bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential correlation between interleukin patterns in disseminated and chronic human paracoccidioidomycosis
Authors: SILVA C L , SILVA M F , FACCIOLI L H , PIETRO R C L , CORTEZ S A E , FOSS N T
Published: November 2013

In an attempt to understand better the immunoregulatory disorders in paracoccidioidomycosis (PCM), the possible correlation between interleukin pattern, lymphoproliferation, C-reactive protein (CRP) and specific antibody levels was investigated in the polarized clinical forms of this disease. We studied 16 PCM patients, eight with the disseminated disease (four under treatment and four non-treated) and eight with the chronic disease. The patients with disseminated disease exhibited high antibody titres specific to Paracoccididoides brasiliensis antigen compared with patients with the chronic form of disease. Tumour necrosis factor (TNF), IL-1, IL-6 and CRP in the serum of non-treated disseminated PCM patients were increased, which correlated positively with the low mitogenic response of peripheral blood mononuclear cells (PBMC) to phytohaemagglutinin (PHA) (P < 0·01) and with the high antibody titres (P < 0·001) of these patients. Moreover, we found in the disseminated PCM patients positive correlations between IL-1 and IL-6 (P = 0·0007); IL-1 and TNF (P = 0·0045); IL-1 and IL-6 with the high antibody titres (P = 0·0834 and P = 0·0631, respectively); IL-1, IL-6 and TNF with CRP levels. By contrast, no correlations were found with those interleukins in the treated disseminated and chronic patients or in controls. It was interesting to find an inverse correlation between IL-4 and antibody production in non-treated disseminated PCM (r = −0·4770); moreover, a significant correlation (P = 0·0820) was found in chronic PCM patients with respect to the low level of either IL-4 and antibody titres against fungus antigen. Chronic PCM patients also had IL-2 levels inversely correlated with antibody production (r = −0·6313; P = 0·0628). Inverse correlations were also observed between IL-2 and IL-6 levels in non-treated disseminated patients (P = 0·0501) and between IL-2 and IL-4 in chronic patients (P = 0·0131). The inflammatory cytokines might have a pivotal role in the genesis and in control of some aspects of the disease, such as granulomatous reaction, hypergammaglobulinaemia and depression of T cell-mediated immunity in PCM.
The role of somatic structure of the fungusParacoccidioides brasiliensisupon B cell activation in experimental paracoccidioidomycosis
Authors: SILVA M F , SILVA C L
Published: November 2013

In this study, we report an increase of the number of antibody-secreting cells and the augmentation of antibody production against unrelated antigens in mice infected with the fungus P. brasiliensis, as well as in mice inoculated with cell wall preparation isolated from P. brasiliensis (CW). The immunomodulatory effect of the live fungus and the CW preparation was dose-dependent, and their actions were mainly restricted to the i.v. or i.p. inoculation simultaneously with the sheep erythrocyte challenge by the i.v. route or restricted to i.p. inoculation of CW when bovine serum albumin (BSA) antigen was used. The dependence of antibody production on different routes of CW inoculation was correlated with the number of antigen-specific B cells in the spleen as determined by direct and reverse plaque-forming cell assays. The immunization schedules using CW preparation caused a preferential production of IgM and IgG3 antibodies. The results also showed that the hyperactive humoral immune response of mice induced by i.p. inoculation of CW was devoid of polyclonal B cell activation compared with the effects observed for the lipopolysaccharide (LPS)-treated groups. Paracoccidioides brasiliensis CW components may have potent immunological properties related to the non-specific B cell activation found in paracoccidioidomycosis.
Interaction of the cell-binding domain of fibronectin with VLA-5 integrin induces monokine production in cultured human monocytes
Authors: TAKIZAWA T , NISHINARITA S , KITAMURA N , HAYAKAWA J , KANG H , TOMITA Y , MITAMURA K , YAMAGAMI K , HORIE T
Published: November 2013

The effect of fibronectin on IL-1α, IL-1β, tumour necrosis factor-alpha (TNF-α), and IL-6 production was investigated with cultured monocytes isolated from human peripheral blood. Monokine concentrations were determined by both ELISA and bioassay. Fibronectin markedly stimulated the secretion of IL-1α, IL-1β, TNF-α and IL-6 from cultured monocytes in a dose-dependent manner, with the maximal effect apparent within 24 h. Northern blot analysis revealed a marked increase in the abundance of mRNA specific for each monokine on exposure of monocytes to fibronectin. Monoclonal antibodies to the α chain of very late antigen (VLA)-5, the β1 integrin, the α chain of Mac-1, and the β2 integrin, as well as the synthetic peptide of GRGDSP (which corresponds to the cell-binding domain of fibronectin), inhibited (>50%) fibronectin-induced monokine production. Monoclonal antibodies to the α chain of VLA-4, and the α chain of LFA-1, as well as the synthetic peptide CS-1 (which corresponds to the alternatively spliced connecting segment of fibronectin) and the control peptide GRADSP, had no inhibitory effect on monokine production. A MoAb, R60, that recognizes an epitope of the fibronectin molecule that includes the RGD sequence, inhibited monokine production, whereas the MoAb Y16, which recognizes another epitope of fibronectin not including RGD, did not. These results indicate that fibronectin-induced production of IL-1α, IL-1β, TNF-α and IL-6 from cultured monocytes is mediated predominantly by interaction of the cell-binding domain of fibronectin with VLA-5, although Mac-1 also may contribute to this effect of fibronectin. Our results indicate that the interaction of fibronectin with integrins may contribute to the cytokine network in inflammatory response.
COMBINED INTRAARTERIAL CISPLATIN INFUSION AND RADIATION THERAPY FOR INVASIVE BLADDER CANCER
Authors: Mizoguchi Hiroaki , Nomura Yoshio , Terada Katsuhiko , Nakagawa Masayuki , Ogata Jiro
Published: November 2013

Combined intraarterial cisplatin infusion and radiation therapy were performed as the initial treatment for 23 patients (mean age: 70 years) with invasive bladder cancers (T2 in 17, T3 in 6) who were suitable for total cystectomy. Of these patients, five who had multiple invasive cancers without laterality had their intrapelvic hemodynamics altered by embolizing a contralateral internal iliac artery. Cisplatin (50 mg) was infused into the internal iliac artery through a subcutaneous reservoir twice a week over three weeks while concurrent radiation therapy with 30 Gy, delivered in 15 fractions, was performed. Additional cisplatin infusions were given in six patients. After this combined therapy, total cystectomy and ileal conduit was performed in six patients and transurethral resection of bladder tumor (TURBT) in 17. Two of the patients who underwent total cystectomy were found to exhibit a complete response. Therefore, the overall response rate was 87%, including 13 complete responses and seven partial responses. The complete response rates in patients with clinical stage T2 and T3 disease were 53 and 67%, respectively. The complete response rate was slightly higher in patients with a non‐papillary cancer than in those with a papillary one. Toxic reactions included a decrease in bladder capacity in two patients and severe diarrhea due to methicillin‐resistant Staphylococcus aureus colitis in one. Other forms of toxicity, including nausea, vomiting, neurotoxicity in the gluteal region, nephrotoxicity and myelosuppression, were tolerable. All but one of the patients are alive. This patient died of distant metastasis and seven other patients had a local recurrence of bladder cancer. One patient who developed invasive bladder cancer reaching the prostatic urethra underwent total cystectomy and ileal conduit. One who had a recurrence at the same site as the previous tumor underwent partial cystectomy. Five patients who had superficial bladder cancer were easily controlled by TURBT. Finally, bladder function was preserved in 65% of all patients in this study at a mean follow‐up time of 29 months.

We conclude that combined intraarterial cisplatin infusion and radiation therapy is useful for the initial treatment of invasive bladder cancer because this combined therapy provides a favorable quality of life with the preservation of bladder function.

Further detailed follow‐up is necessary to determine whether this therapy also has a prophylactic effect on the recurrence of bladder cancer.
SERUM ESTRADIOL LEVELS IN NORMAL MEN AND MEN WITH IDIOPATHIC INFERTILITY
Authors: Yamamoto Masanori , Hibi Hatsuki , Katsuno Satoshi , Miyake Koji
Published: November 2013

Serum estradiol levels were measured in 360 men attending an infertility clinic and 68 proven fertile men to determine whether estradiol measurements are clinically useful. The normal range of estradiol levels found in fertile men was 10–82 pg/ml. Serum concentrations of estradiol in azoospermic or oligozoospermic patients were significantly lower than those in normozoospermic men (p < 0.021). Serum concentrations of testosterone were also significantly decreased in infertile patients (p < 0.025). This decrease in serum estradiol may be partly due to reduced testosterone levels in these men because estradiol is mainly formed by peripheral aromatization of testosterone in fatty and muscle tissues. However, the exact mechanism for the decrease in the serum estradiol levels remains undetermined. It is concluded that serum estradiol levels are significantly low in the men with various testicular disorders.
Lysophosphatidic acid accelerates lung fibrosis by inducing differentiation of mesenchymal stem cells into myofibroblasts
Authors: Tang Na , Zhao Yanxia , Feng Ruopeng , Liu Yinan , Wang Shuling , Wei Wanguo , Ding Qiang , An Michael (Songzhu) , Wen Jinhua , Li Lingsong
Published: November 2013

Lung fibrosis is characterized by vascular leakage and myofibroblast recruitment, and both phenomena are mediated by lysophosphatidic acid (LPA) via its type‐1 receptor (LPA1). Following lung damage, the accumulated myofibroblasts activate and secrete excessive extracellular matrix (ECM), and form fibrotic foci. Studies have shown that bone marrow‐derived cells are an important source of myofibroblasts in the fibrotic organ. However, the type of cells in the bone marrow contributing predominantly to the myofibroblasts and the involvement of LPA‐LPA1 signalling in this is yet unclear. Using a bleomycin‐induced mouse lung‐fibrosis model with an enhanced green fluorescent protein (EGFP) transgenic mouse bone marrow replacement, we first demonstrated that bone marrow derived‐mesenchymal stem cells (BMSCs) migrated markedly to the bleomycin‐injured lung. The migrated BMSC contributed significantly to α‐smooth muscle actin (α‐SMA)‐positive myofibroblasts. By transplantation of GFP‐labelled human BMSC (hBMSC) or EGFP transgenic mouse BMSC (mBMSC), we further showed that BMSC might be involved in lung fibrosis in severe combined immune deficiency (SCID)/Beige mice induced by bleomycin. In addition, using quantitative‐RT‐PCR, western blot, Sircol collagen assay and migration assay, we determined the underlying mechanism was LPA‐induced BMSC differentiation into myofibroblast and the secretion of ECM via LPA1. By employing a novel LPA1 antagonist, Antalpa1, we then showed that Antalpa1 could attenuate lung fibrosis by inhibiting both BMSC differentiation into myofibroblast and the secretion of ECM. Collectively, the above findings not only further validate LPA1 as a drug target in the treatment of pulmonary fibrosis but also elucidate a novel pathway in which BMSCs contribute to the pathologic process.
Colon epithelial proliferation and carcinogenesis in diet‐induced obesity
Authors: Takahashi Hirokazu , Hosono Kunihiro , Endo Hiroki , Nakajima Atsushi
Published: November 2013

Colorectal cancer is the third leading cause of cancer death in Japan and the United States and is strongly associated with obesity, especially visceral obesity. Several metabolic mediators, such as adiponectin, have been suspected to play a role in obesity‐related carcinogenesis. In a previous human study, the existence of a significant correlation between the number of human dysplastic aberrant crypt foci (ACF) and the visceral fat area was demonstrated, and also that of a significant inverse correlation between the number of dysplastic ACF and the plasma adiponectin level. Other studies have investigated the effect of adiponectin under the normal and high‐fat diet conditions in a mouse model of azoxymethane‐induced colon cancer. Enhanced formation of both ACF and tumors was observed in the adiponectin‐deficient mice, as compared with that in the wild‐type, under the high‐fat diet condition but not under the normal diet condition. Furthermore, that the 5′‐AMP‐activated kinase/mammalian target of rapamycin pathway is involved in the promotion of colorectal carcinogenesis in adiponectin‐deficient mice under the high‐fat diet condition was shown. Therefore, that the 5′‐AMP‐activated kinase/mammalian target of rapamycin signaling pathway may play an important role in colorectal carcinogenesis was speculated. Metformin, a biguanide derivative widely used in the treatment of diabetes mellitus, has been shown to exert a suppressive effect on ACF formation in both mouse models and humans. Therefore, metformin might be a promising candidate as a safe drug for chemoprevention of colorectal carcinogenesis. Further studies with high evidence levels, such as randomized, controlled studies, are needed to clarify these relationships.
Non‐alcoholic fatty liver disease: Factors associated with its presence and onset
Authors: Miyake Teruki , Kumagi Teru , Furukawa Shinya , Tokumoto Yoshio , Hirooka Masashi , Abe Masanori , Hiasa Yoichi , Matsuura Bunzo , Onji Morikazu
Published: November 2013

Non‐alcoholic fatty liver disease (NAFLD) may progress to cirrhosis, liver failure, and complicated hepatocellular carcinoma. In addition, NAFLD is a risk factor for the development of other serious diseases, such as diabetes or cardiovascular disease. Therefore, the detection of early‐stage NAFLD is important. Many studies have described the factors that predict the presence of NAFLD and its onset, and several markers have been identified. These markers have enabled the identification of high‐risk patients and have improved routine medical practice. To prevent advanced disease, clinicians need to have simple markers that predict the onset of NAFLD so that interventions can be started at much earlier stages of disease. This review summarizes the current state of knowledge regarding independent factors, as reported in large studies, that predict the presence of NAFLD and its onset, especially markers that can be used in daily medical practice, such as physical measurements and blood tests.
Nutritional components regulate the gut immune system and its association with intestinal immune disease development
Authors: Lamichhane Aayam , Kiyono Hiroshi , Kunisawa Jun
Published: November 2013

The gut is equipped with a unique immune system for maintaining immunological homeostasis, and its functional immune disruption can result in the development of immune diseases such as food allergy and intestinal inflammation. Accumulating evidence has demonstrated that nutritional components play an important role in the regulation of gut immune responses and also in the development of intestinal immune diseases. In this review, we focus on the immunological functions of lipids, vitamins, and nucleotides in the regulation of the intestinal immune system and as potential targets for the control of intestinal immune diseases.
Characteristics and diagnosis of NAFLD/NASH
Authors: Hashimoto Etsuko , Taniai Makiko , Tokushige Katsutoshi
Published: November 2013

Non‐alcoholic fatty liver disease (NAFLD) is considered to be a hepatic manifestation of metabolic syndrome. NAFLD has become an important public health issue because of its high prevalence. NAFLD consists of two clinicopathological entities: simple steatosis, which generally follows a benign non‐progressive clinical course, and non‐alcoholic steatohepatitis (NASH), which may progress to cirrhosis and hepatocellular carcinoma. The diagnosis of NAFLD is based on the following three criteria: non‐alcoholic, detection of steatosis either by imaging or by histology, and appropriate exclusion of other liver diseases. Alcoholic liver disease can occur when daily alcohol consumption exceeds 20 g in women or 30 g in men. Thus, non‐alcoholic indicates lower levels of these alcohol consumptions. However, there is still no clear consensus regarding the threshold alcohol consumption for defining non‐alcoholic liver disease. Then, there is the strong recommendation for a change in the nomenclature, such as use of the term metabolic fatty liver and metabolic steatohepatitis. NASH has emerged as a clinicopathological entity, and even now, a liver biopsy remains the gold standard for making a definitive diagnosis. However, liver biopsy has several drawbacks. In general practice, NAFLD is a convenient‐to‐use term for the diagnosis and management of these patients, and serum biomarkers that indicate the severity of fibrosis serve as clinically useful tools for the identification of NAFLD in patients with bridging fibrosis or cirrhosis. In the future, improved understanding of the pathogenesis of NASH and new technologies may contribute to the diagnostic process and provide reliable, non‐invasive alternatives to liver biopsy.
Response to nutritional support and therapeutic approaches of amino acid and protein metabolism in surgical patients
Authors: Sakurai Yoichi
Published: November 2013

The response to critical illness involves alterations in all aspects of metabolic control, favoring catabolism of body protein. In particular, body protein loss occurring as a result of the alteration of protein metabolism has been reported to be inversely correlated with the survival of critically ill patients. Despite the availability of various therapeutic modalities aiming to prevent loss of the body protein pool, such as total parenteral nutrition, enteral nutrition designed to provide excessive calories as a form of energy substrate, and protein itself, the loss of body protein cannot be prevented by any of these. Loss of the boyd protein store occurs as a consequence of the alteration of the intermediate metabolism that works for the production of energy substrate. This alteration of substrate metabolism may be linked to the alteration of protein metabolism. However, no specific factors regulating amino acid and protein metabolism have been identified. Thus, further investigations evaluating amino acid and protein metabolism are required to obtain better understanding of metabolic regulation in the body, which may lead to the development of novel and more effective therapeutic modalities for nutrition in the future.
Maldigestion from pancreatic exocrine insufficiency
Authors: Pongprasobchai Supot
Published: November 2013

Pancreatic exocrine insufficiency (PEI) is one of the long‐term consequences of chronic pancreatitis (CP). Majority of patients with PEI were undiagnosed or undertreated. Inadequately treated or subclinical severe PEI causes malnutrition and may pose the patients at risk of premature atherosclerosis and cardiovascular events. Indication of pancreatic enzyme replacement therapy (PERT) is patients with severe PEI, as indicated by the presence of steatorrhea, diarrhea, weight loss, fecal fat > 7 g/day, 13C‐mixed triglyceride breath test < 29%, fecal elastase < 100 ug/g stool, imaging or endoscopic findings of pancreatic ductal dilatation or calculi, and eight endosonographic criteria of CP. The mainstay treatment of PEI is PERT. Dietary fat restriction is unnecessary. PERT with lipase > 40 000 U per meal is recommended. Enteric‐coating may be preferred to conventional enzymes because of the availability of high‐dose preparations and no need of acid suppression co‐therapy. Administration of enzymes with meals is proven to be the most effective regimen. Response to PERT should be measured by the improvement of patients' symptoms, nutritional status, and, in selected cases, by fecal fat or 13C‐mixed triglyceride breath test. Patients unresponsive to PERT should be checked for compliance, increase the dose of lipase to 90 000 units/meal or co‐therapy with proton pump inhibitor. In patient with previous gastrointestinal surgery that may interfere enzyme‐food mixing, opening the capsules and administering the enzyme granules with meals. Finally, search for small intestinal bacterial overgrowth syndrome and other causes of small bowel malabsorption.
The relationship between pretreatment dietary composition and weight loss during a randomised trial of different diet approaches
Authors: McVay M. A. , Jeffreys A. S. , King H. A. , Olsen M. K. , Voils C. I. , Yancy W. S.
Published: November 2013

Background

Identifying pretreatment dietary habits that are associated with weight‐loss intervention outcomes could help guide individuals' selection of weight‐loss approach among competing options. A pretreatment factor that may influence weight‐loss outcomes is macronutrient intake.

Methods

Overweight and obese Durham Veterans Affairs outpatients were randomised to a weight‐loss intervention with a low‐carbohydrate diet (n = 71) or orlistat medication therapy plus a low‐fat diet (n = 73). Percentage fat, carbohydrate and protein intake prior to treatment were measured using 4‐day food records. Linear mixed‐effects models were used to determine whether pretreatment percentage macronutrient intake influenced weight trajectories and weight loss in each weight‐loss condition.

Results

Participant's mean age was 53 years, baseline body mass index was 39.3 kg m–2 and 72% were male. A higher pretreatment percentage carbohydrate intake was associated with less rapid initial weight loss (P = 0.02) and less rapid weight regain (P = 0.03) in the low‐carbohydrate diet condition but was not associated with weight trajectories in the orlistat plus low‐fat diet condition. In both conditions, a higher pretreatment percentage fat intake was associated with more rapid weight regain (P < 0.01). Pretreatment percentage protein intake was not associated with weight trajectories. None of the pretreatment macronutrients were associated with weight loss on study completion in either condition.

Conclusions

Selection of a weight‐loss approach on the basis of pretreatment macronutrient intake is unlikely to improve weight outcomes at the end of a 1‐year treatment. However, pretreatment macronutrient intake may have implications for tailoring of interventions to slow weight regain after weight loss.
In routine clinical practice, few physicians use early viral kinetics to guide HCV dual therapy treatment decisions
Authors: Mangia Alessandra , Bányai Tivadar , De Bartolomeo Giuseppe , Gervain Judit , Habersetzer François , Mulkay Jean‐Pierre , Ouzan Denis , Parruti Giustino , Passariello Nicola , Remy Andre‐Jean , Rizzetto Mario , Shiffman Mitchell L. , Tice Alan D. , Schmitz Manuela , Tatsch Fernando , Rodriguez‐Torres Maribel
Published: November 2013

Background & Aims

PROPHESYS is a large, multinational, non‐interventional prospective cohort study of chronic hepatitis C patients treated with peginterferon alfa/ribavirin. This subanalysis assesses rates of premature treatment discontinuation stratified by on‐treatment virological response (VR).

Methods

This PROPHESYS subanalysis is restricted to treatment‐naive, hepatitis C virus (HCV) genotype (G)1/2/3 mono‐infected patients who received peginterferon alfa‐2a (40KD)/ribavirin with intended treatment duration of 48 (G1) or 24 weeks (G2/3). Early virological responses were classified into four mutually exclusive categories [rapid VR (RVR), complete early VR (cEVR), partial EVR (pEVR), no RVR/EVR], using standard criteria.

Results

The likelihood for shortening treatment owing to good efficacy was highest among patients with an RVR and HCV RNA ≤400 000 IU/ml (G1 10.0%; G2/3 5.8%) whereas for poor efficacy, it was highest in G1 non‐RVR/EVR patients with HCV RNA >400 000 IU/ml (56.6%). Factors significantly associated with early treatment discontinuation as a result of good efficacy in G1 patients included RVR vs. no RVR/EVR and, at baseline, lower HCV RNA, lower FIB‐4 score, HCV infection via injection drug use. For G2/3 patients, factors included lower baseline HCV RNA and G2 vs. G3 infection. Most patients started with the recommended peginterferon alfa‐2a dose, but a high proportion received a higher‐than‐recommended ribavirin dose.

Conclusions

Despite international guidelines, few physicians used early viral kinetics to abbreviate treatment. Therefore, relatively few patients with an RVR and low baseline HCV RNA abbreviated treatment. In addition, there were deviations in ribavirin starting doses, suggesting that physicians tailor treatment according to local guidelines or previous experience.
An acoustic valve within the nose of sperm whales Physeter macrocephalus
Authors: Huggenberger Stefan , André Michel , Oelschläger Helmut H. A.
Published: November 2013

Sperm whales Physeter macrocephalus emit impulsive sound signals in short series of rhythmic clicks (codas) for communication, and in long series of single acoustic events (usual clicks) for echolocation. Both click types are generated pneumatically within the hypertrophied nasal complex, at the ‘monkey lips’ at the rostral end of the right nasal passage. Each individual click comprises repetitive pulses decaying in intensity. However, the decay rate is distinctly higher in usual clicks than in coda clicks.

The mechanism of decay rate control in the clicks is still unclear, and it is unclear why the right nasal passage crosses the nasal acoustic pathway between two hypertrophied acoustic fat bodies (spermaceti organ, junk), so that it resembles a ‘bent acoustic horn’.

We present a new concept to explain how the flat right nasal passage can serve as a variable acoustic valve, and how the amount and distribution of its air filling can be controlled by muscle action. This mechanism allows the whale to determine the pulse decay rate and thus switch between the two modes of click production. Coda clicks are generated by reverberations within the spermaceti organ (partial trapping of sound) and by the release of sound energy in fractions through the air‐filled right nasal passage. In contrast, echolocation clicks as single events are released during the partial collapse of the right nasal passage between the spermaceti organ and the junk.

This interpretation of the right nasal passage as an adaptive acoustic valve elucidates why the spermaceti organ and the junk are separated from each other by an air‐filled space of variable volume crossing the sound path of the ‘bent acoustic horn’ in the posterior part of the nasal complex.
Practical guidance for the use of a pattern‐matching technique in case‐study research: A case presentation
Authors: Almutairi Adel F. , Gardner Glenn E. , McCarthy Alexandra
Published: November 2013

This paper reports on a study that demonstrates how to apply pattern matching as an analytical method in case‐study research. Case‐study design is appropriate for the investigation of highly‐contextualized phenomena that occur within the social world. Case‐study design is considered a pragmatic approach that permits employment of multiple methods and data sources in order to attain a rich understanding of the phenomenon under investigation. The findings from such multiple methods can be reconciled in case‐study analysis, specifically through a pattern‐matching technique. Although this technique is theoretically explained in the literature, there is scant guidance on how to apply the method practically when analyzing data. This paper demonstrates the steps taken during pattern matching in a completed case‐study project that investigated the influence of cultural diversity in a multicultural nursing workforce on the quality and safety of patient care. The example highlighted in this paper contributes to the practical understanding of the pattern‐matching process, and can also make a substantial contribution to case‐study methods.
Change in Spinal Alignment after Total Hip Arthroplasty
Authors: Radcliff Kristen E , Orozco Fabio , Molby Nicholas , Delasotta Lawrence , Chen Eric , Post Zachary , Ong Alvin
Published: November 2013

Objective

The study hypotheses were that: (i) there would be a difference in sagittal plane alignment between patients with symptomatic osteoarthritis of the hip and those with lumbar degenerative disk disease; and (ii) that sagittal plane lumbar alignment would change following total hip arthroplasty (THA).

Methods

In this prospective study, a series of patients without back pain or lumbar complaints who were scheduled to undergo THA underwent lateral lumbar radiography prior to and nine months after elective THA. Radiographic measurements of lumbar alignment included sacral slope, lumbar lordosis, and L1 axis S1 distance (L1 ASD). All measurements were performed on upright, standing, lateral radiographs. A control group of patients underwent serial radiography over the same period for evaluation of lumbar degenerative disease. The independent sample t‐test was used to compare the mean sacral slope, lumbar lordosis, and L1 ASD in the THA and control groups.

Results

There were 12 patients in the THA group and 34 in the control group. Mean follow‐up was 9 months. Average age in the control group was 63 years and in the THA group 64.2 years. The sacral slope was greater in the THA group (mean, 23°) than in the lumbar patients (control group) and this difference was statistically significant (mean, 11°, P = 0.001). There were no statistically significant differences between THA and control patients in lumbar lordosis or L1 ASD. Change before and after THA was measured. There were no statistically significant differences in assessed radiographic variables preoperatively versus postoperatively.

Conclusion

There is no significant change in spinal alignment after unilateral THA. At baseline, patients with symptomatic spine complaints have less sacral slope than their hip arthroplasty counterparts.
Cloning and functional analysis of the promoters that upregulate carotenogenic gene expression during flower development in Gentiana lutea
Authors: Zhu Changfu , Yang Qingjie , Ni Xiuzhen , Bai Chao , Sheng Yanmin , Shi Lianxuan , Capell Teresa , Sandmann Gerhard , Christou Paul
Published: November 2013

Over the last two decades, many carotenogenic genes have been cloned and used to generate metabolically engineered plants producing higher levels of carotenoids. However, comparatively little is known about the regulation of endogenous carotenogenic genes in higher plants, and this restricts our ability to predict how engineered plants will perform in terms of carotenoid content and composition. During petal development in the Great Yellow Gentian (Gentiana lutea), carotenoid accumulation, the formation of chromoplasts and the upregulation of several carotenogenic genes are temporally coordinated. We investigated the regulatory mechanisms responsible for this coordinated expression by isolating five G. lutea carotenogenic gene (GlPDS, GlZDS, GlLYCB, GlBCH and GlLYCE) promoters by inverse polymerase chain reaction (PCR). Each promoter was sufficient for developmentally regulated expression of the gusA reporter gene following transient expression in tomato (Solanum lycopersicum cv. Micro‐Tom). Interestingly, the GlLYCB and GlBCH promoters drove high levels of gusA expression in chromoplast‐containing mature green fruits, but low levels in chloroplast‐containing immature green fruits, indicating a strict correlation between promoter activity, tomato fruit development and chromoplast differentiation. As well as core promoter elements such as TATA and CAAT boxes, all five promoters together with previously characterized GlZEP promoter contained three common cis‐regulatory motifs involved in the response to methyl jasmonate (CGTCA) and ethylene (ATCTA), and required for endosperm expression (Skn‐1_motif, GTCAT). These shared common cis‐acting elements may represent binding sites for transcription factors responsible for co‐regulation. Our data provide insight into the regulatory basis of the coordinated upregulation of carotenogenic gene expression during flower development in G. lutea.
Environmental Provisions in American and EU Free Trade Agreements: A Preliminary Comparison and Research Agenda
Authors: Jinnah Sikina , Morgera Elisa
Published: November 2013

Environmental provisions are included into bilateral trade agreements in increasingly creative ways. This article offers an initial exploration of the policy and legal dimensions of environmental provisions included in recent bilateral trade agreements concluded by the United States and by the European Union. Based primarily on a coding analysis of the environmental provisions contained in American and EU trade agreements since the mid‐2000s, the article illuminates the variable characteristics of these environmental provisions, including the different approaches of the United States and the EU (punitive versus cooperative) to their implementation. The article pays particular attention to the unprecedented links that these treaties create with multilateral environmental agreements. It concludes with a discussion of avenues for future research, including approaches that are comparative and interdisciplinary in nature.
Courage, regulatory responsibility, and the challenge of higher‐order reflexivity
Authors: Perez Oren
Published: November 2013

Contemporary regulators must respond to ever‐increasing societal demands in various domains. Regulators must cope with these demands under conditions of extreme epistemic scarcity and ideological divide. This leaves regulators perplexed about what action they should take. Regulatory praxis offers two primary responses to this moral and epistemic dilemma: technical canonization and reflexive regulation. While these two approaches represent contrary regulatory philosophies, they suffer from two common blind spots: (a) disregard of the critical role of discretionary judgment in regulatory action; and (b) disregard of the dilemma of higher‐order reflexivity. The article explores the idea of higher‐order reflexivity in the regulatory context. This exploration renders visible the abysses that are faced by regulators as they attempt to resolve regulatory dilemmas through a cognizant and introspective process. The article argues that the Socratic concept of courage and the idea of forward‐looking responsibility provide a plausible framework for thinking about the challenge of regulatory judgment. It concludes with a discussion of the legal and institutional mechanisms that could both facilitate and put to scrutiny the realization of this ideal (but noting also several features of the contemporary regulatory system which constitute potential barriers).
Cross‐national variations in industry regulation: A factor analytic approach with an application to telecommunications
Authors: Perkins Susan
Published: November 2013

This study applies factor analytic techniques to 131 telecommunications regulatory agencies in 80 countries to develop a comparative framework for better understanding the cross‐national institutional variation in industrial regulation. While some of these measures are specific to the telecom industry (i.e. World Trade Organization Basic Telecom Agreement participation), most of these regulatory variables can be applied to other regulated industries. After analyzing 30 variables, these techniques identify and quantify six distinct dimensions of industry regulation, namely, the competitive market structure rules, industry standards rules, entry barrier rules, institutional stability, political appointment process, and the regulatory governance structure. Despite the conventional wisdom that suggests the “rules of the game” are key to industry regulation, this study finds that the single largest source of cross‐national variation is the level of regulatory institutional stability (accounting for 16 percent of the total variation in cross‐national industry regulation). This suggests that more focus and attention should be given to the role formal institutions play in industry regulation. This study also finds differences in industry regulation between developed, developing, and least developed nations. Developed countries on average have significantly higher regulation, with the US being the highest. This suggests that regulation is a critical component of industrial regimes and the competitiveness of developed economies.
Continuity of care in day surgical care – perspective of patients
Authors: Suominen Tarja , Turtiainen Ann‐Marie , Puukka Pauli , Leino‐Kilpi Helena
Published: November 2013

Background

The realisation of continuity in day surgical care is analysed in this study. The term ‘continuity of care’ is used to refer to healthcare processes that take place in time (time flow) and require coordination (coordination flow), rapport (caring relationship flow) and information (information flow). Patients undergoing laparoscopic cholecystectomy or inguinal hernia day surgery are ideal candidates for studying the continuity of care, as the diseases are very common and the treatment protocol is mainly the same in different institutions, in addition to which the procedure is elective and most patients have a predictable clinical course.

Aim

The aim of the study was to describe, from the day surgery patients' own perspective, how continuity of care was realised at different phases of the treatment, prior to the day of surgery, on the day of surgery and after it.

Method

The study population consisted of 203 day surgical patients 10/2009–12/2010 (N = 350, response rate 58%). A questionnaire was developed for this study.

Results

Based on the results, the continuity of care was well realised as a rule. Continuity is improved by the fact that patients know the nurse who will look after them in the hospital before the day of surgery and have a chance to meet the nurse even after the operation. Meeting the surgeon who performed the operation afterwards also improves patients' perception of continuation of care.

Conclusions

Continuity of care may be improved by ensuring that the patient meets caring staff prior to the day of operation and after the procedure. An important topic for further research would be how continuation of care is realised in the case of other patient groups (e.g. in internal medicine). On the other hand, realisation of continuation of care should also be studied from the viewpoint of those taking part in patient care in order to find similarities/differences between patients' perceptions and professionals' views. Studying interventions aimed to promote continuity of care, for example in patient guidance, would also be of great importance.
The Persistence of Workplace Gender Segregation in the US
Authors: Cohen Philip N.
Published: November 2013

Occupational gender segregation remains one of the defining elements of gender inequality in modern societies. Recent trends for the United States show that occupational segregation remains high and did not substantially decline in the decade of the 2000s for the first time since 1960. Men and women work in different occupations because of a combination of forces, including culturally defined choices by workers themselves, discrimination by employers, and differences in skill levels and qualities. Research has shown that occupational segregation is an important aspect of gender inequality in earnings and contributes to other forms of inequality as well. The prospects for reducing gender segregation in the short term appear slim, based on the weak effects of educational attainment, cultural attitudes, and state intervention in the current period.
Phylogeny of a new supertribeCephenniitae with generic review ofEutheiini and description of a new tribeMarcepaniini (Coleoptera:Staphylinidae:Scydmaeninae)
Authors: JAŁOSZYŃSKI PAWEŁ
Published: November 2013

Genera ofEutheiini are reviewed andEutheimorphusis removed from this tribe of ant‐like stone beetles (Scydmaeninae) and transferred toCephenniini. A monogenericMarcepaniinitrib.n.is described to accommodateMarcepaniagen.n.fromMalaysia, with five species:M. semengohensissp.n.(the type species ofMarcepania),M. tuberculatasp.n.,M. seramaensissp.n.,M. minutissimasp.n.andM. elongatasp.n.A phylogenetic analysis of all genera ofCephenniini,Eutheiini andMarcepaniini based on adult morphological characters resulted in recovering a well‐supported monophyletic cladeEutheiini + (Marcepaniini + Cephenniini) and these tribes are included inCephenniitaestat.n.(Eutheiini andCephenniini are therefore removed fromScydmaenitae). Only a weak support for monophyly ofEutheiini was found, but morphological characters allow for maintaining this presumably relic group as a separate tribe. Previously proposed monophyletic groups withinCephenniini were recovered as such, but after inclusion ofEutheimorphus, a sister taxon to the ‘Cephennomicrusgroup’, the latter lineage gained weak statistical support. The evolutionary history ofCephenniitae is discussed, with focus on known northern hemisphere fossils classified inScydmaenitae andHapsomelitae, but possibly closely allied toCephenniitae. Establishing the supertribeCephenniitae is the first step toward a profound reclassification ofScydmaeninae on a robust phylogenetic basis.

This published work has been registered in ZooBank,http://zoobank.org/urn:lsid:zoobank.org:pub:B0E1B12D-9587-4C4F-A908-A12A0C424A8C.
Our Policies, Their Text: German Language Students' Strategies with and Beliefs about Web‐Based Machine Translation
Authors: White Kelsey D. , Heidrich Emily
Published: November 2013

Most educators are aware that some students utilize web‐based machine translators for foreign language assignments, however, little research has been done to determine how and why students utilize these programs, or what the implications are for language learning and teaching. In this mixed‐methods study we utilized surveys, a translation task, and interviews to discover some of the students' beliefs and strategies in using such tools. Our results suggest that students hold a range of beliefs about the usefulness of machine translators for writing assignments, and that many of them can articulate and reflect upon the strategies that they use. We discuss implications for the use of machine translation in the foreign language curriculum based on the example of university German.
International communication in a technology services call centre in India
Authors: LOCKWOOD JANE
Published: November 2013

The data for this study was gathered from a US multinational company information technology enabled services (ITES) worksite offshored to India. The focus of the study is the exploration of the nature of English communication between professional support engineers across ‘Inner, Outer and Expanding Circles,’ and in particular the use of accommodation strategies used by the support engineers in the process of getting their professional work done on the phones with colleagues from all over the world. To date, little research into the needs and nature of English communication has been completed in this important industry in offshored destinations such as the Philippines and India. Such Outer Circle destinations are increasingly being selected by multinationals for offshoring and outsourcing due to the perception that these societies speak good English. But what does good English mean in globalized settings?
Discussion of “Flow-Excited Acoustic Resonance Excitation Mechanism, Design Guidelines and Counter Measures,” (Ziada, S., and Lafon, P., 2014, ASME Appl. Mech. Rev., 66(1), p. 010802)
Authors: Moody Frederick J.
Published: November 2013

The authors have done extensive research in gathering historical background on the subject of flow excited acoustic resonance. They have provided extensive discussion to justify creative formulations for predicting the onset of resonance and estimating the associated maximum pressure amplitudes. Their approach makes use of reported experimental studies plus some of their own to make charts that should be useful for some common industrial problems. An independent scaling approach is offered in this review to verify the dominant parameters and variables employed by the authors in their predictive methods. It was found that for low Mach number flows, a specific Reynolds number (Re) dependence was missing. However, since it is known that the Strouhal dependence is very weak on Reynolds numbers up to about 105, the absence of specific Re dependence is probably inconsequential. Another concern was that interaction between the acoustics and vortex shedding or shear layer instabilities could affect the eigenfrequencies. A simple model showed that this is possible, but Quad Cities experience cited by the authors indicated one case where it was not important. The Rolls-Royce Vertical Lift System example with coaxial closed side-branches could have had a significant interaction with the annular liquid mass on eigenmodes. The mass effect resulting from the annular space connecting both branches could act less like an oscillating shear layer and more like a Helmholtz resonator. This could have a significant effect on the natural frequency of either or both branch pipes. Although that effect is not specifically considered here, if it was significant, it would be naturally embraced in a scale model based on the scaling laws presented in this review.
On trajectories of rolling marbles in cones and other funnels
Authors: White Gary D.
Published: November 2013

We report on theoretical and experimental results for a ball that rolls without slipping on a surface of revolution, whose symmetry axis is aligned with a uniform gravitational field, particularly investigating both near-circular orbits and scattering-type orbits in cones. The experimental data give support for the theoretical treatment, a non-trivial application of Newton's second law that expands on our previous work and related work of others. Our findings refine those from a recent article in this journal, and largely replicate those obtained from an earlier Lagrangian approach, adding some new details and commentary. While the orbits of marbles rolling in cones do not match inverse-square-law orbits quantitatively (e.g., instead of Kepler's 3rd law, we have T2∝R), we argue that students should experience these qualitative phenomena—precession of orbits, escape velocity behavior, spin-orbit coupling, conservation laws for angular momentum, energy, and spin projection—as much for the fun and kinesthetic impressions as for the raw learning. We also report on a heretofore largely ignored variable in the exploration of rolling orbits in a gravity well: the marble's spin about its own axis as it rolls. Experimenters can, intentionally or not, vary this initial condition and produce different orbital periods for a given orbital radius—a distinctly non-celestial behavior. Careful selection of the initial spin direction and speed for a particular cone can result in marble orbits that mimic the planetary ellipses.
Differential Diagnosis of Azoospermia with Proteomic Biomarkers ECM1 and TEX101 Quantified in Seminal Plasma
Authors: Drabovich Andrei P. , Dimitromanolakis Apostolos , Saraon Punit , Soosaipillai Antoninus , Batruch Ihor , Mullen Brendan , Jarvi Keith , Diamandis Eleftherios P.
Published: November 2013

Measurements of seminal plasma proteins ECM1 and TEX101 facilitate the differential diagnosis of azoospermia.
Searching for Needles in the T Cell Receptor Haystack
Authors: Callahan Margaret K.
Published: November 2013

New technology permits high-throughput identification and analysis of specific T cell receptors.