bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of Hospitalization Impact Scale among families with children hospitalized for cancer treatment
Authors: Lyu Qi‐Yuan , Kong Sarah Kit Fong , Wong Frances Kam Yuet , You Li‐Ming
Published: May 2015

Aim

To make further modifications to and validate the psychometric properties of the Hospitalization Impact Scale.

Background

A child's repeated and prolonged hospitalization for cancer treatment can result in great changes for the entire family. A hospitalization‐specific screening tool is needed to help clinical nurses identify families who are experiencing major impacts during their child's hospitalization.

Design

A cross‐sectional study was employed to examine the psychometric properties of the Hospitalization Impact Scale.

Method

The sample consisted of 253 families with children hospitalized for cancer treatment in four paediatric oncology departments in four hospitals in mainland China from September 2013 – March 2014. Parents completed the 36‐item Hospitalization Impact Scale, demographic measures and the Family Impact Module of the Pediatric Quality of Life Inventory. Reliability, construct validity, known‐group validity and concurrent validity were examined.

Result

The revised Hospitalization Impact Scale included six factors containing 34 items. It demonstrated sound concurrent validity with the Family Impact Module of the Pediatric Quality of Life Inventory and excellent internal consistency.

Conclusion

The revised Hospitalization Impact Scale met the standard psychometric criteria for reliability and validity. Thus, it could be applied in paediatric oncology departments to help nurses assess and identify families experiencing major impacts during a child's hospitalization for cancer treatment.
MicroRNA‐132/212 family enhances arteriogenesis after hindlimb ischaemia through modulation of the Ras‐MAPK pathway
Authors: Lei Zhiyong , van Mil Alain , Brandt Maarten M. , Grundmann Sebastian , Hoefer Imo , Smits Michiel , el Azzouzi Hamid , Fukao Taro , Cheng Caroline , Doevendans Pieter A. , Sluijter Joost P.G.
Published: May 2015

Arteriogenesis is a complicated process induced by increased local shear‐and radial wall‐stress, leading to an increase in arterial diameter. This process is enhanced by growth factors secreted by both inflammatory and endothelial cells in response to physical stress. Although therapeutic promotion of arteriogenesis is of great interest for ischaemic diseases, little is known about the modulation of the signalling cascades via microRNAs. We observed that miR‐132/212 expression was significantly upregulated after occlusion of the femoral artery. miR‐132/212 knockout (KO) mice display a slower perfusion recovery after hind‐limb ischaemia compared to wildtype (WT) mice. Immunohistochemical analysis demonstrates a clear trend towards smaller collateral arteries in KO mice. Although Ex vivo aortic ring assays score similar number of branches in miR‐132/212 KO mice compared to WT, it can be stimulated with exogenous miR‐132, a dominant member of the miR‐132/212 family. Moreover, in in vitro pericyte‐endothelial co‐culture cell assays, overexpression of miR‐132 and mir‐212 in endothelial cells results in enhanced vascularization, as shown by an increase in tubular structures and junctions. Our results suggested that miR‐132/212 may exert their effects by enhancing the Ras‐Mitogen‐activated protein kinases MAPK signalling pathway through direct inhibition of Rasa1, and Spred1. The miR‐132/212 cluster promotes arteriogenesis by modulating Ras‐MAPK signalling via direct targeting of its inhibitors Rasa1 and Spred1.
Residency and movement patterns of Arctic charr Salvelinus alpinus relative to major estuaries
Authors: Spares A. D. , Stokesbury M. J. W. , Dadswell M. J. , O'Dor R. K. , Dick T. A.
Published: May 2015

Estuarine residency and marine movements of 43 anadromous Arctic charr Salvelinus alpinus (mean ± s.d. fork length = 523 ± 97 mm) were examined using acoustic tracking in inner Frobisher Bay (IFB; 63° N; 68° W), Canada, from July to September 2008 and 2009. A mean ± s.d. migration duration of 63 ± 7 days occurred from late June to early September. Detected S. alpinus were either continuously (maximum 34 days) or intermittently present in estuarine zones, on average residing approximately one third of time tracked and returning once every 9 days. Significantly higher estuarine residency during the final 15 migration days suggested that a transition phase may occur prior to freshwater re‐entry. Low travel rates during flood tide suggested individuals staged before accessing intertidal and estuarine zones. Although the two main estuaries were c. 22 km apart, 19% of tagged individuals used both. Individuals remained relatively close to freshwater overwintering systems, although late‐migration inter‐estuarine movements may have indicated natal homing. Approximately half of the individuals exhibited extra‐estuarine travel, mostly during mid‐migration, but remained within 3 km of shore ranging < 30 km straight line distance (SLD) of either estuary. It was concluded that IFB S. alpinus (1) spent a significant portion of their migration within or adjacent to the estuaries and (2) had a restricted marine distribution within 30 km SLD of the river mouths.
Morphological and molecular characterization of separated pelagic eggs from Lophius litulon (Lophiiformes; Lophiidae)
Authors: Oh J. , Kim S.
Published: May 2015

Free‐floating eggs of Lophius litulon were collected using plankton nets after their release from a pelagic egg mass. The eggs were identified based on molecular analysis and several morphological characteristics. These rare, separated eggs have not been reported previously and represent the first such finding for Lophiiformes.
Antimicrobial Effectiveness of Gelatin–Alginate Film Containing Oregano Essential Oil for Fish Preservation
Authors: Kazemi Seyede Marzieh , Rezaei Masoud
Published: May 2015

This study aimed to evaluate the effect of gelatin–alginate film containing 1.5% oregano essential oil (OEO) on the shelf life of rainbow trout (Oncorhynchus mykiss) slices during refrigerated storage over a period of 15 days. The blend film was prepared at 75% fish gelatin to 25% sodium alginate ratio and OEO was added to the film formulation. All the treatments (the control and wrapped slices) were analyzed periodically in terms of microbiological factors (total viable count, psychrotrophic count and spoilage microorganism, such as lactic acid bacteria, Pseudomonas spp. and Enterobacteriaceae). In addition, the samples were analyzed in terms of total volatile base nitrogen (TVB‐N) and pH. Use of the OEO–blend film delayed bacterial growth throughout 15 days of storage compared with the control and slices treated with blend films without OEO (P < 0.05). The lowest TVB‐N and pH levels were 59.98 and 6.75, respectively, in OEO film at the end of the storage. Therefore, this study showed that OEO–blend film was an effective antimicrobial suitable for the potential food packaging applications.

Practical Applications

Development of edible films incorporated with essential oils is an attractive option for improving packaging food. In this study, the effect of gelatin–alginate edible film containing oregano essential oil (OEO) on spoilage bacteria was investigated. Strong antimicrobial effect of OEO and restricted access of oxygen by films make gelatin–alginate film incorporated with OEO suitable for fish packaging.
A Retrospective Comparison of Older and Younger Adults Undergoing Early Laparoscopic Cholecystectomy for Mild to Moderate Calculous Cholecystitis
Authors: Fuks David , Duhaut Pierre , Mauvais Francois , Pocard Marc , Haccart Vincent , Paquet Jean‐Christophe , Millat Bertrand , Msika Simon , Sielezneff Igor , Scotté Michel , Chatelain Denis , Regimbeau Jean Marc
Published: May 2015

Objectives

To compare the demographic characteristics and intra‐ and postoperative outcomes in elderly adults (≥75) with those of younger adults undergoing early (<5 days after onset of complaints) cholecystectomy.

Design

Retrospective analysis from May 2010 to August 2012.

Setting

Randomized, multicenter, clinical trial (ABCAL Study, NCT01015417).

Participants

Individuals with mild or moderate acute calculous cholecystitis (ACC) according to the Tokyo Guidelines (N = 414; n = 78 aged 75–94, median 82; n = 336 aged 18–74, median 49).

Measurements

Demographic characteristics and pre‐, intra‐, and postoperative data.

Results

The elderly group was more likely to have an American Society of Anesthesiologists score of 3 or greater (62% vs 23%, P < .001), higher serum creatinine (103 vs 74 μmol/L, P < .001), and more‐severe ACC (moderate ACC (62% vs 50%, P = .05), gangrenous cholecystitis (38% vs 15%, P = .001)) on preoperative imaging and confirmed intraoperatively. Ulcerated mucosa (76% vs 61%, P = .001) was significantly more frequent in the elderly group. Operative time, postoperative mortality, and postoperative infectious (18% vs 14%, P = .35) and noninfectious (9% vs 3%, P = .80) complications were similar between the two groups. Median length of stay (7.0 vs 5.0 days, P = .54) and readmission rate (15% vs 4%, P = .07) were not significantly higher in the elderly group. No significant difference was observed for the subgroup of participants aged 80 and older.

Conclusion

In this randomized trial that included a selected sample of older adults, there was no difference in major outcomes between elderly adults and their younger counterparts after early cholecystectomy. The findings are limited because important geriatric outcomes such as delirium and functional decline were not examined.
Differentiated Thyroid Cancer in People Aged 85 and Older
Authors: Marvin Kastley , Parham Kourosh
Published: May 2015

Objectives

To describe the characteristics and treatment patterns of differentiated thyroid cancer in older adults.

Design

Retrospective cohort study.

Setting

The National Cancer Institute Surveillance, Epidemiology, and End Results database.

Participants

Individuals age 85 and older with a primary thyroid cancer diagnosis of papillary or follicular histology diagnosed between 1988 and 2007 (N = 424).

Measurements

Age, sex, histology, extent of disease, tumor size, treatment, type of surgery, cause of death, and length of survival.

Results

Tumor size and extent of disease were significantly related to cause of death (P = .02). Participants who did not have surgery were more likely to die of their thyroid cancer than of any other cause (P = .01), and whether a participant had surgery was significantly related to age (P = .002). Participants who had surgery had significantly longer survival than those who did not (P < .001). Type of surgery (P = .92) and adding radioactive iodine after surgery (P = .07) did not appear to influence length of survival.

Conclusion

Although differentiated thyroid cancer is typically considered a relatively indolent disease, this is not the case in older adults. Surgery appears to reduce the likelihood of death from thyroid cancer in this population and confers a survival benefit. Type of surgery and adding radioactive iodine therapy do not seem to improve the survival benefit of surgical management.
Correlation of central memory CD4+ T‐Cell decrease in the peripheral blood with disease progression in SIVmac251‐infected Chinese rhesus macaques
Authors: Cong Zhe , Xue Jing , Xiong Jing , Yao Nan , Wang Wei , Jiang Hong , Chen Ting , Chen Zhiwei , Wei Qiang , Qin Chuan
Published: May 2015

Background

Correlation of CD4+ Tcm cells in the peripheral blood to disease progression in SIVmac251 infection was examined in Chinese rhesus macaques.

Methods

Plasma viral RNA loads were measured by a quantitative real‐time reverse transcription–PCR (qRT‐PCR) assay for SIV gag. Disease progression was determined based on time of survival. Phenotyping of CD4+ T‐cell subsets in the peripheral blood was longitudinally performed by flow cytometry.

Results

Although CD4+ T‐cell decrease and low CD4+/CD8+ T‐cell ratio in the peripheral blood after SIVmac251 infection did not correlate with disease progression, CD4+ Tcm cell decrease was observed to be correlated to disease progression in the SIVmac251‐infected Chinese rhesus macaques.

Conclusions

Our findings suggest that CD4+ Tcm cell decrease could be used as a predictive marker for defining the pathogenesis of the SIV disease and consequently HIV/SIV vaccine efficacy in Chinese rhesus macaques.
Immune dysfunction in Niemann‐Pick disease type C
Authors: Platt Nick , Speak Annelise O. , Colaco Alexandria , Gray James , Smith David A. , Williams Ian M. , Wallom Kerri‐Lee , Platt Frances M.
Published: May 2015

Lysosomal storage diseases are inherited monogenic disorders in which lysosome function is compromised. Although individually very rare, they occur at a collective frequency of approximately one in five thousand live births and usually have catastrophic consequences for health. The lysosomal storage diseases Niemann‐Pick disease type C (NPC) is caused by mutations predominantly in the lysosomal integral membrane protein NPC1 and clinically presents as a progressive neurodegenerative disorder. In this article we review data that demonstrate significant dysregulation of innate immunity in NPC, which occurs both in peripheral organs and the CNS. In particular pro‐inflammatory responses promote disease progression and anti‐inflammatory drugs provide benefit in animal models of the disease and are an attractive target for clinical intervention in this disorder.

image

Niemann‐Pick disease type C is a rare, devastating, inherited lysosomal storage disease with a unique cellular phenotype characterized by lysosomal accumulation of sphingosine, various glycosphingolipids and cholesterol and a reduction in lysosomal calcium. In this review we highlight the impact of the disease on innate immune activities in both the central nervous system (CNS) and peripheral tissues and discuss their contributions to pathology and the underlying mechanisms.
Accumulation of type VI collagen in the primary osteon of the rat femur during postnatal development
Authors: Kohara Yukihiro , Soeta Satoshi , Izu Yayoi , Amasaki Hajime
Published: May 2015

In rodents, the long bone diaphysis is expanded by forming primary osteons at the periosteal surface of the cortical bone. This ossification process is thought to be regulated by the microenvironment in the periosteum. Type VI collagen (Col VI), a component of the extracellular matrix (ECM) in the periosteum, is involved in osteoblast differentiation at early stages. In several cell types, Col VI interacts with NG2 on the cytoplasmic membrane to promote cell proliferation, spreading and motility. However, the detailed functions of Col VI and NG2 in the ossification process in the periosteum are still under investigation. In this study, to clarify the relationship between localization of Col VI and formation of the primary osteon, we examined the distribution of Col VI and osteoblast lineages expressing NG2 in the periosteum of rat femoral diaphysis during postnatal growing periods by immunohistochemistry. Primary osteons enclosing the osteonal cavity were clearly identified in the cortical bone from 2 weeks old. The size of the osteonal cavities decreased from the outer to the inner region of the cortical bone. In addition, the osteonal cavities of newly formed primary osteons at the outermost region started to decrease in size after rats reached the age of 4 weeks. Immunohistochemistry revealed concentrated localization of Col VI in the ECM in the osteonal cavity. Col VI‐immunoreactive areas were reduced and they disappeared as the osteonal cavities became smaller from the outer to the inner region. In the osteonal cavities of the outer cortical regions, Runx2‐immunoreactive spindle‐shaped cells and mature osteoblasts were detected in Col VI‐immunoreactive areas. The numbers of Runx2‐immunoreactive cells were significantly higher in the osteonal cavities than in the osteogenic layers from 2 to 4 weeks. Most of these Runx2‐immunoreactive cells showed NG2‐immunoreactivity. Furthermore, PCNA‐immunoreactivity was detected in the Runx2‐immunoreactive spindle cells in the osteonal cavities. These results indicate that Col VI provides a characteristic microenvironment in the osteonal cavity of the primary osteon, and that differentiation and proliferation of the osteoblast lineage occur in the Col VI‐immunoreactive area. Interaction of Col VI and NG2 may be involved in the structural organization of the primary osteon by regulating osteoblast lineages.
Living with chronic illness in adults: a concept analysis
Authors: Ambrosio Leire , Senosiain García Juana Maria , Riverol Fernández Mario , Anaut Bravo Sagrario , Díaz De Cerio Ayesa Sara , Ursúa Sesma María Eugenia , Caparrós Neus , Portillo Mari Carmen
Published: May 2015

Aims and objectives

To report an analysis of the concept of Living with chronic illness in adults, using Rodger's evolutionary analytical methodology.

Background

In the literature, several qualitative studies exist that address the question of Living with chronic illness from the adult patient's perspective. However, the lack of clarity and consensus among the existing studies renders this concept ambiguous when it is analysed in depth.

Design

A narrative review.

Methods

A systematic search has been carried out on electronic databases such as Medline (PubMed), Cinahl (Ebsco), Cochrane Library, PsycINFO (Ovid), Embase, Cuiden, Dialnet and Scielo. This was limited to articles published in either Spanish or English, from 2003–2013.

Results

Living with chronic illness is a complex, dynamic, cyclic and multidimensional process, and involves the development of five different attributes: Acceptance, Coping, Self‐management, Integration and Adjustment. Depending on how these attributes operate, there are four different ways of living which can result from the process of Living with chronic illness: (1) Disavowal, (2) False Normality, (3) The New Normal and (4) Disruption.

Conclusions

This paper contributes to the understanding of the concept ‘Living with chronic illness’. Findings in this analysis have to be evaluated with caution and further research is needed on this topic to confirm them. Also, more studies in evaluating how patients live a long‐term condition are recommended to foster patient‐centred care.

Relevance to clinical practice

Findings generated from this concept analysis can raise awareness of Living with chronic illness so that this process could be assessed in a correct and uniform way in the clinical community and improved when needed.
The role of nurses/social workers in using a multidimensional guideline for diagnosis of anxiety and challenging behaviour in people with intellectual disabilities
Authors: Pruijssers Addy , van Meijel Berno , Maaskant Marian , Keeman Noortje , Teerenstra Steven , van Achterberg Theo
Published: May 2015

Aims and objectives

This study seeks (1) to investigate the impact of the implementation of the ‘Diagnostic Guideline for Anxiety and challenging behaviours in clients with intellectual disability’ on nurses/social workers' knowledge and self‐efficacy; and (2) to evaluate the role of nurses/social workers in the diagnostic process when applying the guideline.

Background

Nurses/social workers have extensive contact with clients with intellectual disabilities. Despite this key position, the contribution of nurses/social workers to the diagnosis of mental health problems and challenging behaviours is rather limited. The authors developed the multidimensional ‘Diagnostic Guideline for Anxiety and challenging behaviours’. In this article, the implementation of this guideline is evaluated concerning knowledge and self‐efficacy of nurses/social workers, as well the role of nurses/social workers in the diagnostic process.

Design

This study employed a comparative multiple case study design.

Methods

Qualitative and quantitative research methods.

Results

Working with the ‘Diagnostic Guideline for Anxiety and challenging behaviours’ led to a statistically significant increase in knowledge and self‐efficacy among the nurses/social workers in the experimental condition, compared with nurses/social workers in the control condition. Nurses/social workers and psychologists appreciated the more active contribution of the nurses/social workers in the diagnostic process.

Conclusions

Working with the guideline increased the knowledge and self‐efficacy of nurses/social workers, and led to more active participation of nurses/social workers in the diagnostic process.

Relevance to clinical practice

After following a training programme, nurses/social workers can effectively contribute to the diagnostic process in clients with anxiety and related challenging behaviours.
Dental, skeletal asymmetries and functional characteristics in Class II subdivision malocclusions
Authors: Li J. , He Y. , Wang Y. , Chen T. , Xu Y. , Xu X. , Zeng H. , Feng J. , Xiang Z. , Xue C. , Han X. , Bai D.
Published: May 2015

Treatment outcomes of Angle Class II subdivision malocclusions may be compromised because of the uncertainty of the aetiology. Previous studies have reported controversial ideas about the origins, but the existence of a primary contributor still remains unknown. Functional factors have been mentioned as a probable cause, but until now, there have been no supporting data. This study was a cross‐sectional investigation of the characteristics of Angle Class II subdivision malocclusion, including dental, skeletal and functional factors, by comparison of the subdivision group and the normal occlusion group. The evaluations of dental and skeletal asymmetries of both groups were carried out by cone‐beam computed tomography (CBCT) and analysis of dental casts. The functional deviations were evaluated by cast mounting and measuring. In the subdivision group, the asymmetric position of the glenoid fossa was found to be the most significant skeletal asymmetry. No dentoalveolar asymmetry was found in this group. The most important finding was that, in subdivision malocclusions, functional deviation resulting in pseudoasymmetry occurred in 32·86% of the study participants. This deviation is probably related to the disharmonious arch width between maxillary and mandibular dental arches in the premolar section. The origin of Angle Class II subdivision malocclusion is multifactorial, with dental, skeletal and functional factors included. Functional deviation occurs, probably due to dental arch width disharmony. Asymmetric position of the glenoid fossa may account for most of the skeletal asymmetry.
Genetic Diversity of Badnaviruses Associated with Bougainvillea in Brazil
Authors: Alexandre Maria Amélia Vaz , Duarte Ligia Maria Lembo , Harakava Ricardo
Published: May 2015

The genus Bougainvillea is native to South America and is cultivated worldwide for ornamental purposes. To investigate the diversity of bougainvillea badnavirus populations, plants with various types of symptoms from different regions of Brazil were collected and subjected to DNA extraction, PCR, cloning and sequencing. Sequence analysis revealed that clones from the Brasília (DF) isolate showed maximum identity of 71.7%. No genetic diversity was observed in partial RT/RNase H sequences of Badnavirus isolates derived from the bougainvillea clones grown in São Paulo (SP) state, which shared a monophyletic group with 100% bootstrap in the tree topology reconstructed by maximum likelihood. One clade consistently supported by 100% bootstrap formed by clones of the samples from Minas Gerais (MG) and Ceará (CE) states and Taiwan was also observed. Furthermore, DF, CE and MG isolates formed a monophyletic group with the Delhi isolate, which may represent a new Badnavirus species that infects bougainvillea. Two Brazilian isolates and one from Taiwan appeared to have recombination sites in the RT and RNase H conserved region of BCVBV. These results demonstrate the existence of at least three probably new bougainvillea badnavirus species or strains, which may be spread, as this ornamental is vegetatively propagated.
The effectiveness of environmental strategies on noise reduction in a pediatric intensive care unit: Creation of single‐patient bedrooms and reducing noise sources
Authors: Kol Emine , Aydın Perihan , Dursun Oguz
Published: May 2015

Purpose

Noise is a substantial problem for both patients and healthcare workers in hospitals. This study aimed to determine the effectiveness of environmental strategies (creating single‐patient rooms and reducing noise sources) in noise reduction in a pediatric intensive care unit.

Design and Methods

Noise measurement in the unit was conducted in two phases. In the first phase, measurements aimed at determining the unit's present level of noise were performed over 4 weeks in December 2013. During the month following the first measurement phase, the intensive care unit (ICU) was moved to a new location and noise‐reducing strategies were implemented. The second phase, in May 2014, measured noise levels in the newly constructed environment.

Results

The noise levels before and after environmental changes were statistically significant at 72.6 dB‐A and 56 dB‐A, respectively (p < .05).

Practice Implications

Single‐patient rooms and noise‐reducing strategies can be effective in controlling environmental noise in the ICU.
Octreotide prevents liver failure through upregulating 5′‐methylthioadenosine in extended hepatectomized rats
Authors: Du Zhenggui , Zhou Yongjie , Lu Xufeng , Li Lei , Lu Changli , Li Li , Li Bo , Bu Hong , Yang Jiayin , Shi Yujun
Published: May 2015

Background & Aims

Insufficient liver regeneration and hepatocyte injury caused by excessive portal perfusion are considered to be responsible for post‐hepatectomy liver failure (PLF) or small‐for‐size syndrome in living‐donor liver transplantation. Somatostatin can decrease portal vein pressure (PVP) but simultaneously inhibits liver regeneration. This interesting paradox motivated us to investigate the outcome of PLF in response to somatostatin treatment.

Methods

Rats receiving extended partial hepatectomy (90% PH) were treated with octreotide, a somatostatin analogue, or placebo. Animal survival, serum parameters and hepatic histology were evaluated. Metabolomic analysis was performed to investigate the effect of octreotide on hepatocyte metabolism.

Results

Despite significantly inhibiting early regeneration, octreotide application noticeably improved the hepatic histology, liver function and survival after PH but did not decrease the PVP level. Metabolomic analysis exhibited that octreotide profoundly and exclusively altered the levels of five metabolites that participate in or closely associate with the methionine cycle, a biochemical reaction that uniquely produces S‐adenosylmethionine (SAMe), an active methyl residual donor for methyltransferase reactions. Among these metabolites, 5′‐methylthioadenosine (MTA), a derivate of SAMe, increased three‐fold and was found independently improve the hepatic histology and reduce inflammatory cytokines in hepatectomized rats.

Conclusions

Octreotide exclusively regulates the methionine cycle reaction and augments the MTA level in hepatocytes. MTA prominently protects hepatocytes against shear stress injury and reduces the secondary inflammation, thereby protecting rats from PLF.
Risk prediction for patients with hepatocellular carcinoma undergoing chemoembolization: development of a prediction model
Authors: Kim Beom Kyung , Shim Ju Hyun , Kim Seung Up , Park Jun Yong , Kim Do Young , Ahn Sang Hoon , Kim Kang Mo , Lim Young‐Suk , Han Kwang‐Hyub , Lee Han Chu
Published: May 2015

Backgrounds & Aims

We aimed to generate and validate a novel risk prediction model for patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE).

Methods

Patients receiving TACE as the first‐line therapy between 2006 and 2009 were selected from the databases of two major tertiary hospitals in Korea. This study population was randomly assigned into training (n = 340) and validation (n = 145) sets. From a multivariate Cox‐regression model for overall survival (OS), tumour Size, tumour Number, baseline Alpha‐foetoprotein level, Child–Pugh class and Objective radiological Response after the first TACE session were selected and then scored to generate a 10‐point risk prediction model (named as “SNACOR” model) in the training set. Thereafter, the prognostic performance was assessed in the validation set.

Results

In the training set, the time‐dependent areas under receiver‐operating characteristic curves (AUROCs) for OS at 1‐, 3‐ and 6‐years were 0.756, 0.754 and 0.742 respectively. According to the score of the SNACOR model, patients were stratified into three groups; low‐ (score 0–2), intermediate‐ (score 3–6) and high‐risk group (score 7–10) respectively. The low‐risk group had the longest median OS (49.8 months), followed by intermediate‐ (30.7 months) and high‐risk group (12.4 months) (log‐rank test, P < 0.001). Compared with the low‐risk group, the intermediate‐risk (hazard ratio [HR] 2.13, P < 0.001) and high‐risk group (HR 6.17, P < 0.001) retained significant risks of death. Similar results were obtained in the validation set.

Conclusion

A simple‐to‐use SNACOR model for patients with HCC treated with TACE might be helpful in appropriate prognostification and guidance for decision of further treatment strategies.
Optimizing the Power of Choice: Supporting Student Autonomy to Foster Motivation and Engagement in Learning
Authors: Evans Miriam , Boucher Alyssa R.
Published: May 2015

Choice plays a critical role in promoting students' intrinsic motivation and deep engagement in learning. Across a range of academic outcomes and student populations, positive impacts have been seen when student autonomy is promoted through meaningful and personally relevant choice. This article presents a theoretical perspective on the motivational role of choice in learning, based on self‐determination theory. Theoretical principles and current research on student motivation and engagement are described. Conditions under which choice promotes students' intrinsic motivation are then presented.
Abscisic acid deficiency increases defence responses against Myzus persicae in Arabidopsis
Authors: Hillwig Melissa S. , Chiozza Mariana , Casteel Clare L. , Lau Siau Ting , Hohenstein Jessica , Hernández Enrique , Jander Georg , MacIntosh Gustavo C.
Published: May 2015

Comparison of Arabidopsis thaliana (Arabidopsis) gene expression induced by Myzus persicae (green peach aphid) feeding, aphid saliva infiltration and abscisic acid (ABA) treatment showed a significant positive correlation. In particular, ABA‐regulated genes are over‐represented among genes that are induced by M. persicae saliva infiltration into Arabidopsis leaves. This suggests that the induction of ABA‐related gene expression could be an important component of the Arabidopsis–aphid interaction. Consistent with this hypothesis, M. persicae populations induced ABA production in wild‐type plants. Furthermore, aphid populations were smaller on Arabidopsis aba1‐1 mutants, which cannot synthesize ABA, and showed a significant preference for wild‐type plants compared with the mutant. Total free amino acids, which play an important role in aphid nutrition, were not altered in the aba1‐1 mutant line, but the levels of isoleucine (Ile) and tryptophan (Trp) were differentially affected by aphids in wild‐type and mutant plants. Recently, indole glucosinolates have been shown to promote aphid resistance in Arabidopsis. In this study, 4‐methoxyindol‐3‐ylmethylglucosinolate was more abundant in the aba1‐1 mutant than in wild‐type Arabidopsis, suggesting that the induction of ABA signals that decrease the accumulation of defence compounds may be beneficial for aphids.
Progressive multifocal leukoencephalopathy: Dot‐shaped inclusions and virus‐host interactions
Authors: Shishido‐Hara Yukiko
Published: May 2015

Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating disease caused by reactivation of the asymptomatic persistent pathogen human polyomavirus JC (JC virus). The pathology of affected brain tissues demonstrates oligodendroglia‐like cells with viral inclusions in their enlarged nuclei, a diagnostic hallmark of this disease. Today, the pathological features of this disease are expanding, partly due to an unsteady balance between viral virulence and host immunity. Intranuclear viral inclusions were initially thought to be amphophilic materials comprising the entire enlarged nucleus, based on HE staining (full inclusions). Howevewr, recent immunohistochemical analyses detected the presence of intranuclear viral inclusions in dots (dot‐shaped inclusions). The dot‐shaped inclusions reflect clustered progeny virions at punctuated subnuclear domains called promyelocytic leukemia nuclear bodies, and are indicative of early‐stage viral infection or suppressed viral proliferation. Second, the JC virus is usually reactivated in patients with impaired immunity, and therefore the inflammatory reactions are poor. However, the causes of immunosuppression are divergent, as seen with the frequent use of immunosuppressive drugs, including natalizumab. Therefore, the degree of host immunity is variable; some patients show marked anti‐viral inflammatory reactions and a good prognosis, indicating that a strong resistance against viral infection remains. Recovery of the immune system may also induce paradoxical clinical worsening, known as immune reconstitution inflammatory syndrome, the mechanism of which has not been clarified. The virus‐host interactions have increased in complexity, and the pathology of PML is diverging. In this review, the pathology of PML will be described, with a focus on the intranuclear target of JC virus infection and host inflammatory reactions.
Variation in the use of surveillance endomyocardial biopsy among pediatric heart transplant centers over time
Authors: Godown Justin , Harris Michelle T. , Burger Judith , Dodd Debra A.
Published: May 2015

EMB is widely utilized for graft surveillance after HTx; however, there is significant variation in the frequency of surveillance EMB use during the first year post‐HTx. The aim of this study was to assess changes in the utilization of surveillance EMB over time among member institutions of PHTS. A survey of PHTS centers assessing the frequency of surveillance EMB use during the first year post‐HTx was conducted in 2006. The same survey was repeated in 2014 to assess changes in practice over time. The number of EMB in infants ranged from 0 to 9 and in adolescents 0 to 16. The number of EMB decreased or remained unchanged in the majority of centers. Fewer EMB are performed in infants compared to adolescents and this practice did not change over time. There was a significant decrease in surveillance EMB use in adolescents (p = 0.012). International centers perform significantly fewer EMB in adolescents when compared to centers within the United States (p = 0.006). There continues to be significant variation in the utilization of surveillance EMB, with a shift toward less reliance on EMB for adolescents in the current era. Further research is necessary to determine the optimal frequency of invasive monitoring that reduces costs without compromising outcomes.
Origins of the Intermediate Spectral Form in M100 Mutants of Photoactive Yellow Protein
Authors: Kumar Anil , Woolley George Andrew
Published: May 2015

Numerous single‐site mutants of photoactive yellow protein (PYP) from Halorhodospira halophila and as well as PYP homologs from other species exhibit a shoulder on the short wavelength side of the absorbance maximum in their dark‐adapted states. The structural basis for the occurrence of this shoulder, called the “intermediate spectral form,” has only been investigated in detail for the Y42F mutation. Here we explore the structural basis for occurrence of the intermediate spectral form in a M121E derivative of a circularly permuted H. halophila PYP (M121E‐cPYP). The M121 site in M121E‐cPYP corresponds to the M100 site in wild‐type H. halophila PYP. High‐resolution NMR measurements with a salt‐tolerant cryoprobe enabled identification of those residues directly affected by increasing concentrations of ammonium chloride, a salt that greatly enhances the fraction of the intermediate spectra form. Residues in the surface loop containing the M121E (M100E) mutation were found to be affected by ammonium chloride as well as a discrete set of residues that link this surface loop to the buried hydroxyl group of the chromophore via a hydrogen bond network. Localized changes in the conformational dynamics of a surface loop can thereby produce structural rearrangements near the buried hydroxyl group chromophore while leaving the large majority of residues in the protein unaffected.
Buddhists and Violence: Historical Continuity/Academic Incongruities
Authors: Jerryson Michael
Published: May 2015

Within the last several decades, there has been a surge in Buddhist‐influenced conflicts in places like the Tibetan region of China, Myanmar, Thailand and Sri Lanka. Every religious system has had violent instances. In many ways, the phenomenon speaks more about the nature of humanity than it does about religion. People have violent tendencies making violence present in all religious traditions. One prominent challenge in the study of religion and violence is defining the parameters for violence. As perpetrators of violence rarely locate themselves as aggressors or see themselves as deficient in moral justifications, this essay treats violence as the act of harming oneself and/or others. However, it also outlines the ways in which Buddhists see intentionality as influential in the ethics of such acts. Although scholars of religion and violence have critically shown how religiously‐motivated violence is multidimensional and a multi‐determined phenomenon (e.g., Aho ; Juergensmeyer ; Jones ), there persists global patterns to align religious traditions like Islam as a cause for violence and others like Buddhism as an explanation of peace. Such wide‐sweeping comparisons are at best superficial assessments that draw upon limited evidence. There may be a rash of contemporary examples of Buddhist‐inspired violence in places like Sri Lanka, Myanmar, Thailand, and China, but this does not make Buddhism any more violent than other religions. However, incidents like recent Buddhist attacks in Sri Lanka, Myanmar and Thailand are important pieces to the puzzle of Buddhism and violence. On the most basic of levels, they dispel the ahistorical myth that Buddhists are wholly peaceful.
Elusive Critical Elements of Transformative Risk Assessment Practice and Interpretation: Is Alternatives Analysis the Next Step?
Authors: Francis Royce A.
Published: May 2015

This article argues that “game‐changing” approaches to risk analysis must focus on “democratizing” risk analysis in the same way that information technologies have democratized access to, and production of, knowledge. This argument is motivated by the author's reading of Goble and Bier's analysis, “Risk Assessment Can Be a Game‐Changing Information Technology—But Too Often It Isn't” (Risk Analysis, 2013; 33: 1942–1951), in which living risk assessments are shown to be “game changing” in probabilistic risk analysis. In this author's opinion, Goble and Bier's article focuses on living risk assessment's potential for transforming risk analysis from the perspective of risk professionals—yet, the game‐changing nature of information technologies has typically achieved a much broader reach. Specifically, information technologies change who has access to, and who can produce, information. From this perspective, the author argues that risk assessment is not a game‐changing technology in the same way as the printing press or the Internet because transformative information technologies reduce the cost of production of, and access to, privileged knowledge bases. The author argues that risk analysis does not reduce these costs. The author applies Goble and Bier's metaphor to the chemical risk analysis context, and in doing so proposes key features that transformative risk analysis technology should possess. The author also discusses the challenges and opportunities facing risk analysis in this context. These key features include: clarity in information structure and problem representation, economical information dissemination, increased transparency to nonspecialists, democratized manufacture and transmission of knowledge, and democratic ownership, control, and interpretation of knowledge. The chemical safety decision‐making context illustrates the impact of changing the way information is produced and accessed in the risk context. Ultimately, the author concludes that although new chemical safety regulations do transform access to risk information, they do not transform the costs of producing this information—rather, they change the bearer of these costs. The need for further risk assessment transformation continues to motivate new practical and theoretical developments in risk analysis and management.
Effectiveness of cold water immersion for treating exertional heat stress when immediate response is not possible
Authors: Flouris A. D. , Friesen B. J. , Carlson M. J. , Casa D. J. , Kenny G. P.
Published: May 2015

Immediate treatment with cold water immersion (CWI) is the gold standard for exertional heatstroke. In the field, however, treatment is often delayed due to delayed paramedic response and/or inaccurate diagnosis. We examined the effect of treatment (reduction of rectal temperature to 37.5 °C) delays of 5, 20, and 40 min on core cooling rates in eight exertionally heat‐stressed (40.0 °C rectal temperature) individuals. We found that rectal temperature was elevated above baseline (P < 0.05) at the end of all delay periods (5 min: 40.08 ± 0.32; 20 min: 39.92 ± 0.40; 40 min: 39.57 ± 0.29 °C). Mean arterial pressure was reduced (P < 0.05) below baseline (92 ± 1.8 mm Hg) after all delay periods (5 min: 75 ± 2.6; 20 min: 74 ± 1.7; 40 min: 70 ± 2.1 mm Hg; P > 0.05). Rectal core cooling rates were similar among conditions (5 min: 0.20 ± 0.01; 20 min: 0.17 ± 0.02; 40 min: 0.17 ± 0.01 °C/min; P > 0.05). The rectal temperature afterdrop following CWI was similar across conditions (5 min: 35.95; 20 min: 35.61; 40 min: 35.87 °C; P > 0.05). We conclude that the effectiveness of 2 °C CWI as a treatment for exertional heat stress remains high even when applied with a delay of 40 min. Therefore, our results support that CWI is the most appropriate treatment for exertional heatstroke as it is capable of quickly reversing hyperthermia even when treatment is commenced with a significant delay.
Mild evaporative cooling applied to the torso provides thermoregulatory benefits during running in the heat
Authors: Filingeri D. , Fournet D. , Hodder S. , Havenith G.
Published: May 2015

We investigated the effects of mild evaporative cooling applied to the torso, before or during running in the heat. Nine male participants performed three trials: control‐no cooling (CTR), pre‐exercise cooling (PRE‐COOL), and during‐exercise cooling (COOL). Trials consisted of 10‐min neutral exposure and 50‐min heat exposure (30 °C; 44% humidity), during which a 30‐min running protocol (70% VO2max) was performed. An evaporative cooling t‐shirt was worn before the heat exposure (PRE‐COOL) or 15 min after the exercise was started (COOL). PRE‐COOL significantly lowered local skin temperature (Tsk) (up to −5.3 ± 0.3 °C) (P < 0.001), mean Tsk (up to −2 ± 0.1 °C) (P < 0.001), sweat losses (−143 ± 40 g) (P = 0.002), and improved thermal comfort (P = 0.001). COOL suddenly lowered local Tsk (up to −3.8 ± 0.2 °C) (P < 0.001), mean Tsk (up to −1 ± 0.1 °C) (P < 0.001), heart rate (up to −11 ± 2 bpm) (P = 0.03), perceived exertion (P = 0.001), and improved thermal comfort (P = 0.001). We conclude that the mild evaporative cooling provided significant thermoregulatory benefits during exercise in the heat. However, the timing of application was critical in inducing different thermoregulatory responses. These findings provide novel insights on the thermoregulatory role of Tsk during exercise in the heat.
Human behavioral thermoregulation during exercise in the heat
Authors: Flouris A. D. , Schlader Z. J.
Published: May 2015

The human capacity to perform prolonged exercise is impaired in hot environments. To address this issue, a number of studies have investigated behavioral aspects of thermoregulation that are recognized as important factors in determining performance. In this review, we evaluated and interpreted the available knowledge regarding the voluntary control of exercise work rate in hot environments. Our analysis indicated that: (a) Voluntary reductions in exercise work rate in uncompensable heat aid thermoregulation and are, therefore, thermoregulatory behaviors. (b) Unlike thermal behavior during rest, the role of thermal comfort as the ultimate mediator of thermal behavior during exercise in the heat remains uncertain. By contrast, the rating of perceived exertion appears to be the key perceptual controller under such conditions, with thermal perception playing a more modulatory role. (c) Prior to increases in core temperature (when only skin temperature is elevated), reductions in self‐selected exercise work rate in the heat are likely mediated by thermal perception (thermal comfort and sensation) and its influence on the rating of perceived exertion. (d) However, when both core and skin temperatures are elevated, factors associated with cardiovascular strain likely dictate the rate of perceived exertion response, thereby mediating such voluntary reductions in exercise work rate.
Hydration and endocrine responses to intravenous fluid and oral glycerol
Authors: van Rosendal S. P. , Strobel N. A. , Osborne M. A. , Fassett R. G. , Coombes J. S.
Published: May 2015

Athletes use intravenous (IV) saline in an attempt to maximize rehydration. The diuresis from IV rehydration may be circumvented through the concomitant use of oral glycerol. We examined the effects of rehydrating with differing regimes of oral and IV fluid, with or without oral glycerol, on hydration, urine, and endocrine indices. Nine endurance‐trained men were dehydrated by 4% bodyweight, then rehydrated with 150% of the fluid lost via four protocols: (a) oral = oral fluid only; (b) oral glycerol = oral fluid with added glycerol (1.5 g/kg); (c) IV = 50% IV fluid, 50% oral fluid; and (d) IV with oral glycerol = 50% IV fluid, 50% oral fluid with added glycerol (1.5 g/kg), using a randomized, crossover design. They then completed a cycling performance test. Plasma volume restoration was highest in IV with oral glycerol > IV > oral glycerol  > oral. Urine volume was reduced in both IV trials compared with oral. IV and IV with oral glycerol resulted in lower aldosterone levels during rehydration and performance, and lower cortisol levels during rehydration. IV with oral glycerol resulted in the greatest fluid retention. In summary, the IV conditions resulted in greater fluid retention compared with oral and lower levels of fluid regulatory and stress hormones compared with both oral conditions.