bluuebunny/crossref_metadata_2025 huggingface dataset:
Endoscopic versus surgical treatment for pancreatic pseudocyst
Authors: Zhao Xin , Feng Tao , Ji Wu
Published: September 2015

Background and Aim

To evaluate the effectiveness and safety of endoscopic treatment for pancreatic pseudocyst compared with surgical treatment.

Methods

PubMed and The Cochrane Library were systematically searched to identify all comparative trials investigating endoscopic versus surgical treatment for pancreatic pseudocyst. Main outcome measures included treatment success rate, adverse events, recurrence rate, length of hospital stay and hospital cost.

Results

Five comparative studies with 255 participants were included in this meta‐analysis. The surgical group exhibited a higher treatment success rate than the endoscopic group (OR, 0.43; 95% CI, 0.20–0.95; P = 0.04). However, there was no difference in the rates of adverse events (OR, 0.67; 95% CI, 0.33–1.36; P = 0.27) or recurrence (OR, 1.53; 95% CI, 0.37–6.39; P = 0.56) between the endoscopic and the surgical groups. Evidence from included studies demonstrated that the endoscopic group was associated with shorter length of hospital stay and lower hospital cost compared to the surgical group.

Conclusion

Endoscopic treatment may be the first‐line treatment approach for patients with pancreatic pseudocyst.
Improvement of gastroesophageal reflux disease in Japanese patients with spinal kyphotic deformity who underwent surgical spinal correction
Authors: Sugimoto Mitsushige , Hasegawa Tomohiko , Nishino Masafumi , Sahara Shu , Uotani Takahiro , Ichikawa Hitomi , Kagami Takuma , Sugimoto Ken , Yamato Yu , Togawa Daisuke , Kobayashi Sho , Hoshino Hironobu , Matsuyama Yukihiro , Furuta Takahisa
Published: September 2015

Background and Aim

Spinal kyphotic deformity occasionally results in gastroesophageal reflux disease (GERD). The effects of acid reflux on the esophagus in kyphotic patients are unclear, however, and it is unknown whether acid reflux, endoscopic GERD, and reflux‐related symptoms improve following surgical spinal correction in these patients. Herein, we investigated the characteristics of GERD in kyphotic patients and the improvement in GERD following surgical correction.

Methods

In 48 patients with severe kyphotic deformity scheduled for surgical spinal correction, we conducted esophagogastroduodenoscopy, 24‐h pH monitoring and three questionnaire surveys, including the frequency scale for the symptoms of GERD (FSSG). We repeated these measurements after surgical correction and compared pre‐ and post‐surgery values.

Results

Of 48 patients, 70.8% [95% CI: 55.9–83.0%, 34/48] had endoscopically evaluated esophageal mucosal injury. Regarding pH before surgery, 64.9% (CI: 47.5–79.8%, 24/37) had abnormal acid reflux (intraesophageal pH < 4 more than 5% of the time). FSSG score was significantly associated with the severity of GERD, and the positive rate was 52.6% (CI: 35.8–69.0%, 20/38). Following surgical correction, esophageal mucosal injury improved endoscopically in 90% of patients, and median total FSSG score significantly decreased from 8 (0–30) to 5 (0–19) (P = 0.005). Regarding pH after surgery, prevalence of abnormal acid reflux decreased from 66.7% (95% CI: 41.0–86.7%) to 33.3% (95% CI: 13.3–59.0%) (P = 0.045).

Conclusion

Surgical spinal correction in kyphosis patients improves not only kyphotic deformity‐related disorders but also esophageal mucosal injury, abnormal acid reflux, and reflux‐related symptoms.
Factors associated with healing of artificial ulcer after endoscopic submucosal dissection with reference to Helicobacter pylori infection, CYP2C19 genotype, and tumor location: Multicenter randomized trial
Authors: Yoshizawa Yashiro , Sugimoto Mitsushige , Sato Yoshihiko , Sahara Shu , Ichikawa Hitomi , Kagami Takuma , Hosoda Yoshisuke , Kimata Masaharu , Tamura Satoshi , Kobayashi Yousuke , Osawa Satoshi , Sugimoto Ken , Miyajima Hiroaki , Furuta Takahisa
Published: September 2015

Background and Aim

Healing speed of peptic ulcer is affected by a number of factors, including Helicobacter pylori (H. pylori) infection and intragastric pH. Acid inhibition exerted by proton pump inhibitors differs by CYP2C19 genotype. Herein, we investigated whether healing speed of artificial ulcers formed after endoscopic submucosal dissection (ESD) was influenced by H. pylori infection, CYP2C19 genotype, or other factors.

Methods

A total of 96 H. pylori‐positive patients with gastric tumors scheduled for ESD were randomly assigned to receive eradication therapy for H. pylori before ESD (pre‐ESD eradication) (n = 44) or after (post‐ESD eradication) (n = 52). Patients received eradication therapy consisting of lansoprazole 30 mg, amoxicillin 750 mg, and clarithromycin 200 mg twice daily for 1 week. After ESD, lansoprazole 30 mg was given once daily for 8 weeks. Ulcer size was endoscopically measured on the next day and at 4 and 8 weeks after ESD.

Results

Mean reduction rate of artificial ulcer area in the pre‐ESD eradication group was 94.7% ± 5.5% at 4 weeks, which was similar to that in the post‐ESD eradication group (94.7% ± 6.7%, P = 0.987), irrespective of CYP2C19 genotype. In multivariate analyses, location of gastric tumor (middle and upper, odds ratio: 4.05, 95% CI: 1.620–10.230, P = 0.003) was a factor for 97% reduction of artificial ulcer area at 4 weeks post‐ESD, but CYP2C19 genotype and H. pylori infection were not.

Conclusion

Healing speed of ESD‐induced artificial ulcer was affected by tumor location, but not by time of H. pylori eradication, resected size, or CYP2C19 genotype.
Decreasing prevalence in cerebral palsy: a multi‐site European population‐based study, 1980 to 2003
Authors: Sellier Elodie , Platt Mary Jane , Andersen Guro L , Krägeloh‐Mann Ingeborg , De La Cruz Javier , Cans Christine ,   Surveillance of Cerebral Palsy Network
Published: September 2015

Aim

To monitor the trends in prevalence of cerebral palsy (CP) by birthweight in Europe, 1980 to 2003.

Method

Data were collated from 20 population‐based registers contributing to the Surveillance of Cerebral Palsy in Europe database. Trend analyses were conducted in four birthweight groups: <1000g (extremely low birthweight [ELBW]); 1000 to 1499g (very low birthweight [VLBW]); 1500 to 2499g (moderately low birthweight [MLBW]); and >2499g (normal birthweight [NBW]).

Results

The overall prevalence ofCPdecreased from 1.90 to 1.77 per 1000 live births,p<0.001, with a mean annual fall of 0.7% (95% confidence interval [CI] −0.3% to −1.0%). Prevalence inNBWchildren showed a non‐significant trend from 1.17 to 0.89 per 1000 live births (p=0.22). Prevalence inMLBWchildren decreased from 8.5 to 6.2 per 1000 live births (p<0.001), but not linearly. Prevalence inVLBWchildren also declined from 70.9 to 35.9 per 1000 live births (p<0.001) with a mean annual fall of 3.4% (95%CI−2.4% to −4.3%). Prevalence inELBWchildren remained stable, at a mean rate of 42.4 per 1000 live births.

Interpretation

The decline in prevalence ofCPin children ofVLBWcontinues, and confirms that previously reported. For the first time, there is also a significant decline among those ofMLBW, resulting in a significant overall decrease in the prevalence ofCP.
Inappropriate prescribing in elderly people with diabetes admitted to hospital
Authors: Formiga F. , Vidal X. , Agustí A. , Chivite D. , Rosón B. , Barbé J. , López‐Soto A. , Torres O. H. , Fernández‐Moyano A. , García J. , Ramírez‐Duque N. , San José A. ,   Potentially Inappropriate Prescription in Older Patients in Spain (PIPOPS) Investigators' Project
Published: September 2015

Aims

To assess inappropriate prescribing in older people with diabetes mellitus during the month prior to a hospitalization, using tools on potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs) and comparing inappropriate prescribing in patients with without diabetes.

Methods

In an observational, prospective multicentric study, we assessed inappropriate prescribing in 672 patients aged 75 years and older during hospital admission. The Beers, Screening Tool of Older Person's Prescriptions (STOPP) and Screening Tool to Alert Doctors to Right Treatment (START) criteria and Assessing Care of Vulnerable Elders (ACOVE‐3) medicine quality indicators were used. We analysed demographic and clinical factors associated with inappropriate prescribing.

Results

Of 672 patients, 249 (mean age 82.4 years, 62.9% female) had a diagnosis of diabetes mellitus. The mean number of prescribing drugs per patient with diabetes was 12.6 (4.5) vs. 9.4 (4.3) in patients without diabetes (P < 0.001). Of those patients with diabetes, 74.2% used 10 or more medications; 54.5% of patients with diabetes had at least one Beers‐listed PIM, 68.1% had at least one STOPP‐listed PIM, 64.6% had at least one START‐listed PPO and 62.8% had at least one ACOVE‐3‐listed PPO. Except for the Beers criteria, these prevalences were significantly higher in patients with diabetes than in those without. After excluding diabetes‐related items from these tools, only STOPP‐listed PIMs remained significantly higher among patients with diabetes (P = 0.04).

Conclusions

Polypharmacy is common among older patients with diabetes mellitus. Inappropriate prescribing is higher in older patients with diabetes, even when diabetes‐related treatment is excluded from the inappropriate prescribing evaluation.
Poor structural social support is associated with an increased risk of Type 2 diabetes mellitus: findings from the MONICA/KORA Augsburg cohort study
Authors: Altevers J. , Lukaschek K. , Baumert J. , Kruse J. , Meisinger C. , Emeny R. T. , Ladwig K. H.
Published: September 2015

Aims

Several psychosocial factors have been shown to increase the risk of Type 2 diabetes mellitus. This study investigated the association between structural social support and incidence of Type 2 diabetes mellitus in men and women.

Methods

Data were derived from three population‐based MONICA/KORA surveys conducted in 1984–1995 in the Augsburg region (southern Germany) and followed up by 2009. The study population comprised 8952 participants (4669 men/4283 women) aged 30–74 years without diabetes at baseline. Structural social support was assessed using the Social Network Index. Sex‐specific hazard ratios were estimated from Cox proportional hazard models.

Results

Within follow‐up, 904 incident Type 2 diabetes mellitus cases (558 men, 346 women) were observed. Crude incidence rates for Type 2 diabetes mellitus per 10 000 person‐years were substantially higher in poor compared with good structural social support (men: 94 vs. 69, women: 58 vs. 43). After adjustment for age, survey, parental history of diabetes, smoking status, alcohol intake, physical activity, hypertension, dyslipidaemia, BMI, education, sleep complaints and depressed mood, risk of Type 2 diabetes mellitus for participants with poor compared with good structural social support was 1.31 [95% confidence interval (CI) = 1.11–1.55] in men and 1.10 (95% CI = 0.88–1.37) in women. Stratified analyses revealed a hazard ratio of 1.50 (95% CI = 1.23–1.83) in men with a low level of education and 0.87 (95% CI = 0.62–1.22) in men with a high level of education (P for interaction: 0.0082).

Conclusions

Poor structural social support is associated with Type 2 diabetes mellitus in men. This association is independent of risk factors at baseline and is particularly pronounced in men with a low level of education.
Molecular components of the circadian clock in mammals
Authors: Takahashi J. S.
Published: September 2015

The circadian clock mechanism in animals involves a transcriptional feedback loop in which the bHLH‐PAS proteins CLOCK and BMAL1 form a transcriptional activator complex to activate the transcription of the Period and Cryptochrome genes, which in turn feed back to repress their own transcription. In the mouse liver, CLOCK and BMAL1 interact with the regulatory regions of thousands of genes, which are both cyclically and constitutively expressed. The circadian transcription in the liver is clustered in phase and this is accompanied by circadian occupancy of RNA polymerase II recruitment and initiation. These changes also lead to circadian fluctuations in histone H3 lysine4 trimethylation (H3K4me3) as well as H3 lysine9 acetylation (H3K9ac) and H3 lysine27 acetylation (H3K27ac). Thus, the circadian clock regulates global transcriptional poise and chromatin state by regulation of RNA polymerase II.
Sleep efficiency as a determinant of insulin sensitivity in overweight and obese adolescents
Authors: Dorenbos E. , Rijks J. M. , Adam T. C. , Westerterp‐Plantenga M. S. , Vreugdenhil A. C. E.
Published: September 2015

Insulin resistance (IR) occurs in a transient manner during puberty. Obese adolescents may be at risk for persistent IR during puberty. The objective of the study is to review the literature on the association of the anthropometry and lifestyle characteristics with insulin sensitivity in overweight and obese adolescents, and include data from a new study. Relevant papers were selected and reviewed. In addition, 137 overweight and obese adolescents (42 male/95 female, age 14.4 ± 2.3 years, BMI z‐score +3.3 ± 0.7, HOMA‐IR 3.4 ± 1.8) from the Centre for Overweight Adolescent and Children's Healthcare (MUMC+) were included in this study. Anthropometrics, Tanner stages, sleep characteristics, food intake behaviour and physical activity were determined, and possible associations with homeostasis model assessment of insulin resistance (HOMA‐IR) were tested. Results: Overweight and obese adolescents with unfavourable fat partitioning and family history of NIDDM are at risk for persistent IR. Overweight and obese adolescents from the new cohort showed a higher HOMA‐IR postpubertally. BMI z‐score, age, pubertal stage and prepubertally total sleeping time (TST) and sleep efficiency (SE) were identified as significant contributors. Overweight and obese adolescents showed a persistently higher instead of transiently higher HOMA‐IR during puberty, associated with BMI z‐score, age, pubertal stage and prepubertally less TST and SE.
Interplay between cellular redox oscillations and circadian clocks
Authors: Rey G. , Reddy A. B.
Published: September 2015

The circadian clock is a cellular timekeeping mechanism that helps organisms from bacteria to humans to organize their behaviour and physiology around the solar cycle. Current models for circadian timekeeping incorporate transcriptional/translational feedback loop mechanisms in the predominant model systems. However, recent evidence suggests that non‐transcriptional oscillations such as metabolic and redox cycles may play a fundamental role in circadian timekeeping. Peroxiredoxins, an antioxidant protein family, undergo rhythmic oxidation on the circadian time scale in a variety of species, including bacteria, insects and mammals, but also in red blood cells, a naturally occurring, non‐transcriptional system. The profound interconnectivity between circadian and redox pathways strongly suggests that a conserved timekeeping mechanism based on redox cycles could be integral to generating circadian rhythms.
Role of the clock gene Rev‐erbα in metabolism and in the endocrine pancreas
Authors: Vieira E. , Merino B. , Quesada I.
Published: September 2015

Several hormones are regulated by circadian rhythms to adjust the metabolism to the light/dark cycles and feeding/activity patterns throughout the day. Circadian rhythms are mainly governed by the central clock located in the suprachiasmatic nucleus but also by clocks present in peripheral organs, like the endocrine pancreas. Plasma glucose levels and the main pancreatic hormones insulin and glucagon also exhibit daily variations. Alterations in circadian rhythms are associated with metabolic disturbances and pathologies such as obesity and diabetes. The molecular components of central and peripheral clocks and their regulatory mechanisms are well established. Among the different clock genes, Rev‐erbα is considered one of the key links between circadian rhythms and metabolism. Rev‐erbα is a critical part of a negative feedback loop in the core circadian clock and modulates the clock oscillatory properties. In addition, Rev‐erbα plays an important role in the regulation of lipid and glucose metabolism, thermogenesis, adipocyte and muscle differentiation as well as mitochondrial function. In the endocrine pancreas, Rev‐erbα regulates insulin and glucagon secretion and pancreatic β‐cell proliferation. In the present review, we discuss all these subjects and, particularly, the role of the clock gene Rev‐erbα in the endocrine pancreas.
Molecular clocks and the human condition: approaching their characterization in human physiology and disease
Authors: Fitzgerald G. A. , Yang G. , Paschos G. K. , Liang X. , Skarke C.
Published: September 2015

Molecular clockworks knit together diverse biological networks and compelling evidence from model systems infers their importance in metabolism, immunological and cardiovascular function. Despite this and the diurnal variation in many aspects of human physiology and the phenotypic expression of disease, our understanding of the role and importance of clock function and dysfunction in humans is modest. There are tantalizing hints of connection across the translational divide and some correlative evidence of gene variation and human disease but most of what we know derives from forced desynchrony protocols in controlled environments. We now have the ability to monitor quantitatively ex vivo or in vivo the genome, metabolome, proteome and microbiome of humans in the wild. Combining this capability, with the power of mobile telephony and the evolution of remote sensing, affords a new opportunity for deep phenotyping, including the characterization of diurnal behaviour and the assessment of the impact of the clock on approved drug function.
Effects of plant diversity and structural complexity on parasitoid behaviour in a field experiment
Authors: KOSTENKO OLGA , LAMMERS MARK , GROOTEMAAT SASKIA , KROON THOMAS , HARVEY JEFFREY A. , VAN GEEM MONIEK , BEZEMER T. MARTIJN
Published: September 2015

1. In natural ecosystems, plants containing hosts for parasitoids are often embedded within heterogeneous plant communities. These plant communities surrounding host‐infested plants may influence the host‐finding ability of parasitoids.

2. A release‐recapture‐approach was used to examine whether the diversity and structural complexity of the community surrounding a host‐infested plant influences the aggregation behaviour of the leaf‐miner parasitoidDacnusa sibiricaTelenga and naturally occurring local leaf‐miner parasitoids. Released and locally present parasitoids were collected on pottedJacobaea vulgarisGaertn.plants infested with the generalist leaf‐minerChromatomyia syngenesiaeHardy. The plants were placed in experimentally established plant communities differing in plant diversity (1–9 species) and habitat complexity (bare ground, mown vegetation, and tall vegetation). Additionally, parasitoids were reared out from host mines on the trap plants.

3. Plant diversity did not influence the mean number of recapturedD. sibiricaor captures of other locally present parasitoids but the number of recaptured parasitoids was influenced by habitat complexity. NoD. sibiricaparasitoids were recaptured in the bare ground plots or plots with mown vegetation. The mean number of recapturedD. sibiricagenerally increased with increasing complexity of the plant community, whereas locally present parasitoids were captured more frequently in communities with more bare ground. There was a unimodal relationship between the number of reared out parasitoids and diversity of the surrounding vegetation with the highest density of emerged parasitoids at intermediate diversity levels.

4. The present study adds to the thus far limited body of literature examining the aggregation behaviour of parasitoids in the field and suggests that the preference of parasitoids to aggregate in complex versus simple vegetation is association specific and thus depends on the parasitoid species as well as the identity of the plant community.
The role of youth mental health services in the treatment of young people with serious mental illness: 2‐year outcomes and economic implications
Authors: Brimblecombe Nicola , Knapp Martin , Murguia Silvia , Mbeah‐Bankas Henrietta , Crane Steve , Harris Abi , Evans‐Lacko Sara , Ardino Vittoria , Iemmi Valentina , King Derek
Published: September 2015

Aim

This study aims to evaluate the outcomes and economic case for a UK innovative youth‐specific mental health service for 16–25 year olds.

Methods

A pre‐, during‐ and post‐treatment comparative design for 20 young people at high risk of developing psychosis who received 2 years' treatment with the service, using outcomes that concurred with the service aims: changes in mental health, employment rates and service use.

Results

Forty‐five percent of those at risk and with symptoms of serious mental illness commencing treatment were not receiving mental health services at baseline. Compared with service use prior to treatment at the youth‐specific service, hospital admissions, Accident and Emergency, and criminal justice system use appear to decrease over the 2 years of treatment and the year after treatment, with potential cost differences of £473 000. Mental health improved or stayed the same, compared with baseline. Employment rates improved, although the sample size for this is very small. Potential cost differences associated with service users moving into employment over the 2 years are £148 000. The estimated cost over 2 years of providing the youth‐specific mental health service to these young people was £106 000.

Conclusions

Given the extensive long‐term negative consequences and high costs of untreated mental illness in the 16–25 age group and the documented problems young people have in receiving appropriate services, this youth‐specific, age‐appropriate service model appears to be successful, with improved outcomes and cost differences in the short‐term, and with encouraging implications for the longer term.
‘Real‐life’ experience of preapproval carfilzomib‐based therapy in myeloma – analysis of cardiac toxicity and predisposing factors
Authors: Danhof Sophia , Schreder Martin , Rasche Leo , Strifler Susanne , Einsele Hermann , Knop Stefan
Published: September 2015

Background

Carfilzomib, the second‐generation proteasome inhibitor, is still awaiting approval for the treatment of multiple myeloma in Europe. Results from clinical trials have demonstrated favorable efficacy in advanced disease but have opened an ongoing debate on cardiac complications related to carfilzomib treatment. ‘Real‐life’ data are scarce.

Methods/Patients

At our institution, 22 patients were registered within the European Carfilzomib Access Program for treatment with carfilzomib, dexamethasone, and a third combination partner depending on patient characteristics and prior treatment. Patients had received a median of six previous lines of therapy, and most were refractory to bortezomib (77%) and immunomodulatory drugs (95%).

Results

Overall response rate was 65% with a median progression‐free survival of 6.0 months and a median duration of response of 6.8 months. Median overall survival was 14.9 months. Grade 3/4 adverse events (AEs) occurred in 50% of patients with 23% experiencing left ventricular failure. The risk of cardiac AEs was markedly increased after previous radiotherapy of the thoracic spine and concomitant administration of doxorubicin.

Conclusion

Carfilzomib‐based treatment is efficient in advanced multiple myeloma. In our ‘real‐life’ patients, we found considerable cardiotoxic effects in some cases, indicating a need for careful patient selection and close monitoring of the at‐risk population.
Oligomeric α‐synuclein and β‐amyloid variants as potential biomarkers for Parkinson's and Alzheimer's diseases
Authors: Williams Stephanie M. , Schulz Philip , Sierks Michael R.
Published: September 2015

Oligomeric forms of α‐synuclein and β‐amyloid are toxic protein variants that are thought to contribute to the onset and progression of Parkinson's disease (PD) and Alzheimer's disease (AD), respectively. The detection of toxic variants in human cerebrospinal fluid (CSF) and blood has great promise for facilitating early and accurate diagnoses of these devastating diseases. Two hurdles that have impeded the use of these protein variants as biomarkers are the availability of reagents that can bind the different variants and a sensitive assay to detect their very low concentrations. We previously isolated antibody‐based reagents that selectively bind two different oligomeric variants of α‐synuclein and two of β‐amyloid, and developed a phage‐based capture enzyme‐linked immunosorbent assay (ELISA) with subfemtomolar sensitivity to quantify their presence. Here, we used these reagents to show that these oligomeric α‐synuclein variants are preferentially present in PD brain tissue, CSF and serum, and that the oligomeric β‐amyloid variants are preferentially present in AD brain tissue, CSF, and serum. Some AD samples also had α‐synuclein pathology and some PD samples also had β‐amyloid pathology, and, very intriguingly, these PD cases also had a history of dementia. Detection of different oligomeric α‐synuclein and β‐amyloid species is an effective method for identifying tissue, CSF and sera from PD and AD samples, respectively, and samples that also contained early stages of other protein pathologies, indicating their potential value as blood‐based biomarkers for neurodegenerative diseases.
Lack of motor recovery after prolonged denervation of the neuromuscular junction is not due to regenerative failure
Authors: Sakuma Miyuki , Gorski Grzegorz , Sheu Shu‐Hsien , Lee Stella , Barrett Lee B. , Singh Bhagat , Omura Takao , Latremoliere Alban , Woolf Clifford J.
Published: September 2015

Motor axons in peripheral nerves have the capacity to regenerate after injury. However, full functional motor recovery rarely occurs clinically, and this depends on the nature and location of the injury. Recent preclinical findings suggest that there may be a time after nerve injury where, while regrowth to the muscle successfully occurs, there is nevertheless a failure to re‐establish motor function, suggesting a possible critical period for synapse reformation. We have now examined the temporal and anatomical determinants for the re‐establishment of motor function after prolonged neuromuscular junction (NMJ) denervation in rats and mice. Using both sciatic transection–resuture and multiple nerve crush models in rats and mice to produce prolonged delays in reinnervation, we show that regenerating fibres reach motor endplates and anatomically fully reform the NMJ even after extended periods of denervation. However, in spite of this remarkably successful anatomical regeneration, after 1 month of denervation there is a consistent failure to re‐establish functional recovery, as assessed by behavioural and electrophysiological assays. We conclude that this represents a failure in re‐establishment of synaptic function, and the possible mechanisms responsible are discussed, as are their clinical implications.
Factors associated with recurrent stroke and recanalization in patients presenting with isolated symptomatic carotid occlusion
Authors: Damania D. , Kung N. T.‐M. , Jain M. , Jain A. R. , Liew J. A. , Mangla R. , Koch G. E. , Sahin B. , Miranpuri A. S. , Holmquist T. M. , Replogle R. E. , Benesch C. G. , Kelly A. G. , Jahromi B. S.
Published: September 2015

Background and purpose

Patients with symptomatic internal carotid artery (ICA) occlusion constitute a small proportion of stroke/transient ischaemic attack patients who are at increased risk of early stroke recurrence and poor outcome. The optimal medical treatment for patients with symptomatic ICA occlusion who are ineligible for thrombolysis or thrombectomy is unknown.

Methods

Consecutive patients presenting at a single center with newly diagnosed symptomatic ICA occlusion (not involving the circle of Willis) were retrospectively reviewed. Those treated with intravenous thrombolysis or intra‐arterial thrombolysis/thrombectomy were excluded. Patients were divided into two groups based on whether they experienced recurrent in‐hospital stroke.

Results

The selected study population (n = 33) represented a small (20.4%) proportion of all newly symptomatic carotid occlusions, who nevertheless had an elevated risk of recurrent stroke during admission (24.2%). Of the variables examined (age, gender, admission National Institutes of Health Stroke Scale score, vascular risk factors, atrial fibrillation, prior stroke/transient ischaemic attack and anticoagulation within 48 h of presentation), only anticoagulation was significantly associated with a lower risk of in‐hospital recurrent stroke. Anticoagulated patients showed a decreased incidence of stroke recurrence within the first week (6.7% vs. 38.9%, P = 0.032) and fewer strokes or deaths at 1 month (13.3% vs. 47.1%, P = 0.040). Hemorrhagic transformation was not observed in any patient. On follow‐up imaging, ICA recanalization was significantly more frequent in anticoagulated patients (46.2% vs. 9.1%, P = 0.047).

Conclusion

Patients with newly diagnosed symptomatic ICA occlusion (not involving the circle of Willis) represent a small but high risk subgroup of patients with carotid occlusion. Early anticoagulation was associated with fewer recurrent strokes and increased ICA recanalization. Larger scale prospective studies may be justified.
Family‐based genome‐wide association study in Patagonia confirms the association of the DMD locus and cleft lip and palate
Authors: Fonseca Renata F. , de Carvalho Flávia M. , Poletta Fernando A. , Montaner David , Dopazo Joaquin , Mereb Juan C. , Moreira Miguel A. M. , Seuanez Hector N. , Vieira Alexandre R. , Castilla Eduardo E. , Orioli Iêda M.
Published: September 2015

The etiology of cleft lip with or without cleft palate (CL±P) is complex and heterogeneous, and multiple genetic and environmental factors are involved. Some candidate genes reported to be associated with oral clefts are located on the X chromosome. At least three genes causing X‐linked syndromes [midline 1 (MID1), oral‐facial‐digital syndrome 1 (OFD1), and dystrophin (DMD)] were previously found to be associated with isolated CL±P. We attempted to confirm the role of X‐linked genes in the etiology of isolated CL±P in a South American population through a family‐based genome‐wide scan. We studied 27 affected children and their mothers, from 26 families, in a Patagonian population with a high prevalence of CL±P. We conducted an exploratory analysis of the X chromosome to identify candidate regions associated with CL±P. Four genomic segments were identified, two of which showed a statistically significant association with CL±P. One is an 11‐kb region of Xp21.1 containing the DMD gene, and the other is an intergenic region (8.7 kb; Xp11.4). Our results are consistent with recent data on the involvement of the DMD gene in the etiology of CL±P. The MID1 and OFD1 genes were not included in the four potential CL±P‐associated X‐chromosome genomic segments.
Ecology and evolution of pathogens in natural populations of Lepidoptera
Authors: Myers Judith H. , Cory Jenny S.
Published: September 2015

Pathogens are ubiquitous in insect populations and yet few studies examine their dynamics and impacts on host populations. We discuss four lepidopteran systems and explore their contributions to disease ecology and evolution. More specifically, we elucidate the role of pathogens in insect population dynamics. For three species, western tent caterpillars, African armyworm and introduced populations of gypsy moth, infection by nucleopolyhedrovirus (NPV) clearly regulates host populations or reduces their outbreaks. Transmission of NPV is largely horizontal although low levels of vertical transmission occur, and high levels of covert infection in some cases suggest that the virus can persist in a nonsymptomatic form. The prevalence of a mostly vertically transmitted protozoan parasite, Ophryocystis elektroscirrha, in monarch butterflies is intimately related to their migratory behaviour that culls highly infected individuals. Virulence and transmission are positively related among genotypes of this parasite. These systems clearly demonstrate that the interactions between insects and pathogens are highly context dependent. Not only is the outcome a consequence of changes in density and genetic diversity: environmental factors, particularly diet, can have strong impacts on virulence, transmission and host resistance or tolerance. What maintains the high level of host and pathogen diversity in these systems, however, remains a question.
Equine ophthalmic examination: Routine diagnostic techniques
Authors: Seruca C. , Lowe R.
Published: September 2015

A complete, thorough ophthalmic examination is essential in the clinical approach to equine ocular diseases. In the majority of cases and more than in most systems, an ophthalmic diagnosis can be achieved at the time of examination because most ocular structures can be visualised either directly or indirectly. This article describes examination protocol and the techniques, instruments and diagnostic procedures currently available to equine general practitioners.
Life on the edge: survival and behavioural responses of freshwater gill‐breathing snails to declining water level and substratum drying
Authors: Poznańska Małgorzata , Kakareko Tomasz , Gulanicz Tomasz , Jermacz Łukasz , Kobak Jarosław
Published: September 2015

Reductions in water level and temporary exposure of substratum to air are two of the most important factors structuring communities in temperate near‐shore zones. Snails are suitable model organisms to study responses of aquatic communities to water‐level fluctuations, as they often inhabit near‐shore zones and are relatively mobile.

In a laboratory study, we investigated survival and behavioural responses (horizontal migration and burrowing) of three freshwater gill‐breathing snails: Viviparus viviparus (L.) (large and small individuals), Bithynia tentaculata (L.) and Potamopyrgus antipodarum (Gray) to substratum drying. We studied the effect of distance to a suitable habitat (24 and 48 cm) and rate of dewatering (gradual: eight days or sudden) on horizontal migrations of snails as well as their burrowing depth.

Large V. viviparus individuals were best adapted to dewatering: they were resistant to drying (surviving more than 3 weeks of air exposure) and migrated in response to decreasing water level and/or burrowed into the substratum. Their horizontal movement was negatively related to the rate of dewatering and distance needed to get to a submerged area. However, they were able to migrate to some extent even after a sudden dewatering and to reach a distant submerged refuge. Small V. viviparus exhibited similar behavioural responses as large individuals, but were less resistant to drying, surviving approximately one week of air exposure. Neither B. tentaculata nor P. antipodarum exhibited behavioural adaptations to desiccation, although resistance to drying differed markedly from approximately 3 weeks for B. tentaculata to 3–4 days for P. antipodarum.

Resistance to drying and behavioural adaptations are two factors enabling benthic organisms to survive in harsh near‐shore environments. Our study revealed marked intra‐ and interspecific differences in response to dewatering, depending on body size, distance to a refuge and rate of dewatering. Appropriate physiological and behavioural responses may increase fitness of organisms under changing environmental conditions and contribute to their survival.
Chromium‐isotope signatures in scleractinian corals from the Rocas Atoll, Tropical South Atlantic
Authors: Pereira N. S. , Voegelin A. R. , Paulukat C. , Sial A. N. , Ferreira V. P. , Frei R.
Published: September 2015

Chromium‐isotope compositions (expressed as δ53Cr) of recent and ancient skeletal and non‐skeletal carbonates are currently explored as a (paleo‐) redox‐proxy for shallow seawater. The idea behind this approach is that biogenic and non‐biogenic carbonates could potentially be used as archives recording the Cr‐isotope composition of seawater in which they formed, and with this contribute to the reconstruction of past paleo‐environmental changes in the marine realm, and potentially to climate changes on land. However, investigations addressing the behavior and uptake mechanism of Cr, and the potential isotope fractionations between seawater and biogenic carbonates are scarce. Here, we present a study of Cr‐isotope variations in three species of corals and contemporary seawater from the Rocas Atoll, NE, Brazil. Cr‐isotope values of the studied coral species (Siderastrea stellata, Porites sp., and Montastrea cavernosa) vary from −0.5 to +0.33‰ and point to significant isotopic disequilibrium with coexisting seawater characterized by a Cr‐isotope value of +0.92 ± 0.2‰. This isotopic offset requires reduction of hexavalent Cr(VI) in the sequestration process of all the studied coral species. Cr‐isotope values in a profile across an S. stellata colony returned homogeneous, slightly positively fractioned δ53Cr values of +0.07 ± 0.08‰ (n = 8, 2σ), which we interpret to reflect a constant reductive uptake during the 20‐year growth period recorded in this coral. In contrast, samples across a 12‐year growth profile from Porites sp. display rather heterogeneous Cr‐isotope values with δ53Cr varying from −0.50 to +0.10‰, indicating Cr incorporation under changing redox processes during its growth intervals. We propose a mechanism whereby initial photoreduction of isotopically heavy Cr(VI) to isotopically lighter Cr(III) in the endodermal layer of corals must be followed by efficient and effective re‐oxidation of reduced Cr species to favor subsequent chromate () substitution during the calcifying processes ultimately leading to the formation of the coral skeleton.
Soil fungal and bacterial responses to conversion of open land to short‐rotation woody biomass crops
Authors: Xue Chao , Penton Christopher Ryan , Zhang Bangzhou , Zhao Mengxin , Rothstein David E. , Mladenoff David J. , Forrester Jodi A. , Shen Qirong , Tiedje James M.
Published: September 2015

Short‐rotation woody biomass crops (SRWCs) have been proposed as an alternative feedstock for biofuel production in the northeastern US that leads to the conversion of current open land to woody plantations, potentially altering the soil microbial community structures and hence functions. We used pyrosequencing of 16S and 28S rRNA genes in soil to assess bacterial and fungal populations when ‘marginal’ grasslands were converted into willow (Salix spp.) and hybrid poplar (Populus spp.) plantations at two sites with similar soils and climate history in northern Michigan (Escanaba; ES) and Wisconsin (Rhinelander; RH). In only three growing seasons, the conversion significantly altered both the bacterial and fungal communities, which were most influenced by site and then vegetation. The fungal community showed greater change than the bacterial community in response to land conversion at both sites with substantial enrichment of putative pathogenic, ectomycorrhizal, and endophytic fungi associated with poplar and willow. Conversely, the bacterial community structures shifted, but to a lesser degree, with the new communities dissimilar at the two sites and most correlated with soil nutrient status. The bacterial phylum Nitrospirae increased after conversion and was negatively correlated to total soil nitrogen, but positively correlated to soil nitrate, and may be responsible for nitrate accumulation and the increased N2O emissions previously reported following conversion at these sites. The legacy effect of a much longer grassland history and a second dry summer at the ES site may have influenced the grassland (control) microbial community to remain stable while it varied at the RH site.
Norm Diffusion and Reputation: The Rise of the Extractive Industries Transparency Initiative
Authors: David‐Barrett Elizabeth , Okamura Ken
Published: September 2015

Transparency in the extractives sector is widely seen as an important tool for improving accountability and deterring corruption. Yet for those very reasons, it is a puzzle that so many governments in corruption‐prone countries have voluntarily signed up to greater scrutiny in this area by joining the Extractive Industries Transparency Initiative (EITI). We argue that EITI serves as a reputational intermediary, whereby reformers can signal good intentions and international actors can reward achievement. International and domestic actors thus utilize EITI to diffuse the norm of resource transparency and to advance reformist aims in a highly problematic policy area.
Expanded roles of two‐component response regulator OmpR in Escherichia coli: genomic SELEX search for novel regulation targets
Authors: Shimada Tomohiro , Takada Hiraku , Yamamoto Kaneyoshi , Ishihama Akira
Published: September 2015

The two‐component system (TCS) is a sophisticated bacterial signal transduction system for regulation of genome transcription in response to environmental conditions. The EnvZ‐OmpR system is one of the well‐characterized TCS of Escherichia coli, responding to changes in environmental osmolality. Regulation has largely focused on the differential expression of two porins, OmpF and OmpC, which transport small molecules across the outer membrane. Recently, it has become apparent that OmpR serves a more global regulatory role and regulates additional targets. To identify the entire set of regulatory targets of OmpR, we performed the genomic SELEX screening of OmpR‐binding sites along the E. coli genome. As a result, more than 30 novel genes have been identified to be under the direct control of OmpR. One abundant group includes the genes encoding a variety of membrane‐associated transporters that mediate uptake or efflux of small molecules, while another group encodes a set of transcription regulators, raising a concept that OmpR is poised to control a diverse set of responses by altering downstream transcriptional regulators.
An Evaluation of Sharp Interface Models for CO2‐Brine Displacement in Aquifers
Authors: Swickrath Michael J. , Mishra Srikanta , Ravi Ganesh Priya
Published: September 2015

Understanding multiphase transport within saline aquifers is necessary for safe and efficient CO2 sequestration. To that end, numerous full‐physics codes exist for rigorously modeling multiphase flow within porous and permeable rock formations. High‐fidelity simulation with such codes is data‐ and computation‐intensive, and may not be suitable for screening‐level calculations. Alternatively, under conditions of vertical equilibrium, a class of sharp‐interface models result in simplified relationships that can be solved with limited computing resources and geologic/fluidic data. In this study, the sharp‐interface model of Nordbotten and Celia (2006a,2006b) is evaluated against results from a commercial full‐physics simulator for a semi‐confined system with vertical permeability heterogeneity. In general, significant differences were observed between the simulator and the sharp‐interface model results. A variety of adjustments were made to the sharp‐interface model including modifications to the fluid saturation and effective viscosity in the two‐phase region behind the CO2‐brine interface. These adaptations significantly improved the predictive ability of the sharp interface model while maintaining overall tractability.
Antibody Production and Th1‐biased Response Induced by an Epitope Vaccine Composed of Cholera Toxin B Unit and Helicobacter pylori Lpp20 Epitopes
Authors: Li Yan , Chen Zhongbiao , Ye Jianbin , Ning Lijun , Luo Jun , Zhang Lili , Jiang Yin , Xi Yue , Ning Yunshan
Published: September 2015

Background

The epitope vaccine is an attractive potential for prophylactic and therapeutic vaccination against Helicobacter pylori (H. pylori) infection. Lpp20 is one of major protective antigens which trigger immune response after H. pylori invades host and has been considered as an excellent vaccine candidate for the control of H. pylori infection. In our previous study, one B‐cell epitope and two CD4+ T‐cell epitopes of Lpp20 were identified.

Objective

In this study, an epitope vaccine composed of mucosal adjuvant cholera toxin B subunit (CTB) and these three identified Lpp20 epitopes were constructed to investigate the efficacy of this epitope vaccine in mice.

Methods

The epitope vaccine including CTB, one B‐cell, and two CD4+ T‐cell epitopes of Lpp20 was constructed and named CTB‐Lpp20, which was then expressed in Escherichia coli and used for intraperitoneal immunization in BALB/c mice. The immunogenicity, specificity, and ability to induce antibodies against Lpp20 and cytokine secretion were evaluated. After that, CTB‐Lpp20 was intragastrically immunized to investigate the prophylactic and therapeutic efficacy in infected mice.

Results

The results indicated that the epitope vaccine CTB‐Lpp20 possessed good immunogenicity and immunoreactivity and could elicit specific high level of antibodies against Lpp20 and the cytokine of IFN‐γ and IL‐17. Additionally, CTB‐Lpp20 significantly decreased H. pylori colonization in H. pylori challenging mice, and the protection was correlated with IgG, IgA, and sIgA antibody and Th1‐type cytokines.

Conclusion

This study will be better for understanding the protective immunity of epitope vaccine, and CTB‐Lpp20 may be an alternative strategy for combating H. pylori invasion.
Immunocytochemical p63 expression discriminates between primary cutaneous follicle centre cell and diffuse large B cell lymphoma‐leg type, and is of the TAp63 isoform
Authors: Robson Alistair , Shukur Zena , Ally Mina , Kluk Justine , Liu Kun , Pincus Laura , Sahni Debjani , Sundram Uma , Subtil Antonio , Karai Laszlo , Kempf Werner , Schieke Stefan , Coates Philip
Published: September 2015

Aims

The p63 gene shares structural and functional homologies with the p53 family of transcriptional activators, but differs in exhibiting a consistent expression pattern in normal tissues. Although p63 is rarely mutated in malignancy studies of primary human tumours and cell lines suggest that p63 may promote tumour development. In non‐Hodgkin's nodal lymphoma, TAp63 expression in follicular lymphoma (54%) and diffuse large B cell lymphoma (34%) has been described and correlated with the proliferative index. In this study, we analysed a series of primary cutaneous B cell lymphomas for immunohistochemical expression of p63.

Methods and results

Thirty cases of diffuse large B cell lymphoma leg type (pcDLBCLL) and 34 cases of follicle centre cell lymphoma (pcFCCL) were stained using a generic antibody to p63, and a subset of these with an antibody specific for delta‐Np63 isoform. The results indicate a significant difference between pcDLBCLL (21 of 30) and pcFCCL (four of 34) in p63 expression (P = 0.000); expression correlated strongly with the proliferation rate as assessed by Ki‐67 (P = 0.015). None of the p63(+) cases tested expressed the delta‐Np63 isoform, suggesting that expression is of the TAp63 isoform.

Conclusions

Functional studies are required to clarify the significance of p63 overexpression in primary cutaneous B cell lymphoma.
Rethinking Holocaust Representation: Reflections on Rex Bloomstein'sKZ
Authors: HODGKINSON SARAH
Published: September 2015

In 2005, film‐maker Rex Bloomstein releasedKZ, which aimed to find a new way to represent the Holocaust for future generations who face a world with no living survivors, yet a mediated world oversaturated with images of global atrocity. Despite much critical acclaim,KZreceived little academic attention. Ten years later, this article provides a reflective analysis of the film, exploring the emergent themes, and their criminological significance. Focus is given to bystanders of atrocity who bear witness to the past. The moral dilemmas of Holocaust representation, such as its commodification for both entertainment and tourism, are additionally discussed.