bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of testosterone on the transgender male voice
Authors: Irwig M. S. , Childs K. , Hancock A. B.
Published: September 2016

There is sparse prospective data on the effects of testosterone therapy on the voices of transgender men (also referred to as trans men or female‐to‐male transsexuals). Our aim was to investigate the timing and degree of voice deepening over 12 months among an ethnically diverse sample of transgender men. This was a prospective 12‐month study at an academic outpatient endocrinology clinic and speech and voice center. The participants were seven transgender men naïve to testosterone therapy. All patients received two voice assessments at baseline and one assessment at 3, 6, 9, and 12 months while on intramuscular testosterone esters. Serum testosterone and estradiol concentrations were measured at baseline and every 3 months. All seven transgender men reached a cisgender male mean fundamental frequency (MF0) within 6 months of testosterone therapy and four continued to experience a decrease after 6 months. The mean decrease in MF0 after 12 months of testosterone therapy was 6.4 semitones (49 Hz). Several patterns emerged regarding the extent and timing. For example, some participants showed no decrease in MF0 within the first 3 months of testosterone therapy, whereas others showed their greatest decrease in MF0. We concluded that transgender men who start testosterone therapy display different patterns of voice lowering. Clinicians should counsel transgender men that they may or may not experience voice lowering within the first 3 months of testosterone therapy and that the majority of voice deepening will occur within 6–9 months.
The inter‐relationship of symptom severity and quality of life in 2055 patients with primary biliary cholangitis
Authors: Dyson J. K , Wilkinson N. , Jopson L. , Mells G. , Bathgate A. , Heneghan M. A. , Neuberger J. , Hirschfield G. M. , Ducker S. J. ,   The UK‐PBC Consortium, Sandford R. , Alexander G. , Stocken D. , Jones D. E. J.
Published: September 2016

Background

Age at presentation with primary biliary cholangitis (PBC) is associated with differential response to ursodeoxycholic acid (UDCA) therapy. Younger‐presenting patients are less likely to respond to treatment and more likely to need transplant or die from the disease. PBC has a complex impact on quality of life (QoL), with systemic symptoms often having significant impact.

Aim

To explain the impact of age at presentation on perceived QoL and the inter‐related symptoms which impact upon it.

Methods

Using the UK‐PBC cohort, symptoms were assessed using the PBC‐40 and other validated tools. Data were available on 2055 patients.

Results

Of the 1990 patients reporting a global PBC‐QoL score, 66% reported good/neutral scores and 34% reported poor scores. Each 10‐year increase in age at presentation was associated with a 14% decrease in risk of poor perceived QoL (OR = 0.86, 95% CI: 0.75–0.98, P < 0.05). All symptom domains were similarly age‐associated (P < 0.01). Social dysfunction was the symptom factor with the greatest impact on QoL. Median (interquartile range) PBC‐40 social scores for patients with good perceived QoL were 18 (14–23) compared with 34 (29–39) for those with poor QoL.

Conclusion

The majority of patients with primary biliary cholangitis do not feel their QoL is impaired, although impairment is reported by a sizeable minority. Age at presentation is associated with impact on perceived QoL and the symptoms impairing it, with younger patients being more affected. Social dysfunction makes the greatest contribution to QoL impairment, and it should be targeted in trials aimed at improving life quality.
Population pharmacokinetics and dosing recommendations for the use of deferiprone in children younger than 6 years
Authors: Bellanti Francesco , Del Vecchio Giovanni C. , Putti Maria C. , Maggio Aurelio , Filosa Aldo , Cosmi Carlo , Mangiarini Laura , Spino Michael , Connelly John , Ceci Adriana , Della Pasqua Oscar ,   on behalf of the Consortium DEferiprone Evaluation in Paediatrics (DEEP)
Published: September 2016

Aims

Despite long clinical experience with deferiprone, there is limited information on its pharmacokinetics in children aged <6 years. Here we assess the impact of developmental growth on the pharmacokinetics of deferiprone in this population using a population approach. Based on pharmacokinetic bridging concepts, we also evaluate whether the recommended doses yield appropriate systemic exposure in this group of patients.

Methods

Data from a study in which 18 paediatric patients were enrolled were available for the purposes of this analysis. Patients were randomised to three deferiprone dose levels (8.3, 16.7 and 33.3 mg kg−1). Blood samples were collected according to an optimised sampling scheme in which each patient contributed to a maximum of five samples. A population pharmacokinetic model was developed using NONMEM v.7.2. Model selection criteria were based on graphical and statistical summaries.

Results

A one‐compartment model with first‐order absorption and first‐order elimination best described the pharmacokinetics of deferiprone. Drug disposition parameters were affected by body weight, with both clearance and volume increasing allometrically with size. Simulation scenarios show that comparable systemic exposure (AUC) is achieved in children and adults after similar dose levels in mg kg−1, with median (5–95th quantiles) AUC values, respectively, of 340.6 (223.2–520.0) μmol l−1 h and 318.5 (200.4–499.0) μmol l−1 h at 75 mg kg−1 day–1, and 453.7 (297.3–693.0) μmol l−1 h and 424.2 (266.9–664.0) μmol l−1 h at 100 mg kg−1 day–1 given as three times daily (t.i.d.) doses.

Conclusions

Based on the current findings, a dosing regimen of 25 mg kg−1 t.i.d. is recommended in children aged <6 years, with the possibility of titration up to 33.3 mg kg−1 t.i.d.
Virtual Inflation of the Cerebral Artery Wall for the Integrated Exploration of OCT and Histology Data
Authors: Glaßer S. , Hoffmann T. , Boese A. , Voß S. , Kalinski T. , Skalej M. , Preim B.
Published: September 2016

Intravascular imaging provides new insights into the condition of vessel walls. This is crucial for cerebrovascular diseases including stroke and cerebral aneurysms, where it may present an important factor for indication of therapy. In this work, we provide new information of cerebral artery walls by combining ex vivo optical coherence tomography (OCT) imaging with histology data sets. To overcome the obstacles of deflated and collapsed vessels due to the missing blood pressure, the lack of co‐alignment as well as the geometrical shape deformations due to catheter probing, we developed the new image processing method virtual inflation. We locally sample the vessel wall thickness based on the (deflated) vessel lumen border instead of the vessel's centerline. Our method is embedded in a multi‐view framework where correspondences between OCT and histology can be highlighted via brushing and linking yielding OCT signal characteristics of the cerebral artery wall and its pathologies. Finally, we enrich the data views with a hierarchical clustering representation which is linked via virtual inflation and further supports the deduction of vessel wall pathologies.
Conservation implications of physiological carry‐over effects in bats recovering from white‐nose syndrome
Authors: Davy Christina M. , Mastromonaco Gabriela F. , Riley Julia L. , Baxter‐Gilbert James H. , Mayberry Heather , Willis Craig K.R.
Published: September 2016

Although it is well documented that infectious diseases can pose threats to biodiversity, the potential long‐term consequences of pathogen exposure on individual fitness and its effects on population viability have rarely been studied. We tested the hypothesis that pathogen exposure causes physiological carry‐over effects with a pathogen that is uniquely suited to this question because the infection period is specific and time limited. The fungus Pseudogymnoascus destructans causes white‐nose syndrome (WNS) in hibernating bats, which either die due to the infection while hibernating or recover following emergence from hibernation. The fungus infects all exposed individuals in an overwintering site simultaneously, and bats that survive infection during hibernation clear the pathogen within a few weeks following emergence. We quantified chronic stress during the active season, when bats are not infected, by measuring cortisol in bat claws. Free‐ranging Myotis lucifugus who survived previous exposure to P. destructans had significantly higher levels of claw cortisol than naïve individuals. Thus, cryptic physiological carry‐over effects of pathogen exposure may persist in asymptomatic, recovered individuals. If these effects result in reduced survival or reproductive success, they could also affect population viability and even act as a third stream in the extinction vortex. For example, significant increases in chronic stress, such as those indicated here, are correlated with reduced reproductive success in a number of species. Future research should directly explore the link between pathogen exposure and the viability of apparently recovered populations to improve understanding of the true impacts of infectious diseases on threatened populations.
Cerebrospinal fluid viral load and biomarkers of neuronal and glial cells in Ramsay Hunt syndrome
Authors: Lindström Johan , Grahn Anna , Zetterberg Henrik , Studahl Marie
Published: September 2016

Reactivation of varicella zoster virus (VZV) can manifest with facial palsy diagnosed as Ramsay Hunt Syndrome (RHS) or Ramsay Hunt Syndrome zoster sine herpete (RHS‐ZSH). These syndromes are associated with poor prognosis despite treatment with antivirals and corticosteroids. Concentrations of biomarkers such as neurofilament protein (NFL), S‐100β protein and glial fibrillary acidic protein (GFAp) have previously been measured in cerebrospinal fluid (CSF) to assess neuronal damage and glial pathology. We employed immunochemical methods to measure concentrations of NFL, S‐100β protein and GFAp in CSF from patients with RHS (n = 15) and RHS‐ZSH (n = 13) diagnosed by detection of VZV DNA in the CSF by quantitative PCR, and compared with a control group (n = 52). The biomarker concentrations were correlated with CSF viral load and outcome measured by House‐Brackmann score. NFL and GFAp concentrations were increased compared with controls (P = 0.008 and P = 0.04), while S‐100β levels were decreased. This pattern was more pronounced in patients with RHS compared to the patients with RHS‐ZSH (NS and P = 0.028). The amount of viral DNA in CSF correlated with increased GFAp (P = 0.003) and NFL (P = 0.006). No correlations were found between biomarker concentrations and patient outcome. Patients with facial palsy caused by VZV had biochemical signs of neuronal damage and astrogliosis. High amounts of viral DNA may be associated with the degree of damage on neuronal and astroglial cells. Prospective studies are warranted to elucidate the association of elevated biomarkers in the CSF and outcome assessed by more sensitive tests.
Management of congenital quantitative fibrinogen disorders: a Delphi consensus
Authors: Casini A. , de Moerloose P. ,   the Congenital Fibrinogen Disorders Group
Published: September 2016

Introduction

No evidence‐based guidelines for the management of patients suffering from afibrinogenaemia and hypofibrinogenaemia are available.

Aim and method

The aim of this study was to harmonize patient's care among invited haemophilia experts from Belgium, France and Switzerland. A Delphi‐like methodology was used to reach a consensus on: prophylaxis, bleeding, surgery, pregnancy and thrombosis management.

Results

The main final statements are as follows: (i) a secondary fibrinogen prophylaxis should be started after a first life‐threatening bleeding in patients with afibrinogenaemia; (ii) during prophylaxis the target trough fibrinogen level should be 0.5 g L−1; (iii) if an adaptation of dosage is required, the frequency of infusions rather than the fibrinogen amount should be modified; (iv) afibrinogenaemic patients undergoing a surgery at high bleeding risk should receive fibrinogen concentrates regardless of the personal or family history of bleeding; (v) moderate hypofibrinogenaemic patients (i.e. ≥0.5 g L−1) without previous bleeding (despite haemostatic challenges) undergoing a surgery at low bleeding risk may not receive fibrinogen concentrates as prophylaxis; (vi) monitoring the trough fibrinogen levels should be performed at least once a month throughout the pregnancy and a foetal growth and placenta development close monitoring by ultrasound is recommended; (vii) fibrinogen replacement should be started concomitantly to the introduction of anticoagulation in afibrinogenaemic patients suffering from a venous thromboembolic event; and (viii) low‐molecular‐weight heparin is the anticoagulant of choice in case of venous thromboembolism.

Conclusion

The results of this initiative should help clinicians in the difficult management of patients with congenital fibrinogen disorders.
The impact of a haemophilia education intervention on the knowledge and health related quality of life of parents of Indian children with haemophilia
Authors: Phadnis S. , Kar A.
Published: September 2016

Introduction

The impact of haemophilia education on the quality of life of parents of children with haemophilia from low income settings has not been studied.

Aim

The purpose of this study was to determine the impact of an education intervention on health related quality of life (HRQOL) of parents of children with haemophilia, parent's knowledge about haemophilia and its management, and to determine whether education about haemophilia can positively impact these outcomes.

Methods

One hundred thirty‐three parents from across Maharashtra state, India were provided information about haemophilia, care of child and self‐care. The impact of the intervention was measured as changes occurring from baseline to 6 months and 1 year after intervention. Knowledge and practice of management of bleeding was measured using pretested structured questionnaires. HRQOL was measured using a validated Peds Quality of Life™ Family Impact Module (PedsQL™FIM) tool.

Results

There was improvement in knowledge scores immediately after intervention, which remained significantly higher than baseline 1 year after intervention. HRQOL showed significant improvement at 6 months but reduced to baseline levels 1 year after intervention. There were statistically significant changes in terms of practice of management of bleeding episodes at 6 months and 1 year after intervention.

Conclusion

Education about haemophilia resulted in improvement of knowledge, and practice of management of bleeding which was retained till a year after the intervention. However, a long‐term effect on the HRQOL of parents could not be observed after administration of a single education intervention.
Some New Perspective on the Reaction Mechanism of MgO–SiO2–H2O System
Authors: Chen Junhong , Li Tong , Li Xiaoping , Chou Kuo‐Chih , Hou Xinmei
Published: September 2016

The application of MgO–SiO2–H2O system, one of the most popular basic refractories, is greatly limited because of the hydration of MgO. In this work, the phase and morphological development of MgO–SiO2–H2O system during aging were analyzed using various techniques. It is found that Mg(OH)2initially appears and the amount increases after 10 days aging at room temperature. At elevated temperature, the heat treatment can facilitate the hydration reaction. Mg(OH)2covers the surface of silica fume particles. The combination product connects with each other and distributes homogeneously around MgO particles to produce M–S–H gels, which inhibit the further hydration.
Impact of the Royal Australasian College of Physicians' clinical examination preparation on basic physician trainee assessment of jugular venous pressure
Authors: Sibbin C. P. , Bihari S. , Russell P.
Published: September 2016

Australian internal medicine trainees undergo intensive training in preparation for the Royal Australasian College of Physicians (RACP) clinical examination. Trainees preparing for the 2013 RACP clinical examination assessed the jugular venous pressure (JVP) of patients, with central venous pressure monitoring in the intensive care unit before and after the exam. RACP clinical examination preparation was associated with improvements of trainees’ ability to identify JVP that were not elevated, although the JVP examination was performed marginally as a diagnostic test. Ongoing training might further improve this skill.
‘Finishing up’ on country: challenges and compromises
Authors: Waran E. , O'Connor N. , Zubair M. Y. , May P.
Published: September 2016

A core consideration in the care of Indigenous patients at the end of life is their place of death. Dying in community can be of paramount importance to Indigenous people. This paper reports the experiences of the Top End Palliative Care Service with respect to the barriers and solutions in the return of Indigenous patients to community for end‐of‐life care. These barriers include not only those associated with the significant distances and remoteness in the Northern Territory but, also, spiritual and cultural factors, which often influence healthcare delivery.
Retracted: MicroRNA‐181b negatively regulates the proliferation of human epidermal keratinocytes in psoriasis through targeting TLR4
Authors: Feng Cheng , Bai Ming , Yu Nan‐Ze , Wang Xiao‐Jun , Liu Zeng
Published: September 2016

Our study aims to explore the role of microRNA‐181b (miR‐181b) and TLR in the regulation of cell proliferation of human epidermal keratinocytes (HEKs) in psoriasis. Twenty‐eight patients diagnosed with psoriasis vulgaris were selected as a case group with their lesional and non‐lesional skin tissues collected. A control group consisted of 20 patients who underwent plastic surgery with their healthy skin tissues collected. Real‐time quantitative fluorescence polymerase chain reaction (RT‐qPCR), in situ hybridization and immunohistochemistry were used to detect the expressions of miR‐181b and TLR4 in HEKs of healthy skin, psoriatic lesional skin and non‐lesional skin respectively. The 3′ untranslated region (3′UTR) of TLR4 combined with miR‐181b was verified by a dual‐luciferase reporter assay. Western blotting and bromodeoxyuridine were applied for corresponding detection of TLR4 expression and cell mitosis. The expression of miR‐181b in HEKs of psoriatic lesional skin was less than healthy skin and psoriatic non‐lesional skin. In psoriatic lesional and non‐lesional skin, TLR4‐positive cell rates and the number of positive cells per square millimetre were higher than healthy skin. The dual‐luciferase reporter assay verified that miR‐181b targets TLR4. HEKs transfected with miR‐181b mimics had decreased expression of TLR4, along with the decrease of mitotic indexes and Brdu labelling indexes. However, HEKs transfected with miR‐181b inhibitors showed increased TLR4 expression, mitotic indexes and Brdu labelling indexes. HEKs transfected with both miR‐181b inhibitors and siTLR4 had decreased mitotic indexes and Brdu labelling indexes. These results indicate that miR‐181b can negatively regulate the proliferation of HEKs in psoriasis by targeting TLR4.
Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity
Authors: Sibley Margaret H. , Swanson James M. , Arnold L. Eugene , Hechtman Lily T. , Owens Elizabeth B. , Stehli Annamarie , Abikoff Howard , Hinshaw Stephen P. , Molina Brooke S.G. , Mitchell John T. , Jensen Peter S. , Howard Andrea L. , Lakes Kimberley D. , Pelham William E. ,   the MTA Cooperative Group
Published: September 2016

Objective

Longitudinal studies of children diagnosed with ADHD report widely ranging ADHD persistence rates in adulthood (5–75%). This study documents how information source (parent vs. self‐report), method (rating scale vs. interview), and symptom threshold (DSM vs. norm‐based) influence reported ADHD persistence rates in adulthood.

Method

Five hundred seventy‐nine children were diagnosed with DSM‐IV ADHD‐Combined Type at baseline (ages 7.0–9.9 years) 289 classmates served as a local normative comparison group (LNCG), 476 and 241 of whom respectively were evaluated in adulthood (Mean Age = 24.7). Parent and self‐reports of symptoms and impairment on rating scales and structured interviews were used to investigate ADHD persistence in adulthood.

Results

Persistence rates were higher when using parent rather than self‐reports, structured interviews rather than rating scales (for self‐report but not parent report), and a norm‐based (NB) threshold of 4 symptoms rather than DSM criteria. Receiver‐Operating Characteristics (ROC) analyses revealed that sensitivity and specificity were optimized by combining parent and self‐reports on a rating scale and applying a NB threshold.

Conclusion

The interview format optimizes young adult self‐reporting when parent reports are not available. However, the combination of parent and self‐reports from rating scales, using an ‘or’ rule and a NB threshold optimized the balance between sensitivity and specificity. With this definition, 60% of the ADHD group demonstrated symptom persistence and 41% met both symptom and impairment criteria in adulthood.
Indoleamine 2,3 dioxygenase as a prognostic and follow‐up marker in melanoma. A comparative study with LDH and S100B
Authors: de Lecea M.V. , Palomares T. , Al Kassam D. , Cavia M. , Geh J.L.C. , de Llano P. , Muñiz P. , Armesto D. , Martinez‐Indart L. , Alonso‐Varona A.
Published: September 2016

Background

To date, lactate dehydrogenase (LDH) and S100B remain the most useful biomarkers for follow‐up of melanoma patients. In recent years, indoleamine 2,3‐dioxygenase (IDO), an immunosuppressive enzyme, has been proposed as a new potential tumour biomarker for melanoma. However, further studies are needed to confirm the usefulness of IDO expression as an independent prognostic factor.

Objective

To explore the potential association between serum IDO levels and melanoma stage at diagnosis and recurrence, and to compare the results to those obtained with LDH and S100B. In addition, we also investigated a possible cut off for IDO level as a prognostic factor for overall survival.

Methods

IDO, LDH and S100B levels were measured in serum samples of 186 patients in all melanoma stages at diagnosis and twice a year thereafter. A cut‐off point for IDO levels was calculated using receiver operating characteristic curves to explore the association between these levels and the likelihood of lymphatic spread. Survival curves were estimated for patient groups stratified by IDO level (higher or lower than the cut off), using the Kaplan–Meier method.

Results

At diagnosis, serum IDO levels were significantly higher in stages IB, II, III and IV, whereas S100B levels were significantly higher in stages III and IV, and LDH levels were only higher in stage IV. In relapsed patients, significant increases were found in levels of all three markers. Finally, overall survival was significantly longer in patients with IDO levels below a cut off of 1.65 μM at diagnosis than in those with higher levels (91.3 vs. 71.0% at 36 months).

Conclusion

In melanoma patients, serum IDO levels are significantly associated with disease stage, relapses and overall survival. These results indicate IDO could be a useful serum prognostic marker for melanoma.
Social problem‐solving in Chinese baccalaureate nursing students
Authors: Fang Jinbo , Luo Ying , Li Yanhua , Huang Wenxia
Published: September 2016

Objective

To describe social problem solving in Chinese baccalaureate nursing students.

Methods

A descriptive cross‐sectional study was conducted with a cluster sample of 681 Chinese baccalaureate nursing students. The Chinese version of the Social Problem‐Solving scale was used. Descriptive analyses, independent t‐test and one‐way analysis of variance were applied to analyze the data.

Findings

The final year nursing students presented the highest scores of positive social problem‐solving skills. Students with experiences of self‐directed and problem‐based learning presented significantly higher scores in Positive Problem Orientation subscale. The group with Critical thinking training experience, however, displayed higher negative problem solving scores compared with nonexperience group.

Conclusions

Social problem solving abilities varied based upon teaching–learning strategies. Self‐directed and problem‐based learning may be recommended as effective way to improve social problem‐solving ability.
Fecal neutrophil gelatinase‐associated lipocalin as a biomarker for inflammatory bowel disease
Authors: Thorsvik Silje , Damås Jan Kristian , Granlund Atle vB , Flo Trude Helen , Bergh Kåre , Østvik Ann Elisabet , Sandvik Arne Kristian
Published: September 2016

Background and Aim

Accurate, noninvasive biomarkers are needed to diagnose and monitor inflammatory bowel disease (IBD). Neutrophil gelatinase‐associated lipocalin (NGAL), also known as lipocalin 2, is expressed in inflamed colonic epithelium and neutrophilic granulocytes. This study explores its properties as a biomarker in feces and plasma and, for the first time, compares fecal NGAL systematically with the existing fecal biomarker calprotectin.

Methods

Neutrophil gelatinase‐associated lipocalin was measured in feces from 73 patients with IBD, 21 patients with infectious enterocolitis, 21 patients with irritable bowel syndrome, and 23 healthy subjects using ELISA. The results were correlated to calprotectin, clinical score, endoscopic score, and high‐sensitive C‐reactive protein. Plasma from 119 patients with IBD and 28 healthy controls was analyzed for NGAL.

Results

Fecal NGAL levels (median and interquartile range) were significantly elevated in active ulcerative colitis (UC) 6.05 (3.6–15.1) mg/kg and Crohn's disease (CD) 4.9 (1.5–7.7) mg/kg, compared with patients with inactive UC 1.3 (0.4–2.6) mg/kg, inactive CD 1.5 (0.5–1.7) mg/kg, irritable bowel syndrome 0.4 (0.2–0.6) mg/kg, and healthy controls (HC) 0.3 (0.1–0.4) mg/kg. Patients with infectious enterocolitis had significantly higher fecal‐NGAL levels, 2.7 (1.4–5.6) mg/kg than HC. Sensitivity and specificity was 94.7% and 95.7%, respectively, for distinguishing between active IBD and HC. Stability of NGAL in stool was excellent for 7 days in room temperature. Plasma NGAL was significantly elevated in UC and CD compared with HC.

Conclusions

Fecal NGAL is a promising biomarker for IBD. As existing biomarkers are expressed mainly in granulocytes, NGAL's epithelial localization may give supplementary diagnostic information.
Label‐free detection of fibrillar collagen deposition associated with vascular elements in glioblastoma multiforme by using multiphoton microscopy
Authors: JIANG L.W. , WANG X.F. , WU Z.Y. , LIN P.H. , DU H.P. , WANG S. , LI L.H. , FANG N. , ZHUO S.M. , KANG D.Z. , CHEN J.X.
Published: September 2016

Glioblastoma multiforme (GBM‐WHO grade IV) is the most common and the most aggressive form of brain tumors in adults with the median survival of 10–12 months. The diagnostic detection of extracellular matrix (ECM) component in the tumour microenvironment is of prognostic value. In this paper, the fibrillar collagen deposition associated with vascular elements in GBM were investigated in the fresh specimens and unstained histological slices by using multiphoton microscopy (MPM) based on two‐photon excited fluorescence (TPEF) and second harmonic generation (SHG). Our study revealed the existence of fibrillar collagen deposition in the adventitia of remodelled large blood vessels and in glomeruloid vascular structures in GBM. The degree of fibrillar collagen deposition can be quantitatively evaluated by measuring the adventitial thickness of blood vessels or calculating the ratio of SHG pixel to the whole pixel of glomeruloid vascular structure in MPM images. These results indicated that MPM can not only be employed to perform a retrospective study in unstained histological slices but also has the potential to apply for in vivo brain imaging to understand correlations between malignancy of gliomas and fibrillar collagen deposition.
Comparative analysis of cesarean section rates using Robson Ten‐Group Classification System and Lorenz curve in the main institutions in Japan
Authors: Ono Tetsuo , Matsuda Yoshio , Sasaki Kemal , Satoh Shoji , Tsuji Shunichiro , Kimura Fuminori , Murakami Takashi
Published: September 2016

Aim

The aim of this study was to clarify the indication for cesarean section (CS) using the Robson Ten‐Group Classification System (RTGCS) and to clarify the center variation using the Lorenz curve in the main institutions in Japan.

Methods

The records of 68 702 deliveries, which were performed in 125 institutions, were extracted from the Japanese perinatal database in 2013 and the cases were classified using the RTGCS, which classifies deliveries into one of 10 groups on the basis of five parameters. The equality of the CS rate of each hospital was evaluated by the Lorenz curve and the Gini coefficient. The standard error (SE) and 95% confidence intervals (95%CI) for the Gini coefficient were determined by the bootstrap method. The institutions were divided into three categories depending on their scale: comprehensive center (CC, Category I), regional center (RC, Category II) and others (Category III).

Results

The overall CS rate was 37.3%. The difference between Categories I (42.6%) and II (34.3%) was significant (P = 0.02). The CS rates that were classified as RTGCS group 3 (multiparous, single cephalic, ≥37 weeks, with spontaneous labor) were higher in Category I (4.0%) than in Category II (2.7%, P = 0.01). The Gini coefficient of Category I (0.119 ± 0.015; 95%CI, 0.092–0.152) was significantly lower than that of Category II (0.189 ± 0.013; 95%CI, 0.16–0.217).

Conclusion

We clarified the indication of CS and center variation. These two types of methods are useful for the evaluation of medical intervention in the perinatal field.
Who Participates and Who Benefits From Employer‐Provided Child‐Care Assistance?
Authors: Hipp Lena , Morrissey Taryn W. , Warner Mildred E.
Published: September 2016

Support from employers to help parents balance work and family responsibilities has become an increasingly important issue, particularly in the United States, where public support for families is scarce. Little is known about the effectiveness of employer‐provided child‐care support. Who participates in these programs, and what are their benefits? This study is among the first to address these questions using a dataset that combines administrative with survey data from employees at a large organization. Findings indicate that employer financial support for child care can be structured so that employees with the greatest need benefit and employee participation is not associated with stigma. Results suggest the employer benefits from increased employee commitment and reduced employee stress, but employees do not report increased parent or child satisfaction with care. Although employer financial support alone cannot compensate for structural problems with regard to child care, it may reduce stress and increase employee commitment in the workplace.
Cortical Thickness and Episodic Memory Impairment in Systemic Lupus Erythematosus
Authors: Bizzo Bernardo Canedo , Sanchez Tiago Arruda , Tukamoto Gustavo , Zimmermann Nicolle , Netto Tania Maria , Gasparetto Emerson Leandro
Published: September 2016

BACKGROUND AND PURPOSE

The purpose of this study was to investigate differences in brain cortical thickness of systemic lupus erythematosus (SLE) patients with and without episodic memory impairment and healthy controls.

METHODS

We studied 51 patients divided in 2 groups (SLE with episodic memory deficit, n = 17; SLE without episodic memory deficit, n = 34) by the Rey Auditory Verbal Learning Test and 34 healthy controls. Groups were paired based on sex, age, education, Mini‐Mental State Examination score, and accumulation of disease burden. Cortical thickness from magnetic resonance imaging scans was determined using the FreeSurfer software package.

RESULTS

SLE patients with episodic memory deficits presented reduced cortical thickness in the left supramarginal cortex and superior temporal gyrus when compared to the control group and in the right superior frontal, caudal, and rostral middle frontal and precentral gyri when compared to the SLE group without episodic memory impairment considering time since diagnosis of SLE as covaried. There were no significant differences in the cortical thickness between the SLE without episodic memory and control groups.

CONCLUSIONS

Different memory‐related cortical regions thinning were found in the episodic memory deficit group when individually compared to the groups of patients without memory impairment and healthy controls.
Prosthodontic decision‐making relating to dentitions with compromised molars: the perspective of Swedish General Dental Practitioners
Authors: Korduner E.‐K. , Collin Bagewitz I. , Vult von Steyern P. , Wolf E.
Published: September 2016

The aim of this investigation was to study the clinical prosthodontic decision‐making process relating to dentitions with compromised molars among Swedish general dental practitioners (GDPs). Eleven Swedish GDPs were purposively selected, and all agreed to participate. Then, in‐depth, semi‐structured interviews were conducted and covered treatment considerations concerning two authentic patient cases, initially with complete dental arches, and later, a final treatment based on a shortened dental arch (SDA) was discussed. The cases involved patients with compromised teeth situated mainly in the molar regions. One patient suffered from extensive caries and the other from severe periodontal disease. Qualitative content analysis was used to analyse the data. In the systematic analysis, two main categories were identified: holistic and functional approach. Among the interviewed GDPs, focus was put on patients’ needs, background history and motivation for treatment as well as the preservation of molar support. Within the limitations of this study, the following can be concluded: keeping a dental arch with molars seems to be important to Swedish general dental practitioners. The SDA concept does not seem to have a substantial impact on the prosthodontic decision‐making relating to dentitions with compromised molars. The dentist's experiences, as well as colleagues’ or consulting specialist advice together with aetiological factors and the patient's individual situation, influence the decision‐making more than the SDA concept. The conflicting results in the prosthetic decision‐making process concerning the relevance of age and the need for molar support need further investigation, for example based on decisions made in the dentist′s own clinical practice.
Involving Service Users with Intellectual Disability in Research: Experiences from the STOP Diabetes Study
Authors: Tyrer Freya , Dunkley Alison J. , Spong Rebecca , Gangadharan Satheesh K. , Bhaumik Sabyasachi , Khunti Kamlesh
Published: September 2016

The involvement of service users (people who use health and social care services) in research is central to UK policies, is an integral component of many research funding programs and improves the quality and uptake of research. People with intellectual disability are often excluded from research involvement. The purpose of this article is to describe how adult service users with intellectual disability were involved in the early stages of a diabetes screening study conducted in Leicestershire, UK. People who volunteered were involved in five key areas: publicity, study documentation and process development, acceptability of measures, recruitment of research staff, and training of staff. Service users helped with logo selection, publicity materials, designing art work, raising awareness of the study, study documents, rehearsing clinics, and recruiting and training research staff. Our findings demonstrate that with careful planning adults with intellectual disability can meaningfully be involved and benefit from involvement in research. We look forward to continued involvement with service users with intellectual disability in future research studies.
Occurrence of jasmonates during cystocarp development in the red alga Grateloupia imbricata
Authors: Pilar Garcia‐Jimenez , Olegario Brito‐Romano , Rafael Robaina R.
Published: September 2016

In this study, we highlight the effects of methyl jasmonate (MeJa) on cystocarp development in the red macroscopic alga Grateloupia imbricata. In G. imbricata, jasmonate release is related to the reproductive state, as fertile thalli (i.e., those that have cystocarps) released significant amounts of this volatile compound (1.27 ± 0.20 mM · mg fw−1 · h−1) compared with infertile thalli (0.95 ± 0.12 mM · mg fw−1 · h−1). Treating G. imbricata thalli with MeJa revealed a significant increase in cystocarp number (1.5 ± 0.27 cystocarps · mm−2), which was ~7.5‐fold greater than in untreated thalli (0.2 ± 0.07 cystocarps · mm−2). Maturation was completed within 48 h with MeJa treatment, a shortening of the typical >3‐week maturation period, and included the opening of cystocarps and the presence of dehiscent cavities. Release rates of jasmonates after exogenous MeJa treatment were also modified based on the cystocarp maturation level. All of these effects were reduced in the presence of phenidone, which blocks MeJa production, indicating that the MeJa action is genuine. The effects of MeJa during cystocarp maturation were not replicated by derivatives of reactive oxygen species from the same jasmonic acid biosynthetic pathway, as the activities of scavenger enzymes and lipid peroxidation were unchanged between infertile and fertile thalli. Therefore, a reactive oxygen species–based mechanism is not involved during cystocarp development. We conclude that MeJa has an independent function as a growth regulator during G. imbricata reproduction.
Plasma and serum concentrations of cytarabine administered via continuous intravenous infusion to dogs with meningoencephalomyelitis of unknown etiology
Authors: Early P. J. , Crook K. I. , Williams L. M. , Davis E. G. , Muñana K. R. , Papich M. G. , Messenger K. M.
Published: September 2016

The objective of this study was to evaluate the plasma and serum concentrations of cytarabine (CA) administered via constant rate infusion (CRI) in dogs with meningoencephalomyelitis of unknown etiology (MUE). Nineteen client‐owned dogs received a CRI of CA at a dose of 25 mg/m2/h for 8 h as treatment for MUE. Dogs were divided into four groups, those receiving CA alone and those receiving CA in conjunction with other drugs. Blood samples were collected at 0, 1, 8, and 12 h after initiating the CRI. Plasma (n = 13) and serum (n = 11) cytarabine concentrations were measured by high‐pressure liquid chromatography. The mean peak concentration (CMAX) and area under the curve (AUC) after CRI administration were 1.70 ± 0.66 μg/mL and 11.39 ± 3.37 h·μg/mL, respectively, for dogs receiving cytarabine alone, 2.36 ± 0.35 μg/mL and 16.91 + 3.60 h·μg/mL for dogs administered cytarabine and concurrently on other drugs. Mean concentrations for all dogs were above 1.0 μg/mL at both the 1‐ and 8‐h time points. The steady‐state achieved with cytarabine CRI produces a consistent and prolonged exposure in plasma and serum, which is likely to produce equilibrium between blood and the central nervous system in dogs with a clinical diagnosis of MUE. Other medications commonly used to treat MUE do not appear to alter CA concentrations in serum and plasma.
The Right to Left Atrial Volume Ratio Predicts Outcomes after Circumferential Pulmonary Vein Isolation of Longstanding Persistent Atrial Fibrillation
Authors: SASAKI TAKEHITO , NAKAMURA KOHKI , NAITO SHIGETO , MINAMI KENTARO , KOYAMA KEIKO , YAMASHITA EIJI , KUMAGAI KOJI , OSHIMA SHIGERU
Published: September 2016

Background

We aimed to identify the predictors of clinical outcomes after circumferential pulmonary vein isolation (CPVI) without any substrate modification for longstanding persistent atrial fibrillation (LSP‐AF).

Methods

This study retrospectively analyzed 70 consecutive LSP‐AF patients who underwent an initial CPVI and were followed‐up for more than 1 year. The right and left atrial volumes indexed to the body surface areas (right atrial volume index [RAVI] and left atrial volume index [LAVI]) were determined by preacquired contrast‐enhanced computed tomography (CT). The %RAVI/LAVI was obtained as 100 × RAVI/LAVI.

Results

During a median follow‐up period of 15 months (interquartile range, 13–19 months), 21 patients (30%) had arrhythmia recurrences after the CPVI. Antiarrhythmic drugs were continued in 34 patients (48%). In the Cox proportional hazard model, the %RAVI/LAVI was a significant positive predictor of arrhythmia recurrences (hazard ratio, 1.048; P = 0.039). A receiver‐operating characteristic analysis demonstrated that at an optimal cutoff of 100.1 for the %RAVI/LAVI, the sensitivity and specificity for predicting arrhythmia recurrences were 85.7% and 71.4%, respectively. The Kaplan‐Meier analysis showed that arrhythmia recurrences were less frequent in patients with a %RAVI/LAVI of <100.1 than in those with a %RAVI/LAVI of ≥100.1 (P < 0.0001), and the arrhythmia‐free survival rate at 12 months was 89.7% and 45.2%, respectively.

Conclusions

The ratio of the RAVI to LAVI on CT may be a useful predictor of clinical outcomes after CPVI of LSP‐AF. LSP‐AF patients with a less predominant right atrial enlargement relative to the left atrial enlargement may be good candidates for successful treatment with CPVI alone as the ablation strategy for LSP‐AF.
New discoveries of tetrapods (ichthyostegid‐like and whatcheeriid‐like) in the Famennian (Late Devonian) localities of Strud and Becco (Belgium)
Authors: Olive Sébastien , Ahlberg Per E. , Pernègre Vincent N. , Poty Édouard , Steurbaut Étienne , Clément Gaël
Published: September 2016

The origin of tetrapods is one of the key events in vertebrate history. The oldest tetrapod body fossils are Late Devonian (Frasnian–Famennian) in age, most of them consisting of rare isolated bone elements. Here we describe tetrapod remains from two Famennian localities from Belgium: Strud, in the Province of Namur, and Becco, in the Province of Liège. The newly collected material consists of an isolated complete postorbital, fragments of two maxillae, and one putative partial cleithrum, all from Strud, and an almost complete maxilla from Becco. The two incomplete maxillae and cleithrum from Strud, together with the lower jaw previously recorded from this site, closely resemble the genusIchthyostega, initially described from East Greenland. The postorbital from Strud and the maxilla from Becco do not resemble the genusIchthyostega. They show several derived anatomical characters allowing their tentative assignment to a whatcheeriid‐grade group. The new tetrapod records show that there are at least two tetrapod taxa in Belgium and almost certainly two different tetrapod taxa at Strud. This locality joins the group of Devonian tetrapod‐bearing localities yielding more than one tetrapod taxon, confirming that environments favourable to early tetrapod life were often colonized by several tetrapod taxa.
A Comparison of Genicular Nerve Treatment Using Either Radiofrequency or Analgesic Block with Corticosteroid for Pain after a Total Knee Arthroplasty: A Double‐Blind, Randomized Clinical Study
Authors: Qudsi‐Sinclair Salima , Borrás‐Rubio Enrique , Abellan‐Guillén Juan F. , Padilla del Rey María Luz , Ruiz‐Merino Guadalupe
Published: September 2016

Background

Knee osteoarthritis is a disease that affects a third of the population over 65 years of age, and it is increasingly becoming a motive for consultation and a source of pain and disability. The gold standard surgical treatment is a total knee arthroplasty; however, 15% to 30% of patients who have undergone surgery continue to experience pain and functional limitation.

Methods

A double‐blind, randomized clinical study compared neurolysis using traditional radiofrequency (RF) to local anesthetic and corticosteroid block of the superolateral, superomedial, and inferomedial branches of the knee genicular nerves in patients who had total knee arthroplasty but still experience pain.

Results

Twenty‐eight patients, 14 on each treatment arm, were followed for over a 1‐year period. A reduction in pain and significant joint function improvement during the first 3 to 6 months was shown, with similar results using both techniques. No adverse effects were noted. An improvement in both disability and quality of life was observed, as well as a reduction in the need for analgesics in both treatment groups.

Conclusions

Further clinical trials need to be undertaken, with a larger sample size, in order to demonstrate the efficacy of this technique and to detect the possible appearance of any long‐term adverse effects.
Monitoring 3D Vibrations in Structures using High‐resolution Blurred Imagery
Authors: McCarthy David M. J. , Chandler Jim H. , Palmeri Alessandro
Published: September 2016

Photogrammetry has been used in the past to monitor the laboratory testing of civil engineering structures using multiple image‐based sensors. This has been successful, but detecting vibrations during dynamic structural tests has proved more challenging because they usually depend on high‐speed cameras which often results in lower image resolutions and reduced accuracy. To overcome this limitation, a novel approach has been devised to take measurements from blurred images in long‐exposure photographs. The motion of the structure is captured in individual motion‐blurred images without dependence on imaging speed. A bespoke algorithm then determines each measurement point's motion. Using photogrammetric techniques, a model structure's motion with respect to different excitation frequencies is captured and its vibration envelope recreated in 3D. The approach is tested and used to identify changes in the model's vibration response.
A whole‐killed, blood‐stage lysate vaccine protects against the malaria liver stage
Authors: Lu X. , Liu T. , Zhu F. , Chen L. , Xu W.
Published: September 2016

Although the attenuated sporozoite is the most efficient vaccine to prevent infection with the malaria parasite, the limitation of a source of sterile sporozoites greatly hampers its application. In this study, we found that the whole‐killed, blood‐stage lysate vaccine could confer protection against the blood stage as well as the liver stage. Although the protective immunity induced by the whole‐organism vaccine against the blood stage is dependent on parasite‐specific CD4+ T‐cell responses and antibodies, in mice immunized with the whole‐killed, blood‐stage lysate vaccine, CD8+, but not CD4+ effector T‐cell responses greatly contributed to protection against the liver stage. Thus, our data suggested that the whole‐killed, blood‐stage lysate vaccine could be an alternative promising strategy to prevent malaria infection and to reduce the morbidity and mortality of patients with malaria.