bluuebunny/crossref_metadata_2025 huggingface dataset:
Lesson of the month: festinare lente – a case where a malignant ulcer was not all that it seemed to be
Authors: O'Hare L. , Napier S. , Marley J.
Published: September 2014

As an oral surgeon, it is essential to recognise the various forms of malignancy within the mouth as promptly as possible, to diagnose accurately and early and be able to communicate effectively with a range of multidisciplinary teams. This case describes an elderly lady who was referred with a malignant‐looking ulcer on the right ventral surface of the tongue. However, in spite of convincing evidence from histopathology, there remained a lingering doubt of the diagnosis with the oral surgery component of the multidisciplinary team (MDT).

Comprehensive investigation and extensive discussion led to review of the diagnosis, ultimately recognising it as Epstein Barr Virus‐positive mucocutaneous ulcer, a rare but reactive lymphoproliferative disorder, presenting as a relapsing and remitting ulcer. This case highlights the importance of careful preoperative assessment and clinicopathological correlation to ensure confidence in the diagnosis, particularly when dealing with unusual lesions, and should encourage active participation by all of the professional groups at the MDT meeting.
Is there potential to adapt soybean (Glycine max Merr.) to future [CO2]? An analysis of the yield response of 18 genotypes in free‐air CO2 enrichment
Authors: BISHOP KRISTEN A. , BETZELBERGER AMY M. , LONG STEPHEN P. , AINSWORTH ELIZABETH A.
Published: September 2014

Rising atmospheric [CO2] is a uniform, global change that increases C3 photosynthesis and could offset some of the negative effects of global climate change on crop yields. Genetic variation in yield responsiveness to rising [CO2] would provide an opportunity to breed more responsive crop genotypes. A multi‐year study of 18 soybean (Glycine max Merr.) genotypes was carried out to identify variation in responsiveness to season‐long elevated [CO2] (550 ppm) under fully open‐air replicated field conditions. On average across 18 genotypes, elevated [CO2] stimulated total above‐ground biomass by 22%, but seed yield by only 9%, in part because most genotypes showed a reduction in partitioning of energy to seeds. Over four years of study, there was consistency from year to year in the genotypes that were most and least responsive to elevated [CO2], suggesting heritability of CO2 response. Further analysis of six genotypes did not reveal a photosynthetic basis for the variation in yield response. Although partitioning to seed was decreased, cultivars with the highest partitioning coefficient in current [CO2] also had the highest partitioning coefficient in elevated [CO2]. The results show the existence of genetic variation in soybean response to elevated [CO2], which is needed to breed soybean to the future atmospheric environment.
Molecular and biochemical properties of two P1B2‐ATPases, CsHMA3 and CsHMA4, from cucumber
Authors: MIGOCKA MAGDALENA , PAPIERNIAK ANNA , MACIASZCZYK‐DZIUBINSKA EWA , POSYNIAK EWELINA , KOSIERADZKA ANNA
Published: September 2014

P1B‐ATPases (heavy metal ATPases, HMAs) constitute a multigenic subfamily of P‐ATPases involved in the transport of monovalent and divalent heavy metals in plant cells. Here, we present the organization of genes encoding the HMA family in the cucumber genome and report the function and biochemical properties of two cucumber proteins homologous to the HMA2‐4‐like plant HMAs. Eight genes encoding putative P1B‐ATPases were identified in the cucumber genome. Among them, CsHMA3 was predominantly expressed in roots and up‐regulated by Pb, Zn and Cd excess, whereas the CsHMA4 transcript was most abundant in roots and flowers of cucumber plants, and elevated under Pb and Zn excess. Expression of CsHMA3 in Saccharomyces cerevisiae enhanced yeast tolerance to Cd and Pb, whereas CsHMA4 conferred increased resistance of yeast cells to Cd and Zn. Immunostaining with specific antibodies raised against cucumber proteins revealed tonoplast localization of CsHMA3 and plasma membrane localization of CsHMA4 in cucumber root cells. Kinetic studies of CsHMA3 and CsHMA4 in yeast membranes indicated differing heavy metal cation affinities of these two proteins. Altogether, the results suggest an important role of CsHMA3 and CsHMA4 in Cd and Pb detoxification and Zn homeostasis in cucumber cells.
First Japanese family with primary familial brain calcification due to a mutation in the PDGFB gene: An exome analysis study
Authors: Hayashi Teruo , Legati Andrea , Nishikawa Tadashi , Coppola Giovanni
Published: September 2014

Aims

Primary familial brain calcification (PFBC) is a rare disorder characterized by abnormal deposits of calcium in the basal ganglia and cerebellum. PFBC can present with a spectrum of neuropsychiatric symptoms resembling those seen in dementia and schizophrenia. Mutations in a few genes have been identified as causing PFBC: namely, the SLC20A2 gene that codes for the sodium‐dependent phosphate transporter and the PDGFRB gene that codes for the platelet‐derived growth factor receptor β (PDGF‐Rβ). A recent study identified mutations in PDGFB coding for PDGF‐B, the main ligand for PDGF‐Rβ, in six families with PFBC. Here we report the first Japanese family with PFBC carrying a mutation in PDGFB, which causes the substitution of an arginine with a stop codon at amino acid 149 of the PDGF‐B protein (p. Arg149*).

Methods

Clinical histories and computed tomography scan images were provided. Sanger sequencing was performed for the exome analysis of SLC20A2 and PDGFB genes.

Results

One family member began to complain of auditory hallucination at 16 years of age and had been treated for schizophrenia. His father suffered from memory and gait disturbances in his late 60s. A computed tomography scan revealed a symmetrical area of calcification over the basal ganglia in both cases. A known mutation in PDGFB (c.445C>T, p.Arg149*) was consistently detected in both PFBC cases by Sanger sequencing. No mutations in SLC20A2 were detected.

Conclusions

Our findings suggest that this mutation in PDGF‐B is responsible for PFBC in this Japanese family and that abnormal PDGF signaling may be involved in the pathophysiology of certain psychiatric disorders.
Scalp Hair Heterochromia in a 5‐Year‐Old Child: Rare Somatic Mosaicism?
Authors: Bonamonte Domenico , Filoni Angela , Vestita Michelangelo , Angelini Gianni , Foti Caterina
Published: September 2014

Scalp hair heterochromia presenting in tufts with no underlying skin changes is rare and can be a sign of somatic mosaicism. We describe the case of a healthy 5‐year‐old boy with this condition.
Relationship Between Skin Barrier Function in Early Neonates and Diaper Dermatitis During the First Month of Life: A Prospective Observational Study
Authors: Yonezawa Kaori , Haruna Megumi , Shiraishi Mie , Matsuzaki Masayo , Sanada Hiromi
Published: September 2014

Diaper dermatitis, a common skin problem in newborn infants, is characterized by poor functioning of the skin barrier. This study aimed to elucidate the relationship between skin barrier function in 4‐day‐old infants and the occurrence of diaper dermatitis during the first month of life. We recruited healthy Japanese infants born at 35 weeks of gestation or more. We measured indicators of skin barrier function, namely skin pH and transepidermal water loss, in 4‐day‐old infants on four places on the body. Individual characteristics were recorded from the infants' medical charts. The presence of diaper dermatitis was judged using the diaper rash and erythema scoring scale, which was based on daily recording of the infants' skin condition by their parents. The parents also filled out a questionnaire 1 month after birth regarding stool frequency and certain external factors. The association between diaper dermatitis and skin barrier function was assessed using multiple logistic regression analysis. The analysis included 88 infants. The incidence of diaper dermatitis was 25.0%. After adjusting for stool frequency for 1 month we noted that high pH on the inner arm skin in 4‐day‐old infants increased the risk of diaper dermatitis during the first month of life (adjusted odds ratio 3.35 [95% confidence interval = 1.12, 10.04]). Early neonatal skin pH may predict the risk of diaper dermatitis during the first month of life. Our results may be useful in devising strategies to prevent diaper dermatitis.
Is Phototherapy Useful in the Treatment of Atopic Dermatitis in Asian Children? A 5‐Year Report from Singapore
Authors: Mok Zhun‐Rui , Koh Mark Jean‐Aan , Chong Wei‐Sheng
Published: September 2014

The goal of the current study was to review a cohort of Asian children with atopic dermatitis (AD) treated using phototherapy at a tertiary dermatologic center in Singapore. We performed a retrospective review of patients younger than 16 years old with a clinical diagnosis of AD treated with phototherapy at the National Skin Center, Singapore, over a 5‐year period from 2004 to 2008. Twenty‐five patients were identified who were ages 7 to 15 years at the time they underwent phototherapy, with equal sex distribution. The duration of disease ranged from 2 to 14 years. Most patients had extensive disease involving more than 70% of their body surface area. Fifteen patients were treated with narrowband ultraviolet B (NBUVB) phototherapy, with 10 (66%) showing improvement of symptoms. The duration of therapy was 3 to 30 months (mean 11 mos), with a mean of 60 treatment sessions (range 12–104). Nine patients were treated with combined ultraviolet A (UVA) and NBUVB phototherapy. Five patients (55%) improved, with four having good response and one having mild improvement. The duration of therapy was 1–6 months (mean 3.6 mos), with an average of 22 treatment sessions (range 10–44). Two patients underwent combined UVA/broad‐band UVB (BBUVB) phototherapy. Both had worsening of disease requiring cessation of treatment. Phototherapy is a useful adjunct in the treatment of moderate to severe AD in children. More than half of the patients treated with NBUVB or combined UVA and NBUVB improved with phototherapy, but the usefulness of combined UVA and BBUVB requires further evaluation.
Plica “Neuropathica” in an 11‐Month‐Old Boy
Authors: Verma Shikha , Thakur Binod K.
Published: September 2014

Plica neuropathica is an acquired, irreversible tangling and matting of scalp hair presenting as discrete masses. Many cases are reported in the literature, but it has never been reported in an infant. Herein we report the first case of plica neuropathica in an 11‐month‐old.
Structural changes in plastids of developing Splachnum ampullaceum sporophytes and relationship to odour production
Authors: McCuaig B. , Dufour S. C. , Raguso R. A. , Bhatt A. P. , Marino P.
Published: September 2014

Many mosses of the family Splachnaceae are entomophilous and rely on flies for spore dispersal. Splachnum ampullaceum produces a yellow‐ or pink‐coloured hypophysis that releases volatile compounds, attracting flies to the mature moss. The biosynthetic sources of the visual and aromatic cues within the hypophysis have not been identified, and may be either symbiotic cyanobacteria or chromoplasts that break down lipids into volatile compounds. Here, we used transmission electron microscopy and gas chromatography‐mass spectrometry (GC‐MS) to investigate the sources of these attractants, focusing on different tissues and stages of maturation. Microscopy revealed an abundance of plastids within the hypophysis, while no symbiotic bacteria were observed. During plant maturation, plastids differentiated from amyloplasts with large starch granules to photosynthetic chloroplasts and finally to chromoplasts with lipid accumulations. We used GC‐MS to identify over 50 volatile organic compounds from mature sporophytes including short‐chain oxygenated compounds, unsaturated irregular terpenoids, fatty acid‐derived 6‐ and 8‐carbon alcohols and ketones, and the aromatic compounds acetophenone and p‐cresol. The hypophysis showed localised production of pungent volatiles, mainly short‐chain fermentation compounds and p‐cresol. Some of these volatiles have been shown to be produced from lipid oxidase degradation of linolenic acid within chromoplasts. However, other compounds (such as cyclohexanecarboxylic acid esters) may have a microbial origin. Further investigation is necessary to identify the origin of fly attractants in these mosses.
Acute effects of MDMA on autonomic cardiac activity and their relation to subjective prosocial and stimulant effects
Authors: Clark Christine M. , Frye Charles G. , Wardle Margaret C. , Norman Greg J. , de Wit Harriet
Published: September 2014

MDMA is a stimulant with unique “prosocial” effects, the physiological and pharmacological mechanisms of which are unknown. Here, we examine the relationship of measures of parasympathetic and sympathetic nervous system activity to the prosocial effects of MDMA. Parasympathetic activity was measured using respiratory sinus arrhythmia (RSA) and sympathetic activity using pre‐ejection period (PEP). Over three sessions, 33 healthy volunteers received placebo, 0.75 mg/kg, and 1.5 mg/kg MDMA under counterbalanced, double‐blind conditions, while we measured subjective feelings, RSA, and PEP. RSA and PEP data were available for 26 and 21 participants, respectively. MDMA increased prosocial and stimulated feelings, decreased RSA, and decreased PEP. At 1.5 mg/kg, subjective prosocial effects correlated with stimulated feelings and PEP, but not RSA. This suggests sympathetic, rather than parasympathetic, effects relate to the prosocial effects of MDMA.
Using pretest data to screen low‐reactivity individuals in the autonomic‐based concealed information test
Authors: Matsuda Izumi , Ogawa Tokihiro , Tsuneoka Michiko , Verschuere Bruno
Published: September 2014

The concealed information test (CIT) can be used to assess whether an individual possesses crime‐related information. However, its discrimination performance has room for improvement. We examined whether screening out participants who do not respond distinctively on a pretest improves the diagnosticity of a mock‐crime CIT. Before conducting the CIT, we gave a pretest to 152 participants, 80 of whom were assigned as guilty. Pretest screening significantly improved the diagnostic value of the mock‐crime CIT; however, it also led to a substantial number of undiagnosed participants (33.6%). Pretest screening holds promise, but its application would benefit from dedicated measures for screening out participants.
Group Peer Disagreement
Authors: Carter J. Adam
Published: September 2014

A popular view in mainstream social epistemology maintains that, in the face of a revealed peer disagreement over p, neither party should remain just as confident vis‐a‐vis p as she initially was. This ‘conciliatory’ insight has been defended with regard to individual epistemic peers. However, to the extent that (non‐summativist) groups are candidates for group knowledge and beliefs, we should expect groups (no less than individuals) to be in the market for disagreements. The aim here will be to carve out and explore an extension of the conciliatory insight from individual peer disagreement to group peer disagreement; in doing so, I'll raise and address three key problems that face any plausible defence of such a constraint.
Mini Nutritional Assessment Short‐Form predicts exacerbation frequency in patients with chronic obstructive pulmonary disease
Authors: Yoshikawa Masanori , Fujita Yukio , Yamamoto Yoshifumi , Yamauchi Motoo , Tomoda Koichi , Koyama Noriko , Kimura Hiroshi
Published: September 2014

Background and objective

Exacerbations of chronic obstructive pulmonary disease (COPD) are a major cause of morbidity, mortality and reduced health status. Thus, to predict and prevent exacerbations is essential for the management of COPD. The aims of this study were to determine whether nutritional status as assessed by the Mini Nutritional Assessment Short‐Form (MNA‐SF) predicts COPD exacerbation and to compare the ability of the MNA‐SF to predict COPD exacerbation with that of the COPD Assessment Test (CAT).

Methods

Pulmonary function, the modified Medical Research Council (mMRC) scale and body mass index (BMI) were evaluated in 60 stable patients with COPD (mean age, 72 years; mean forced expiratory volume in 1 s (FEV1), 51.1% predicted). The MNA‐SF and CAT were also completed. Exacerbations were recorded prospectively for 1 year after the initial assessment.

Results

The mean MNA‐SF score was 11.4 ± 2.4 (well nourished, 51%; at risk, 37%; and malnourished, 12%). The mean CAT score was 14.4 ± 7.5 (low impact, 37%; medium impact, 38%; high impact, 20%; and very high impact, 5%). The CAT scores were significantly associated with the mMRC scale and %FEV1, but were not associated with BMI and the MNA‐SF score. The exacerbation frequency was associated with the MNA‐SF score but not with the CAT score.

Conclusions

The MNA‐SF predicts COPD exacerbation independently of the CAT.
Can non‐invasive positive pressure ventilation prevent endotracheal intubation in acute lung injury/acute respiratory distress syndrome? A meta‐analysis
Authors: Luo Jian , Wang Mao‐yun , Zhu Hui , Liang Bin‐miao , Liu Dan , Peng Xia‐ying , Wang Rong‐chun , Li Chun‐tao , He Chen‐yun , Liang Zong‐an
Published: September 2014

The role of non‐invasive positive pressure ventilation (NIPPV) in acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is controversial. The aim of this study was to investigate whether NIPPV could prevent endotracheal intubation and decrease mortality rate in patients with ALI/ARDS. Randomized controlled trials (RCT) which reported endotracheal intubation and mortality rate in patients with ALI/ARDS treated by NIPPV were identified in Pubmed, Medline, Embase, Central Cochrane Controlled Trials Register, Chinese National Knowledge Infrastructure, reference lists and by manual searches. Fixed‐ and random‐effects models were used to calculate pooled relative risks. This meta‐analysis included six RCT involving 227 patients. The results showed that endotracheal intubation rate was lower in NIPPV (95% confidence interval (CI): 0.44–0.80, z = 3.44, P = 0.0006), but no significant difference was found either in intensive care unit (ICU) mortality (95% CI: 0.45–1.07, z = 1.65, P = 0.10) or in hospital mortality (95% CI: 0.17–1.58, z = 1.16, P = 0.25). Only two studies discussed the aetiology of ALI/ARDS as pulmonary or extra‐pulmonary, and neither showed statistical heterogeneity (I2 = 0%, χ2 = 0.31, P = 0.58), nor a significant difference in endotracheal intubation rate (95% CI: 0.35–9.08, z = 0.69, P = 0.49). In conclusion, the early use of NIPPV can decrease the endotracheal intubation rate in patients with ALI/ARDS, but does not change the mortality of these patients.
Mapping the Spatial Distribution of a Disease-Transmitting Insect in the Presence of Surveillance Error and Missing Data
Authors: Hong Andrew E. , Barbu Corentin M. , Small Dylan S. , Levy Michael Z. ,   The Chagas Disease Working Group in Arequipa
Published: September 2014

Maps of the distribution of epidemiological data often ignore surveillance error or possible correlations between missing information and outcomes. We analyse presence–absence data at the household level (12050 points) of a disease-carrying insect in Mariano Melgar, Peru, collected as part of the Arequipan Ministry of Health's efforts to control Chagas disease. We construct a Bayesian hierarchical model to locate regions that are vulnerable to under-reporting due to surveillance error, accounting for variability in participation due to infestation status. The spatial correlation in the data allows us to identify relative inspector sensitivity and to elucidate the relationship between participation and infestation. We show that naive estimates of prevalence would be biased by surveillance error and missingness at random assumptions. We validate our results through simulations and observe how randomized inspector assignments may improve prevalence estimates. Our results suggests that bias due to imperfect observations and missingness at random can be assessed and corrected in prevalence estimates of spatially auto-correlated binary variables.
Resolution of HLA‐B*44:02:01G, ‐DRB1*14:01:01G and ‐DQB1*03:01:01G reveals a high allelic variability among 12 European populations
Authors: Vidan‐Jeras B. , Buhler S. , Dubois V. , Grubic Z. , Ivanova M. , Jaatinen T. , Ligeiro D. , Lokki M.‐L. , Papasteriades C. , Poli F. , Spyropoulou‐Vlachou M. , Tordai A. , Viken M.K. , Wenda S. , Nunes J.M. , Sanchez‐Mazas A. , Tiercy J.‐M.
Published: September 2014

Within the framework of the EU‐funded HLA‐NET action, an analysis of three G‐group alleles, HLA‐B*44:02:01G, DRB1*14:01:01G and DQB1*03:01:01G, was undertaken in 12 European populations. Ambiguities were resolved by polymerase chain reaction‐sequence‐specific amplification (PCR‐SSP) or PCR‐sequence‐based typing (PCR‐SBT) in a total of 5095 individuals. The results of the DRB1*14:01/14:54 ambiguity showed high relative ratios (24–53%) of DRB1*14:01 in Bulgarians, Croatians, Greeks, Italians and Slovenians, contrasting with low ratios (6–13%) in Austrians, Finnish, French, Hungarians, Norwegians and Swiss. Resolution of the B*44:02/44:27 ambiguity showed that B*44:27 had a high relative ratio in Slovenians (25.5%) and Bulgarians (37%) and low in French and Swiss (0.02–1%), and was not observed in Greeks and Italians. The highest relative ratio of DQB1*03:19 was found in Portuguese (11%), by contrast with low ratios (0–3%) in the other five populations. Analysis of the A, B, DRB1 phenotypes and family‐derived haplotypes in 1719 and 403 individuals positive for either HLA‐B*44:02G or DRB1*14:01G ambiguities, respectively, showed some preferential associations, such as A*26∼DRB1*14:01, B*35∼DRB1*14:01, B*38∼DRB1*14:01 and B*44:27∼DRB1*16. Because these ambiguities are located outside the peptide‐binding site, they may not be recognized by alloreactive T‐cells. However, because of strong linkage disequilibrium (LD), the DRB1*14:01 vs DRB1*14:54 and the B*44:02 vs B*44:27 mismatches are associated to DRB3‐, and C‐mismatches, respectively. These results are informative for algorithms searching unrelated hematopoietic stem cell donors. For B*44:27‐positive patients, searches are expected to be more successful when requesting donors from Southeastern‐European ancestry. Furthermore, the introduction of human leukocyte antigen (HLA)‐typing strategies that allow resolving exon 4 (for class I) and exon 3 (for class II) polymorphisms can be expected to contribute significantly to population genetics studies.
HLA‐A*11:188: a new allele identified by sequence‐based typing in a Chinese blood donor
Authors: Li Z. , Lu L. , Nie D. , Wu J. , Zhang H. , Zhen J. , Wang D.
Published: September 2014

A novel allele HLA‐A*11:188 differs from HLA‐A*11:01:01 by a single mutation at position 439 in exon 3.
A novel allele, HLA‐A*11:127N, was identified in a Taiwanese individual by the sequence‐based typing method
Authors: Lin C.‐Y. , Chang C.‐L.
Published: September 2014

A one nucleotide replacement in codon 171 of HLA‐A*11:01:01 results in a novel allele, HLA‐A*11:127N.
Interferon‐gamma gene polymorphism +874 A/T is associated with an increased risk of cytomegalovirus infection among Hispanic renal transplant recipients
Authors: Vu D. , Shah T. , Ansari J. , Sakharkar P. , Yasir Q. , Naraghi R. , Hutchinson I. , Min D.
Published: September 2014

Background

Cytomegalovirus (CMV) is the most common cause of viral infection, causing morbidity and mortality among renal transplant recipients (RTRs). Cytokines such as tumor necrosis factor‐alpha (TNF‐α), interleukin‐10 (IL‐10), and interferon‐gamma (IFN‐γ) have been shown to possess antiviral properties, and their polymorphisms are associated with disease outcome. The aim was to investigate the association of gene polymorphisms in IL‐10, IFN‐γ, and TNF‐α with CMV infection in RTRs.

Methods

IL‐10 −1082 A>G, −592 A>C; TNF‐α −308 A>G; and IFN‐γ +874 A>T gene polymorphisms were studied in 247 Hispanic RTRs (52 RTRs with CMV infection and 195 without CMV infection), using DNA‐based polymerase chain reaction with sequence‐specific primers and restriction.

Results

Median time to CMV infection was 8 months, with a mean peak CMV viral load of 25,314 copies/mL. Patients with donor‐positive/recipient‐negative (D+/R−) serostatus were found to be associated with a high risk of CMV infection (P = 0.001). A statistically significant correlation was found between IFN‐γ +874 A>T polymorphism and the risk of CMV infection. The IFN‐γ +874 AA genotype was associated with a 3.4‐fold increased risk for the CMV‐infected group compared to the non‐CMV group (odds ratio = 3.4, 95% confidence interval = 1.24–9.34, P = 0.01). The association was independently significant in multiple logistic regression (P = 0.01), along with serologic status D+/R−, acute rejection, and anti‐thymocyte globulin induction. The allelic as well as genotypic frequencies of TNF‐α and IL‐10 did not significantly differ between the CMV‐infection group and the control group. Individuals with IFN‐γ +874 AT and AA genotypes exhibited higher risk of allograft loss.

Conclusion

This study suggested that RTRs with variant homozygous IFN‐γ AA genotype were at risk of CMV infection, whereas the high producer IFN‐γ +874 TT genotype appears to be associated with lower risk of CMV infection.
Transfusion and component characteristics are not associated with allergic transfusion reactions to apheresis platelets
Authors: Savage William J. , Tobian Aaron A.R. , Savage Jessica H. , Hamilton Robert G. , Borge P. Dayand , Kaufman Richard M. , Ness Paul M.
Published: September 2014

Background

Transfusion‐related characteristics have been hypothesized to cause allergic transfusion reactions (ATRs) but they have not been thoroughly studied. The primary objective of this study is to evaluate the associations of infusion rate, infusion volume, ABO mismatching, component age, and pretransfusion medication with the incidence and severity of ATRs. A secondary objective is to compare the risk of these attributes relative to the previously reported risk factor for aeroallergen sensitization in transfusion recipients, as measured by an aeroallergen‐specific immunoglobulin (Ig)E antibody screen.

Study Design and Methods

Clinical and transfusion‐related data were collected on subjects with reported ATRs and uneventful (control) apheresis platelet (PLT) transfusions over a combined 21‐month period at two academic medical centers. Control transfusions were selected as the next uneventful transfusion after an ATR was reported. Logistic regression, Mann‐Whitney, and t tests were used to assess associations with ATRs. Previously reported aeroallergen‐specific IgE screening data were incorporated into a multivariable logistic regression.

Results

A total of 143 ATRs and 61 control transfusions were evaluated among 168 subjects, ages 2 to 86 years. Infusion rate, infusion volume, ABO mismatching, component age, and pretransfusion medication showed no significant association with ATRs (p > 0.05). Neither infusion rate nor infusion volume increased the risk of anaphylaxis versus mucocutaneous‐only ATRs. Aeroallergen sensitization has previously been associated with ATRs. After transfusion‐related covariates were controlled for, aeroallergen sensitization remained significantly associated with ATRs (odds ratio, 2.68; 95% confidence interval, 1.26‐5.69).

Conclusions

Transfusion‐ and component‐specific attributes are not associated with ATRs. An allergic predisposition in transfusion recipients is associated most strongly with ATR risk.
Initial serum ferritin predicts number of therapeutic phlebotomies to iron depletion in secondary iron overload
Authors: Panch Sandhya R. , Yau Yu Ying , West Kamille , Diggs Karen , Sweigart Tamsen , Leitman Susan F.
Published: September 2014

Background

Therapeutic phlebotomy is increasingly used in patients with transfusional siderosis to mitigate organ injury associated with iron overload (IO). Laboratory response variables and therapy duration are not well characterized in such patients.

Study Design and Methods

We retrospectively evaluated 99 consecutive patients undergoing therapeutic phlebotomy for either transfusional IO (TIO, n = 88; 76% had undergone hematopoietic transplantation) or nontransfusional indications (hyperferritinemia or erythrocytosis; n = 11). Complete blood cell count, serum ferritin (SF), transferrin saturation, and transaminases were measured serially. Phlebotomy goal was an SF level of less than 300 μg/L.

Results

Mean SF levels before phlebotomy among TIO and nontransfusional subjects were 3093 and 396 μg/L, respectively. Transfusion burden in the TIO group was 94 ± 108 (mean ± SD) RBC units; approximately half completed therapy with 24 ± 23 phlebotomies (range, 1‐103). One‐third were lost to follow‐up. Overall, 15% had mild adverse effects, including headache, nausea, and dizziness, mainly during first phlebotomy. Prior transfusion burden correlated poorly with initial ferritin and total number of phlebotomies to target in the TIO group. However, number of phlebotomies to target was strongly correlated with initial SF (R2 = 0.8; p < 0.0001) in both TIO and nontransfusional groups. ALT decreased significantly with serial phlebotomy in all groups (mean initial and final values, 61 and 39 U/L; p = 0.03).

Conclusions

Initial SF but not transfusion burden predicted number of phlebotomies to target in patients with TIO. Despite good treatment tolerance, significant losses to follow‐up were noted. Providing patients with an estimated phlebotomy number and follow‐up duration, and thus a finite endpoint, may improve compliance. Hepatic function improved with iron offloading.
Efficiency Sorting Among Foreign Affiliates: Evidence From China
Authors: Chen Yasheng , Ge Ying , Lai Huiwen , Liu Qing
Published: September 2014

This paper uses a large micro‐level data set to investigate the efficiency sorting pattern of foreign affiliates serving different markets. We find systematic differences among the attributes of foreign affiliates serving the local and overseas markets. Affiliates serving only the host country market are the most productive, the most capitalintensive and the most skill‐intensive. Affiliates serving only the international market are the most unskilled and labour‐intensive, the least efficient, pay the lowest wages and invest least in innovation and advertising. Affiliates serving both markets offer high wages and invest most in innovation and advertising. The results also suggest that the most productive affiliates choose to serve the host country market, whereas the least efficient affiliates target the international market.
A comparison of tissue oxygen saturation measurements by 2 different near‐infrared spectroscopy monitors in 21 healthy dogs
Authors: Engbers Sarah , Boysen Søren R. , Engbers Jordan , Chalhoub Serge
Published: September 2014

Objective

To determine whether a difference exists in tissue oxygen saturation (StO2) measurements between 2 near‐infrared spectroscopy monitors on the sartorius muscle in healthy dogs.

Design

Prospective experimental study.

Setting

University veterinary teaching facility.

Animals

Seventeen healthy student volunteered dogs and 4 healthy veterinary medicine teaching dogs.

Interventions

An Inspectra 650 and INVOS 5100C StO2 probe were simultaneously placed on the medial right and left sartorius muscles of each dog for 2 minutes of real‐time recording while standing and in left lateral recumbency. Left and right probe locations were reversed for both standing and lateral measurements. The peak value over the first 30 seconds on the Inspectra was also recorded.

Measurements and Main Results

Peak StO2 values on the Inspectra over 30 seconds yielded an average of 89.9 ± 4.8%. There was no significant difference between groups above or below 9 kg, or between male and female dogs. The 2‐minute averaged mean for the Inspectra was statistically higher than the INVOS (87.7 ± 5.47% and 64.1 ± 5.51%, respectively). The linear mixed‐effects model showed that there is a 1.82% decrease in StO2 when standing compared to left lateral recumbency, which was elicited on both machines. On average, the INVOS underestimated the StO2 by 23.7% compared to the Inspectra.

Conclusions

The INVOS significantly underestimates StO2 when compared to the Inspectra. Given this difference is on average 23.7%, StO2 cut off values used to guide therapy based on Inspectra readings cannot be applied to the INVOS. While there was a statistically significant difference in standing versus lateral positions on both devices, it is unlikely to be clinically significant. Studies using different devices should not be directly compared, and it is important to use the same monitor when taking serial measurements.
Outcome of positive‐pressure ventilation in dogs and cats with congestive heart failure: 16 cases (1992–2012)
Authors: Edwards Thomas H. , Erickson Coleman Amanda , Brainard Benjamin M. , DeFrancesco Teresa C. , Hansen Bernard D. , Keene Bruce W. , Koenig Amie
Published: September 2014

Objective

To describe the indications, duration of ventilation, underlying cardiac diseases, and outcome of dogs and cats undergoing positive‐pressure ventilation (PPV) for treatment of congestive heart failure (CHF).

Design

Two‐site retrospective study (1992–2012).

Setting

Two university small animal teaching hospitals.

Animals

Six cats and 10 dogs undergoing PPV for CHF.

Interventions

None.

Measurements and Main Results

Medical records were searched to identify patients requiring PPV for treatment of pulmonary edema secondary to CHF. Sixteen animals fulfilled these criteria. Patient signalment, duration of PPV, underlying cardiac disease, arterial or venous blood gas values, pharmacologic therapy before, during, and after PPV, anesthetic drugs, complications, and outcome were recorded. Overall survival to discharge was 62.5% (10/16). Mean (±SD) duration of PPV was 30.8 ± 21.3 hours and average time from presentation for CHF to initiation of PPV was 5.9 ± 6.4 hours. Azotemia at the time of initiation of ventilation, development of anuria or oliguria, and use of pentobarbital for anesthesia were negatively associated with survival (P= 0.011,P= 0.036, andP= 0.036, respectively). Survival‐to‐discharge rate was 77% (10/13) for patients treated after 2005 and those not receiving pentobarbital. There was no significant effect attributed to age, sex, weight, species, nature of heart disease, furosemide dose, length of ventilation, use of vasopressors, first‐time CHF events, or plasma lactate concentration on survival to discharge.

Conclusions

Dogs and cats requiring PPV for CHF have a good overall prognosis for hospital discharge and require PPV for a relatively short duration. Azotemia, oliguria or anuria, and the use of pentobarbital are negatively associated with outcome.
Accuracy of calculated arterial saturation in oxygen in neonatal foals and effects of monitor, sensor, site of sensor placement, and degree of hypoxemia on the accuracy of pulse oximetry
Authors: Giguère Steeve , Sanchez L. Chris , Shih Andre
Published: September 2014

Objectives

To (1) assess the agreement between calculated values for arterial hemoglobin saturation of oxygen (SaO2) and values obtained by co‐oximetry, (2) assess the accuracy of 2 pulse oximetry monitors for measurement of SaO2in foals, and for each monitor, and (3) determine the optimal combination of sensor type and site of sensor placement for SaO2monitoring.

Design

Prospective experimental study.

Setting

University teaching hospital.

Animals

Six neonatal foals.

Interventions

Foals were anesthetized with isoflurane and SaO2was manipulated by varying the inspired fraction of oxygen. SaO2was calculated from oxygen tension or measured by pulse oximetry using 2 monitors equipped with transmission or reflectance sensors attached to the foal's tongue, lip, ear, or inserted rectally (reflectance sensor only). SaO2values measured by co‐oximetry were used as the gold standard to calculate bias.

Measurements and Main Results

Mean (±SD) SaO2determined by co‐oximetry was 65.2% ± 11.8%, 85.4% ± 2.5%, and 97.2% ± 0.4% at the low, intermediate, and high SaO2level, respectively. Sensors attached to the ear failed to provide SaO2readings for most attempts. Reflectance sensors placed on the lip or rectally gave significantly larger biases at low SaO2(−17.0% and −23.6%, respectively) than at higher levels. Bias of all other combinations of monitors, sensors, and sites (−1.8 to −4.1%) was not significantly influenced by the level of SaO2or different from each other. The bias of calculated saturation was similar to that of pulse oximetry.

Conclusions

Transmission sensors placed on the lip or tongue or reflectance sensors placed on the tongue give the most accurate assessment of SaO2in anesthetized neonatal foals. Calculated saturation is not more accurate than pulse oximetry to estimate SaO2.
Plasma lactate concentrations in septic peritonitis: A retrospective study of 83 dogs (2007–2012)
Authors: Cortellini Stefano , Seth Mayank , Kellett‐Gregory Lindsay M.
Published: September 2014

Objective

To determine if absolute plasma lactate concentration or lactate clearance in dogs with septic peritonitis is associated with morbidity or mortality.

Design

Retrospective cohort study from 2007 to 2012.

Setting

University teaching hospital.

Animals

Eighty‐three dogs with septic peritonitis were included. Patients had at least 1 plasma lactate measurement during the course of the hospitalization.

Results

Sixty‐four percent of the patients survived to discharge, 22% were euthanized, and 14% died during hospitalization. Plasma lactate concentration >2.5 mmol/L on admission (29% of the patients) was associated with mortality (P= 0.001). Median admission plasma lactate concentration (n= 81) was significantly different between nonsurvivors (2.5 mmol/L, range 0.5–8.4) and survivors (1.4 mmol/L, range 0.5–9.7;P= 0.007). Admission plasma lactate concentration >4 mmol/L yielded a sensitivity of 36% and a specificity of 92% for nonsurvival. The inability to normalize plasma lactate concentration within 6 hours of admission (n= 10/24) yielded a sensitivity of 76% and specificity of 100% for nonsurvival. Postoperative hyperlactatemia (plasma lactate concentration >2 mmol/L;n= 18/76) had a sensitivity of 46% and specificity of 88% for nonsurvival. Persistent postoperative hyperlactatemia (n= 11/18) had a sensitivity of 92% and a specificity of 100% for nonsurvival. Lactate clearance less than 21% at 6 hours (n= 20) had a sensitivity of 54% and specificity of 91% for nonsurvival. Lactate clearance less than 42% at 12 hours (n= 18) had a sensitivity of 82% and a specificity of 100% for nonsurvival.

Conclusions

Admission plasma lactate concentration and lactate clearance were good prognostic indicators in dogs with septic peritonitis.
Conversion of the Kowa RC‐2 camera to a digital version, instructions for use, and postprocessing of the images
Authors: Dulaurent Thomas , Bath Alasdair , Isard Pierre‐François
Published: September 2014

Objective

To describe a means of converting the Kowa RC‐2 camera to a digital version.

Procedure

The optic (OP) and the film portions (FP) of the Kowa RC‐2 were separated. The lateral rails were unscrewed from the front plate of the FP. The front plate was detached from the FP. The plate was fixed to an anodized aluminum plate (AAP). The rails were screwed back onto the front plate. This system was reattached to the OP by means of the rails. A T2‐E mount ring was screwed onto the AAP and fixed to a digital camera body (DCB). A flash sync extension cord was used to connect the flash cable of the Kowa to the DCB. The images obtained with the converted Kowa were inverted horizontally and vertically using image processing software.

Results

The images obtained with the converted Kowa RC‐2 were identical in format to those using the film version with a circular image surrounded by a black rectangle. The imaged ocular structures were accurately depicted, appearing upside down and reversed on the LCD screen. The DCB was set to manual mode and focus. The shutter speed was initially set to 1/250 s, and the ISO was adjusted based on the ocular structure being photographed. An extra filter had to be placed over the light source to dim the light when imaging reflective fundi.

Conclusion

The converted digital version of the Kowa RC‐2 as described provides an affordable means of obtaining high‐quality images of various ocular structures.
High‐Fidelity Simulation Effects on CPR Knowledge, Skills, Acquisition, and Retention in Nursing Students
Authors: Aqel Ahmad A. , Ahmad Muayyad M.
Published: September 2014

Background

There is a gap in the literature regarding learning outcomes linked to the use of high‐fidelity simulators compared to that of traditional teaching methods.

Aim

To examine the effect of using high‐fidelity simulators on knowledge and skills acquisition and retention with university students.

Methods

A randomized two‐arm trial using two different educational approaches on 90 nursing students assigned randomly to two groups was used at two points of time.

Findings

The results showed significant differences in favor of the participants in the high‐fidelity simulator group on both the acquisition and retention of knowledge and skills over time. However, a significant loss of cardiopulmonary resuscitation knowledge and skills occurred at 3 months after training in both groups.

Conclusions

The findings of this study may assist educators in integrating high‐fidelity simulators in education and training. In addition, the findings may help nursing educators to arrange additional cardiopulmonary resuscitation training sessions in order to improve cardiac arrested patients’ outcomes.

Linking Evidence to Action

High‐fidelity simulation (HFS) provides students with interactive learning experiences in a safe controlled environment. HFS enables teachers to implement critical clinical scenarios, such as cardiac arrest, without risk to patients. Integrating the simulation training into nursing curricula will help to overcome the challenges that face many courses, specifically the shortage of clinical areas for training and the increase in numbers of nursing students.
The Relationship Between Physical Activity and Depressive Symptoms in Adolescents: A Systematic Review
Authors: Bursnall Patricia
Published: September 2014

Background and Purpose

Depression affects a significant number of adolescents and requires creative treatment planning. Physical activity (PA) as a treatment option for depression has moderate support through repeated systematic reviews in adults, but not in adolescents. The purpose of this work is to present a systematic review of the evidence within the past 5 years regarding the relationship between PA and depressive symptoms (DS) in adolescents, and to determine if the evidence supports PA as a viable treatment option for this age group.

Methods

An extensive search was conducted through MEDLINE (i.e., Ovid and PubMed), CINAHL, and PsycINFO databases. Ten primary articles were ultimately selected and reviewed for their quality and contributions to the subject. The SORT tool was utilized to grade individual works and the body of evidence as a whole.

Findings

As of the writing of this review, the author finds only one randomized controlled trial that explores the interaction between PA and DS in the adolescent age group. However, the body of evidence generated from this review indicates a strong inverse correlation between the two variables.

Linking Evidence to Action

Further research must be conducted to determine causation. However, healthcare providers can and must provide both health education and health promotion surrounding the relationship between PA and DS in the adolescent age group to enhance wellness and prevent disease.
Zinc Oxide Therapy Increases Prevalence and Persistence of Methicillin‐Resistant Staphylococcus aureus in Pigs: A Randomized Controlled Trial
Authors: Slifierz M. J. , Friendship R. , Weese J. S.
Published: September 2014

There is concern that therapeutic use of zinc oxide (ZnO) in swine production may select for methicillin‐resistant Staphylococcus aureus (MRSA) due to co‐location of the zinc resistance gene (czrC) and methicillin resistance gene (mecA) within the staphylococcal cassette chromosome mec (SCCmec). The objective of this investigation was to determine whether MRSA carriage in pigs is influenced by exposure to therapeutic doses of in‐feed ZnO (3000 mg/kg) when compared to the recommended dietary levels (100 mg/kg). A randomized controlled trial was completed using 110 pigs that were naturally colonized with czrC‐positive MRSA. The pigs were followed from birth to weaning (21 d), at which point they were randomized into 8 pens and exposed to either a control feed (100 mg ZnO/kg feed; n = 49 pigs) or a treatment feed (3000 mg ZnO/kg feed; n = 50 pigs); neither feed contained additional antimicrobials. MRSA carriage was monitored weekly in each group for 4 weeks post‐weaning. The prevalence of MRSA was significantly higher in the treatment group at 1‐week (OR = 18.1; P < 0.01) and 2 weeks (OR = 3.01; P = 0.01) post‐weaning when compared to the control group, but there was no difference later in the nursery phase. Persistent MRSA carriage (testing positive ≥2 times post‐weaning) was observed in 2% (1/49) of control pigs and 22% (11/50) of treated pigs (P < 0.01). All MRSA isolates (spa types t034 and t3075) carried czrC and showed uniform resistance to zinc. These findings demonstrate that the prevalence and persistence of MRSA in nursery pigs can be affected by high levels of in‐feed ZnO in the absence of antibiotics.
On fields of rationality for automorphic representations
Authors: Shin Sug Woo , Templier Nicolas
Published: September 2014

This paper proves two results on the field of rationality$\mathbb{Q}({\it\pi})$for an automorphic representation${\it\pi}$, which is the subfield of$\mathbb{C}$fixed under the subgroup of$\text{Aut}(\mathbb{C})$stabilizing the isomorphism class of the finite part of${\it\pi}$. For general linear groups and classical groups, our first main result is the finiteness of the set of discrete automorphic representations${\it\pi}$such that${\it\pi}$is unramified away from a fixed finite set of places,${\it\pi}_{\infty }$has a fixed infinitesimal character, and$[\mathbb{Q}({\it\pi}):\mathbb{Q}]$is bounded. The second main result is that for classical groups,$[\mathbb{Q}({\it\pi}):\mathbb{Q}]$grows to infinity in a family of automorphic representations in level aspect whose infinite components are discrete series in a fixed$L$-packet under mild conditions.
Large Amplitude Thermal Fluctuations of Confined Semiflexible Biopolymer Filaments
Authors: Jonsdottir F. , Freund L. B.
Published: September 2014

The phenomenon of thermal fluctuations of biopolymers has been of active interest for some time with a view toward understanding the effect of filament confinement, migration, and bonding. In this study, we focus our attention on planar fluctuations of a single filament between parallel confining surfaces. Filament slopes, with respect to the centerline of the channel, commonly exceed 0.1 in magnitude and therefore fall outside the range of small amplitude fluctuations. Consequently, large amplitudes are anticipated from the outset. Determination of the partition function leads to the quantitative dependence of free energy and other thermodynamic parameters on the degree of confinement.