bluuebunny/crossref_metadata_2025 huggingface dataset:
Intracardiac Mass as Initial Cardiac Manifestation of Behçet's Disease: Think before You Cut
Authors: Leibowitz David , Korem Maya , Livovsky Dan M. , Peleg Hagit , Chajek‐Shaul Tova , Hiller Nurith
Published: June 2014

Behçet's disease (BD) is a chronic multisystemic inflammatory disorder. Cardiac abnormalities including intracardiac thrombi have been described in up to 16% of cases. The clinical presentation of cardiac complications in BD may include fever, dyspnea, chest pain, hemoptysis, and edema. We present 2 cases of patients who underwent surgical excision of intracardiac masses thought to be intracardiac malignancies. Further pathological and clinical evaluation established intracardiac inflammatory masses due to BD as the final diagnosis. As intracardiac masses may be the presenting manifestation of BD, it is crucial for echocardiographers to consider BD in the differential diagnosis. A careful history and physical exam looking for signs and symptoms of BD is critical before considering surgical excision of unexplained intracardiac masses. If the final diagnosis is BD anti‐inflammatory therapy should be considered the basis of treatment.
“3D Fusion” Echocardiography Improves 3D Left Ventricular Assessment: Comparison with 2D Contrast Echocardiography
Authors: Augustine Daniel , Yaqub Mohammad , Szmigielski Cezary , Lima Eduardo , Petersen Steffen E. , Becher Harald , Noble J. Alison , Leeson Paul
Published: June 2014

Background

Three‐dimensional fusion echocardiography (3DFE) is a novel postprocessing approach that utilizes imaging data acquired from multiple 3D acquisitions. We assessed image quality, endocardial border definition, and cardiac wall motion in patients using 3DFE compared to standard 3D images (3D) and results obtained with contrast echocardiography (2DC).

Methods

Twenty‐four patients (mean age 66.9 ± 13 years, 17 males, 7 females) undergoing 2DC had three, noncontrast, 3D apical volumes acquired at rest. Images were fused using an automated image fusion approach. Quality of the 3DFE was compared to both 3D and 2DC based on contrast‐to‐noise ratio (CNR) and endocardial border definition. We then compared clinical wall‐motion score index (WMSI) calculated from 3DFE and 3D to those obtained from 2DC images.

Results

Fused 3D volumes had significantly improved CNR (8.92 ± 1.35 vs. 6.59 ± 1.19, P < 0.0005) and segmental image quality (2.42 ± 0.99 vs. 1.93 ± 1.18, P < 0.005) compared to unfused 3D acquisitions. Levels achieved were closer to scores for 2D contrast images (CNR: 9.04 ± 2.21, P = 0.6; segmental image quality: 2.91 ± 0.37, P < 0.005). WMSI calculated from fused 3D volumes did not differ significantly from those obtained from 2D contrast echocardiography (1.06 ± 0.09 vs. 1.07 ± 0.15, P = 0.69), whereas unfused images produced significantly more variable results (1.19 ± 0.30). This was confirmed by a better intraclass correlation coefficient (ICC 0.72; 95% CI 0.32–0.88) relative to comparisons with unfused images (ICC 0.56; 95% CI 0.02–0.81).

Conclusion

3DFE significantly improves left ventricular image quality compared to unfused 3D in a patient population and allows noncontrast assessment of wall motion that approaches that achieved with 2D contrast echocardiography.
Scale insects, decay and canker fungi in American beech
Authors: Cale J. A. , Ashby A. W. , West J. L. , Teale S. A. , Johnston M. T. , Castello J. D.
Published: June 2014

Tripartite interactions among phytophagous insects, pathogens and their host plants provide insight into the role of host physiology in determining susceptibility to attack. American beech (Fagus grandifolia) often is simultaneously attacked by beech scale (Cryptococcus fagisuga), one or more Neonectria pathogens and Xylococculus betulae that can result in beech bark disease (BBD). Additionally, beech is frequently infected by heartrot‐decay fungi. Cursory observations in 2011 suggested that beech scale and Neonectria lesion densities were lower and greater, respectively, on trees with decay. In 2012, digital image analysis was used to quantify densities of these organisms on 123 beech from the Adirondack region of New York. Three groups of study trees (n = 41) were used: Inonotus glomeratus‐infected, Phellinus igniarius‐infected and non‐decay trees. Trees infected by decay pathogens supported lower densities of beech scale and higher densities of Neonectria. Densities of X. betulae did not significantly vary among decay groups. These results may be explained by decay‐induced changes in host physiology. Additional work is needed to elucidate the potential role of host bark chemistry in the BBD complex.
A case of anaphylactic shock induced by FX60 polysulfone hemodialyzer but not F6‐HPS polysulfone hemodialyzer
Authors: Shu Kai‐Hsiang , Kao Tze‐Wah , Chiang Wen‐Chih , Wu Vin‐Cent
Published: June 2014

A 75‐year‐old woman was admitted for dyspnea and fever. She underwent emergent dialysis smoothly under F6‐HPS polysulfone hemodialyzer. With two subsequent hemodialysis sessions, severe anaphylactic reaction with cardiopulmonary resuscitation occurred under FX60 polysulfone dialyzer. Further dialysis sessions by F6‐HPS polysulfone dialyzer were uneventful. This rare case demonstrated that dialyzer reaction may be markedly different even with the same material and the same manufacturer.
Association of increased travel distance to dialysis units with the risk of anemia in rural chronic hemodialysis elderly
Authors: Chao Chia‐Ter , Lai Chun‐Fu , Huang Jenq‐Wen , Chiang Chih‐Kang , Huang Sheng‐Jen
Published: June 2014

Geographic remoteness has been found to influence health‐related outcomes negatively. As reported in the literature, rural dialysis patients have a higher risk of mortality with increasing travel distance to dialysis units. However, few studies have focused on the impact of travel distances on the development of dialysis complications. We utilized a prospectively collected chronic hemodialysis patient cohort from a rural regional hospital for analysis. Data on demographics, comorbidities, and serum laboratory results were obtained. Correlation analyses between travel distance to dialysis units and dialysis complications were conducted, and significantly correlated parameters were entered into multivariate logistic regression models to determine their exact associations. A total of 46 rural chronic hemodialysis patients were enrolled, with an average age higher than others in the literature. Significant correlation was found between travel distance and serum hemoglobin levels (R2 = −0.34, P value = 0.029). Multivariate logistic regression found that every 1 km increase in travel distance was associated with an increased risk of anemia (hemoglobin <9 g/dL) (odds ratio 1.46; P value = 0.01). Sensitivity analyses further showed that the associated risk was partially attenuated by serum albumin (odds ratio 1.83; P value = 0.07) and ferritin (odds ratio 1.39; P value = 0.08) levels. This is the first study to demonstrate the association between increased travel distance to dialysis units and the risk of anemia in chronic dialysis patients, especially elderly. Malnutrition, inflammation, and atherosclerosis syndrome could be partially responsible for the observed association. Further research is required to confirm our findings.
Validated finite element analyses of WaveOne Endodontic Instruments: a comparison between M‐Wire and NiTi alloys
Authors: Bonessio N. , Pereira E. S. J. , Lomiento G. , Arias A. , Bahia M. G. A. , Buono V. T. L. , Peters O. A.
Published: June 2014

Aim

To validate torsional analysis, based on finite elements, of WaveOne instruments against in vitro tests and to model the effects of different nickel–titanium (NiTi) materials.

Methodology

WaveOne reciprocating instruments (Small, Primary and Large, n = 8 each, M‐Wire) were tested under torsion according to standard ISO 3630‐1. Torsional profiles including torque and angle at fracture were determined. Test conditions were reproduced through Finite Element Analysis (FEA) simulations based on micro‐CT scans at 10‐μm resolution; results were compared to experimental data using analysis of variance and two‐sided one sample t‐tests. The same simulation was performed on virtual instruments with identical geometry and load condition, based on M‐Wire or conventional NiTi alloy.

Results

Torsional profiles from FEA simulations were in significant agreement with the in vitro results. Therefore, the models developed in this study were accurate and able to provide reliable simulation of the torsional performance. Stock NiTi files under torsional tests had up to 44.9%, 44.9% and 44.1% less flexibility than virtual M‐Wire files at small deflections for Small, Primary and Large instruments, respectively. As deflection levels increased, the differences in flexibility between the two sets of simulated instruments decreased until fracture. Stock NiTi instruments had a torsional fracture resistance up to 10.3%, 8.0% and 7.4% lower than the M‐Wire instruments, for the Small, Primary and Large file, respectively.

Conclusion

M‐Wire instruments benefitted primarily through higher material flexibility while still at low deflection levels, compared with conventional NiTi alloy. At fracture, the instruments did not take complete advantage of the enhanced fractural resistance of the M‐Wire material, which determines only limited improvements of the torsional performance.
Micropush‐out dentine bond strength of a new gutta‐percha and niobium phosphate glass composite
Authors: Carvalho C. N. , Martinelli J. R. , Bauer J. , Haapasalo M. , Shen Y. , Bradaschia‐Correa V. , Manso A. P. , Gavini G.
Published: June 2014

Aim

To characterize an experimental gutta‐percha and niobium phosphate glass composite (GNB) applied with a thermoplastic technique to the root canals without sealer in a moist environment and to evaluate its micropush‐out bond strength to root canal wall dentine.

Methodology

The root canals of sixty human mandibular pre‐molars were prepared using rotary NiTi instruments and irrigation with sodium hypochlorite and EDTA. The teeth were then randomly divided into three groups according to the root filling material used: AH plus sealer and gutta‐percha (AH), EndoSequence BC gutta‐percha without sealer (GBC), and GNB without sealer. The root canals were filled with a single cone using warm vertical condensation. Push‐out bond strengths associated with the filling materials in slices from middle root thirds was determined 30 days after root filling. The failure mode was analyzed with SEM. Analysis using EDX and SEM‐EDS was carried out to verify the composition and distribution of the particles of the tested materials. Data were statistically analyzed by one‐way anova and Tukey's test (P < 0.05).

Results

AH and GNB groups had bond strengths of 2.83 ± 0.64 MPa and 2.68 ± 0.84 MPa, respectively, with no significant difference between them (P > 0.05). The GBC group had the lowest mean bond strength (1.34 ± 0.42 MPa), which was significantly different compared with the other groups (P < 0.05). Cohesive failures prevailed in the AH group, whereas failures were mixed in the GBC and GNB groups. The SEM‐EDS analysis on the surface and in the bulk of GBC revealed only a superficial coating of bioceramic particles. Glass particles were detected both on the surface and in the bulk of GNB.

Conclusions

The experimental root filling composite (GNB) had an ability to adhere to root canal wall dentine equal to the current gold standard root filling with gutta‐percha and sealer (AH Plus).
Impact of Living and Socioeconomic Characteristics on Cardiovascular Risk in Ischemic Stroke Patients
Authors: Amarenco Pierre , Abboud Halim , Labreuche Julien , Arauz Antonio , Bryer Alan , Lavados Pablo M. , Massaro Ayrton , Collazos Mario Munoz , Steg Philippe Gabriel , Yamout Bassem I. , Vicaut Eric ,   for the OPTIC Registry Investigators
Published: June 2014

Objective

We aimed to stratify the risk of vascular event recurrence in patients with cerebral infarction according to living and socioeconomic characteristics and geographic region.

Method

The Outcomes in Patients with TIA and Cerebrovascular Disease (OPTIC) study is an international prospective study of patients aged 45 years or older who required secondary prevention of stroke [following either an acute transient ischemic attack, minor ischemic strokes, or recent (less than six-months previous), stable, first-ever, nondisabling ischemic stroke]. A total 3635 patients from 245 centers in 17 countries in four regions (Latin America, Middle East, North Africa, South Africa) were enrolled between 2007 and 2008. The outcome measure was the two-year rate of a composite of major vascular events (vascular death, myocardial infarction and stroke).

Results

During the two-year follow-up period, 516 patients experienced at least one major cardiovascular event, resulting in an event rate of 15·6% (95% confidence interval 14·4–16·9%). Event rates varied across geographical region ( P < 0·001), ranging from 13·0% in Latin America to 20·7% in North Africa. Unemployment status, living in a rural area, not living in fully serviced accommodation (i.e., house or apartment with its own electricity, toilet and water supply), no health insurance coverage, and low educational level (less than two-years of schooling) were predictors of major vascular events. Major vascular event rates steeply increased with the number of low-quality living/socioeconomic conditions (from 13·4% to 47·9%, adjusted P value for trend <0·001).

Conclusion

Vascular risk in stroke patients in low- and middle-income countries varies not only with the number of arterial beds involved but also with socioeconomic variables.
Innovating job activation by involving employers
Authors: van der Aa Paul , van Berkel Rik
Published: June 2014

This article explores the nature of innovative employer‐oriented activation policies, which aim to influence employers’ willingness to hire or possibly train and guide the unemployed. These policies may focus on responsibilities with regards to activation, which offer services to employers or provide incentives to influence employers’ involvement. Employers may take up a role as client or as co‐producer during policy implementation. Qualitative empirical data from two Dutch cities show that employers have diverse motives to become involved: to hire new workers, to lower costs or to enact social responsibility. Actual practice shows mixed results in terms of labour market participation and employer satisfaction. It appears that the active involvement of employers as co‐producers increases their willingness to be more flexible concerning their demands and leads to greater satisfaction with outcomes. The consequences of this model for the governance of activation policy are discussed.
Nordic reforms to improve the labour market participation of vulnerable youth: An effective new approach?
Authors: Halvorsen Rune , Hvinden Bjørn
Published: June 2014

This article asks how the legitimacy (recognition or misrecognition) of “ethnicity” and “disability” influences public policies to promote the inclusion of young adults in the Nordic labour markets. The article assesses the case for seeing misrecognition and lack of accommodation as significant factors behind troubled transitions from school to work, and the case for regarding social regulation (or self‐regulation) as important ways of preventing, counteracting and correcting exclusionary factors in the transition from school to work among the two groups. The article argues that increased attention at the implementation stage of the policy process is necessary to be able to assess whether seemingly novel or innovative regulatory policies and measures actually enhance equal opportunities.
Policy innovations for including disabled people in the labour market: A study of innovative practices of Dutch sheltered work companies
Authors: van der Torre Lieske , Fenger Menno
Published: June 2014

In its disability strategy, the European Union has expressed the central aim to improve the employment situation of people with disabilities. This article discusses Dutch policies, but specifically the Sheltered Work Act which contributes to this aim by regulating sheltered employment. The goal is to identify and explore innovative practices that have been applied by Dutch sheltered work companies for increasing the inclusion of disabled people in the regular labour market. The article reveals that the Netherlands has implemented a range of initiatives which together have resulted in an increase of non‐sheltered jobs for disabled people. The article argues that the simple “sheltered/non‐sheltered” dichotomy does not do justice to the gradual evolution of labour participation among individual disabled people and that the role of sheltered work places as a first step to the inclusion of disabled people should not be underestimated.
Geological Applications of Laser‐Induced Breakdown Spectroscopy
Authors: McMillan Nancy J. , Rees Shannon , Kochelek Kristen , McManus Catherine
Published: June 2014

Laser‐induced breakdown spectroscopy (LIBS) records light emitted from the decay of electrons to lower‐energy orbitals during cooling of laser‐induced ablation plasmas; the resultant spectra can be used in a variety of geoanalytical applications. Four aspects of LIBS analysis distinguish LIBS from traditional laboratory‐based analytical techniques: (i) the lack of necessary sample preparation, allowing rapid analysis of many samples, (ii) the ability to analyse both 20 to 100 μm‐diameter spots and whole rocks, (iii) the detailed chemical signature contained in a LIBS spectrum and (iv) the ability to take LIBS into the field in backpack portable instrumentation. Three case studies illustrate potential applications of LIBS in the geosciences. First, analysis of the Carrizozo basalt flow in New Mexico, USA, illustrated that LIBS spectra could discriminate between samples of similar composition within uncertainties typical of whole‐rock analysis by X‐ray fluorescence spectrometry. Second, spectra from four sets of rubies from Madagascar and Tanzania illustrate the use of LIBS and multivariate analysis to determine provenance with success rates of > 95%. This technique can also be applied to correlation of units. Finally, a chemical map of a copper ore from Butte, MT, USA, illustrates the use of spatially defined LIBS spectra to understand chemical variations within textural context.
ADrosophilalaboratory evolution experiment points to low evolutionary potential under increased temperatures likely to be experienced in the future
Authors: Schou M. F. , Kristensen T. N. , Kellermann V. , Schlötterer C. , Loeschcke V.
Published: June 2014

The ability to respond evolutionarily to increasing temperatures is important for survival of ectotherms in a changing climate. Recent studies suggest that upper thermal limits may be evolutionary constrained. We address this hypothesis in a laboratory evolution experiment, encompassing ecologically relevant thermal regimes. To examine the potential for species to respond to climate change, we exposed replicate populations ofDrosophila melanogasterto increasing temperatures (0.3 °C every generation) for 20 generations, whereas corresponding replicate control populations were held at benign thermal conditions throughout the experiment. We hypothesized that replicate populations exposed to increasing temperatures would show increased resistance to warm and dry environments compared with replicate control populations. Contrasting replicate populations held at the two thermal regimes showed (i) an increase in desiccation resistance and a decline in heat knock‐down resistance in replicate populations exposed to increasing temperatures, (ii) similar egg‐to‐adult viability and fecundity in replicate populations from the two thermal regimes, when assessed at high stressful temperatures and (iii) no difference in nucleotide diversity between thermal regimes. The limited scope for adaptive evolutionary responses shown in this study highlights the challenges faced by ectotherms under climate change.
An Examination of the Replicability of Angoff Standard Setting Results Within a Generalizability Theory Framework
Authors: Clauser Jerome C. , Margolis Melissa J. , Clauser Brian E.
Published: June 2014

Evidence of stable standard setting results over panels or occasions is an important part of the validity argument for an established cut score. Unfortunately, due to the high cost of convening multiple panels of content experts, standards often are based on the recommendation from a single panel of judges. This approach implicitly assumes that the variability across panels will be modest, but little evidence is available to support this assertion. This article examines the stability of Angoff standard setting results across panels. Data were collected for six independent standard setting exercises, with three panels participating in each exercise. The results show that although in some cases the panel effect is negligible, for four of the six data sets the panel facet represented a large portion of the overall error variance. Ignoring the often hidden panel/occasion facet can result in artificially optimistic estimates of the cut score stability. Results based on a single panel should not be viewed as a reasonable estimate of the results that would be found over multiple panels. Instead, the variability seen in a single panel can best be viewed as a lower bound of the expected variability when the exercise is replicated.
Optimal Bandwidth Selection in Observed‐Score Kernel Equating
Authors: Häggström Jenny , Wiberg Marie
Published: June 2014

The selection of bandwidth in kernel equating is important because it has a direct impact on the equated test scores. The aim of this article is to examine the use of double smoothing when selecting bandwidths in kernel equating and to compare double smoothing with the commonly used penalty method. This comparison was made using both an equivalent groups design and a nonequivalent group with anchor test design. The performance of the methods was evaluated through simulation studies using both symmetric and skewed score distributions. In addition, the bandwidth selection methods were applied to real data from a college admissions test. The results show that the traditional penalty method works well although double smoothing is a viable alternative because it performs reasonably well compared to the traditional method.
Examination of the early infection stages of koi herpesvirus (KHV) in experimentally infected carp, Cyprinus carpio L. using in situ hybridization
Authors: Monaghan S J , Thompson K D , Adams A , Kempter J , Bergmann S M
Published: June 2014

Koi herpesvirus (KHV) causes a highly infectious disease afflicting common carp and koi, Cyprinus carpio L. Various molecular and antibody‐based detection methods have been used to elucidate the rapid attachment and dissemination of the virus throughout carp tissues, facilitating ongoing development of effective diagnostic approaches. In situ hybridization (ISH) was used here to determine the target tissues of KHV during very early infection, after infecting carp with a highly virulent KHV isolate. Analysis of paraffin‐embedded tissues (i.e. gills, skin, spleen, kidney, gut, liver and brain) during the first 8 h and following 10 days post‐infection (hpi; dpi) revealed positive signals in skin mucus, gills and gut sections after only 1 hpi. Respiratory epithelial cells were positive as early as 2 hpi. Viral DNA was also detected within blood vessels of various tissues early in the infection. Notable increases in signal abundance were observed in the gills and kidney between 5 and 10 dpi, and viral DNA was detected in all tissues except brain. This study suggests that the gills and gut play an important role in the early pathogenesis of this Alloherpesvirus, in addition to skin, and demonstrates ISH as a useful diagnostic tool for confirmation of acutely infected carp.
All My Friends Are Doing It: Potentially Offensive Sexual Behavior Perpetration Within Adolescent Social Networks
Authors: Jewell Jennifer , Spears Brown Christia , Perry Brea
Published: June 2014

The current study used social network analysis to investigate peer network and individual predictors of potentially offensive sexual behaviors among high school students. Ninth‐grade students (n = 308; 158 girls) completed surveys assessing their perpetration of potentially offensive sexual behaviors against their peers, as well as measures of their sexualized gender stereotypes and propensity to self‐monitor. Participants selected up to eight of their closest friends from a roster. Results revealed homophily of potentially offensive sexual behaviors, such that adolescents perpetrated similar amounts of physical/verbal, electronic, and homophobic behaviors as their friends. Characteristics of the peer network (e.g., mean network perpetration, centrality of individual, and gender composition) and the individual adolescent (e.g., gender, sexualized gender stereotypes, self‐monitoring) predicted adolescents’ own behavior.
Self‐Destructive Symptomatic Frames in Clinical Adolescents: Is the Same Different?
Authors: Cruz Diana , Narciso Isabel , Pereira Cícero , Sampaio Daniel
Published: June 2014

This study examines individual and family predictors of different self‐destructive patterns—only suicidal ideation, only nonsuicidal self‐injury (NSSI), or suicide attempts (that may also include both suicide ideation (SI) and NSSI)—in a sample of outpatient adolescents (N = 42; 86% females) with mean age of 16 years (SD = 1.86). Results indicated that there are differences in youngsters with self‐destructive behaviors in their perception of paternal rejection and maternal control, when compared with youngsters reporting only SI. Adolescents from the groups with self‐destructive behaviors differ only in age. Together, these data highlight the relevance of adopting an ecosystemic perspective, which includes both the patients and their families, regarding treatment and prevention of self‐destructive symptomatic frames.
Chocolate frogs do not increase completion of parent survey: Randomised study
Authors: Price Anna MH , Coates Cathy , Symeonides Christos , Hiscock Harriet , Smith Libby , York Elissa , Hennel Sabine
Published: June 2014

Four months into a year‐long, national survey assessing parents' experiences of a child's diagnosis of autism spectrum disorder, our response fraction was only 23%. We aimed to determine whether including a chocolate incentive in the postal survey would increase the response fraction. Families enrolled between 15 March and 25 May 2012 were randomised to receive a chocolate frog versus no chocolate frog. Both groups received a written reminder and replacement survey 2 weeks after the survey was posted and up to two telephone reminders thereafter. We analysed the effect of the incentive using χ2 tests for the categorical response variable and t‐tests for the continuous reminder and length of response variables at the end of (i) randomisation and (ii) the study (1 November 2012). A total of 137 families were randomised in the 6‐week period. Parents who received an incentive were more likely to return a completed survey in the 6 weeks than those who did not (21% vs. 6%, P = 0.009). This effect faded by the end of the study (53% vs. 42%, P = 0.4). There were no differences between groups at either follow‐up in the number of reminders that parents received or the number of days it took parents to return the survey. Including a chocolate‐based incentive does not significantly increase response rate in a postal survey over and above standard reminder techniques like posting follow‐up survey packs or phoning families.
Is physiotherapy effective in the management of child and adolescent conversion disorder? A systematic review
Authors: FitzGerald Tara L , Southby Alesha K , Haines Terrence P , Hough Janet P , Skinner Elizabeth H
Published: June 2014

Child and adolescent conversion disorder has the potential to impart significant burden on health‐care services and affect quality of life. Clinically, physiotherapists are involved in conversion disorder management; however, no systematic reviews have examined physiotherapy effectiveness in its management. The aim of this review is to identify the efficacy of physiotherapy management of child and adolescent conversion disorder. A search of multiple databases (Medline, CINAHL, Embase, PsychINFO, PEDro and the Cochrane Library) was completed along with manual searching of relevant reference lists to identify articles including children 0–18 years with a diagnosis of conversion disorder who received physical management. Two independent reviewers screened titles and abstracts using criteria. Data were extracted regarding study characteristics, functional outcome measures, length of stay, physiotherapy service duration and resolution of conversion symptoms. Methodological quality was assessed using a tool designed for observational studies. Twelve observational studies were included. No functional outcome measures were used to assess the effectiveness of the treatment protocols in the case studies. Resolution of symptoms occurred in all but two cases, with conversion symptoms still present at 11 months and at 2 years. Length of stay varied from 3 days to 16 weeks, with similar variation evident in length of physiotherapy service provision (2.5 weeks to 16 weeks). There was limited and poor quality evidence to establish the efficacy of physiotherapy management of child and adolescent conversion disorders. More rigorous study designs with consistent use of reliable, valid and sensitive functional outcome measures are needed in this area.
Primary health‐care costs associated with special health care needs up to age 7 years: Australian population‐based study
Authors: Quach Jon , Oberklaid Frank , Gold Lisa , Lucas Nina , Mensah Fiona K , Wake Melissa
Published: June 2014

Aim

We studied infants and children with and without special health care needs (SHCN) during the first 8 years of life to compare the (i) types and costs to the government's Medicare system of non‐hospital health‐care services and prescription medication in each year and (ii) cumulative costs according to persistence of SHCN.

Methods

Data from the first two biennial waves of the nationally representative Longitudinal Study of Australian Children, comprising two independent cohorts recruited in 2004, at ages 0–1 (n = 5107) and 4–5 (n = 4983) years. Exposure condition: parent‐reported Children with Special Health Care Needs Screener at both waves, spanning ages 0–7 years. Outcome measure: Federal Government Medicare expenditure, via data linkage to the Medicare database, on non‐hospital health‐care attendances and prescriptions from birth to 8 years.

Results

At both waves and in both cohorts, >92% of children had complete SHCN and Medicare data. The proportion of children with SHCN increased from 6.1% at age 0–1 years to 15.0% at age 6–7 years. Their additional Medicare costs ranged from $491 per child at 6–7 years to $1202 at 0–1 year. This equates to an additional $161.8 million annual cost or 0.8% of federal funding for non‐hospital‐based health care. In both cohorts, costs were highest for children with persistent SHCNs.

Conclusions

SHCNs incur substantial non‐hospital costs to Medicare, and no doubt other sources of care, from early childhood. This suggests that economic evaluations of early prevention and intervention services for SHCNs should consider impacts on not only the child and family but also the health‐care system.
Effects of soyabean meal‐ or whey‐based diets on lipid metabolism in weaned piglets
Authors: Theodorou G. , Papadomichelakis G. , Tsiplakou E. , Lampidonis A. D. , Chadio S. , Zervas G. , Politis I.
Published: June 2014

The present study aimed to test the hypothesis that dietary protein source influences lipid metabolism‐related parameters weaned piglets. The effects of soyabean meal (SB) and whey proteins (WP) on gene expression of several genes involved in the lipogenic process in liver, visceral (VAT) and subcutaneous (SAT) adipose tissues, plasma insulin concentration and fatty acid (FA) profile were investigated in 18 weaned piglets. Weaned piglets were fed one of two diets containing either SB or WP as the main protein source. Following a 10‐h fasting period, plasma insulin concentration and FA profile were assessed at 56 and 72 days of age, whereas gene expression in liver, VAT and SAT was assessed at 72 days of age. Plasma insulin concentration was not affected by diet, although it was 40% lower in SB fed pigs. The SB pigs had lower 14:0 (p < 0.01) and higher 18:3n‐3 (p < 0.001) levels in plasma in comparison with WP pigs. However, these changes were attributed to background differences in the dietary FA profile and not to a direct protein source effect. Gene expression of sterol regulatory element‐binding protein 1 (SREBP‐1) in liver and VAT were lower (p < 0.01 and p < 0.05, respectively) in SB compared to WP fed piglets, but no differences occurred in SAT. No changes were observed in sterol regulatory element‐binding protein 2, liver X receptor, peroxisome proliferator‐activated receptors α and γ and plasminogen activator inhibitor 1 mRNA levels, either in liver or in adipose tissues. In conclusion, dietary protein source, accompanied likely by side alterations in the dietary composition, affects lipid metabolism in pigs through the downregulation of SREBP‐1, which is a crucial determinant of lipogenic process.
Adaptive evolution of α‐amylase genes in wild barley (Hordeum spontaneum) on micro and macro scales
Authors: LIU Ya‐Xi , WANG Ji‐Rui , LIU Ze‐Hou , WANG Yan , CHEN Xing , HENRY Robert J. , WEI Yu‐Ming , NEVO Eviatar , ZHENG You‐Liang
Published: June 2014

Alpha‐amylases play essential roles in germination, and the malting and brewing processes, by hydrolyzing starch granules present in the endosperm of barley. Hordeum spontaneum C. Koch, the progenitor of cultivated barley that harbors rich genetic diversity, was collected from seven different environments. To investigate the influence of microclimatic ecological divergence on α‐amylase, single nucleotide polymorphisms (SNPs) in amy genes from these populations were determined. A total of 16 and 17 SNPs were detected in the coding sequences of amy1 and amy2, respectively, from the seven wild barley populations. Among these SNPs, three in amy1‐2 and nine in amy2‐2 were significantly associated with ecological factors. The genetic divergence of amy sequences was significantly different among the populations. Natural microclimatic selection was apparently the major evolutionary driving force causing interslope divergence and adaptive evolution of these genes. The genetic variation in amy1‐2 and amy2‐2 was at least partly ecologically determined in these populations, representing adaptive patterns generated by natural selection. The SNPs were apparently generated by natural selection in climatic environmental patterns at both the micro (“Evolution Canyon”) and macro (across Israel, Galilee, and Negev) scales.
Help from the dead: facilitation during succession can start when neighbours die
Authors: Wilson Scott D.
Published: June 2014

Resco de Dios et al. (2014, this issue) show a shift from negative to positive effects on woody seedlings when grass neighbours died in the second half of a 4‐yr study. Further experiments are needed to unambiguously assign the effects to living and dead neighbours, but the study raises intriguing possibilities, and yet another link between ecosystem‐level ecology and population biology.
Natural loss‐of‐function mutation of EDR1 conferring resistance to tomato powdery mildew in Arabidopsis thaliana accession C24
Authors: Gao Dongli , Appiano Michela , Huibers Robin P. , Loonen Annelies E. H. M. , Visser Richard G. F. , Wolters Anne‐Marie A. , Bai Yuling
Published: June 2014

To screen for potentially novel types of resistance to tomato powdery mildew Oidium neolycopersici, a disease assay was performed on 123 Arabidopsis thaliana accessions. Forty accessions were fully resistant, and one, C24, was analysed in detail. By quantitative trait locus (QTL) analysis of an F2 population derived from C24 × Sha (susceptible accession), two QTLs associated with resistance were identified in C24. Fine mapping of QTL‐1 on chromosome 1 delimited the region to an interval of 58 kb encompassing 15 candidate genes. One of these was Enhanced Disease Resistance 1 (EDR1). Evaluation of the previously obtained edr1 mutant of Arabidopsis accession Col‐0, which was identified because of its resistance to powdery mildew Golovinomyces cichoracearum, showed that it also displayed resistance to O. neolycopersici. Sequencing of EDR1 in our C24 germplasm (referred to as C24‐W) revealed two missing nucleotides in the second exon of EDR1 resulting in a premature stop codon. Remarkably, C24 obtained from other laboratories does not contain the EDR1 mutation. To verify the identity of C24‐W, a DNA region containing a single nucleotide polymorphism (SNP) unique to C24 was sequenced showing that C24‐W contains the C24‐specific nucleotide. C24‐W showed enhanced resistance to O. neolycopersici compared with C24 not containing the edr1 mutation. Furthermore, C24‐W displayed a dwarf phenotype, which was not associated with the mutation in EDR1 and was not caused by the differential accumulation of pathogenesis‐related genes. In conclusion, we identified a natural edr1 mutant in the background of C24.
Involvement of YODA and mitogen activated protein kinase 6 in Arabidopsis post‐embryogenic root development through auxin up‐regulation and cell division plane orientation
Authors: Smékalová Veronika , Luptovčiak Ivan , Komis George , Šamajová Olga , Ovečka Miroslav , Doskočilová Anna , Takáč Tomáš , Vadovič Pavol , Novák Ondřej , Pechan Tibor , Ziemann Anja , Košútová Petra , Šamaj Jozef
Published: June 2014

The role of YODA MITOGEN ACTIVATED PROTEIN KINASE KINASE KINASE 4 (MAPKKK4) upstream of MITOGEN ACTIVATED PROTEIN KINASE 6 (MPK6) was studied during post‐embryonic root development of Arabidopsis thaliana. Loss‐ and gain‐of‐function mutants of YODA (yda1 and ΔNyda1) were characterized in terms of root patterning, endogenous auxin content and global proteomes.

We surveyed morphological and cellular phenotypes of yda1 and ΔNyda1 mutants suggesting possible involvement of auxin. Endogenous indole‐3‐acetic acid (IAA) levels were up‐regulated in both mutants. Proteomic analysis revealed up‐regulation of auxin biosynthetic enzymes tryptophan synthase and nitrilases in these mutants. The expression, abundance and phosphorylation of MPK3, MPK6 and MICROTUBULE ASSOCIATED PROTEIN 65‐1 (MAP65‐1) were characterized by quantitative polymerase chain reaction (PCR) and western blot analyses and interactions between MAP65‐1, microtubules and MPK6 were resolved by quantitative co‐localization studies and co‐immunoprecipitations.

yda1 and ΔNyda1 mutants showed disoriented cell divisions in primary and lateral roots, abortive cytokinesis, and differential subcellular localization of MPK6 and MAP65‐1. They also showed deregulated expression of TANGLED1 (TAN1), PHRAGMOPLAST ORIENTING KINESIN 1 (POK1), and GAMMA TUBULIN COMPLEX PROTEIN 4 (GCP4).

The findings that MPK6 localized to preprophase bands (PPBs) and phragmoplasts while the mpk6‐4 mutant transformed with MPK6AEF (alanine (A)–glutamic acid (E)–phenylanine (F)) showed a root phenotype similar to that of yda1 demonstrated that MPK6 is an important player downstream of YODA. These data indicate that YODA and MPK6 are involved in post‐embryonic root development through an auxin‐dependent mechanism regulating cell division and mitotic microtubule (PPB and phragmoplast) organization.
Eckols reduce dental pulp inflammation through the ERK1/2 pathway independent of COX‐2 inhibition
Authors: Paudel U , Lee Y‐H , Kwon T‐H , Park N‐H , Yun B‐S , Hwang P‐H , Yi H‐K
Published: June 2014

Objectives

The aim of this study was to elucidate the role of 6‐6 bieckol (EB1) and pholorofucofuroeckol‐A (EB5) from brown seaweed marine algae (Eisenia bicyclis) on lipopolysaccharide (LPS)‐induced inflammation in human dental pulp cells (HDPCs).

Methods

The cytotoxicity of EB1 and EB5 was examined by MTT assay on LPS‐induced human dental pulp cells. Their role on expression of inflammatory, odontogenic, and osteogenic molecules was determined by Western blot analysis. The dentin mineralization was checked by alkaline phosphatase activity.

Results

The five compounds from E. bicyclis have different structure with non‐cytotoxic in HDPCs. EB1 and EB5 showed anti‐inflammatory properties and inhibited phosphorylated‐extracellular signal‐regulated kinase (p‐ERK1/2) and phosphorylated‐c‐jun N‐terminal kinases (p‐JNK) without any cytotoxicity. In particular, EB1 inhibited cyclooxygenase‐2 (COX‐2) and p‐ERK1/2 signaling, and EB5 inhibited only p‐ERK1/2 signaling but not COX‐2. Both compounds inhibited nuclear factor kappa‐B (NF‐κB) translocation. Furthermore, EB1 and EB5 increased dentinogenic and osteogenic molecules, and dentin mineralized via alkaline phosphatase activity (ALP) in LPS‐induced HDPCs.

Conclusions

This study elucidates that EB1 and EB5 have different types of anti‐inflammatory property and help in dentin formation. Therefore, these compounds derived from marine algae of E. bicyclis may be used as selective therapeutic strategies for pulpitis and oral diseases.
Common Use of Prescription Off‐Label Acne Therapy in Children Younger Than 12 Years Old
Authors: Parikh Sonal A. , Davis Scott A. , Krowchuk Daniel P. , Feldman Steven R.
Published: June 2014

Acne is occurring more frequently in younger age groups, but most available treatments are considered off‐label in young children. As the epidemiology of acne has changed to include younger children over the past 20 years, neither regulators, pharmaceutical companies, nor clinicians have understood the need or value of obtaining regulatory sanctions for problems physicians have managed using clinical judgment. The objective of this study was to analyze the frequency of off‐label acne treatment according to age and other demographic factors. We searched the National Ambulatory Medical Care Survey from 1993 to 2010 for visits in children younger than 12 years of age for the diagnosis of International Classification of Diseases, Ninth Revision, code 706.1. We tabulated leading acne treatments and assessed factors associated with off‐label prescribing. Off‐label but appropriate acne treatments were used in 29% of acne visits for children younger than 12 years of age. Dermatologists were more likely than pediatricians to prescribe off‐label treatment (p < 0.001). The most frequently used off‐label treatments were topical retinoids, followed by oral antibiotics. There was no significant trend in the rate of off‐label prescribing over time (p = 0.40). Off‐label treatment is well within the standard of care for young children with acne. More data on the use of topical retinoids in young children will improve our understanding of their use, which may help optimize treatment outcomes for children with acne.
Fluorescence In Situ Hybridization Analysis of Atypical Melanocytic Proliferations and Melanoma in Young Patients
Authors: DeMarchis Emilia H. , Swetter Susan M. , Jennings Charay D. , Kim Jinah
Published: June 2014

Morphologic heterogeneity among melanocytic proliferations is a common challenge in the diagnosis of melanoma. In particular, atypical melanocytic lesions in children, adolescents, and young adults may be difficult to classify because of significant morphologic overlap with melanoma. Recently a four‐probe fluorescence in situ hybridization (FISH) protocol to detect chromosomal abnormalities in chromosomes 6 and 11 has shown promise for improving the classification of melanocytic lesions. We sought to determine the correlation between FISH results, morphology, and clinical outcomes in a series of challenging melanocytic proliferations in young patients. We retrospectively performed the standard four‐probe FISH analysis on 21 melanocytic neoplasms from 21 patients younger than 25 years of age (range 5–25 years, mean 14.6 years) from Stanford University Medical Center who were prospectively followed for a median of 51 months (range 1–136 months). The study cohort included patients with 5 confirmed melanomas, 2 melanocytic tumors of uncertain malignant potential (MelTUMPs), 10 morphologically challenging atypical Spitz tumors (ASTs), and 4 typical Spitz nevi. FISH detected chromosomal aberrations in all five melanomas and in one MelTUMP, in which the patient developed subsequent lymph node and distant metastasis. All 10 ASTs, 4 Spitz nevi, and 1 of 2 MelTUMPs were negative for significant gains or losses in chromosomes 6 and 11q. Our findings demonstrated a strong correlation between positive FISH results and the histomorphologic impression of melanoma. This finding was also true for the MelTUMP with poor clinical outcome. Therefore FISH may serve as a helpful adjunct in the classification of controversial melanocytic tumors in young patients.
Sensation seeking and error processing
Authors: Zheng Ya , Sheng Wenbin , Xu Jing , Zhang Yuanyuan
Published: June 2014

Sensation seeking is defined by a strong need for varied, novel, complex, and intense stimulation, and a willingness to take risks for such experience. Several theories propose that the insensitivity to negative consequences incurred by risks is one of the hallmarks of sensation‐seeking behaviors. In this study, we investigated the time course of error processing in sensation seeking by recording event‐related potentials (ERPs) while high and low sensation seekers performed an Eriksen flanker task. Whereas there were no group differences in ERPs to correct trials, sensation seeking was associated with a blunted error‐related negativity (ERN), which was female‐specific. Further, different subdimensions of sensation seeking were related to ERN amplitude differently. These findings indicate that the relationship between sensation seeking and error processing is sex‐specific.
A tale of two mechanisms: A meta‐analytic approach toward understanding the autonomic basis of cardiovascular reactivity to acute psychological stress
Authors: Brindle Ryan C. , Ginty Annie T. , Phillips Anna C. , Carroll Douglas
Published: June 2014

A series of meta‐analyses was undertaken to determine the contributions of sympathetic and parasympathetic activation to cardiovascular stress reactivity. A literature search yielded 186 studies of sufficient quality that measured indices of sympathetic (n = 113) and/or parasympathetic activity (n = 73). A range of psychological stressors perturbed blood pressure and heart rate. There were comparable aggregate effects for sympathetic activation, as indexed by increased plasma epinephrine and norepinephrine, and shortened pre‐ejection period and parasympathetic deactivation, as indexed by heart rate variability measures. Effect sizes varied with stress task, sex, and age. In contrast to alpha‐adrenergic blockade, beta‐blockade attenuated cardiovascular reactivity. Cardiovascular reactivity to acute psychological stress would appear to reflect both beta‐adrenergic activation and vagal withdrawal to a largely equal extent.
Partial Understanding and Concept Possession: A Dilemma
Authors: Verdejo Víctor M. , de Donato Rodríguez Xavier
Published: June 2014

In the light of partial (mis)understanding, we examine the thesis that concepts are individuated in terms of possession conditions and show that adherents face a fatal dilemma: Either concept‐individuating possession conditions include cases of partially (mis)understood concepts or not. If yes, possession conditions do not individuate concepts. If no, the thesis is too restricted and lacks a minimally satisfactory level of generalization.
Commanding Belief
Authors: Goldschmidt Tyron
Published: June 2014

This essay shows three things: first, that we cannot comply with a command from God to believe in God; second, that God cannot command us to believe in God; and, third, that the divine command theory is false. The third conclusion follows from the second, and the second follows from the first. The essay focuses on an argument from the medieval Jewish philosopher, Hasdai Crescas. It also draws from, and is something of a sequel to, an argument from Brown and Nagasawa published previously in this journal.