bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Nanoparticulate CpG Immunotherapy with and without Allergens in Rao‐Affected Horses
Authors: Klier J. , Geis S. , Steuer J. , Reese S. , Fuchs S. , Mueller R.S. , Winter G. , Gehlen H.
Published: September 2015

Reasons for performing study

New therapeutic strategies to modulate immune responses in human and equine allergic airway diseases are under extensive investigation. Stimulation of Treg cells with immune modulating agents is a novel therapeutic option.

Objectives

The aim of this field study was to compare the effects of a nebulised nanoparticulate CpG immunotherapy (CpG‐GNP) with and without specific allergens.

Study design

Longitudinal clinical study comparing 2 therapeutic options.

Methods

Twenty RAO‐affected horses were divided into 2 treatment groups (CpG alone and CpG with allergens). Two specific allergens were selected for each horse according to anamnesis and a functional in vitro test. Treatments were given by nebulisation 7 times and the horses were examined 3 times: baseline (I), after the treatment course (II), and after 6 weeks later (III). Clinical parameters, indirect intrapleural measurement, arterial blood gas, amount of tracheal mucus and neutrophil percentage were evaluated.

Results

CpG alone resulted in a significant improvement in clinical parameters and a significant reduction of tracheal mucus after treatment and at 6 weeks post treatment. After CpG plus specific allergens, there was significant improvement of 70% of examined parameters. However, there were no significant differences in the results compared with CpG‐GNP treatment alone.

Conclusions

There were no significant differences between treatment groups. CpG‐GNP immunotherapy alone produced a potent and persistent effect on allergic and inflammatory parameters and may have potential as for treatment of equine and human allergic inflammatory airway diseases.

Ethical animal research: The study was approved by the regional legal agency for animal experiments of the Government of Bavaria, Germany (No. 55.2‐1‐54‐2531‐31‐10). Owners gave informed consent for their horses' inclusion in the study. Sources of funding: Partly supported by the Deutsche Forschungsgemeinschaft (DFG) (Germany) (GE'2044/4‐1). The AeroNeb Go™ vibrating mesh nebuliser (Aerogen, Galway, Ireland) was sponsored by Inspiration Medical (Bochum, Germany). Competing interests: None declared.
Do Balf Cytokine Profiles Vary Depending on the Sampled Lung in Horses with Unilateral IAD‐Consistent Cytology?
Authors: Hue E. , Orard M. , Depecker M. , Couroucé‐Malblanc A. , Paillot R. , Pronost S. , Richard E.A.
Published: September 2015

Reasons for performing study

Little data on BALF cytokine profiles are available from racehorses with IAD; cytological diagnosis being most frequently made from one lung only per horse.

Objectives

To compare cytokine mRNA expressions and protein concentrations in BALF from both lungs of horses with unilateral IAD‐consistent cytology.

Study design

Cross‐sectional study.

Methods

As part of a larger study, 250 ml saline was randomly instilled in one lung and 500 ml in the contralateral lung of 30 clinically healthy Standardbred racehorses. This procedure was repeated 72 h later, inversing the volume per lung. Cytological cut‐off values for IAD diagnosis was neutrophil proportions >10% when instilling 250 ml. For these samples, mRNA expression and concentrations of IL‐1β, IL‐4, IL‐8, IL‐10, IL‐17, TNF‐α and IFN‐γ were determined by RT‐qPCR and ELISA.

Results

Eleven horses had BALF with IAD‐ and CTL‐consistent cytology from, respectively, each lung, and were enrolled in the study (22 samples). Data were not significantly influenced by the sampling day, and BALF total cell counts or cytokine concentrations were not significantly different among lungs. Relative mRNA expression of IL‐1β (3.887 ± 3.082; P = 0.01) and IL‐10 (3.225 ± 1.710; P = 0.005) were significantly higher in BALF of IAD‐ compared to CTL consistent lungs (respectively 1.408 ± 1.118 and 1.488 ± 1.393); and also correlated to neutrophil proportions (respectively r = 0.54; P = 0.01 and r = 0.65; P = 0.001).

Conclusions

Differences in cytokine mRNA expression were associated with IAD‐ or CTL consistent BALF cytology in the same racehorses in training. These findings suggest that specific local immune reactions or regulation within the lower airways should be considered in IAD.

Ethical animal research: The study was approved by the Regional Animal Ethic Committee, and informed consent was provided by all horse owners. Sources of funding: LABÉO, CISCO‐Oniris and AVEF (French Association of Equine Practitioners). Competing interests: None declared.
Retrospective Observational Study on the Outcome of Medical Treatment of Atrial Fibrillation
Authors: Lotstra R.J. , van den Broek J. , Power T. , Marr C.M. , Wijnberg I.D.
Published: September 2015

Reasons for performing study

Atrial fibrillation is a common equine arrhythmia. Quinidine alone, or with digoxin are common treatments. Studies on outcome in Warmblood populations in which duration of the AF is often unknown are limited.

Objectives

To identify the factors that are associated with the success of full treatment cardioversion with oral medication, and establish whether there are differences in these factors between institutions.

Study design

Retrospective case series using patient records of Equine University Clinic of Utrecht University and Rossdales Equine Hospital, Newmarket.

Methods

Forty‐nine horses treated with quinidine were identified (29 Warmbloods, 20 Thorougbreds, 1 Anglo‐Arabian). Details of signalment, history, duration physical examination and echocardiography including left atrial size and presence of mitral regurgitation were retrieved. Clinical details including mean weight, age and left atrial size were compared between clinics using independent samples t test. Association between variables and cardioconversion were evaluated in a backwards logistic regression using Akaike's information criterium (AIC) and odds ratios were calculated. Factors were sex, clinic, breed, mitral regurgitation, duration and poor performance. Covariates were age, weight and the size of the left atrium. Significance was set at 0.05.

Results

Fifty‐one horses (mean age 8.8 s.d. 4.5 years) were treated with quinidine sulfate, 18 also received digoxin. Eighty per cent converted to sinus rhythm. In 8 horses the known duration was less than 3 months. The only factor associated with successful treatment was the use of digoxin in combination with quinidine sulfate (odds ratio 12.4; 95% CI 2.61 and 91.85 according to AIC analysis).

Conclusions

In this retrospective case series, there is much potential for bias in the data; however, the use of digoxin in addition to quinidine was associated with improved conversion rates regardless of breed even though AF duration was unknown in most horses.

Ethical animal research: Research ethics committee oversight not currently required by this conference: retrospective study of clinical records. Explicit owner informed consent for inclusion of animals in this study was not stated. Source of funding: None. Competing interests: None declared.
Impact of Age at First Immunisation on Equine Influenza Short and Mid‐Term Protective Antibody Levels in Thoroughbred Foals
Authors: Fougerolle S. , Legrand L. , Foursin M. , D'Ablon X. , Bayssat P. , Pronost S. , Paillot R.
Published: September 2015

Reasons for performing study

Every year, several equine influenza (EI) epidemics are reported worldwide. Equine influenza vaccination is the most efficient method of prevention; however, not all horses develop sufficient immunity after EI immunisation, increasing the risk of infection, infectious virus excretion and the spread of the disease.

Objectives

This study aimed to better understand poor vaccine response mechanisms during the primary EI vaccination.

Study design

Cohort study.

Methods

The EI humoral immune response was measured in 118 Thoroughbred foals set in 3 different stud farms (SF#1 to SF#3) after the primary course of EI vaccination. All foals were immunised with a recombinant canarypox‐based EI vaccine, following the vaccine manufacturer's recommendations. The age at first vaccination was 4 to 8 months. Sera were tested by single radial haemolysis (SRH) against the A/equine/Jouars/4/2006 EIV strain (Florida clade 2) at the time of the first vaccination (V1), 2 weeks and 3 months after the second immunisation (V2), 2 days and 3 months after the third immunisation (V3).

Results

Short (V2 + 2 weeks) and mid‐term (V3 + 3 months) SRH antibody levels were statistically different between the stud farms (P‐value = 0.0011 and 0.003, respectively), with SF#1<SF#3<SF#2 and SF#1 SRH antibody titres below the protection threshold (i.e. 85 mm2) at all time points studied. SRH antibody levels induced by EI vaccination were related to the age of foals at the first immunisation (SF#1 median age 143 days, SF#2 median age 181 days and SF#3 median age 156 days), but were independent of the presence of maternal derived antibodies (MDA; P‐value 0.41). Given the results in SF#1, a booster immunisation (V4) was brought forward to restore protective levels of antibody.

Conclusion

Independently of the presence of MDA, the age of foals at first immunisation plays an important role in the establishment of adequate antibody levels.

Ethical animal research: All animal work received ethical approval, and consent was obtained from the owners. Sources of funding: This study was supported by the Basse‐Normandie Region council (France) and the European Regional Development Fund. Competing interests: None declared.
Colic: Horse Owner Knowledge and Experience
Authors: Bowden A. , Brennan M.L. , England G.C.W. , Burford J.H. , Freeman S.L.
Published: September 2015

Reasons for performing study

Colic is the most common equine emergency problem, and one of the main causes of equid deaths. The horse owners' ability to recognise colic is a critical first step in determining case outcome.

Objectives

To assess equine owners' knowledge and recognition of colic.

Study design

Online questionnaire of horse owners.

Methods

An online survey was designed to evaluate owners' approach to colic in the horse. The survey included questions on owner demographics, their recognition of colic (including owner's opinions of their ability to recognise colic, their approach, and their recognition of colic using case vignettes), and their knowledge of normal ranges for clinical parameters. Descriptive and chi squared statistical analysis was performed.

Results

The survey was completed by 1061 UK respondents. Six per cent of owners thought they could recognise all types of colic, 61% said they could recognise most cases and 30% said they could recognise some but not all cases. Owners said they would assess faecal output (73% of respondents), gastrointestinal sounds (69%), respiratory rate (62%) and heart rate (50%) in horses with suspected colic. One fifth (22%) of owners would call a vet immediately without assessing any parameters. Many respondents either did not know, or provided incorrect estimates of normal values for clinical parameters: 30.4% were ‘unsure’ of the normal heart rate and 35.5% gave heart rate values which were outside reference ranges; only 24.5% gave appropriate values for normal respiratory rates and only 31% gave normal temperature values. There was no statistical significance between participants' age, educational qualifications, or their experience with horses and their knowledge of normal clinical parameters.

Conclusions

Owners varied in their approach and ability to recognise colic, and many had significant gaps in their knowledge of normal parameters. Educational materials and/or training to assist owners could help address these issues.

Ethical animal research: The study did not involve animal research. The study was reviewed and approved by the Ethics Committee, School of Veterinary Medicine and Science, University of Nottingham. The questionnaire was conducted in accordance with the 1998 Data Protection Act, and the British Educational Research Association's Revised Ethical Guidelines for Educational Research (2004). Source of funding: Adelle Bowden's studentship is funded by the School of Veterinary Medicine and Science, University of Nottingham. Competing interests: None declared.
Investigating the Normal Management Regimens of Working Equids and Identifying Barriers to the Recognition and Treatment of Colic by Owners in Morocco
Authors: Kalamanova A. , Stringer A.P. , Freeman S.L. , Burford J.H.
Published: September 2015

Reasons for performing study

Colic is a common reason for owners to seek veterinary treatment for their working equids in Morocco. There is no information available regarding cultural, religious or educational barriers to obtaining treatment or about the typical workload of these animals which may predispose them to colic.

Objectives

To characterise the typical workload and feeding regimens of working equids in Morocco; to characterise the ability of owners to recognise the clinical signs and causes of colic; and to identify specific barriers to the veterinary treatment of colic.

Study design

Questionnaire‐based survey.

Methods

A standardised, structured questionnaire was administered, with the assistance of an Arabic speaking interpreter, to the owners of working equids presenting their animals to 2 centres run by SPANA (The Society for the Protection of Animals Abroad). Participation was voluntary and informed consent was obtained prior to the interview.

Results

All of the 102 participants that completed questionnaire were male. Ninety‐eight owners used their animals for pulling carts, with 12% of animals working 7 days per week. 14% of animals were offered water by their owner once per day and 2% every other day. 25% of animals were loose and allowed free to feed unsupervised when not working. 29% of owners were not able to name any cause of colic and 25% did not recognise any clinical signs; only 12% associated colic with gastrointestinal pain. 83% of owners would not seek veterinary treatment due to financial constraints if free treatment at SPANA centres were not available.

Conclusions

Colic remains a common problem amongst working equids in Morocco. Improved knowledge of management factors associated with colic and how to recognise abdominal pain may reduce the incidence of colic and improve prognosis. The findings presented can be used to inform and develop owner education programmes.

Ethical animal research: The study was reviewed and approved by the Ethics Committee, School of Veterinary Medicine and Science, University of Nottingham. Informed consent for participation in the study was obtained from all owners and was delivered in the native language. No details identifying the owner were recorded. Source of funding: None. Competing interests: None declared.
Functional conformer of c‐Myb DNA‐binding domain revealed by variable temperature studies
Authors: Inaba Satomi , Maeno Akihiro , Sakurai Kazumasa , Narayanan Sunilkumar Puthenpurackal , Ikegami Takahisa , Akasaka Kazuyuki , Oda Masayuki
Published: September 2015

The conformational fluctuation in the minimum DNA‐binding domain of c‐Myb, repeats 2 and 3 (R2R3), was studied under closely physiological conditions. A global unfolding transition, involving both the main chain and the side chains, was found to take place at the approximate temperature range 30–70 °C, with a transition temperature of approximately 50 °C. In addition, the observation of simultaneous shift change and broadening of NMR signals in both 1H one‐dimensional and 15N/1H two‐dimensional NMR spectra indicated the occurrence of locally fluctuating state at physiological temperature. In the wild‐type protein containing a cavity in R2, the local fluctuation of R2 is more prominent than that of R3, whereas it is suppressed in the cavity‐filled mutant, V103L. This indicates that the cavity in R2 contributes significantly to the conformational instability and the transition into the locally fluctuating state. For the wild‐type R2R3 protein, the more dynamic conformer is estimated to be present to some extent at 37 °C and is likely beneficial for its biological function: DNA‐binding. This result is in agreement with the concept of an excited‐state conformer that exists in equilibrium with the dominant ground‐state conformer and acts as the functional conformer of the protein. From the findings of the present study, it appears that the tandem repeats of two small domains with no disulfide bonds and with a destabilizing cavity function as the evolutionary strategy of the wide‐type c‐Myb DNA‐binding domain to produce an appropriate fraction of the locally fluctuating state at 37 °C, which is more amenable to DNA‐binding.

Database

Chemical shifts and peak lists have been deposited in the Biological Magnetic Resonance Bank under entries 11584 and 11585.
Assessing the general patterns of forest structure: quantifying tree and forest allometric scaling relationships in theUnitedStates
Authors: Duncanson Laura I. , Dubayah Ralph O. , Enquist Brian J.
Published: September 2015

Aim

Understanding the drivers of forest structure, function and change is a fundamental problem in both theoretical ecology and applied forestry for carbon mapping and monitoring. An important component of forest ecology research often utilizes allometric equations to scale up local measurements to predict large‐scale forest and ecosystem‐level properties. However, both applied and theoretical allometries in forest ecology (such as metabolic scaling theory,MST) assume that many scaling relationships are insensitive to broad‐scale climate gradients or species life histories. We aim to test these assumptions by mapping continental‐scale forest allometry across environmental gradients in theUnitedStates.

Location

UnitedStates.

Methods

We fit exponents to two allometric relationships inc. 100,000ForestInventoryAnalysis (FIA) field plots: (1) the relationship between the height of an individual tree and its diameter, and (2) plot‐level tree size distributions. We compare fitted exponents to environmental and life‐history variables, such as climate, topography and forest structure, in an attempt to explain allometric variability and deviations from theoretically predicted allometries.

Results

We find that the structural allometry of forests varies strongly as a function of location in theUnitedStates. Allometric exponents appear to asymptote at approximately whereMSTtheory predicts with increasing forest height, while deviations fromMSTare partially explained as a function of environmentally driven recruitment limitations and successional status.

Main conclusions

While we find support for invariant tree and stand allometric scaling relationships in forests that are in steady state with regard to demography and resources, we also find considerable spatial variability in forest allometric relationships when steady‐state conditions are violated. These findings suggest that extensions of metabolic scaling theory should incorporate variation in demographic dynamics in younger successional forests, and factors influencing recruitment limitation.
Baton pass hypothesis: successive incorporation of unconserved endogenous retroviral genes for placentation during mammalian evolution
Authors: Imakawa Kazuhiko , Nakagawa So , Miyazawa Takayuki
Published: September 2015

It is well accepted that numerous RNAs derived from endogenous retroviruses (ERVs) are expressed in mammalian reproductive structures, particularly in the uterus, trophoblast, and placenta. Syncytin 1 and syncytin 2 in humans and syncytin A and syncytin B in mice are membrane proteins originating from Env genes of ERVs. These ERVs are involved in the fusion of trophoblast cells, resulting in multinucleated syncytiotrophoblast formation. Evidence accumulated indicates that syncytin‐like fusogenic proteins are expressed in the placenta of rabbits, dogs/cats, ruminant ungulates, tenrecs, and opossums. The syncytin genes so far characterized are known to be endogenized to the host genome only within the past 12–80 million years, more recently than the appearance of mammalian placentas, estimated to be 160–180 million years ago. We speculate that ERVs including syncytin‐like gene variants integrated into mammalian genomes in a locus‐specific manner have replaced the genes previously responsible for cell fusion. We therefore propose the ‘baton pass’ hypothesis, in which multiple successive ERV variants ‘take over’ cell‐fusion roles, resulting in increased trophoblast cell fusion, morphological variations in placental structures, and enhanced reproductive success in placental mammals.
Patient and family involvement in adult critical and intensive care settings: a scoping review
Authors: Olding Michelle , McMillan Sarah E. , Reeves Scott , Schmitt Madeline H. , Puntillo Kathleen , Kitto Simon
Published: September 2015

Background

Despite international bodies calling for increased patient and family involvement, these concepts remain poorly defined within literature on critical and intensive care settings.

Objective

This scoping review investigates the extent and range of literature on patient and family involvement in critical and intensive care settings. Methodological and empirical gaps are identified, and a future agenda for research into optimizing patient and family involvement is outlined.

Methods

Searches of MEDLINE, CINAHL, Social Work Abstracts and PsycINFO were conducted. English‐language articles published between 2003 and 2014 were retrieved. Articles were included if the studies were undertaken in an intensive care or critical care setting, addressed the topic of patient and family involvement, included a sample of adult critical care patients, their families and/or critical care providers. Two reviewers extracted and charted data and analysed findings using qualitative content analysis.

Findings

A total of 892 articles were screened, 124 were eligible for analysis, including 61 quantitative, 61 qualitative and 2 mixed‐methods studies. There was a significant gap in research on patient involvement in the intensive care unit. The analysis identified five different components of family and patient involvement: (i) presence, (ii) having needs met/being supported, (iii) communication, (iv) decision making and (v) contributing to care.

Conclusion

Three research gaps were identified that require addressing: (i) the scope, extent and nature of patient involvement in intensive care settings; (ii) the broader socio‐cultural processes that shape patient and family involvement; and (iii) the bidirectional implications between patient/family involvement and interprofessional teamwork.
HPV load and anal cytological abnormalities
Authors: Maia LB , Marinho LC , Carneiro MV , Bocca AL , Neto FFC , Motoyama AB , Muniz Junqueira MI , Ferreira VMM , Carneiro FP , de Oliveira PG
Published: September 2015

Objectives

The objective of this study was to evaluate the association between estimated human papillomavirus (HPV) viral load and abnormal cytology on anal samples.

Methods

Anal cytological samples of 42 HIV‐positive patients were analysed by conventional cytology and Hybrid Capture II.

Results

On cytology, 30.95% (13 of 42) anal samples were positive for cytological abnormalities, 47.61% (20 of 42) were negative and 21.42% (nine of 42) were unsatisfactory. High‐risk HPV infection was more frequent in anal samples with cytological abnormalities than in negative samples (P = 0.0002, Fisher's exact test), it was detected in all samples with cytological abnormalities and in 35% (seven of 20) of the negative samples. On samples with cytological abnormalities, the median of the relative light unit/cutoff (RLU/CO) value (viral load estimate) was 10.39 (1.02–572.6) and in negative samples it was 0.51 (0.26–51.70). The median of the RLU/CO value was higher in samples with cytological abnormalities when compared with the median in negative samples (P = 0.0001, Mann–Whitney U‐test) and only samples with cytological abnormalities showed RLU/CO values > 100.

Conclusions

The estimated high‐risk HPV viral load is significantly higher in samples with cytological abnormalities than in negative anal samples and may be useful as an adjunct to anal cytology for triage of patients to high‐resolution anoscopy and biopsy.
Using non‐linear mixed effects models to identify patterns of chick growth in House SparrowsPasser domesticus
Authors: Aldredge Robert A.
Published: September 2015

For many animals, adult size is an important determinant of fitness. Thus, after a period of food restriction, offspring often grow quickly to approach an optimal size. Offspring can approach an optimal size by increasing mass faster than the peak growth of offspring that do not delay development (compensatory growth) or by extending the period of rapid growth to reach an optimal size (catch‐up growth). Unfortunately, the most common statistical techniques make it difficult to differentiate alternative growth patterns among developing offspring. Here, I show how random effect estimates can be used to uncover important variation in growth in a short‐lived passerine, the House SparrowPasser domesticus. Specifically, I show that much of the variation in offspring growth can be explained by differences in the timing of peak growth and in final adult size, both within a single population and within treatments of an experimental manipulation. These results suggest that much of the variation in offspring growth may be explained by factors other than growth rate. I also show that offspring that delay development either maintain slow but steady growth across development and reach a small adult size, or extend the period of rapid growth to reach an optimal size, indicative of catch‐up growth. This pattern of extending the period of rapid growth may allow offspring to minimize the cellular damage caused by compensatory growth but still maximize size‐related fitness benefits (e.g. increased survival and fecundity) prior to fledging.
Land use change and pollinator extinction debt in exurban landscapes
Authors: Cusser Sarah , Neff John L. , Jha Shalene
Published: September 2015

For the first time in more than a century, people across the planet are migrating en mass from cities to rural areas. In this process of ‘exurbanisation’ humans are rapidly converting natural and agricultural regions into low‐density housing. Despite the scale of this exurban development and its potential negative impact on biodiversity, little is known about how this specific type of land conversion impacts wild pollinators.

In this study, we conduct an extensive survey of the wild pollinators of the peach agroecosystem and investigate the impact of current and historic land use at multiple spatial scales on pollinator community composition within agroecological landscapes that have recently undergone exurban development.

We reveal that the overall composition of the wild pollinator community is significantly associated with current local agricultural and natural land cover. Specifically, local agricultural land use was associated with ground‐nesting bee community composition, whereas natural lands were associated with cavity‐nesting bee composition, revealing that nesting materials drive community composition for these two groups in exurban habitats.

In contrast, community composition for butterflies and flies, which made up the smallest proportion of our communities, were not strongly associated with any particular land use type, likely due to their non‐central place foraging strategy.

Most interestingly, our results indicate that historic land use remains a significant factor impacting the current abundance of all pollinators in the peach agroecosystem, offering the first evidence of extinction debt in this rapidly expanding exurban landscape.
Sourdough reduces sodium in wheat flour doughs
Authors: Nogueira Amanda de C. , Kussano Julia T. , Steel Caroline J.
Published: September 2015

The reduction of sodium in breads is already an imposed reality, which makes the search for alternatives essential. As sodium chloride has an effect on dough rheology, affecting the production process, it is important to evaluate these properties. This study evaluated the use of dry sourdough for the reduction of sodium in wheat flour dough. Sodium chloride (0–2.5 g/100 g) and dry sourdough (0–10 g/100 g) were added to wheat flour according to a central composite rotatable design, and farinograph, extensograph and pasting parameters were evaluated. The results were analysed using the response surface methodology. The farinograph and extensograph properties were strongly affected by both variables and presented opposite behaviours for most parameters. For pasting properties, only maximum viscosity and breakdown were affected. Despite the antagonistic behaviour of the variables when analysed separately, suitable parameters were reached in intermediate ranges for the manufacture of bakery products with reduced sodium content.
EFFECT OF ANO‐RECEPTIVE HOMOSEXUAL PRACTICE ON T LYMPHOCYTES AND DELAYED HYPERSENSITIVITY IN TRANSSEXUALS
Authors: RATNAM K. V. , WONG T. W. , LEE J. , KAMARRUDIN A. , SNG E. H. , ONG Y. W.
Published: September 2015

To determine whether ano‐receptive sexual intercourse adversely affects a person's cellular immunity, we compared several immunological parameters among 100 transsexual male prostitutes and 40 heterosexual male controls, and also among different durations of prostitution.

The mean ratios of CD‐4 (helper/inducer) lymphocytes to CD‐8 (suppressor/cytotoxic) lymphocytes and the delayed‐type cutaneous hypersensitivity (DTH) scores were significantly lower in transsexuals than they were in heterosexual controls; these parameters also showed a decreasing trend with increasing duration of prostitution. Transsexuals have a significantly higher CD‐8 lymphocyte count than have heterosexuals. No significant differences between transsexuals and heterosexuals were found for lymphocyte counts, pan T cells, and CD‐4 cell counts. We postulate that in these subjects cellular immunity is progressively reduced, probably through repeated and prolonged antigenic challenge via receptive anal intercourse. The impairment in cellular immunity is associated with the duration of prostitution, independent of the man's age.
SEROLOGICAL INVESTIGATIONS IN THE DIAGNOSIS AND MANAGEMENT OF INFECTIVE ENDOCARDITIS
Authors: ROBERTS‐THOMSON P. J. , KOH L. Y. , KENNEDY A. , SMITH M. D. , NEOH S. , TURNIDGE J.
Published: September 2015

In a retrospective study of 39 patients with infective endocarditis (IE) all had elevated concentrations of C reactive protein (CRP) at presentation, patients with the acute variety having significantly higher values than patients with the subacute variety. In addition, the majority of patients with subacute bacterial endocarditis had elevated concentrations of circulating immune complexes (CICs) and rheumatoid factor (RF), both of which were absent in all but one of nine patients with acute bacterial endocarditis. Two patients with subacute and one with acute bacterial endocarditis had low values of C3 and C4. Measurement of CRP, CICs, and RF did not distinguish between patients with and without extracardiac manifestations. Sequential analysis of patients revealed that a successful response to antimicrobial treatment was indicated by a striking and rapid decline in CRP, with less striking declines in CICs, RF, and IgM. Antibiotic failure was indicated by the persistence of high concentrations of CRP and CICs.

We conclude that the measurement of C reactive protein is of some value in the diagnosis and management of infective endocarditis. A normal CRP concentration excludes this diagnosis. The measurement of CRP alone appears sufficient for monitoring most cases of infective endocarditis with the sequential measurement of rheumatoid factor and circulating immune complexes adding no useful information except where the CRP remains elevated despite treatment. In this latter instance, persisting high levels of CRP and circulating immune complexes together herald an ominous course.
CEREBRAL VENOUS THROMBOSIS: A RETROSPECTIVE REVIEW
Authors: GATES P. C.
Published: September 2015

In a retrospective survey of 66 cases (46 proven) of cerebral venous thrombosis in a large number of public teaching hospitals in Australia, the quantity of cases in institutions of similar size varied widely. There were 29 fatal cases (all underwent an autopsy) and in 20 of these the venous thrombosis was considered to be the major cause of death. In 15 of the deaths due to cerebral venous thrombosis the diagnosis was not suspected before death. In 27 cases (18 proven) the underlying cause was infection, while only two cases (both confirmed) were associated with oral contraceptives. These findings suggest that although rare, cerebral venous thrombosis is underdiagnosed and that, even in the era of modern antibiotics, sepsis is the commonest single identifiable cause.
INOBVIOUS STROKE: A CAUSE OF DELIRIUM AND DEMENTIA
Authors: DUNNE J. W. , LEEDMAN P. J. , EDIS R. H.
Published: September 2015

Six hundred and sixty‐one patients with stroke, confirmed by CT scan or at autopsy, were reviewed in order to evaluate the frequency of presentation with altered mental state. Nineteen patients (3%) had presented with delirium, an organic delusional state, the acute onset of dementia, or mania, mimicking psychiatric illness. All had focal cerebrovascular lesions which were usually, but not invariably, right sided. None had a previous history of cognitive impairment, psychiatric disease, drug abuse, or alcohol excess. Neurological signs were absent or mild and transient, and therefore easily missed. Post‐mortem examinations in four patients showed localised cerebral infarctions with no evidence of multiple lesions, Alzheimer's disease, or metabolic encephalopathies. The possible causative factors are discussed and the evidence of asymmetrical cerebral representation of emotion, and for a relationship with epilepsy, is reviewed.
ASSESSMENT OF BILE FLOW BY RADIOSCINTIGRAPHY IN PATIENTS WITH BILIARY‐TYPE PAIN AFTER CHOLECYSTECTOMY
Authors: ROBERTS‐THOMSON I. C. , TOOULI J. , BLANCHETT W. , LICHTENSTEIN M. , ANDREWS J. T.
Published: September 2015

Scintigraphy of the biliary system using 99mTc di‐isopropyl iminodiacetic acid (DIDA) was performed in 65 subjects who had previously undergone cholecystectomy. Of the 65 subjects, 20 were free of pain and 45 had biliary‐type pain both with (group I) and without (group II) features of sphincter of Oddi dysfunction. This dysfunction comprised dilatation of the bile duct, a transient rise in serum levels of liver enzymes after episodes of pain, or both abnormalities. After computer acquisition of images at intervals of 60 seconds for at least 90 minutes, time/activity curves were generated for five regions of interest: liver, common hepatic duct, common bile duct, duodenum, and background. The time at which counts in the common bile duct reached 50% of maximum (CBD T50) and the time of first entry of isotope into the duodenum (TD) were used to compare asymptomatic subjects with those with biliary‐type pain. Patients in group I, but not those in group II, showed significant prolongation of CBD T50 (p < 0.002) and TD (p < 0.02) when compared to values in asymptomatic subjects. Six patients had a second scan at six to 12 months after endoscopic sphincterotomy and all showed a reduction in values for CBD T50 and TD. In patients with pain, a significant correlation was shown between bile duct diameter and CBD T50 (p < 0.01) and between bile duct diameter and TD (p < 0.02) but results from scintigraphy were independent of responses to morphine‐neostigmine and motility in the sphincter of Oddi as assessed by endoscopic manometry. Some patients in group I had delayed excretion of DIDA into the duodenum and this correlated with the degree of dilatation of the biliary system.
CLINICAL EXPERIENCES WITH HUMAN PARATHYROID HORMONE 1–34*
Authors: FURLONG T. J. , SESHADRI M. S. , WILKINSON M. R. , CORNISH C. J. , LUTTRELL B. , POSEN S.
Published: September 2015

Human parathyroid hormone (PTH) 1–34 was given to nine normal subjects and to 10 patients with hypoparathyroidism. There were no side effects associated with the protocol employed.

In normal subjects, five statistically significant changes occurred during the period of observation: plasma cyclic adenosine monophosphate (cAMP) rose by a factor of 3 (at 30 min), nephrogenous cyclic AMP rose approximately 40‐fold (at 60 min), urinary phosphate rose by a factor of 2 (at 120 min), urine calcium levels fell by 50% between 60 and 120 min, and plasma prolactin rose by a factor of 1.4 (at 60 min).

The cAMP responses were significantly blunted in five patients with chronic hypocalcemia, chronic hyperphosphatemia, and detectable serum immunoreactive PTH levels. On the basis of this test these patients were designated as suffering from pseudohypoparathyroidism. The acute phosphaturic and hypocalciuric responses were apparently intact in these five individuals.

Human PTH 1–34 is likely to replace bovine material in the delineation of syndromes associated with PTH resistance.
DIFLUNISAL‐INDUCED NEUTROPENIA
Authors: McLEAN C. A. , BEGLEY C. G. , HARRIS R. A.
Published: September 2015

We report a case of neutropenia associated with the use of diflunisal. The neutropenia occurred with initial administration and on subsequent inadvertent rechallenge with the drug. Bone marrow biopsy showed active granulopoiesis and an immune‐mediated mechanism for this response is postulated.
SUCCESSFUL PREGNANCY IN A RENAL TRANSPLANT RECIPIENT TAKING CYCLOSPORIN A
Authors: DUGGAN C. J. , BOYCE E. S. , CATERSON R. J. , MAHONY J. F.
Published: September 2015

A 27 year old woman with a fourth cadaveric renal transplant successfully completed a 33 week pregnancy whilst taking cyclosporin A and prednisolone. Her renal function remained stable despite recurrent urinary tract infections, hypertension, gestational diabetes, and Clostridium difficile associated diarrhea. The infant, delivered electively at 33 weeks, was small for gestational age but otherwise normal.
A VIRAL ETIOLOGY FOR HODGKIN'S DISEASE?
Authors: DALGLEISH A. G. , McELWAIN T.
Published: September 2015

There have been numerous suggestive but inconclusive reports of a possible infectious etiology for Hodgkin's disease. The discovery of the causative agent of the adult T cell leukemia‐lymphoma syndrome suggests that a similar agent to the human T cell leukemia‐lymphoma virus may have a causal role in Hodgkin's disease.
Impact of Voltage Mapping to Guide Whether to Perform Ablation of the Posterior Wall in Patients With Persistent Atrial Fibrillation
Authors: CUTLER MICHAEL J. , JOHNSON JEREMY , ABOZGUIA KHALID , ROWAN SHANE , LEWIS WILLIAM , COSTANTINI OTTO , NATALE ANDREA , ZIV OHAD
Published: September 2015

Voltage‐Guided Ablation for Persistent Afib

Background

Fibrosis as a substrate for atrial fibrillation (AF) has been shown in numerous preclinical models. Voltage mapping enables in vivo assessment of scar in the left atrium (LA), which can be targeted with catheter ablation.

Objective

We hypothesized that using the presence or absence of low voltage to guide ablation beyond pulmonary vein antral isolation (PVAI) will improve atrial arrhythmia (AF/AT)‐free survival in persistent AF.

Methods and Results

Single‐center retrospective analysis of 2 AF ablation strategies: (1) standard ablation (SA) versus (2) voltage‐guided ablation (VGA). PVAI was performed in both groups. With SA, additional lesions beyond PVAI were performed at the discretion of the operator. With VGA, additional lesions to isolate the LA posterior wall were performed if voltage mapping of this region in sinus rhythm showed scar (LA voltage < 0.5 mV). AF‐/AT‐free endpoint was defined as no sustained AF/AT seen off antiarrhythmic medications after a 2‐month postablation blanking period. Seventy‐six patients underwent SA and 65 underwent VGA. Patients were well matched for comorbidities, LVEF, and left atrial size. Posterior wall ablation was performed in 57% of patient with SA compared to 42% with VGA. VGA ablation increased 1‐year AF‐/AT‐free survival in patients when compared to SA (80% vs. 57%; P = 0.005). In a multivariate analysis, VGA was the only independent predictor of AF‐/AT‐free survival (hazard ratio of 0.30; P = 0.002).

Conclusions

The presence of LA posterior wall scar may be an important ablation target in persistent AF. A prospective randomized trial is needed to confirm these data.
Ablating the Posterior Heart: Cardioesophageal Fistula Complicating Radiofrequency Ablation in the Coronary Sinus
Authors: GÜNEŞ MAHMUT FATIH , GÖKOĞLAN YALÇIN , DI BIASE LUIGI , GIANNI CAROLA , MOHANTY SANGHAMITRA , HORTON RODNEY , BAILEY SHANE , NATALE ANDREA
Published: September 2015

Ablating the Posterior Heart

Cardioesophageal fistulas (CEFs) are uncommon but life‐threatening complications of radiofrequency (RF) catheter ablation of atrial fibrillation (AF). They are usually, but not exclusively, related to ablation of the left atrial posterior wall. We report a case of a 73‐year‐old man that presented with CEF following RF ablation in the coronary sinus, highlighting the importance of esophageal temperature monitoring whenever ablating in the posterior heart.
Lead Integrity Alert Is Useful for Assessment of Performance of Biotronik Linox Leads
Authors: STEINBERG CHRISTIAN , PADFIELD GARETH J. , HAHN EDNA , FLAVELLE SHEILA , McILROY CHERYL , VAN BREMEN OTTO , YEUNG‐LAI‐WAH JOHN A. , KERR CHARLES R. , DEYELL MARC W. , TUNG STANLEY K. , ANDRADE JASON G. , BENNETT MATTHEW T. , BASHIR JAMIL G. , KRAHN ANDREW D. , CHAKRABARTI SANTABHANU
Published: September 2015

LIA and Linox

Introduction

Medtronic's Lead Integrity Alert (LIA) software algorithm is useful for detecting abnormal parameters across various ICD‐lead families. However, its utility in the assessment of the Biotronik Linox™ family of high‐voltage (HV) leads is unknown.

Methods

We conducted a retrospective cohort study to assess the performance of the LIA algorithm to detect abnormalities and lead failure in Linox ICD‐leads. All LIA‐enabled Medtronic devices connected to an active Linox lead were included. The alerts were adjudicated by 2 blinded electrophysiologists and correlated with clinical data.

Results

Between 2008 and 2012, data from 208 patients with 564 patient‐years of follow‐up were available for analysis. The median follow‐up duration was 32 (IQR 21–41 months). Twenty‐one LIA triggers were noted in 20 different patients. The median delay until a positive LIA was 32 months (IQR 21–41 months) postimplant with a 5‐year lead survival free from LIA of 76%. Ninety‐five percent (19/20) LIA alerts were true lead failures. The most common LIA triggers were short V–V intervals (85%) and nonsustained ventricular tachycardia (85%). Abrupt changes of the ICD‐lead impedance occurred in 5/20 triggers. Inappropriate ICD‐shocks were strongly associated with a positive LIA (30% vs. 7.4%; P = 0.006). Of the explanted Linox leads 53% had visible abnormalities. The sensitivity, specificity, and positive predictive value for lead failure in the presence of a LIA trigger were 87%, 99.5%, and 95.2%, respectively.

Conclusions

A positive LIA trigger in Biotronik Linox ICD‐leads is highly predictive of lead failure. LIA is useful in ongoing surveillance of lead performance.
Phosphorylation at Connexin43 Serine‐368 Is Necessary for Myocardial Conduction During Metabolic Stress
Authors: NASSAL MICHELLE M. J. , WERDICH ANDREAS A. , WAN XIAOPING , HOSHI MALCOLM , DESCHÊNES ISABELLE , ROSENBAUM DAVID S. , DONAHUE J. KEVIN
Published: September 2015

Cx43‐S368 Phosphorylation Controls Conduction During Stress

Connexin43 (Cx43) phosphorylation alters gap junction localization and function. In particular, phosphorylation at serine‐368 (S368) has been suggested to alter gap junctional conductance, but previous reports have shown inconsistent results for both timing and functional effects of S368 phosphorylation. The objective of this study was to determine the functional effects of isolated S368 phosphorylation. We evaluated wild‐type Cx43 (AdCx43) and mutations simulating permanent phosphorylation (Ad368E) or preventing phosphorylation (Ad368A) at S368. Function was assessed by optical mapping of electrical conduction in patterned cultures of neonatal rat ventricular myocytes, under baseline and metabolic stress (MS) conditions. Baseline conduction velocity (CV) was similar for all groups. In the AdCx43 and Ad368E groups, MS moderately decreased CV. Ad368A caused complete conduction block during MS. Triton‐X solubility assessment showed no change in Cx43 location during conduction impairment. Western blot analysis showed that Cx43‐S368 phosphorylation was present at baseline, and that it decreased during MS. Our data indicate that phosphorylation at S368 does not affect CV under baseline conditions, and that preventing S368 phosphorylation makes Cx43 hypersensitive to MS. These results show the critical role of S368 phosphorylation during stress conditions.
Are They Listening? Parental Social Coaching and Parenting Emotional Climate Predict Adolescent Receptivity
Authors: Gregson Kim D. , Erath Stephen A. , Pettit Gregory S. , Tu Kelly M.
Published: September 2015

Associations linking parenting emotional climate and quality of parental social coaching with young adolescents' receptivity to parental social coaching were examined (N = 80). Parenting emotional climate was assessed with adolescent‐reported parental warmth and hostility. Quality of parental social coaching (i.e., prosocial advice, benign framing) was assessed via parent‐report and behavioral observations during a parent–adolescent discussion about negative peer evaluation. An adolescent receptivity latent variable score was derived from observations of adolescents’ behavior during the discussion, change in adolescents’ peer response plan following the discussion, and adolescent‐reported tendency to seek social advice from the parent. Parenting climate moderated associations between coaching and receptivity: Higher quality coaching was associated with greater receptivity in the context of a more positive climate. Analyses suggested a stronger association between coaching and receptivity among younger compared to older adolescents.
Effect of dietary Ximenia caffra kernel meal on blood and liver metabolic substrate content and the general clinical biochemistry of Sprague Dawley rats
Authors: Chivandi E. , Moyo D. , Dangarembizi R. , Erlwanger K.
Published: September 2015

We investigated (at the University of the Witwatersrand: GPS coordinates 26°10′ 52.96″S; 28°2′ 33.61″E) the effects of substituting soya bean meal (SBM) with Ximenia caffra kernel meal (XCKM) as a dietary protein source on blood and liver metabolic substrates content, serum markers of liver and kidney function and the general clinical biochemistry of Sprague Dawley (SD) rats. Five diets with similar energy and protein content were formulated (D1–D5) where XCKM replaced SBM on a crude protein basis at 0, 25, 50, 75 and 100%. Forty weanling male SD rats were randomly assigned to diets D1–D5, fed for 37 days and weighed twice weekly. The rats were then fasted overnight, and fasting blood glucose and triglyceride concentrations were determined from tail‐vein‐drawn blood. Immediately thereafter, the rats were euthanised and blood was collected via cardiac puncture. Serum was used to assay for markers of the general health profile. Livers were removed and weighed, and samples were used to determine lipid and glycogen content. Rats fed D4 (75% substitution level) had significantly lower (p < 0.05) blood triglyceride content compared with rats fed D2 (25% level of substitution). The substitution of SBM with XCKM did not affect (p > 0.05) fasting blood glucose and cholesterol concentrations, liver glycogen and lipid content. Additionally, it had no effect (p > 0.05) on serum activity/concentration of surrogate markers of liver (alanine aminotransferase and alkaline phosphatase activity and urea, total bilirubin, globulin and albumin concentrations) and kidney (phosphorus, calcium and creatinine concentrations) function and the general clinical biochemistry of the rats. Defatted XCKM could substitute SBM in rat diets without compromising blood glucose and cholesterol homeostasis, liver and kidney function and the general clinical biochemistry of growing male Sprague Dawley rats.