bluuebunny/crossref_metadata_2025 huggingface dataset:
A randomized phase II trial of personalized peptide vaccine with low dose cyclophosphamide in biliary tract cancer
Authors: Shirahama Takahisa , Muroya Daisuke , Matsueda Satoko , Yamada Akira , Shichijo Shigeki , Naito Masayasu , Yamashita Takuto , Sakamoto Shinjiro , Okuda Koji , Itoh Kyogo , Sasada Tetsuro , Yutani Shigeru
Published: February 2017

Since the prognosis of advanced biliary tract cancer (aBTC) still remains very poor, new therapeutic approaches, including immunotherapies, need to be developed. In the current study, we conducted an open‐label randomized phase II study to test whether low dose cyclophosphamide (CPA) could improve antigen‐specific immune responses and clinical efficacy of personalized peptide vaccination (PPV) in 49 previously treated aBTC patients. Patients with aBTC refractory to at least one regimen of chemotherapies were randomly assigned to receive PPV with low dose CPA (100 mg/day for 7 days before vaccination) (PPV/CPA, n = 24) or PPV alone (n = 25). A maximum of four HLA‐matched peptides were selected based on the pre‐existing peptide‐specific IgG responses, followed by subcutaneous administration. T cell responses to the vaccinated peptides in the PPV/CPA arm tended to be greater than those in the PPV alone arm. The PPV/CPA arm showed significantly better progression‐free survival (median time: 6.1 vs 2.9 months; hazard ratio (HR): 0.427; P = 0.008) and overall survival (median time: 12.1 vs 5.9 months; HR: 0.376; P = 0.004), compared to the PPV alone arm. The PPV alone arm, but not the PPV/CPA arm, showed significant increase in plasma IL‐6 after vaccinations, which might be associated with inhibition of antigen‐specific T cell responses. These results suggested that combined treatment with low dose CPA could provide clinical benefits in aBTC patients under PPV, possibly through prevention of IL‐6‐mediated immune suppression. Further clinical studies would be recommended to clarify the clinical efficacy of PPV/CPA in aBTC patients.
DEMONSTRATED INTEREST: SIGNALING BEHAVIOR IN COLLEGE ADMISSIONS
Authors: Dearden James A. , Li Suhui , Meyerhoefer Chad D. , Yang Muzhe
Published: February 2017

In college admission decisions, important and possibly competing goals include increasing the quality of the freshman class and making the school more selective while attaining the targeted size of the incoming class. Especially for high‐quality applicants who receive multiple competing offers, colleges are concerned about the probability that these students accept the offers of admission. As a result, applicants' contacts with admissions offices, such as campus visits, can be viewed positively by the officers as demonstrated interest in the colleges. We provide empirical evidence on the effects of demonstrated interest on admission outcomes. Specifically, we use unique and comprehensive administrative data, which include all contacts made by each applicant to the admissions office of a medium‐sized highly selective university during two admission cycles. We find that an applicant who contacts the university is more likely to be admitted, and that the effect of the contact on the probability of admission is increasing in the applicant's Scholastic Assessment Test score, particularly when the contact is costly to make. We also use a numerical example to explore policies to reduce the inequity associated with the use of demonstrated interest in admission decisions, examining in particular the subsidization of costly demonstrated interest by low‐income students. (JELD83, I23)
Effect of exercise combined with glucagon‐like peptide‐1 receptor agonist treatment on cardiac function: A randomized double‐blind placebo‐controlled clinical trial
Authors: Jørgensen Peter G. , Jensen Magnus T. , Mensberg Pernille , Storgaard Heidi , Nyby Signe , Jensen Jan S. , Knop Filip K. , Vilsbøll Tina
Published: February 2017

In patients with type 2 diabetes, both supervised exercise and treatment with the glucagon‐like peptide‐1 (GLP‐1) receptor agonist (GLP‐1RA) liraglutide may improve cardiac function. We evaluated cardiac function before and after 16 weeks of treatment with the GLP‐1RA liraglutide or placebo, combined with supervised exercise, in 33 dysregulated patients with type 2 diabetes on diet and/or metformin. Early diastolic myocardial tissue velocity was improved by exercise in the placebo group (mean ± standard deviation [s.d.] −7.1 ± 1.6 to −7.7 ± 1.8 cm/s,
P
 = .01), but not in the liraglutide group (−7.1 ± 1.4 to −7.0 ± 1.4 cm/s,
P
 = .60; between groups,
P
 = .02). Similarly, the mean ± s.d. ratio of early and atrial mitral annular tissue velocities improved in the placebo group (1.0 ± 0.4 to 1.2 ± 0.4,
P
 = .003), but not in the liraglutide group (1.0 ± 0.3 to 1.0 ± 0.3,
P
 = .87; between groups,
P
 = .03). We found no significant differences in heart rate, left ventricular (LV) structure or function within or between the groups. In conclusion, the addition of liraglutide to exercise in sedentary patients with dysregulated type 2 diabetes may blunt the suggested beneficial effect of exercise on LV diastolic function.
Should we intervene at stage 0? A qualitative study of attitudes of asymptomatic youth at increased risk of developing bipolar disorders and parents with established disease
Authors: Davison Jo , Scott Jan
Published: February 2017

Background

Studies of potential interventions for asymptomatic individuals at risk of severe mental disorders (ie, clinical stage 0) have focused on genetic counselling or the views of adults with established disease. No study has interviewed youth at risk of bipolar disorders (BD).

Methods

Qualitative analysis of interviews with asymptomatic adolescent offspring of adults with BD (OSBD = 7) and unrelated parents with bipolar disorders (PBD = 6) to examine manifest and latent themes in the dialogue.

Results

Core themes in both groups were ignorance regarding the magnitude of risk of BD onset in offspring and greater concerns for the health of other family members than for oneself. Parents expressed anxieties in coping with the uncertainty about whether their children would inherit BD and their desire to reduce this risk was partly driven by guilt and their sense of responsibility; PBD favoured the introduction of specialized clinical OSBD services. In contrast, the priority for OSBD was advice on coping with a parent with BD; OSBD favoured access to generic non‐clinical peer group support, which they perceived as less stigmatizing than specialist services.

Conclusion

The study highlights that youth at risk of BD should be allowed to express their ideas on what interventions they believe are likely to be most beneficial for them, as their views may differ from other advocates who are routinely consulted, such as PBD. A noteworthy finding was that OSBD thought that being included in the clinical dialogue about their parents’ BD would decrease rather than increase their stress levels.
Where to go if not the hospital? Reviewing geriatric bed utilization in an acute care hospital in Singapore
Authors: Zhou Ke , Vidyarthi Arpana R. , Wong Chek Hooi , Matchar David
Published: February 2017

Aim

Singapore is one of the fastest‐aging countries in the world, and the demand for acute hospital care for older adults is expected to triple in the next 25 years. Hence, it is crucial to understand the opportunities in reducing potentially avoidable bed days (PABD), which are days spent in acute hospitals delivering only non‐acute services. We aimed to access the prevalence, causes and consequences of PABD among geriatric patients.

Methods

We examined all hospitalizations from 1 August through 31 December 2013 in the geriatric wards of an acute hospital in Singapore. PABD were identified using a modified Appropriateness Evaluation Protocol. Non‐acute services were classified as subacute care, rehabilitative care, long‐term care or social care. Hospitalization patterns were determined based on the presence or absence of non‐acute services, and multinomial logistic regression was used to determine predictors of different patterns.

Results

Of the 273 bed days used by 254 patients, 49% were potentially avoidable. The most common non‐acute services provided were rehabilitative care (19%), subacute care (12%) and long‐term care (8%). New acute issues arose after the admission conditions subsided in 2.4% of hospitalizations, 61% of which were nosocomial infections. Being socially at risk as assessed on admission predicted the development of new acute issues (sensitivity = 62%; specificity = 88%).

Conclusions

In the present study, almost half of the bed days were potentially avoidable. New acute issues can arise after PABD, which are dangerous to these frail older adults. Proactive discharge planning and increasing access to intermediate and long‐term care services are required to reduce PABD. Geriatr Gerontol Int 2017; 17: 1575–1583.
Impact of poor sleep quality and physical inactivity on cognitive function in community‐dwelling older adults
Authors: Nakakubo Sho , Makizako Hyuma , Doi Takehiko , Tsutsumimoto Kota , Lee Sangyoon , Lee Sungchul , Hotta Ryo , Bae Seongryu , Suzuki Takao , Shimada Hiroyuki
Published: February 2017

Aim

The purpose of the present study was to examine whether the combination of subjective sleep quality and physical activity is associated with cognitive performance among community‐dwelling older adults.

Methods

Cross‐sectional data on 5381 older adults who participated in part of the National Center for Geriatrics and Gerontology – Study of Geriatric Syndromes were analyzed. We assessed general cognitive impairment using the Mini‐Mental State Examination, and also assessed story memory, attention, executive function and processing speed using the National Center for Geriatrics and Gerontology Functional Assessment Tool. Physical activity was assessed using two questionnaires, and participants were categorized as active or inactive. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, and participants were categorized as having poor (PS) or good sleep quality (GS).

Results

Participants in the inactive + PS group had worse performances than those in the active + GS group in all cognitive measures (Mini‐Mental State Examination: P = 0.008, story memory: P = 0.007, other cognitive measures: P < 0.001), and also had worse performances than those in the inactive + GS and active + PS groups in the trail‐making test, part B, and the symbol digit substitution test (P < 0.001, respectively). Additionally, participants in the inactive + GS group had worse performances than in the active + GS in the trail‐making test, part B, and the symbol digit substitution test (P = 0.002 and P = 0.001, respectively).

Conclusions

Inactivity and poor sleep quality were associated with poor cognitive performance among community‐dwelling older adults. The combination of poor sleep quality and physical inactivity also worsened cognitive performance. Geriatr Gerontol Int 2017; 17: 1823–1828.
The neural substrate of gait and executive function relationship in elderly women: A PET study
Authors: Sakurai Ryota , Ishii Kenji , Yasunaga Masashi , Takeuchi Rumi , Murayama Yoh , Sakuma Naoko , Sakata Muneyuki , Oda Keiichi , Ishibashi Kenji , Ishiwata Kiichi , Fujiwara Yoshinori , Montero‐Odasso Manuel
Published: February 2017

Aim

Understanding the relationship between age‐related gait impairment, such as slow gait, and executive functioning in seniors may help identify individuals at higher risk of mobility decline, falls, and progression to dementia at earlier stages. We aim to identify brain regions concomitantly associated with poor gait and executive functioning in a cohort of well‐functioning elderly women.

Methods

In total, 149 well‐functioning women aged 70.1 ± 6.2 years underwent FDG‐PET to evaluate regional cerebral metabolic rates of glucose normalized in reference to cerebellar glucose metabolic value (normalized‐rCMRglc) in 16 brain areas. We assessed gait speed, step length and cadence under usual and fast conditions. Executive function was assessed using Trail‐Making‐Tests (TMT) A and B.

Results

Adjusted multiple regression analyses for potential covariates showed that TMT‐B and ΔTMT (TMT B‐A) were associated with gait speed and cadence at fast condition. Lower normalized‐rCMRglc in the posterior cingulate and primary sensorimotor cortices were associated with longer TMT‐B and ΔTMT times (i.e., lower executive function) as well as with slower gait speed and lower cadence at fast condition. Slower gait speed and lower cadence at fast condition were also associated with lower normalized‐rCMRglc in the occipital and parietal cortices. There were no other significant associations.

Conclusions

In healthy elderly women without impending disability or cognitive impairment, reduced glucose metabolism in the posterior cingulate and primary sensorimotor cortices were associated with both lower gait performance and executive functioning. Our results suggest that gait control and executive functions might share the same neural substrate. Geriatr Gerontol Int 2017; 17: 1873–1880.
Correlates of subjective transportation deficiency among older adults attending outpatient clinics in a tertiary care hospital in Mexico City
Authors: Navarrete‐Reyes Ana Patricia , Medina‐Rimoldi Carlos Tonatiuh , Avila‐Funes José Alberto
Published: February 2017

Aim

Older adults frequently report problems of transportation. Little is known about the correlates of transportation deficiency in Latin America. Therefore, the aim of the present study was to determine the correlates of subjective transportation deficiency (STD) among community‐dwelling older adults attending a tertiary care hospital in Mexico City.

Methods

Cross‐sectional study of 228 participants aged ≥70 years being followed in any of the outpatient clinics of a tertiary care hospital in Mexico City. Data were obtained through a structured questionnaire. Univariate and multivariate logistic regression analyses were carried out in order to identify the correlates of STD.

Results

The mean age of the participants was 79.8 years (SD 6.4) and 67.1% were women. STD was present in 46% of participants. The multivariate logistic regression model showed that female sex, illiteracy, mobility disability and the use of an assistive walking device had an independent and statistically significant association with STD.

Conclusions

Female sex, illiteracy, mobility disability and the use of an assistive walking device were independent correlates of STD in the present study. Identifying the frequency and correlates of transportation deficiency in vulnerable populations will allow for the identification and implementation of useful public policies, as well as for the optimization of prevention and treatment strategies in an attempt to preserve mobility and autonomy, especially in low‐ and middle‐income countries where previous work on transportation deficiency is lacking. Geriatr Gerontol Int 2017; 17: 1893–1898.
Chronic condition as a mediator between metabolic syndrome and cognition among community‐dwelling older adults: The moderating role of sex
Authors: Foong Hui Foh , Hamid Tengku Aizan , Ibrahim Rahimah , Haron Sharifah Azizah , Shahar Suzana
Published: February 2017

Aim

Metabolic syndrome and chronic conditions are significant predictors of cognition; however, few studies have examined how they work together in predicting cognition in old age. Therefore, the present study examines whether a chronic condition mediates the association between metabolic syndrome and cognition. In addition, it discusses the moderating role of sex in the relationships between metabolic syndrome, chronic conditions and cognition.

Methods

Secondary analysis was carried out of data from the Malaysian national survey that involved 2322 community residents aged 60 years or older in Peninsular Malaysia. Cognition was measured by the digit symbol substitution test. Metabolic syndrome was assessed by five biomarkers: triglyceride, fasting blood sugar, systolic blood pressure, cholesterol ratio and body mass index. Chronic conditions were assessed by self‐reported medical history. The structural equation modeling technique was used to analyze the mediation and moderation tests.

Results

The number of chronic conditions partially mediated the association between metabolic syndrome and cognition. Men and women did not differ in the relationship between metabolic syndrome and cognition; however, the number of chronic conditions was found to be negatively associated with cognition in older women, but not in men.

Conclusions

Metabolic syndrome might increase the likelihood of older adults to suffer from more chronic conditions; these responses might reduce their cognition. To prevent cognitive decline in old age, specific intervention to minimize the number of chronic conditions by reducing their vascular risk factors is warranted, especially among older women. Geriatr Gerontol Int 2017; 17: 1914–1920.
Factors associated with perceived unmet dental care needs of older adults
Authors: Chae Songi , Lee Yunhwan , Kim Jinhee , Chun Ki Hong , Lee Jeong Keun
Published: February 2017

Aim

Although older adults have high dental care needs as a result of prevalent oral health problems, they have high unmet needs. The purpose of the present study was to examine factors associated with unmet dental care needs among older adults living in the community.

Methods

This study analyzed 1419 adults aged 65 years and older who participated in both the health interview survey and oral examination of the Fifth Korea National Health and Nutrition Examination Survey carried out in 2010. Predisposing (age, sex, education, marital status), enabling (place of residence, work status, income, health insurance) and need (self‐rated oral health, difficulty chewing, toothache, number of teeth, dental caries, periodontal disease) factors associated with self‐perceived unmet dental care needs were analyzed through multiple logistic regression analysis.

Results

Unmet dental care needs accounted for 27.9% in older adults. Age, income, difficulty chewing and the presence of permanent tooth caries were significantly associated with unmet dental care needs, adjusting for covariates. Compared with those aged 75 years and older, the 65–69 years age group showed 1.86‐fold higher odds of unmet dental care needs. Lower household income was associated with a higher likelihood of not receiving dental care when required. Unmet dental care needs were significantly higher among those with chewing difficulty (OR 2.14, 95% CI 1.55, 2.95) and permanent tooth caries (OR 1.86, 95% CI 1.28–2.70).

Conclusions

Unmet dental care needs are prevalent in older people who are socioeconomically disadvantaged and vulnerable in oral health. Geriatr Gerontol Int 2017; 17: 1936–1942.
The Non‐Inferiority Margins in Migraine Research (NIMM) Survey
Authors: Orr Serena L. , Ramsay Timothy , Christie Suzanne N , Dodick David , Gladstone Jonathan , Dowlatshahi Dar
Published: February 2017

Objectives

To survey experts in Headache Medicine on their opinions regarding appropriate non‐inferiority margins for outcomes commonly used in migraine research.

Methods

Members of the American Headache Society and the Canadian Headache Society were invited to participate in the Non‐Inferiority Margins in Migraine Research (NIMM) survey. Adult and child neurologists with expertise in Headache Medicine were eligible to participate. The survey had a multiple choice format and comprised questions on respondent characteristics, eligibility, as well as expert opinion on non‐inferiority margins for outcomes commonly used in trials of both prophylactic and acute interventions for migraine.

Results

Ninety‐nine eligible respondents completed the survey. Most respondents were adult neurologists (84.9%) and 74% reported practicing in the USA. The following were the most commonly selected non‐inferiority margins: (1) change in monthly migraine attacks comparing baseline to the treatment period: 1 attack (39.4% selecting), (2) change in monthly migraine days comparing baseline to the treatment period: 1 day (44.4%), (3) change in average migraine intensity on a 4‐point scale comparing baseline to the treatment period: 1.0 (31.3%), (4) percentage of participants who are pain‐free 2 hours after the intervention: 5% (41.4%), (5) percentage of participants who have a migraine recurrence within 48 hours of treatment: 5% (42.4%), and (6) percentage of participants with sustained pain freedom: 5% (42.4%).

Conclusions

The results of the NIMM survey describe the opinions of a group of experts on appropriate non‐inferiority margins for outcomes commonly used in migraine clinical trials. There was significant variability in responses and lack of consensus on the choice of non‐inferiority margins. The survey did not incorporate the patient perspective and was not validated prior to distribution. Further work in this area is required in order to explore how to incorporate clinical considerations into the selection of non‐inferiority margins for migraine research.
Tantalum carbide coating on Ti‐6Al‐4V by electron beam physical vapor deposition method: Study of corrosion and biocompatibility behavior
Authors: Esmaeili Mohammad Mahdi , Mahmoodi Mahboobeh , Imani Rana
Published: February 2017

This study aimed to improve the corrosion resistance and biocompatibility of titanium alloy (Ti‐6Al‐4V) by tantalum carbide (TaC) deposition through electron beam physical vapor deposition (EB‐PVD) method. The physical and chemical characteristics of the coated surface are comprehensively evaluated. The corrosion resistance and ion release are assessed. Cytocompatibility assay and cell morphology observation are performed to assess toxicity and cell interaction, respectively. The TaC‐coated Ti‐6Al‐4V exhibits more resistance to corrosion and ion release. It provides a surface, which is appropriate for cell adhesion, an expansion as well as better biocompatible performance. So, it could improve osseointegration Ti‐alloy implants in clinical applications.
Evaluation of the high temperature performance of HfB2 UHTC particulate filled Cf/C composites
Authors: Paul Anish , Rubio Virtudes , Binner Jon , Vaidhyanathan Bala , Heaton Andrew , Brown Peter
Published: February 2017

Room and high temperature flexural strength and coefficient of thermal expansion (CTE) of HfB2 ultra‐high temperature ceramic (UHTC) particulate filled Cf/C composites are determined along with UHT oxidation behavior. Both room and high temperature strength of the composites were found to be broadly comparable to those of other thermal protection system materials currently being investigated. The CTE of the composites was measured both along and perpendicular to the fiber direction up to 1700°C and the values were found to depend on fiber orientation by approximately a factor of 3. Arc‐jet testing of the UHTC composites highlighted the excellent ultra‐high temperature oxidation performance of these materials.
Potency of commercial TiO2‐P25 nanoparticles to form stainless steel protective coating
Authors: Pourmoalem Mansour , Naghibi Sanaz
Published: February 2017

This research reports for the first time the surface coating of steel samples with commercial nanoparticles of TiO2. Aiming to improve the substrate corrosion behavior, a stable suspension containing TiO2‐P25 nanoparticles and polyvinyl alcohol in the water was prepared and the coating was applied on the surface of the substrate via dip‐coating. Heat treatment led to the formation of strong connection between the substrate and the coating film. Scanning electron microscopy and scanning probe microscopy were utilized to scrutinize the samples in terms of topography and microstructure. In addition, the samples corrosion behavior was investigated through Tafel polarization and impedance spectroscopy. The results showed that one‐step of sample dip‐coating in sol or heat treatment at 600°C cannot provide for desirable and appropriate physical circumstances in the thin film. The applied thin film showed the highest corrosion behavior improvement when the sample was coated with two or three films and the heat treatment was carried out at 400°C. In this respect, according to the Tafel curves, the applied coating efficiency was measured to be approximately 90%. The electrochemical impedance spectroscopy results indicated that the reference sample was single‐time constant and the coated sample was double‐time constant. Applying the coating increased impedance, reduced the capacitive element, and diminished the resistance area. All three mentioned factors contributed to the enhancement of corrosion behavior.
Investigation of the clinical features of geographic tongue: unveiling its relationship with oral psoriasis
Authors: Picciani Bruna , Santos Vanessa de Carla , Teixeira‐Souza Thays , Izahias Lívia Maria , Curty Áquila , Avelleira João Carlos , Azulay David , Pinto Jane , Carneiro Sueli , Dias Eliane
Published: February 2017

Background

Few studies have examined the clinical features of geographic tongue (GT), an inflammatory lesion, making diagnosis and the investigation of oral psoriasis difficult.

Purpose

To investigate the clinical features of GT to facilitate its identification and understand its relationship with psoriasis.

Methods

A total of 96 participants diagnosed with GT underwent stomatological and dermatological examinations. The parameters assessed were burning sensation; number, classification, and location of lesions; loss of papillae; severity of GT lesions; and association with fissured tongue (FT). Psoriatic patients (PS) and those without psoriasis (NPS) were compared.

Results

Burning sensation was reported by 45 (47%) patients, 67 (70%) patients showed active GT, 68 (71%) presented with typical lesions, and 59 (61%) exhibited moderate lesions. GT was associated with FT in 75% of the cases and exhibited a diffused pattern associated with severe lesions. It was also more frequent in the PS group. The comparative analysis between the PS and NPS groups showed significant differences between the groups with regard to gender, presence of burning sensation, and GT severity.

Conclusion

GT is a symptomatic lesion with a thick halo. In contrast, psoriatic patients are frequently asymptomatic and exhibit severe lesions with greater loss of papillae that are associated with severe FT. The present study is the first to demonstrate clinical differences in the GT of patients with and without psoriasis, suggesting that some GT cases may represent true oral psoriasis and some cases may represent only GT.
Histopathological aspects of cutaneous erythematous‐papular eruptions induced by immune checkpoint inhibitors for the treatment of metastatic melanoma
Authors: Perret Raul E. , Josselin Nicolas , Knol Anne‐Chantal , Khammari Amir , Cassecuel Julie , Peuvrel Lucie , Dreno Brigitte ,   Supported by GESTIM Nantes group of cutaneous adverse events induced by anticancer drugs
Published: February 2017

Background

Immune checkpoint blockade therapy (ICBT) for the treatment of melanoma has led to an important improvement of overall survival in advanced stage patients. However, secondary cutaneous maculopapular eruptions (CMPEs) are frequent and remain poorly characterized.

Methods

We performed a retrospective analysis of melanoma patients from our institution who developed CMPEs during ICBT. Clinical information was retrieved, and histopathological and immunohistochemical characterization was performed by two pathologists. For comparison, a group of biopsies from CMPE caused by anti‐v‐raf murine sarcoma viral oncogene homolog B1 (BRAF) therapy was analyzed.

Results

Eleven patients met the inclusion criteria. On clinical grounds, CMPE developed mainly on early onset of immunotherapy and were of low grade. Typical lesions included erythematous papules and macules affecting the trunk and/or extremities with associated pruritus. The histopathological patterns consisted of a superficial perivascular lymphocytic dermatitis (SPLD) with eosinophils followed by a granulomatous dermatitis. Other patterns included lichenoid, spongiotic, and a case of Grover's disease. The inflammatory infiltrate consisted of T lymphocytes (CD3+) with a predominance of CD4+ over CD8+ cells; isolated Foxp3+ cells were invariably present, and PD‐1 was not expressed. Biopsies from CMPE caused by anti‐BRAF therapy showed an SPLD and a similar lymphocytic immunophenotype.

Conclusions

Our study showed the clinical features of a group of melanoma patients with CMPE for ICBT and emphasized the wide spectrum of histological findings as well as their immunohistochemical profile. Differential diagnosis can be difficult with CMPE provoked by other therapies as was seen in our comparison group of anti‐BRAF‐induced eruptions.
Natural spawning of a Hawaiian sea urchin, Tripneustes gratilla
Authors: Johnson Darren W. , Ranelletti Marla E.
Published: February 2017

Observations of natural spawning events are rare but critically important for the field of fertilization ecology. For broadcast spawners, knowing the natural behavior of spawning, including proximity of animals and the timing of spawning, is essential for informing spawning experiments and directing future study. Here we describe a natural spawning event that took place on the island of Maui in the winter of 2010. Groups of Tripnuestes gratilla were observed to spawn in the late afternoon shortly after a local high tide that was a lower high of a mixed, semidiurnal tide cycle. Urchins appeared to increase the probability of fertilization by ascending to the local high points of the reefs and spawning within groups of 2–5. Although the majority of the urchins that spawned were T. gratilla, two individuals of Echinothrix diadema were observed to spawn at the same time, raising questions about potential hybridization in the wild.
Occurrence of Focal Atrial Tachycardia During the Ablation Procedure Is Associated With Arrhythmia Recurrence After Termination of Persistent Atrial Fibrillation
Authors: IWAI SHINSUKE , TAKAHASHI YOSHIHIDE , MASUMURA MAYUMI , YAMASHITA SYU , DOI JUNICHI , YAMAMOTO TASUKU , SAKAKIBARA ATSUSHI , NOMOTO HIDETSUGU , YOSHIDA YOSHINORI , SUGIYAMA TOMOYO , OUMI TETSUO , OHNO MASAKAZU , SATO YASUHIRO , HIRAO KENZO , ISOBE MITSUAKI
Published: February 2017

Focal AT and Recurrence After AF Ablation

Introduction

Catheter ablation can terminate persistent atrial fibrillation (AF). However, atrial tachycardia (AT) often arises after termination of AF.

Methods and Results

Of 215 patients who underwent index stepwise ablation for persistent AF, 141 (66%) patients (64 ± 9 years) in whom AF terminated during the ablation procedure were studied. If AF converted into AT, ablation for AT was subsequently performed. ATs were categorized as focal or macroreentrant AT. We assessed whether type of AT occurring after conversion of AF during the ablation procedure was associated with freedom from atrial tachyarrhythmia (AF or AT) during follow‐up. Sinus rhythm was directly restored from AF in 37 patients, while 34, 37, and 33 patients had focal AT alone, a mix of focal and macroreentrant AT, and macroreentrant AT alone after termination of AF, respectively. Arrhythmia‐free survival rates at 1 year after the index procedure were 30%, 34%, 61%, and 59% in the patients with focal AT alone, a mix of focal AT and macroreentrant AT, macroreentrant AT alone, and direct restoration of sinus rhythm, respectively (P = 0.004). Type of AT occurring during the index procedure was associated with type of recurrent AT (P = 0.03), but the origin of focal AT occurring during the index ablation differed from that of the recurrent AT in 85% of patients.

Conclusion

In patients who had AF termination by ablation, occurrence of focal AT during the ablation procedure was associated with worse clinical outcome than occurrence of macroreentrant AT, likely due to ATs arising from other foci during follow‐up.
Surface ECG f Wave Analysis at Initial Onset of Paroxysmal and Persistent Atrial Fibrillation
Authors: SHARMA PARTH , BARRETT TYLER W. , NG JASON , KNOTEN CLAIRE , FERREIRA ALLISON J. , GOLDBERGER JEFFREY J.
Published: February 2017

Surface ECG f Wave Analysis X

Introduction

Dominant frequency (DF) analysis of electrocardiograms (ECGs) from patients with paroxysmal (PAF) and persistent (PeAF) atrial fibrillation has identified higher DFs in PeAF. We therefore hypothesized that among patients initially presenting to the emergency department (ED) with new onset AF, surface ECG features could differentiate PeAF from PAF.

Methods and Results

Initial 12‐lead ECGs from patients presenting to the ED with a first episode of symptomatic AF were analyzed. Following QRS‐T subtraction, fast Fourier transform (FFT) analysis of the AF fibrillatory waves was performed to measure DF and organization index (OI). Median DF of all leads and the DF in the lead with maximum OI were determined. Maximum f wave amplitude and vector magnitudes were measured. One hundred sixty‐one patients (age 59 ± 16 years, 68% men) were included in this analysis, of whom 96 (58%) spontaneously converted to sinus rhythm within 7 days (PAF group). The remaining 65 patients underwent cardioversion or remained in AF (PeAF group). ECG features (DF, OI, f wave amplitude, and vector magnitude) did not differ among PAF and PeAF patients.

Conclusions

ECG features (DF, OI, amplitude, vector magnitude) do not differ among patients with PAF versus PeAF when the ECGs are obtained at the initial onset of symptoms. Thus, prior data showing higher DF in PeAF likely reflect electrophysiologic remodeling rather than a marker for any specific type of AF or extent of underlying substrate.
Protocols for Argentine ant eradication in conservation areas
Authors: Boser C. L. , Hanna C. , Holway D. A. , Faulkner K. R. , Naughton I. , Merrill K. , Randall J. M. , Cory C. , Choe D.‐H. , Morrison S. A.
Published: February 2017

The Argentine ant (Linepithema humile) is a widespread, abundant and ecologically disruptive invader that is present throughout major portions of coastal California and on half of the California Channel Islands. On Santa Cruz Island, the Argentine ant had invaded about 2% of the island's area in four distinct locations as of 2012. Given the negative ecological effects resulting from Argentine ant invasions, we sought to develop a cost‐effective method of eradication. Here, we describe the results of large‐scale, field‐tested methods for Argentine ant eradication and post‐treatment detection. Our eradication protocol employs a novel toxicant‐delivery system: an aqueous solution of sucrose and 6 ppm of thiamethoxam mixed with hydrating polyacrylamide beads. Ants feed on the solution present on the bead's surface for about 24 h after which time bead dehydration prevents feeding. We distributed hydrated beads by helicopter over 74 ha of infested areas plus a 50‐m buffer on 14 occasions between June 2013 and September 2014. Treatments reduced Argentine ant activity to subdetectable levels within four months. In 2014, we conducted a high‐intensity detection protocol using lures (n = 55 363) in areas treated in 2013. This effort did not detect Argentine ants. In 2015, we conducted a medium‐intensity detection protocol using lures (n = 2250) in areas treated in 2013 and 2014 but not searched in 2014; this sampling effort did not detect Argentine ant activity except for a single remnant infestation (c. 0.3 ha in area), which was retreated in 2015. The cost of treatments was approximately $1400 per ha; this cost is comparable to other ant eradication efforts. The cost of our preferred detection method, which used lures spaced every 10 m, was $500 per ha. These results demonstrate sufficient protocol efficacy to justify expansion of treatments to other infested areas in ecologically sensitive areas.
Water temperature and dietary histidine affect cataract formation in Atlantic salmon (Salmo salar L.) diploid and triploid yearling smolt
Authors: Sambraus F , Fjelldal P G , Remø S C , Hevrøy E M , Nilsen T O , Thorsen A , Hansen T J , Waagbø R
Published: February 2017

The aim of the present study was to investigate cataract development in diploid (2N) and triploid (3N) Atlantic salmon smolts and post‐smolts at two water temperatures (10 and 16 °C) given diets with different histidine supplementation (LH, 10.4 and HH, 13.1 g kg−1) before and after seawater transfer. In freshwater, a severe cataract outbreak was recorded in both ploidies reared at 16 °C. The cataract score was significantly higher in triploids compared to diploids, and the severity was lower in both ploidies fed the HH diet. The cataract development at 10 °C was minor. Low gill Na+, K+‐ATPase activity in fish reared at 16 °C before seawater transfer was followed by osmoregulatory stress with elevated plasma electrolyte concentrations and high mortality in sea water. Both diploids and triploids reared at 10 °C developed cataracts during the seawater period, with higher severities in triploids than diploids and a reduced severity in the fish fed the HH diet. The findings of this study demonstrate the importance of environmental conditions in the husbandry of Atlantic salmon, and particularly triploids, with regard to smoltification and adjusted diets to mitigate cataract development in fresh and sea water.
In vivo adherence of Flavobacterium psychrophilum to mucosal external surfaces of rainbow trout (Oncorhynchus mykiss) fry
Authors: Papadopoulou A , Dalsgaard I , Lindén A , Wiklund T
Published: February 2017

The adherence of Flavobacterium psychrophilum to surfaces of epithelial tissues has been inconclusively suggested as a mechanism, which enables the bacterium to invade the host. Hence, the present study aimed to examine the adherence of the cells of two colony phenotypes, smooth and rough, of F. psychrophilum to mucosal tissues of rainbow trout fry and to test the skin mucus as a nutrient for the growth of F. psychrophilum. Fish were immersed in water containing 106 CFU mL−1 F. psychrophilum for each colony phenotype. Mucosal tissue samples from fins, gills, skin and eyes, and swab samples from spleen and kidney were taken and inoculated onto TYES agar plates. Colony phenotypes of F. psychrophilum were identified and number of colonies counted. The results showed that cells of both phenotypes initially (0 h) adhered to all mucosal surfaces, but only the rough cells were still present on tissues 1 h post‐immersion. Both phenotypes showed a tissue tropism with the fin tissue being the most adhered. Furthermore, skin mucus promoted the growth of both colony phenotypes. We suggest that the growth of F. psychrophilum cells in skin mucus apparently facilitates the bacterial adherence to mucosal surfaces, and the subsequent invasion into the host.
A survey of microparasites present in adult migrating Chinook salmon (Oncorhynchus tshawytscha) in south‐western British Columbia determined by high‐throughput quantitative polymerase chain reaction
Authors: Bass A L , Hinch S G , Teffer A K , Patterson D A , Miller K M
Published: February 2017

Microparasites play an important role in the demography, ecology and evolution of Pacific salmonids. As salmon stocks continue to decline and the impacts of global climate change on fish populations become apparent, a greater understanding of microparasites in wild salmon populations is warranted. We used high‐throughput, quantitative PCR (HT‐qRT‐PCR) to rapidly screen 82 adult Chinook salmon from five geographically or genetically distinct groups (mostly returning to tributaries of the Fraser River) for 45 microparasite taxa. We detected 20 microparasite species, four of which have not previously been documented in Chinook salmon, and four of which have not been previously detected in any salmonids in the Fraser River. Comparisons of microparasite load to blood plasma variables revealed some positive associations between Flavobacterium psychrophilum, Cryptobia salmositica and Ceratonova shasta and physiological indices suggestive of morbidity. We include a comparison of our findings for each microparasite taxa with previous knowledge of its distribution in British Columbia.
The Role of Ischemia Modified Albumin and D‐dimer as Early or Late Biochemical Markers in Ovarian Torsion
Authors: Karatas Gurgun Ayca , Kaban Isık , Aka Nurettin , Mentese Ahmet , Aker Fugen , Uras Ahmet Rıza
Published: February 2017

Objective

Our aim was to examine the potential roles of ischemia modified albumin(IMA) and D‐dimer as reliable early diagnostic markers of ovarian torsion.

Materials and Methods

24 Wistar albino rats were included and randomized into three groups. Control (sham) rats underwent laparotomy then bilateral ovaries removed for histopathological examination and concomitant blood sampling for IMA and D‐dimer assays after 4 h. In the remaining groups, ovarian ischemia was achieved by rotating bilateral ovaries 1080° clockwise then blood samples were obtained and ovaries were removed after 4 h and 24 h. IMA and D‐dimer levels as well as the histopathological injury scores were assessed in all groups.

Results

A statistically higher significant difference in D‐dimer levels in the 4‐h torsion group (Group 2) than the other groups (P = 0.001, P < 0.01).

Despite absence of statistical significance, the difference in IMA levels between the groups was close to statistical significance (P = 0.064; P > 0.05); accordingly IMA levels were higher in the 24‐h torsion group (Group 3), than in 4‐h torsion (Group 2) or sham (Group 1) group.

Conclusıon

Our results suggest that D‐dimer may represent a valuable acute marker of ovarian torsion. The cut‐off value for D‐dimer was 402 ng/ml. Although rats in Group3 had higher IMA than in other groups, the difference was only close to statistical significance. Also, increasing duration of torsion was associated with reduced D‐dimer levels, while IMA levels exhibited an increase during the 24 h period. In contrast with previous studies, IMA appeared to be a potential marker in the long term rather than the short term.
The issues regarding postoperative adjuvant therapy and prognostic risk factors for patients with stage I–II cervical cancer: A review
Authors: Takekuma Munetaka , Kasamatsu Yuka , Kado Nobuhiro , Kuji Shiho , Tanaka Aki , Takahashi Nobutaka , Abe Masakazu , Hirashima Yasuyuki
Published: February 2017

The treatment for most patients with early‐stage cervical cancer involves radical hysterectomy and pelvic lymph node dissection, and indications for postoperative adjuvant therapy have been determined by evaluating the prognostic risk factors for recurrence in each case. The aim of this review is to raise and discuss the various issues that have not yet been resolved regarding the prognostic risk factors and postoperative adjuvant therapy.

Several clinicopathological factors, such as tumor size, lymphovascular space involvement, deep stromal invasion, parametrial involvement and lymph node metastasis, have been identified to have prognostic significance in early‐stage cervical cancer. However, this remains controversial because there is suggested to be substantial heterogeneity among patients after radical hysterectomy and lymphadenectomy and it would be difficult to define the risk groups clearly. This indicates the need to develop more convenient and accurate criteria to define risk groups.

According to the currently available evidence, patients in the high‐risk group should receive adjuvant concurrent chemoradiotherapy (CCRT) with cisplatin (CDDP) and fluolouracil. However, CCRT with CDDP administered weekly (CCRT‐P) has instead been applied in a clinical context worldwide. Whether CCRT‐P has a survival benefit compared with radiotherapy (RT) alone is unknown because no randomized phase III trials have been performed for patients in the high‐risk group after radical surgery. Patients with high‐risk factors have a high incidence of distant metastasis, for whom systemic chemotherapy might be a key to improving overall survival.

The pivotal study that investigated the role of RT alone for patients with intermediate‐risk factors after hysterectomy is the GOG092 trial. This trial showed a 47% reduction in the risk of recurrence after RT compared with no further treatment (NFT). However, the improvement in overall survival with RT did not reach statistical significance, while patients allocated to the RT group did experience an increase in severe toxicities compared with the NFT group. This could be why many physicians are reluctant to treat patients with this approach, although guidelines recommend RT for patients with intermediate‐risk factors.

With regard to toxicities, postoperative RT would be problematic because the organs in the pelvis targeted by RT have already been damaged by radical surgery. To reduce the toxicities, intensity‐modulated radiotherapy would best be used worldwide.

Further improvement in adjuvant therapy will come from enhanced definition of prognostic risk factors, better patient selection, and refinements in both local and systematic therapies.
Increased podocyturia in pregnant women compared to non‐pregnant women
Authors: Furuta Itsuko , Zhai Tianyue , Umazume Takeshi , Ishikawa Satoshi , Nakagawa Kinuko , Akaishi Rina , Yamada Takahiro , Morikawa Mamoru , Minakami Hisanori
Published: February 2017

Aim

Hyperfiltration is a cause of podocyturia and occurs physiologically in the kidney of pregnant women. Podocyturia is increased in preeclamptic pregnancies, but it is unclear whether there is also any increase in uncomplicated pregnancies. This study was performed to examine whether podocyturia and urine aquaporin 2 mRNA expression are increased in healthy pregnant women (PW) compared to healthy non‐pregnant women (NPW).

Methods

Eleven urines obtained from 11 NPW and longitudinal 76 urines from 40 PW with uncomplicated pregnancies (median number [range] of urine samples/person, 2 [1 – 3]) were studied. Determination of protein and creatinine concentrations and number of cells in urine other than blood cells, and quantitative analyses of the mRNA expression of aquaporin 2 (AQP2‐mRNA), podocin (Pod‐mRNA), and nephrin (Nep‐mRNA) were performed using RT‐PCR in pelleted urine samples. Podocyturia was monitored with urine Pod‐ and Nep‐mRNA expression levels normalized relative to creatinine.

Results

Urine cell density and urine AQP2‐, Pod‐, and Nep‐mRNA expression normalized relative to creatinine were significantly higher in PW than NPW. The number of cells per milligram of creatinine was significantly positively correlated with expression of all three mRNAs with correlation coefficients (R‐value) of 0.442, 0.481, and 0.561 for Pod‐, Nep‐, and AQP2‐mRNA, respectively. AQP2‐mRNA expression was strongly (R  >  0.8) positively correlated with both Pod‐ and Nep‐mRNA expression.

Conclusion

Podocyturia monitored by Pod‐ and Nep‐mRNA expression and urine cells expressing AQP2‐mRNA were increased in uncomplicated pregnancies compared to healthy non‐pregnant women. Urine cells expressing AQP2‐mRNA increased with increasing podocyturia in healthy women.