOR) signaling were induced by OGD stress and enhanced by TK. MEK/ERK inhibitor U0126 alone elevated autophagy in OGD conditions, but impaired TK‐induced autophagy. Blockade of AMPK/TSC2/mTOR signaling by AMPK inhibitor compound C and shRNA mediated the knockdown of AMPK α1 and TSC2 but abolished autophagy in SH‐SY5Y cells exposed to OGD treated either with or without TK. Moreover, B2R expression was up‐regulated by OGD exposure. B2R knockdown attenuated autophagy and suppressed MEK1/2/ERK1/2 and AMPK/TSC2/mTOR signaling in OGD conditions in either the presence or absence of TK. In sum, we revealed the significance of B2R‐mediated MEK/ERK and AMPK signaling in autophagy induction under OGD stress, and proposed novel mechanisms involved in the neuropotective function of TK through B2R‐dependent regulation of autophagy.

image

We propose the depicted model for the neuroprotective mechanism of tissue kallikrein (TK) during OGD stress: TK enhances bradykinin B2 receptor (B2R)‐mediated MEK1/2/ERK1/2 and AMPK/TSC2/mTOR signaling, thus inducing protective autophagy. The findings reported in this study should provide new evidence for the pro‐survival role of B2R‐mediated autophagy in cerebral ischemia.
Balloon‐Expandable Transcatheter Aortic Valves Can Be Successfully and Safely Implanted Transfemorally Without Balloon Valvuloplasty
Authors: Aggarwal Suneil K. , Delahunty Nicola , Wong Bethany , Tamimi Asad N. , Reinthaler Markus , Cheang Mun‐Hong , Roberts Neil , Yap John , Ozkor Muhiddin , Mullen Michael J.
Published: June 2016

Objectives

To assess the necessity for balloon aortic valvuloplasty (BAV) during transfemoral transcatheter aortic valve implantation (TAVI) when using balloon‐expandable valves.

Background

BAV is a usual part of TAVI procedures, prior to valve implantation. However, the benefits and necessity of this are unknown and recent evidence in self‐expanding valves suggests it may not be necessary.

Methods

Retrospective single‐center study of 154 patients undergoing first‐time, transfemoral TAVI for native aortic valve stenosis, with (N = 76), and without (N = 78), BAV as part of the procedure. Data collected included demographic, procedural, and outcome data.

Results

BAV did not alter VARC‐2 defined procedural success or early safety compared to not performing a BAV, including mortality, degree of aortic regurgitation, or need for post‐TAVI balloon dilatation, although there was a strong trend to reduced stroke when not performing a BAV. There was a significantly reduced procedural time (P = 0.01) and fluoroscopic time (P < 0.001) without performing a BAV. There were no differences in cerebral embolization (solid, gaseous, or total emboli) noted between the 2 groups, as measured on transcranial doppler (TCD).

Conclusions

TAVI can be effectively and safely performed without a BAV and this results in reduced procedural and fluoroscopic times, although embolization to the brain is not reduced. There is a trend toward reduced stroke risk. (J Interven Cardiol 2016;29:319–324)
Second‐Generation Drug‐Eluting Balloon for Ostial Side Branch Lesions (001‐Bifurcations): Mid‐Term Clinical and Angiographic Results
Authors: Vaquerizo Beatriz , Fernández‐Nofreiras Eduardo , Oategui Inmanol , Suarez de Lezo Javier , Rumoroso José Ramón , Martín Pedro , Routledge Helen , Tizón‐Marcos Helena
Published: June 2016

Background

In the drug‐eluting stent era, the best strategy to treat Medina 001 lesion remains unestablished. This is the first prospective registry assessing the efficacy and safety of the second‐generation drug‐coated balloon in patients with side‐branch ostial lesion.

Methods

Forty‐nine patients with de novo Medina 001 lesion and associated myocardial ischemia were treated with second‐generation drug‐coated balloon—Dior balloon catheter (Eurocor GmbH, Bonn Germany), and prospectively included in this study. After mandatory pre‐dilatation, a paclitaxel‐eluting balloon was inflated for a minimum of 45 seconds. Left main bifurcation, severely calcified lesions and cardiogenic shock, were the only exclusion criteria.

Results

The inclusion period was 2.7 years. Mean age was 62 ± 12 years old, 41% diabetic, 65% presented with acute coronary syndrome. The most common vessel treated was the first diagonal (50%). Pre‐dilatation with a cutting balloon was used in 59%. Angiographic success was 86% (in 14% a bare metal stent was implanted because of acute recoil [n = 5] or coronary dissection more than type B [n = 2]). At a mean of 12.2 ± 2.2 months, major cardiac adverse events rate was 14.3% (1 myocardial infarction, 0 cardiac deaths, 7 target lesion revascularization). There was no thrombosis or occlusion. At a mean of 7.2 ± 1.1 months, binary restenosis was 22.5% (n = 7) with a late loss of 0.32 ± 0.73 mm.

Conclusion

Medina 001 lesion is an infrequent type of coronary lesion. Drug‐coated balloon—Dior is a safe and technically easy therapeutic option, associated with acceptable mid‐term clinical outcomes. (J Interven Cardiol 2016;29:285–292)
A Randomized Trial of Complete Versus Culprit‐Only Revascularization During Primary Percutaneous Coronary Intervention in Diabetic Patients With Acute ST Elevation Myocardial Infarction and Multi Vessel Disease
Authors: Hamza Mohamed , Mahmoud Ahmed N. , Elgendy Islam Y.
Published: June 2016

Background

Recent randomized trials and meta‐analyses demonstrated that a complete revascularization of significant non culprit lesions in patients with ST elevation myocardial infarction (STEMI) is superior to a culprit only revascularization approach in reducing major adverse cardiac events (MACE), however the proportion of diabetic patients was low in these trials.

Objectives

To investigate whether a complete revascularization approach is associated with better outcomes in diabetic patients with STEMI and multi‐vessel disease.

Methods

One hundred diabetic patients with acute STEMI with at least one non‐culprit lesion were randomized to either complete revascularization (n = 50) or culprit‐only treatment (n = 50). Complete revascularization was performed either at the time of primary percutaneous coronary intervention (PCI) or within 72 hours during hospitalization. The primary endpoint was the composite of all‐cause mortality, recurrent MI, and ischemia‐driven revascularization at 6 months.

Results

A complete revascularization approach was significantly associated with a reduction in the primary outcome (6% vs. 24%, P = 0.01), primarily due to reduction in ischemia driven revascularization in the complete revascularization group (2% vs. 12%; P = 0.047). There was no significant reduction in death or MI (2% vs. 8%; P = 0.17) and (2% vs. 4%; P = 0.56) respectively, or in the safety endpoints of major or minor bleeding, contrast‐induced nephropathy, or stroke between the groups.

Conclusions

In diabetic patients with multi‐vessel coronary artery disease undergoing PPCI, complete revascularization is associated with significantly reduced risk of adverse cardiovascular events, as compared with culprit vessel only PCI. (J Interven Cardiol 2016;29:241–247)
Same or Different Drug‐Eluting Stent Re‐Implantation for Drug‐Eluting Stent Restenosis: An Assessment Including Second‐Generation Drug‐Eluting Stents
Authors: Yabe Takayuki , Toda Mikihito , Nakanishi Rine , Saito Daiga , Watanabe Ippei , Okubo Ryo , Amano Hideo , Ikeda Takanori
Published: June 2016

Objectives

We examined the long‐term outcomes of implanting a different type of drug‐eluting stent (DES), including second‐generation DES, for treatment of DES‐in stent restenosis (ISR).

Background

Treatment for DES‐ISR has not been standardized.

Methods

The subjects were 80 patients with 89 lesions underwent DES implantation for DES‐ISR. The patients were divided into the group of patients receiving the same DES for DES‐ISR (Homo‐stent: 24 patients, 25 lesions) and a different DES for DES‐ISR (Hetero‐stent: 56 patients, 64 lesions). The primary endpoint was survival free of major adverse cardiovascular events (MACE), including cardiac death, myocardial infarction, and target vessel revascularization (TVR). The secondary endpoint was late loss at 8–12 months follow‐up. In the subgroup of patients who were treated with second‐generation DES for DES‐ISR, we also assessed the survival free of MACE.

Results

During a mean follow‐up of 45.1 ± 21.2 months, 26 patients experienced MACE. There was no significant difference in the survival free of MACE (Log rank P = 0.17). In the sub‐analysis of second generation DES, MACE was significantly higher in the Homo‐stent group compared to the Hetero‐stent group (Log rank P = 0.04). Late loss was significantly higher in the Homo‐stent group than in the Hetero‐stent group (0.86 ± 1.03 vs. 0.38 ± 0.74 mm, P = 0.03). This trend was prominent in the first‐generation DES group.

Conclusions

Although there was no significant difference in MACE between the Hetero‐stent and the Homo‐stent groups including both first and second‐generation DES, the sub‐analysis demonstrated different DES implantation for DES‐ISR significantly improved the MACE rate among patients treated with second‐generation DES. (J Interven Cardiol 2016;29:311–318)
Repartnering After Union Dissolution in Later Life
Authors: Schimmele Christoph M. , Wu Zheng
Published: June 2016

The authors estimated the timing of repartnering among individuals who had experienced a union dissolution at age 45 or older, treating cohabitation and marriage as competing risks. The analysis used retrospective data from the 2007 Canadian General Social Survey and life table analysis and Cox models to examine patterns of repartnering. The study offered three major conclusions. First, age constraints on repartnering are large when union dissolution occurs in midlife or later. This age constraint is particularly strong for women and contributes to a wide gender gap in repartnering. Second, in contrast to repartnering at earlier life stages, cohabitation is not the predominant choice of repartnering for those experiencing union dissolution at age 45 and older. Third, union exit status (divorce, cohabitation separation, and widowhood) is a key repartnering differential. The most disadvantageous routes to repartnering are through the experience of cohabitation separation and widowhood.
Exploring Categorical Body Mass Index Trajectories in Elementary School Children
Authors: Moreno‐Black Geraldine , Boles Shawn , Johnson‐Shelton Deb , Evers Cody
Published: June 2016

BACKGROUND

Studies of body mass index (BMI) change have focused on understanding growth trajectories from childhood to adolescence and adolescence to adulthood, but few have explored BMI trajectories solely in elementary (grades K‐5) school children. This report complements these studies by exploring changes in obesity status using analytic methods developed to investigate categorical changes in life‐course events.

METHODS

Sequences of a 4‐state BMI variable (underweight, normal, overweight, and obese) were calculated using height and weight data collected annually (2008‐2013) from 414 kindergarten and first‐grade students participating in the Community and Schools Together (CAST) project. These sequences were explored using the TraMineR software package to investigate the distribution of sequences and states, calculate transition rates among states, and examine clustering of sequences.

RESULTS

Aggregated cluster solutions were identified consisting of either 4 clusters (normal, stepped, mixed, and obese) or 3 clusters (aggregation of obese cluster cases into stepped cluster) with membership in the former predicted by ethnicity and socioeconomic status (SES) and the latter by SES alone. Transition rate patterns among states varied markedly by cluster and state.

CONCLUSION

The finding of early emergence of stable obesity states, especially in Hispanic children confirms the need for early childhood interventions to influence BMI.
Setting Adolescents Up for Success: Promoting a Policy to Delay High School Start Times
Authors: Barnes Margaux , Davis Krista , Mancini Mackenzie , Ruffin Jasmine , Simpson Tina , Casazza Krista
Published: June 2016

BACKGROUND

A unique biological shift in sleep cycles occurs during adolescence causing later sleep and wake times. This shift is not matched by a concurrent modification in school start times, resulting in sleep curtailment for a large majority of adolescents. Chronic inadequate sleep is associated with poor academic performance including executive function impairments, mood, and behavioral issues, as well as adverse health outcomes such as an increased risk of obesity, hypertension, and cardiovascular disease. In order to address sleep deficits and the potential negative outcomes associated with chronic sleep deprivation, the American Academy of Pediatrics (AAP) and US Centers for Disease Control and Prevention (CDC) support delaying school start times for middle and high school students.

METHODS

We summarize current evidence, explicate the need for policy change, and urge school districts to put adolescent students' health as top priority and implement school start times consistent with their developmental needs.

RESULTS

Whereas substantial evidence illustrating adverse consequences of inadequate sleep on psychological and physical health, and recommendations exist to adapt daytime school schedules to match sleep needs have been released, actual implementation of these recommendations have been limited.

CONCLUSIONS

This is a call to action for the implementation of AAP/CDC recommendations across the state and nation.
Pirfenidone suppresses MAPK signalling pathway to reverse epithelial‐mesenchymal transition and renal fibrosis
Authors: Li Zhenzhen , Liu Xianghua , Wang Baoying , Nie Yali , Wen Jianguo , Wang Qingwei , Gu Chaohui
Published: June 2016

Aim

Recent studies indicate that pirfenidone (PFD) may have anti‐fibrotic effects in many tissues, but the potential molecular mechanism remains unknown. The purpose of this study is to investigate the potential effects of PFD on epithelial‐to‐mesenchymal transition (EMT) and renal fibrosis in a unilateral ureteral obstruction (UUO) rat model and the involved molecular mechanism related to cultured human renal proximal tubular epithelial cells (HK‐2).

Methods

Sixty rats were randomly divided into three groups: sham‐operated, vehicle‐treated UUO, and PFD‐treated UUO. Kidney specimens were collected at day 7 or 14 after UUO. PFD treatment was also performed for human HK‐2. The tubulointerstitial injury, interstitial collagen deposition, and expression of type I and III collagen, α‐SMA, S100A4, fibronection and E‐cadherin were assessed. In addition, extracellular signal regulated kinase (ERK1/2), p38 MAPK (p38), and c‐Jun N‐terminal kinase/stress‐activated protein kinase (JNK) were also detected.

Results

In vitro, PFD significantly attenuated TGF‐β1‐induced EMT and extracellular matrix (ECM) synthesis, as determined by reducing expression of α‐SMA, type I and III collagen, S100A4, fibronection, and increased expression of E‐cadherin. PFD treatment attenuated TGF‐β1‐induced up‐regulation of phosphorylation of ERK1/2, p38 and JNK. In vivo, PFD reduced the degree of tubulointerstitial injury and renal fibrosis, which was associated with reduced expression of TGF‐β1, type III collagen, α‐SMA, S100A4, fibronection, and increased expression of E‐cadherin.

Conclusion

These results suggest that pirfenidone is able to attenuate EMT and fibrosis in vivo and in vitro through antagonizing the MAPK pathway, providing a potential treatment to alleviate renal tubulointerstitial fibrosis.
NODULES WITH ACTIVATED DEFENSE 1 is required for maintenance of rhizobial endosymbiosis in Medicago truncatula
Authors: Wang Chao , Yu Haixiang , Luo Li , Duan Liujian , Cai Liuyang , He Xinxing , Wen Jiangqi , Mysore Kirankumar S. , Li Guoliang , Xiao Aifang , Duanmu Deqiang , Cao Yangrong , Hong Zonglie , Zhang Zhongming
Published: June 2016

The symbiotic interaction between legume plants and rhizobia results in the formation of root nodules, in which symbiotic plant cells host and harbor thousands of nitrogen‐fixing rhizobia.

Here, a Medicago truncatula nodules with activated defense 1 (nad1) mutant was identified using reverse genetics methods. The mutant phenotype was characterized using cell and molecular biology approaches. An RNA‐sequencing technique was used to analyze the transcriptomic reprogramming of nad1 mutant nodules.

In the nad1 mutant plants, rhizobial infection and propagation in infection threads are normal, whereas rhizobia and their symbiotic plant cells become necrotic immediately after rhizobia are released from infection threads into symbiotic cells of nodules. Defense‐associated responses were detected in nad1 nodules. NAD1 is specifically present in root nodule symbiosis plants with the exception of Morus notabilis, and the transcript is highly induced in nodules. NAD1 encodes a small uncharacterized protein with two predicted transmembrane helices and is localized at the endoplasmic reticulum.

Our data demonstrate a positive role for NAD1 in the maintenance of rhizobial endosymbiosis during nodulation.
Buccal flap: is it still useful for intraoral reconstruction
Authors: Verma R.K. , Sunku S.K. , Panda N.K.
Published: June 2016

Aim

To evaluate usefulness of the buccal flap as a reconstructing tool for various surgical defects in the oral cavity.

Study design

Retrospective observational study.

Materials and methods

Retrospective charts reviews of 15 patients, with carcinoma of the oral cavity in whom a buccal flap was used to repair the defect after excision of the primary lesion, were reviewed. All these patients were called for follow‐up and analysed for functional and aesthetic outcomes.

Results

All flaps survived successfully. Three had marginal necrosis of the flap which was managed conservatively. Mild chewing difficulty and trismus were other problems commonly encountered.

Conclusion

Buccal flap is a sensate, easy to harvest local flap with well‐defined neuro vascular bundle that can be used in reconstructing various surgical defects of oral cavity and oropharynx thus obviating the need for distal tissue transfer.
Two forms of self‐criticism mediate differently the shame–psychopathological symptoms link
Authors: Castilho Paula , Pinto‐Gouveia José , Duarte Joana
Published: June 2016

Objectives

This study explored the relation between external shame, two types of self‐criticism, and depressive, anxious and stress symptoms, in a clinical sample. Specifically, we set out to test whether the impact of external shame on such symptoms would be mediated by two forms of self‐criticism.

Method

A total of 279 patients (228 female and 51 male; mean age of 28.58) with axis I andIIdisorders recruited from several outpatients psychiatric services in Portugal completed the Other as Shamer Scale (OAS), the Forms of Self‐Criticizing/Attacking and Self‐Reassuring Scale (FSCRS), and the Depression, Anxiety and Stress Scale (DASS‐42).

Results

Self‐criticism mediated in part the shame–psychopathological symptoms link, especially the hated self form. The alternative model where shame mediates the link between self‐criticism and psychopathological symptoms was also significant. This result suggests that fear of being devalued in the minds of others has a significant impact on people's psychological well‐being, and this effect can be partially explained by self‐criticism.

Conclusions

This study highlights that inadequate self and hated self are separable types of self‐criticism, because they show different patterns of association with psychopathology. Shame and self‐criticism appear to mutually enhance one another, and both are associated with psychopathological symptoms. External shame and self‐criticism should be a target in treatment.

Practitioner points

External shame and self‐criticism are associated with depressive, anxious, and stress symptoms, in a clinical sample.

Self‐criticism, especially hatred for the self, mediates the shame–psychopathological symptoms link.

Shame and self‐criticism should be addressed in therapeutic interventions targeting the reduction of depression, anxiety, and stress symptoms.