bluuebunny/crossref_metadata_2025 huggingface dataset:
Approach to haemangiomatosis causing congestive heart failure
Authors: Tal Roie , Dotan Moshe , Lorber Avraham
Published: February 2016

Haemangiomas represent the most common tumour of infancy. Although most cases are cutaneous benign lesions, multiple skin haemangiomas are associated with visceral involvement, especially of the liver. Hepatic haemangiomatosis may be complicated by high‐output cardiac failure due to high‐flow arteriovenous connections within the lesions. Different therapeutic strategies for treating haemangiomatosis causing heart failure include medical, surgical and interventional modalities. This study aimed to review the treatment options, discuss their benefits and flaws and propose a practical therapeutic approach for this medical situation.

Conclusion

Our approach incorporates heart failure medications, dietary support and propranolol as first‐line treatment, while corticosteroids, vincristine, percutaneous intervention and surgery are reserved for refractory cases.
Systematic review with meta‐analysis: faecal occult blood tests show lower colorectal cancer detection rates in the proximal colon in colonoscopy‐verified diagnostic studies
Authors: Hirai H. W. , Tsoi K. K. F. , Chan J. Y. C. , Wong S. H. , Ching J. Y. L. , Wong M. C. S. , Wu J. C. Y. , Chan F. K. L. , Sung J. J. Y. , Ng S. C.
Published: February 2016

Background

The performance of faecal occult blood tests (FOBTs) to screen proximally located colorectal cancer (CRC) has produced inconsistent results.

Aim

To assess in a meta‐analysis, the diagnostic accuracy of FOBTs for relative detection of CRC according to anatomical location of CRC.

Methods

Diagnostic studies including both symptomatic and asymptomatic cohorts assessing performance of FOBTs for CRC were searched from MEDINE and EMBASE. Primary outcome was accuracy of FOBTs according to the anatomical location of CRC. Bivariate random‐effects model was used. Subgroup analyses were performed to evaluate test performance of guaiac‐based FOBT (gFOBT) and immunochemical‐based FOBT (iFOBT).

Results

Thirteen studies, with 17 cohorts, reporting performance of FOBT were included; a total of 26 342 patients (mean age 58.9 years; 58.1% male) underwent both colonoscopy and FOBT. Pooled sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of FOBTs for CRC detection in the proximal colon were 71.2% (95% CI 61.3–79.4%), 93.6% (95% CI 90.7–95.7%), 11.1 (95% CI 7.8–15.8) and 0.3 (95% CI 0.2–0.4) respectively. Corresponding findings for CRC detection in distal colon were 80.1% (95% CI 70.9–87.0%), 93.6% (95% CI 90.7–95.7%), 12.6 (95% CI 8.8–18.1) and 0.2 (95% CI 0.1–0.3). The area‐under‐curve for FOBT detection for proximal and distal CRC were 90% vs. 94% (P = 0.0143). Both gFOBT and iFOBT showed significantly lower sensitivity but comparable specificity for the detection of proximally located CRC compared with distal CRC.

Conclusion

Faecal occult blood tests, both guaiac‐ and immunochemical‐based, show better diagnostic performance for the relative detection of colorectal cancer in the distal colon than in the proximal bowel.
Multi‐scale modelling of ovarian follicular development: From follicular morphogenesis to selection for ovulation
Authors: Monniaux Danielle , Michel Philippe , Postel Marie , Clément Frédérique
Published: February 2016

In this review, we present multi‐scale mathematical models of ovarian follicular development that are based on the embedding of physiological mechanisms into the cell scale. During basal follicular development, follicular growth operates through an increase in the oocyte size concomitant with the proliferation of its surrounding granulosa cells. We have developed a spatio‐temporal model of follicular morphogenesis explaining how the interactions between the oocyte and granulosa cells need to be properly balanced to shape the follicle. During terminal follicular development, the ovulatory follicle is selected amongst a cohort of simultaneously growing follicles. To address this process of follicle selection, we have developed a model giving a continuous and deterministic description of follicle development, adapted to high numbers of cells and based on the dynamical and hormonally regulated repartition of granulosa cells into different cell states, namely proliferation, differentiation and apoptosis. This model takes into account the hormonal feedback loop involving the growing ovarian follicles and the pituitary gland, and enables the exploration of mechanisms regulating the number of ovulations at each ovarian cycle. Both models are useful for addressing ovarian physio‐pathological situations. Moreover, they can be proposed as generic modelling environments to study various developmental processes and cell interaction mechanisms.
Role of COX‐2‐derived PGE2 on vascular stiffness and function in hypertension
Authors: Avendaño M S , Martínez‐Revelles S , Aguado A , Simões M R , González‐Amor M , Palacios R , Guillem‐Llobat P , Vassallo D V , Vila L , García‐Puig J , Beltrán L M , Alonso M J , Cachofeiro M V , Salaices M , Briones A M
Published: February 2016

Background and Purpose

Prostanoids derived from COX‐2 and EP receptors are involved in vascular remodelling in different cardiovascular pathologies. This study evaluates the contribution of COX‐2 and EP1 receptors to vascular remodelling and function in hypertension.

Experimental Approach

Spontaneously hypertensive rats (SHR) and angiotensin II (AngII)‐infused (1.44 mg·kg−1·day−1, 2 weeks) mice were treated with the COX‐2 inhibitor celecoxib (25 mg·kg−1·day−1 i.p) or with the EP1 receptor antagonist SC19220 (10 mg·kg−1·day−1 i.p.). COX‐2−/− mice with or without AngII infusion were also used.

Key Results

Celecoxib and SC19220 treatment did not modify the altered lumen diameter and wall : lumen ratio in mesenteric resistance arteries from SHR‐infused and/or AngII‐infused animals. However, both treatments and COX‐2 deficiency decreased the augmented vascular stiffness in vessels from hypertensive animals. This was accompanied by diminished vascular collagen deposition, normalization of altered elastin structure and decreased connective tissue growth factor and plasminogen activator inhibitor‐1 gene expression. COX‐2 deficiency and SC19220 treatment diminished the increased vasoconstrictor responses and endothelial dysfunction induced by AngII infusion. Hypertensive animals showed increased mPGES‐1 expression and PGE2 production in vascular tissue, normalized by celecoxib. Celecoxib treatment also decreased AngII‐induced macrophage infiltration and TNF‐α expression. Macrophage conditioned media (MCM) increased COX‐2 and collagen type I expression in vascular smooth muscle cells; the latter was reduced by celecoxib treatment.

Conclusions and Implications

COX‐2 and EP1 receptors participate in the increased extracellular matrix deposition and vascular stiffness, the impaired vascular function and inflammation in hypertension. Targeting PGE2 receptors might have benefits in hypertension‐associated vascular damage.
Detrital zircon geochronology of pre‐ and syncollisional strata, Acadian orogen, Maine Appalachians
Authors: Bradley Dwight C. , O'Sullivan Paul
Published: February 2016

The Central Maine Basin is the largest expanse of deep‐marine, Upper Ordovician to Devonian metasedimentary rocks in the New England Appalachians, and is a key to the tectonics of the Acadian Orogeny. Detrital zircon ages are reported from two groups of strata: (1) the Quimby, Rangeley, Perry Mountain and Smalls Falls Formations, which were derived from inboard, northwesterly sources and are supposedly older; and (2) the Madrid, Carrabassett and Littleton Formations, which were derived from outboard, easterly sources and are supposedly younger. Deep‐water deposition prevailed throughout, with the provenance shift inferred to mark the onset of foredeep deposition and orogeny. The detrital zircon age distribution of a composite of the inboard‐derived units shows maxima at 988 and 429 Ma; a composite from the outboard‐derived units shows maxima at 1324, 1141, 957, 628, and 437 Ma. The inboard‐derived units have a greater proportion of zircons between 450 and 400 Ma. Three samples from the inboard‐derived group have youngest age maxima that are significantly younger than the nominal depositional ages. The outboard‐derived group does not share this problem. These results are consistent with the hypothesised provenance shift, but they signal potential problems with the established stratigraphy, structure, and (or) regional mapping. Shallow‐marine deposits of the Silurian to Devonian Ripogenus Formation, from northwest of the Central Maine Basin, yielded detrital zircons featuring a single age maximum at 441 Ma. These zircons were likely derived from a nearby magmatic arc now concealed by younger strata. Detrital zircons from the Tarratine Formation, part of the Acadian foreland‐basin succession in this strike belt, shows age maxima at 1615, 980 and 429 Ma. These results are consistent with three episodes of zircon recycling beginning with the deposition of inboard‐derived strata of the Central Maine Basin, which were shed from post‐Taconic highlands located to the northwest. Next, southeasterly parts of this succession were deformed in the Acadian orogeny, shedding detritus towards the northwest into what remained of the basin. Finally, by Pragian time, all strata in the Central Maine Basin had been deformed and detritus from this new source accumulated as the Tarratine Formation in a new incarnation of the foreland basin. Silurian‐Devonian strata from the Central Maine Basin have similar detrital zircon age distributions to coeval rocks from the Arctic Alaska and Farewell terranes of Alaska and the Northwestern terrane of Svalbard. We suggest that these strata were derived from different segments of the 6500‐km‐long Appalachian‐Caledonide orogen.
Racial/ethnic and socio‐economic biases in child maltreatment severity assessment in Spanish child protection services caseworkers
Authors: Arruabarrena Ignacia , de Paúl Joaquín , Indias Silvia , García Mikel
Published: February 2016

Evidence from several countries has shown the over‐representation of racial/ethnic minority groups in child protection services (CPS). The objective of the present study was to explore whether racial/ethnic and socio‐economic biases influence Spanish CPS caseworkers' judgements of the severity of child maltreatment. Moreover, the study attempted to explore the influence on these judgements of the use of structured instruments and professional experience. Two case vignettes of child maltreatment were presented to 405 CPS caseworkers and 169 students of social work and psychology. Family ethnic origin and income were manipulated in the vignettes. The findings showed no statistical evidence of biases related to family ethnic origin or socio‐economic status (SES) in Spanish CPS caseworkers' judgements of maltreatment severity. Biases related to family SES were found for students for the vignettes of physical abuse. CPS caseworkers and students who did not use a structured instrument to assess maltreatment severity tended to underestimate the severity for the vignettes of parental incapacity to control child/adolescent behaviour and to overestimate it for the vignettes of physical abuse. CPS caseworkers who used a structured instrument showed higher percentages of accuracy and inter‐rater agreement, supporting the relevance of structured tools in reducing potential caseworkers' biases.
Fetal growth patterns in Beckwith–Wiedemann syndrome
Authors: Mussa A. , Russo S. , de Crescenzo A. , Freschi A. , Calzari L. , Maitz S. , Macchiaiolo M. , Molinatto C. , Baldassarre G. , Mariani M. , Tarani L. , Bedeschi M.F. , Milani D. , Melis D. , Bartuli A. , Cubellis M.V. , Selicorni A. , Silengo M.C. , Larizza L. , Riccio A. , Ferrero G.B.
Published: February 2016

We provide data on fetal growth pattern on the molecular subtypes of Beckwith–Wiedemann syndrome (BWS):IC1gain of methylation (IC1‐GoM),IC2loss of methylation (IC2‐LoM), 11p15.5 paternal uniparental disomy (UPD), andCDKN1Cmutation. In this observational study, gestational ages and neonatal growth parameters of 247BWSpatients were compared by calculating gestational age‐corrected standard deviation scores (SDS) and proportionality indexes to search for differences amongIC1‐GoM(n= 21),UPD(n= 87),IC2‐LoM(n= 147), andCDKN1Cmutation (n= 11) patients. InIC1‐GoMsubgroup, weight and length are higher than in other subgroups. Body proportionality indexes display the following pattern: highest inIC1‐GoMpatients, lowest inIC2‐LoM/CDKN1Cpatients, intermediate inUPDones. Prematurity was significantly more prevalent in theCDKN1C(64%) andIC2‐LoMsubgroups (37%). Fetal growth patterns are different in the four molecular subtypes ofBWSand remarkably consistent with altered gene expression primed by the respective molecular mechanisms.IC1‐GoMcases show extreme macrosomia and severe disproportion between weight and length excess. InIC2‐LoM/CDKN1Cpatients, macrosomia is less common and associated with more proportionate weight/length ratios with excess of preterm birth.UPDpatients show growth patterns closer to those ofIC2‐LoM, but manifest a body mass disproportion rather similar to that seen inIC1‐GoMcases.
Guided bone regeneration and abutment connection augment the buccal soft tissue contour: 3‐year results of a prospective comparative clinical study
Authors: Benic Goran I. , Ge Yanjun , Gallucci German O. , Jung Ronald E. , Schneider David , Hämmerle Christoph H. F.
Published: February 2016

Aim

To test whether implant placement with simultaneous guided bone regeneration (GBR) differs from implant placement without GBR regarding the change in marginal mucosal contour.

Materials and methods

In 28 patients, single implants were placed >4 months after tooth extraction. Eighteen implants were completely surrounded by native bone, and no bone augmentation was performed. At 10 implant sites, bone defects and thin bone plates were grafted with deproteinized bovine‐derived bone mineral and covered with collagen membrane. Impressions were taken prior to implant placement (baseline), at 3 months before abutment connection, at 6 months immediately after crown insertion, at 1 year, and at 3 years. Models were optically scanned and 3D images were superimposed for the evaluation of mucosal contour changes at the mid‐buccal aspect. The nonparametric Mann–Whitney U‐test was applied to detect differences.

Results

From baseline to 6 months, horizontal contour change at the level 1 and 2 mm apical to the mucosal margin measured 0.65 ± 0.74 mm and 0.55 ± 0.56 mm at sites without GBR, and 1.92 ± 0.87 mm and 1.76 ± 0.70 mm at sites with GBR (P < 0.05). In the period from baseline to 1 year, the corresponding values amounted to 0.81 ± 0.67 mm and 0.60 ± 0.55 mm in the group without GBR, and to 1.81 ± 0.86 mm and 1.37 ± 0.62 mm in the group with GBR (P < 0.05). From baseline to 6 months, mucosal margin moved 0.16 ± 0.49 mm in the coronal direction in the group without GBR and 0.82 ± 0.65 mm in the group with GBR (P < 0.05). In the period from baseline to 1 year, vertical change of mucosal margin amounted to 0.64 ± 0.54 mm in the group without GBR and to 1.17 ± 0.53 mm in the GBR group (P < 0.05). From 1 to 3 years, the mucosal contours remained stable.

Conclusions

Implant placement with simultaneous GBR resulted in more gain of buccal soft tissue contour in comparison with implant placement without GBR. Abutment connection increased the contour of the marginal mucosa at the augmented and the nonaugmented sites. GBR procedure contributed more to the contour gain than did the abutment connection. The augmented and the nonaugmented ridges exhibited stable peri‐implant mucosal contour over a 3‐year period.
Endoscopic ultrasound‐guided ablation of branch‐duct intraductal papillary mucinous neoplasms: Feasibility and safety tests using porcine gallbladders
Authors: Park Jin‐Seok , Seo Dong‐Wan , Song Tae Jun , Park Do Hyun , Lee Sang Soo , Lee Sung Koo , Kim Myung‐Hwan
Published: February 2016

Background and Aim

Radiofrequency ablation (RFA) and ethanol ablation are accepted methods of tissue destruction for treating cystic tumors. The aim of the present study was to evaluate the feasibility, efficacy, and safety of endoscopic ultrasound (EUS)‐guided ablation using normal porcine gallbladders as a substitute model for branch‐duct intraductal papillary mucinous neoplasms (BD‐IPMN).

Methods

Six adult mini pigs were included in this prospective study. EUS‐guided RFA with or without ethanol ablation of the gallbladder was carried out using a prototype 18‐gauge endoscopic RFA electrode, and RFA and ethanol ablation were done in a single session. Outcomes were assessed in terms of macroscopic and microscopic evaluations of the treated gallbladders.

Results

The prototype RFA electrode was used for ablation of the mucosa, aspiration of the internal contents of the gallbladder, and ethanol injection. RFA plus ethanol lavage resulted in a greater mean percentage of denuded gallbladder mucosa (97.5%) than RFA alone (55.8%). Effects of ablation extending to the cystic duct and partially denuded cystic duct mucosae were detected in five of the six pigs. There were no major procedure‐related adverse events.

Conclusions

EUS‐guided ablation of the gallbladder mucosa was feasible and effective in the porcine model. Additional studies will be required to fully assess the risk of procedure‐related damage to the main pancreatic duct before using this technique in a clinical setting.
After us, the deluge: German miners’ experience with pay‐as‐you‐go pensions and the intergenerational contract before the great inflation
Authors: JOPP TOBIAS A.
Published: February 2016

Many public pension insurance schemes today use the pay‐as‐you‐go financing mechanism. This mechanism is vulnerable to an ageing population, which puts pressure on the intergenerational contract implicit in these schemes and raises the question as to how they might be eroded. This is not a new problem, and to put it into historical perspective, this article studies the intergenerational contract that formed the core of the Prussian miners’ invalidity insurance in the nineteenth and the early twentieth century (1861–1920). With the so‐called Knappschaften, miners relied on what was probably the most comprehensive and advanced occupational pension system existing in Germany around the time when Bismarckian social insurance was established. Financed via the pay‐as‐you‐go mechanism, the miners’ pension funds faced stress from their ageing memberships early on, and this potentially undermined their ability to maintain intergenerationally fair pensions. In order to examine whether or not the intergenerational contract among German miners showed signs of erosion, we look at the Knappschaftens’ profitability, as measured by actual and promised internal rates of return. This article shows that the intergenerational contract indeed weakened over time unless miners’ funds were large and continued to grow, and that a pension reform in 1906 served to stabilize generosity.
Robot‐assisted total knee arthroplasty in haemophilic arthropathy
Authors: Kim K.‐I. , Kim D.‐K. , Juh H.‐S. , Khurana S. , Rhyu K.‐H.
Published: February 2016

Introduction

Execution of total knee arthroplasty (TKA) in end‐stage haemophilic arthropathy is challenging because of soft tissue fibrosis, flexion contractures, poor quality of the bone, and the altered bony anatomy. Restoring the lower limb alignment and achieving range of motion (ROM) is difficult. Robots have been used in TKA to reduce the chances of malalignment and improve accuracy and precision. However, there has been no report in literature on use of robots for TKA in haemophilic arthropathy. The aim of this study was to evaluate whether robot‐assisted TKA can be successfully carried out in haemophilic arthropathy and what precision could be obtained.

Methods

Thirty‐two robot‐assisted TKA were evaluated in 29 haemophilia patients. The mean follow up period was 5 years (range, 3–7 years). Hip‐knee‐ankle (HKA) axis, component angles, and radiographic loosening were evaluated. Clinically ROM, Knee Society scores (KSS) and SF‐36 were assessed.

Results

The HKA axis was within a range of 0 ± 3° in 30 knees (93.8%). The alignment of the components also presented satisfying results. KSS were improved from 27.1 to 82.8 postoperatively (P < 0.001). The ROM was improved from 70.7 to 84.7 postoperatively (P = 0.006). Complications included early haematoma in three knees, heterotopic ossification in three knees, periprosthetic infection in two knees.

Conclusions

Though robotic TKA gives excellent accuracy of lower limb and component alignment, expensive cost, additional preparation time, longer operation time with similar clinical results in haemophilic arthropathy should be concerned.
Branched‐chain amino acid‐enriched nutrient increases blood platelet count in patients after endoscopic injection sclerotherapy
Authors: Furuichi Yoshihiro , Imai Yasuharu , Miyata Yuki , Sugimoto Katsutoshi , Sano Takatomo , Taira Junichi , Kojima Mayumi , Kobayashi Yoshiyuki , Nakamura Ikuo , Moriyasu Fuminori
Published: February 2016

Aim

Protein and energy malnutrition is a severe problem for patients with liver cirrhosis (LC) and fasting often induces starvation which is a vitally important outcome. Dietary restriction is essential for endoscopic injection sclerotherapy (EIS) in patients with risky esophageal varices, thereby creating the possible exacerbation of nutritional state and inducing liver dysfunction. Whether EIS induces nutritional deficiency in LC patients and the effects of branched‐chain amino acid (BCAA)‐enriched nutrient are prospectively investigated.

Methods

A total of 61 LC patients were randomly divided into an EIS monotherapy group (non‐BCAA group, n = 31) and an EIS combined with BCAA therapy group (n = 30). Platelet count, blood chemistry and somatometry values were prospectively measured at five time points.

Results

The platelet counts before treatment were at the same level in both groups (P = 0.72). Three months after treatment, the counts decreased in the non‐BCAA group; however, they increased in the BCAA group (P = 0.019). Body mass index, triceps skin fold thickness and arm muscle circumference significantly decreased in both groups. The BCAA and tyrosine ratio value increased only in the BCAA group (P < 0.01). The skeletal muscle volume measured by InBody720 significantly decreased in the non‐BCAA group (P < 0.001).

Conclusion

EIS induced protein‐energy malnutrition, however, skeletal muscle volume was maintained by taking BCAA. Administration of BCAA had some effect in maintaining the nutritional state, and may improve the platelet count. Taking a greater amount of nutrients and shorter dietary restriction period or hospitalization was desirable.
Eliminating the use of intravenous glass bottles using a FOCUS-PDCA model and providing a practical stability reference guide
Authors: Maraiki Fatma , Farooq Faiyaz , Ahmed Mohamed
Published: February 2016

Objectives

To identify the intravenous (IV) medications that are prepared in glass bottles at the institution and establish which of these medications can be prepared in flexible IV bags such as polyvinyl chloride (PVC) or non-PVC instead of glass bottles. The cost implication of switching from glass bottles to flexible IV bags was calculated.

Methods

A study using FOCUS-PDCA model to identify IV medications prepared in glass bottles and establish which of these medications could be prepared in IV bags (PVC or non-PVC). The cost impact of switching from glass bottles to IV plastic bags (including PVC or non-PVC) was calculated. The stability data obtained were used as a reference for updating pharmacy internal IV preparation charts.

Key findings

A total of 17 IV medications were found to be prepared in IV glass bottles. Of these 17 medications, only 8 (47%) were prepared in IV glass bottles due to incompatibility with PVC bags. For 7 (41%) of the medications, of which 6 were monoclonal antibodies (MABs), the reason for preparation in glass bottles was unclear as these medications are compatible with either PVC or non-PVC or both. The potential cost savings associated with switching all of the identified medications to IV plastic bags (either non-PVC or PVC) exceeded $200 000.

Conclusions

The elimination of glass bottles within the institution resulted in a significant cost saving. The use of FOCUS-PDCA model can help healthcare institution achieve significant improvements in process and realize significant cost savings.
Refocusing on physical health: Community psychiatric nurses’ perceptions of using enhanced health checks for people with severe mental illness
Authors: Bressington Daniel , Mui Jolene , Wells Harvey , Chien Wai Tong , Lam Claire , White Jacquie , Gray Richard
Published: February 2016

In the present qualitative, descriptive study, we explored Hong Kong community psychiatric nurses’ (CPN) perceptions of using comprehensive physical health checks for service users diagnosed with severe mental illness (SMI). Research interviews were conducted with a purposive sample of 11 CPN in order to explore their perceptions about the use of the Health Improvement Profile (HIP) over a 1‐year period. Interview data were analysed using inductive thematic analysis. The analysis revealed that the majority of CPN appreciated the comprehensive focus on the physical health of their clients and reported positive changes in their clinical practice. Many of them observed an increase in the motivation of their clients to improve their physical health, and also noted observable benefits in service users’ well‐being. The use of the HIP also helped the CPN identify implementation barriers, and highlighted areas of the tool that required modifications to suit the local cultural and clinical context. To our knowledge, this is the first study conducted in an Asian mental health service that explores nurses’ views about using comprehensive health checks for people with SMI. The findings suggest that such approaches are viewed as being acceptable, feasible, and potentially beneficial in the community mental health setting.
U‐Th Zircon Dating by Laser Ablation Single Collector Inductively Coupled Plasma‐Mass Spectrometry (LA‐ICP‐MS)
Authors: Guillong Marcel , Sliwinski Jakub T. , Schmitt Axel , Forni Francesca , Bachmann Olivier
Published: February 2016

Zircon crystals in the age range of ca. 10–300 ka can be dated by 230Th/238U (U‐Th) disequilibrium methods because of the strong fractionation between Th and U during crystallisation of zircon from melts. Laser ablation inductively coupled plasma‐mass spectrometry (LA‐ICP‐MS) analysis of nine commonly used reference zircons (at secular equilibrium) and a synthetic zircon indicates that corrections for abundance sensitivity and dizirconium trioxide molecular ions (Zr2O3+) are critical for reliable determination of 230Th abundances in zircon. When corrected for abundance sensitivity and interferences, mean activity ratios of (230Th)/(238U) for nine reference zircons analysed on five different days averaged 0.995 ± 0.023 (95% confidence weighted by data‐point uncertainty only, MSWD = 1.6; n = 9), consistent with their U‐Pb ages > 4 Ma that imply equilibrium for all intermediate daughter isotopes (including 230Th) within the 238U decay chain. U‐Th zircon ages generated by LA‐ICP‐MS without mitigating (e.g., by high mass resolution) or correcting for abundance sensitivity and molecular interferences on 230Th are potentially unreliable. To validate the applicability of LA‐ICP‐MS to this dating method, we acquired data from three late Quaternary volcanic units: the 41 ka Campanian Ignimbrite (plutonic clasts), the 161 ka Kos Plateau Tuff (juvenile clasts) and the 12 ka Puy de Dôme trachyte lava (all eruption ages by Ar/Ar, with zircon U‐Th ages being of equal or slightly older). A comparison of the corrected LA‐ICP‐MS results with previously published secondary ion mass spectrometry (SIMS) data for these rocks shows comparable ages with equivalent precision for LA‐ICP‐MS and SIMS, but much shorter analysis durations (~ 2 min vs. ~ 15 min) per spot with LA‐ICP‐MS and much simpler sample preparation. Previously undated zircons from the Yali eruption (Kos‐Nisyros volcanic centre, Greece) were analysed using this method. This yielded a large age spread (~ 45 to > 300 ka), suggesting significant antecryst recycling. The youngest zircon age (~ 45 ± 10 ka) provides a reasonable maximum estimate for the eruption age, in agreement with the previously published age using oxygen isotope stratigraphy (~ 31 ka).
Reduced Sink Activity in Growing Shoot Tissues of Maize under Salt Stress of the First Phase may be Compensated by Increased PEP‐Carboxylase Activity
Authors: Hütsch B. W. , Osthushenrich T. , Faust F. , Kumar A. , Schubert S.
Published: February 2016

The effects of salt stress (100 mm NaCl for 6 days) on growing tissues (shoot apex, growing leaf segments, root tips) of young maize plants (Zea mays L. cv. Pioneer 3906) were investigated in comparison to an unsalinized control, focusing on assimilate supply from source leaves and the activity of sucrolytic enzymes in the sink tissues. The objectives were to test whether (i) phloem unloading in growing tissues is mainly symplastic, (ii) salinity reduces sink activity, determined either as sucrose synthase activity (indicator for the symplastic pathway) or as acid invertase activity (indicator for the apoplastic pathway), and (iii) PEP‐carboxylase activity is increased under salinity to compensate for reduced sink activity. For growing tissues of young maize shoots, it can be assumed that phloem transport of sucrose is mainly driven by symplastic unloading into the sink cells. In maize root tips, both, apoplastic and symplastic pathways, contributed to carbohydrate supply to the sink cells. The activity of acid invertase in growing shoot tissues was very low, and the alkaline invertase contributed less than 10 % to the cytoplasmic sucrolytic activity. Salt stress of the first phase (mainly osmotic stress) caused a significant inhibition of acid invertase activity in the growing leaf segments and in the root tips, which was also true for alkaline invertase activity in the root tips as well as for sucrose synthase activity in root tips and shoot apex. The decrease of sucrose synthase activity in shoot apex might be particularly detrimental for the plant growth, as this tissue with a high cell division rate relied entirely on cytoplasmic enzyme activities. Under salt stress, PEP carboxylase activity was significantly increased in growing leaves and the shoot apex of maize, whereas no significant effect was observed in the root apex. In conclusion, PEP carboxylase can have an anaplerotic function supporting the demand for metabolites in growing shoot tissues of young maize plants under salt stress. In root tips, an additional supply of organic acids to the tricarboxylic acid cycle is probably not needed, as sucrolytic sink activity, which was high even under saline conditions, can meet the demand of the sink cells.
Nursing diagnoses, outcomes and interventions as measures of patient complexity and nursing care requirement in Intensive Care Unit
Authors: Castellan Cristiana , Sluga Silvia , Spina Eleonora , Sanson Gianfranco
Published: February 2016

Aims

To describe the nursing diagnoses, outcomes and interventions for patients admitted to intensive care units and to assess their possible relation with classical outcomes like length of stay and mortality.

Background

The analysis of nursing diagnosis frequencies may help to estimate the patients’ complexity and the need for nursing interventions and can predict hospital outcomes. Nonetheless, few studies were conducted on critical patients.

Design

Prospective cohort observational study.

Methods

Between 15 July–31 October 2013 we collected the above‐described nursing parameters of 100 subjects throughout their stay in intensive care. We classified the parameters according to established taxonomies. The independent association between the number of nursing diagnoses and length of stay/mortality was investigated with multiple regressions.

Results

We found an average of 19 diagnoses, 24 outcomes and 60 interventions per patient. Most frequently, the plans of care involved support for self‐care deficits or interrupted family processes. They also included strategies to prevent infection, disuse syndrome and impairment of skin integrity. Nineteen nursing diagnoses were significantly related with mortality or length of stay in bivariate analyses. In regression models, the number of such diagnoses explained 29·7% of the variance in length of stay and was an independent predictor of mortality.

Conclusion

In critically ill patients, the analysis of nursing diagnoses, outcomes and interventions confirmed an intense activity in response to a broad spectrum of patient needs. The number of nursing diagnoses allowed to predict patient outcomes.
Blood Pressure Control Provides Less Cardiovascular Protection in Adults With Than Without Apparent Treatment‐Resistant Hypertension
Authors: Egan Brent M. , Kai Bo , Wagner C. Shaun , Henderson Joseph H. , Chandler Archie H. , Sinopoli Angelo
Published: February 2016

Hypertension control may offer less protection from incident cardiovascular disease (CVDi) in adults with than without apparent treatment‐resistant hypertension (aTRH), ie, blood pressure uncontrolled while taking three or more antihypertensive medications or controlled to <140/<90 mm Hg while taking four or more antihypertensive medications. Electronic health data were matched to health claims for 2006–2012. Patients with CVDi in 2006–2007 or with untreated hypertension were excluded, leaving 118,356 treated hypertensives, including 40,690 with aTRH, and 460,599 observation years. Blood pressure and medication number were determined by all clinic visit means from 2008 to CVDi or end of study. Primary outcome was first CVDi (stroke, coronary heart disease, heart failure) from hospital and emergency department claims. Controlling for age, race, sex, diabetes, chronic kidney disease, and statin use, hypertension control afforded less CVDi protection in patients with aTRH (hazard ratio, 0.87; 95% confidence interval, 0.82–0.93) than without aTRH (hazard ratio, 0.69; 95% confidence interval, 0.65–0.74; P<.001). Strategies beyond hypertension control may prevent more CVDi in patients with aTRH.
Effects of Single and Multiple Blood Pressure Measurement Strategies on the Prediction of Prevalent Screen‐Detected Diabetes Mellitus: A Population‐Based Survey
Authors: Mbanya Vivian N. , Mbanya Jean‐Claude , Kufe Clement , Kengne Andre P.
Published: February 2016

The authors investigated the effects of single and multiple blood pressure (BP) measurements during the same encounter on screen‐detected diabetes risk. Data for 9018 Cameroonian adults from a community‐based survey were used. Resting BP was measured three times 5 minutes apart. Logistic regressions were used to compute the odd ratio (OR) per standard deviation (SD) higher BP variables. Systolic BP, diastolic BP, and mean arterial pressure (MAP), but not pulse pressure, were related to prevalent diabetes. The highest OR (95% confidence interval [CI]) per SD higher pressure were recorded for MAP (OR, 1.16; 95% CI, 1.05–1.28) and systolic BP (OR, 1.15; 95% CI, 1.04–1.27). Estimates of the association were highest for the first, then third, and lastly the second BP measurements. Estimates from average BP measurements were not better than those from single measurement. Single BP measurement is more effective for diabetes risk screening than multiple measurements. Community‐based diabetes strategies utilizing a single measurement are simple without compromising the yield.
Controversies Surrounding Renal Denervation: Lessons Learned From Real‐World Experience in Two United Kingdom Centers
Authors: Burchell Amy E. , Chan Kenneth , Ratcliffe Laura E.K. , Hart Emma C. , Saxena Manish , Collier David J. , Jain Ajay K. , Mathur Anthony , Knight Charles J. , Caulfield Mark J. , Paton Julian F.R. , Nightingale Angus K. , Lobo Melvin D. , Baumbach Andreas
Published: February 2016

Renal denervation (RDN) is a therapy that targets treatment‐resistant hypertension (TRH). The Renal Denervation in Patients With Uncontrolled Hypertension (Symplicity) HTN‐1 and Symplicity HTN‐2 trials reported response rates of >80%; however, sham‐controlled Symplicity HTN‐3 failed to reach its primary blood pressure (BP) outcome. The authors address the current controversies surrounding RDN, illustrated with real‐world data from two centers in the United Kingdom. In this cohort, 52% of patients responded to RDN, with a 13±32 mm Hg reduction in office systolic BP (SBP) at 6 months (n=29, P=.03). Baseline office SBP and number of ablations correlated with office SBP reduction (R=−0.47, P=.01; R=−0.56, P=.002). RDN appears to be an effective treatment for some patients with TRH; however, individual responses are highly variable. Selecting patients for RDN is challenging, with only 10% (33 of 321) of the screened patients eligible for the study. Medication alterations and nonadherence confound outcomes. Adequate ablation is critical and should impact future catheter design/training. Markers of procedural success and improved patient selection parameters remain key research aims.
Aortic VCAM‐1: an early marker of vascular inflammation in collagen‐induced arthritis
Authors: Denys Anne , Clavel Gaëlle , Lemeiter Delphine , Schischmanoff Olivier , Boissier Marie‐Christophe , Semerano Luca
Published: February 2016

Cardiovascular disease (CVD) is a major cause of morbidity and mortality in rheumatoid arthritis (RA). There are limited experimental data on vascular involvement in arthritis models. To study the link between CVD and inflammation in RA, we developed a model of vascular dysfunction and articular inflammation by collagen‐induced arthritis (CIA) in C57Bl/6 (B6) mice. We studied the expression of vascular inflammatory markers in CIA with and without concomitant hyperlipidic diet (HD). Collagen‐induced arthritis was induced with intradermal injection of chicken type‐II collagen followed by a boost 21 days later. Mice with and without CIA were fed a standard diet or an HD for 12 weeks starting from the day of the boost. Arthritis severity was evaluated with a validated clinical score. Aortic mRNA levels of vascular cell adhesion molecule‐1 (VCAM‐1), inducible nitric oxide synthase (iNOS) and interleukin‐17 were analysed by quantitative RT‐PCR. Vascular cell adhesion molecule‐1 localization in the aortic sinus was determined by immunohistochemistry. Atherosclerotic plaque presence was assessed in aortas. Collagen‐induced arthritis was associated with increased expression of VCAM‐1, independent of diet. VCAM‐1 overexpression was detectable as early as 4 weeks after collagen immunization and persisted after 15 weeks. The HD induced atheroma plaque formation and aortic iNOS expression regardless of CIA. Concomitant CIA and HD had no additive effect on atheroma or VCAM‐1 or iNOS expression. CIA and an HD diet induced a distinct and independent expression of large‐vessel inflammation markers in B6 mice. This model may be relevant for the study of CVD in RA.
Prognostic significance of EZH2 expression in patients with oesophageal cancer: a meta‐analysis
Authors: Wang Yawei , Gao Fang , Zhao Meng , Li Bing , Xing Dan , Wang Jie , Yang Yang
Published: February 2016

Enhancer of zeste 2 (EZH2), a key component of polycomb repressive complex 2 (PRC2), was of great importance in human cancer pathogenesis. Various studies examined the relationship between EZH2 overexpression with the clinical outcome in patients with digestive cancers, but yielded conflicting results. Electronic databases updated to January 2015 were searched to find relevant studies. A meta‐analysis was conducted with eligible studies which quantitatively evaluated the relationship between EZH2 overexpression and survival of patients with digestive cancers. Survival data were aggregated and quantitatively analysed. We performed a meta‐analysis of 10 studies (n = 1461 patients) that evaluated the correlation between EZH2 overexpression and survival in patients with digestive cancers. Combined hazard ratios suggested that EZH2 overexpression was associated with poor prognosis of overall survival (HR = 1.54, 95% CI: 1.27–1.81) in patients with oesophageal cancer. In the stratified analysis, no significant risks were found among gastric cancer (HR = 0.66, 95% CI: 0.16–1.15) and colorectal cancer (HR = 0.91, 0.63–1.19), indicating that EZH2 was not an indicator of poor prognosis in gastric cancer or colorectal cancer. Enhancer of zeste 2 overexpression indicates a poor prognosis for patients with oesophageal cancer, but not among gastric cancer or colorectal cancer.
Forecasting Domestic Violence: A Machine Learning Approach to Help Inform Arraignment Decisions
Authors: Berk Richard A. , Sorenson Susan B. , Barnes Geoffrey
Published: February 2016

Arguably the most important decision at an arraignment is whether to release an offender until the date of his or her next scheduled court appearance. Under the Bail Reform Act of 1984, threats to public safety can be a key factor in that decision. Implicitly, a forecast of “future dangerousness” is required. In this article, we consider in particular whether usefully accurate forecasts of domestic violence can be obtained. We apply machine learning to data on over 28,000 arraignment cases from a major metropolitan area in which an offender faces domestic violence charges. One of three possible post‐arraignment outcomes is forecasted within two years: (1) a domestic violence arrest associated with a physical injury, (2) a domestic violence arrest not associated with a physical injury, and (3) no arrests for domestic violence. We incorporate asymmetric costs for different kinds of forecasting errors so that very strong statistical evidence is required before an offender is forecasted to be a good risk. When an out‐of‐sample forecast of no post‐arraignment domestic violence arrests within two years is made, it is correct about 90 percent of the time. Under current practice within the jurisdiction studied, approximately 20 percent of those released after an arraignment for domestic violence are arrested within two years for a new domestic violence offense. If magistrates used the methods we have developed and released only offenders forecasted not to be arrested for domestic violence within two years after an arraignment, as few as 10 percent might be arrested. The failure rate could be cut nearly in half. Over a typical 24‐month period in the jurisdiction studied, well over 2,000 post‐arraignment arrests for domestic violence perhaps could be averted.
Outcomes of intrahepatic cholangiocarcinoma with portal vein tumor thrombus following hepatic resection
Authors: Lu Chong De , Wang Kang , Zhang Cun Zhen , Zhou Fei Guo , Guo Wei Xing , Wu Meng Chao , Cheng Shu Qun
Published: February 2016

Background and Aim

Portal vein tumor thrombus (PVTT) is not commonly used in the treatment of intrahepatic cholangiocarcinoma (ICC), and its impact on the prognosis of ICC is unclear. We aimed to assess the outcomes of ICC with or without PVTT after hepatic resection.

Methods

From January 2000 to December 2005, the data from all consecutive patients with ICC who underwent hepatic resection at our hospital were retrospectively analyzed. According to the Cheng's PVTT Classification (types I–IV), we compared the survival outcomes of ICC patients (with or without PVTT) and prognosis of patients with ICC with different types of PVTT.

Results

Three hundred and three patients with ICC were enrolled in this study (59 with PVTT). The incidence of PVTT was 19.4% (59/303). The median survival times were 12.68 and 28.91 months for ICC patients with and without PVTT, respectively (P < 0.001). The multivariate analysis demonstrated that PVTT (hazard ratio [HR] 1.783; confidence interval 95% [1.279; 2.487]) was an independent risk factor for overall survival. Patients with type I PVTT exhibited significantly better survival than those with types II and III PVTT.

Conclusion

The ICC patients with PVTT exhibit a poorer prognosis compared with ICC patients without PVTT after hepatic resection.
Electric Motorcycles in Thailand: A Life Cycle Perspective
Authors: Kerdlap Piya , Gheewala Shabbir H.
Published: February 2016

Battery electric motorcycles offer the potential to reduce greenhouse gas emissions and fossil fuel consumption in road transportation, but result in problem shifting when considering potential environmental impacts during vehicle production and disposal. This study evaluates the life cycle environmental impacts of implementing lithium‐ion and lead‐acid battery electric motorcycles in Thailand's motorcycle fleet to meet the government's motorcycle energy reduction target of 2,791 kilotonnes oil equivalent, compared to conventional motorcycles. A stock‐turnover model is used to determine the market growth of electric motorcycles on the fleet from 2015 to 2030 to meet the energy reduction target. The total costs of ownership of each motorcycle are analyzed on a single vehicle basis to compare the cost benefits. The results of the study reveal that the environmental performance of an electric motorcycle fleet is sensitive to variations in use‐phase energy consumption, the electricity mix consumed, and battery disposal scenarios. Realization of Thailand's Power Development Plan can reduce total impacts of the electric motorcycle fleet to global warming by 6% to 10%. It is crucial that batteries from electric motorcycles are recycled to avoid 98% of impacts to toxicity. Lead‐acid battery electric motorcycles are a more affordable option for consumers in Thailand compared to conventional motorcycles and lithium‐ion battery electric motorcycles. Recommendations are made to improve the environmental performance of electric motorcycle implementation strategies in Thailand.
Couple‐Level Economic and Career Concerns and Intimate Partner Violence in Young Adulthood
Authors: Copp Jennifer E. , Giordano Peggy C. , Manning Wendy D. , Longmore Monica A.
Published: February 2016

Family scholars have demonstrated that economic conditions influence marital quality and relationship instability. Similarly, researchers have identified low income and poverty as important risk factors for intimate partner violence (IPV). Yet limited work has examined how economic factors influence the use of violence in the romantic context, particularly during young adulthood. Using the Toledo Adolescent Relationships Study (n = 928), the authors examined the influence of economic and career concerns as specific sources of conflict on IPV among a sample of young adults. Findings suggest that these areas of disagreement within romantic relationships are associated with IPV risk, net of traditional predictors. The implications of our findings for intervention and prevention efforts are discussed.
Children's Postdivorce Residence Arrangements and Parental Experienced Time Pressure
Authors: van der Heijden Franciëlla , Poortman Anne‐Rigt , van der Lippe Tanja
Published: February 2016

Although the rise in postdivorce joint physical custody has fueled scholarly interest in its impact on children, consequences for parents remain understudied. Because children's residence arrangements determine time and coordination demands associated with child care, this study investigated the relationship between postdivorce residence arrangements and parents' time pressure. Regression analyses on 4,460 formerly married or cohabiting parents in the Netherlands showed that main residence (mother residence, father residence, or joint physical custody) is more strongly related to time pressure than is nonresident parents' visitation frequency. Compared with mother residence, joint physical custody is associated with less time pressure for mothers and slightly greater pressure for fathers, which supports the idea of higher care demands when parents spend more time with their children. The results do not support the role of coordination demands; the extent of interparental contact and the number of transitions the child makes are not related to time pressure.