bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding HPV tests and their appropriate applications
Authors: Cubie H. A. , Cuschieri K.
Published: September 2013

Greater understanding of the role played by human papillomavirus (HPV) in the causation of disease has led to the development of an increasing number of HPV tests with different characteristics. The bewildering choice facing healthcare professionals and providers is daunting. Clearly, HPV testing is no longer simply of research interest, but can provide information that can be used for individual patient management and at the population level for cervical screening and vaccine surveillance. This review aims to provide the background to the development of HPV tests, to explain the different technologies and to discuss the challenges of the application of these optimally in the varied contexts of disease management.

Few HPV tests are approved for clinical use and it is important that clinicians understand which test can be utilized, in what circumstances, with what specimens and the meaning of the report issued. HPV testing is no longer applicable only to cervical disease, and we have suggested additional areas, such as the oropharynx, in which HPV testing services might be implemented in the near future. New tests will continue to emerge and we have identified some of the indirect measures of HPV activity, or biomarkers, that could help in the risk stratification of HPV infection and associated disease.

The challenges relating to the optimal application of the various HPV technologies are compounded by the lack of evidence regarding their performance in vaccinated populations. Currently published work, including modelling studies, has been undertaken in non‐immunized populations. We therefore end by addressing the issues regarding appropriate strategies and tests for immunized populations.
Spatially explicit analyses highlight idiosyncrasies: species extinctions and the loss of evolutionary history
Authors: Batista Mariana C. G. , Gouveia Sidney F. , Silvano Débora L. , Rangel Thiago F.
Published: September 2013

Aim

Scenarios of species extinction have been created to assess how the loss of species affects the loss of evolutionary history (EH). However, estimates of the rate of EH loss at regional scales are scarce. Here we provide the first estimate of projected EH loss of New World anurans encompassing both continental and regional scales.

Location

New World.

Methods

We implemented two distinct extinction scenarios to investigate variations in rates of EH loss, contrasted through a suboptimality index. The analytical procedure was carried out on a continental scale, comprising all 3017 New World anuran species, and on a regional scale, for each of the 3858 cells of the grid, according to the species assemblage within each cell.

Results

About 64% of the EH of the New World anurans would still exist even if half of the New World anurans go extinct, regardless of whether extinction is random or threatened species go extinct first. The extinction of all 951 threatened anuran species in the New World, or the same number of species chosen randomly from the 3017 total, would cause similar loss of EH. However, spatially explicit analyses that account for idiosyncrasies in the phylogenetic structure and threat status of each regional assemblage show that EH loss caused by extinction of threatened species is uneven across the continent.

Main conclusions

Conservation strategies that aim to mitigate pressures on EH loss must be designed with a focus on regional spatial scales, in order to embody the phylogenetic structure and threat status of species that are particular to each assemblage.
Has Cinderella Become so Fragmented That She Can No Longer Identify her Area of Expertise
Authors: Feather Denis
Published: September 2013

The question addressed by this article is whether lecturers delivering HEBCs in FECs in England perceive their institutions to be fragmented, i.e. has Cinderella lost her identity via the demands and pressures placed upon her by the UK government and other stakeholders? The research adopts a qualitative approach, where 26 interviews were conducted in FECs in the Yorkshire and Humber regions. The findings, although not surprising, were quite candid and indicated that there may be some role conflict, as management seemed to prioritise funding over everything else, including the well‐being of their employees.
Adolescent Literacy in Europe — An Urgent Call for Action
Authors: Sulkunen Sari
Published: September 2013

This article focuses on the literacy of the adolescents who, in most European countries, are about to leave or have recently left basic education with the assumption that they have the command of functional literacy as required in and for further studies, citizenship, work life and a fulfilling life as individuals. First, the overall performance level in the EU member countries with a special focus on poor literacy is examined. Also, the most persistent inequities in adolescent literacy are reviewed, including the gender gap, the socio‐economic gap, the migrant gap and the digital gap. Secondly, the focus turns to developing adolescent literacy and reading education in Europe in a constantly changing global context with increasing literacy demands calling for a lifelong and a life‐wide development of literacy. The article outlines elements of effective literacy education for adolescents in Europe.
Receptor trafficking hypothesis revisited: Plasticity of AMPA receptors during established status epilepticus
Authors: Rajasekaran Karthik , Joshi Suchitra , Kozhemyakin Maxim , Todorovic Marko S. , Kowalski Samuel , Balint Corinne , Kapur Jaideep
Published: September 2013

Status epilepticus (SE) is associated with a dynamic plasticity of postsynaptic neurotransmitter receptors. The plasticity of AMPA receptor (AMPAR)–mediated glutamatergic transmission during established SE (ESE), after development of benzodiazepine resistance, was evaluated. There was increased frequency and inward rectification of AMPAR‐mediated excitatory postsynaptic currents at Schaffer collateral ‐ CA1 pyramidal neuron synapses during ESE. Surface expression of the GluA1 subunit increased, and this was a consequence of N‐methyl‐d‐aspartate receptor activation. Further, diminishing glutamate release by activation of somatostatin receptors prevented SE. These studies suggest that AMPAR‐mediated glutamatergic transmission is strengthened during ESE.
Antagomirs and microRNA in status epilepticus
Authors: Henshall David C.
Published: September 2013

MicroRNAs are an important class of noncoding RNA, which function as posttranscriptional regulators of protein levels within cells. Emerging work has revealed that status epilepticus produces select changes to microRNA levels within the brain, which may impact levels of proteins involved in neuronal structure and excitability, gliosis, inflammation, and apoptosis. Animal studies show that targeting microRNAs using locked nucleic acid–modified oligonucleotides (“antagomirs”) can have potent effects on status epilepticus, seizure‐induced neuronal death, and the later emergence of recurrent spontaneous seizures. Accordingly, microRNA‐based therapeutics may have potential as a future treatment of status epilepticus.
Role of adenosine in status epilepticus: A potential new target?
Authors: Boison Detlev
Published: September 2013

The homeostatic bioenergetic network regulator adenosine is an endogenous anticonvulsant of the brain that plays critical roles in seizure termination and postictal refractoriness. Adenosine homeostasis in the adult brain is largely under the control of metabolic clearance through adenosine kinase (ADK), expressed predominantly in astrocytes. The role of adenosine in status epilepticus (SE) appears to be a double‐edged sword. We demonstrated that the severity of an SE clearly depends on the expression levels of ADK. A genetic knockdown of ADK prevented SE in a mouse model, whereas transgenic overexpression of the enzyme aggravated the SE. Therefore, ADK inhibition or adenosine augmentation might be a therapeutic strategy to terminate or attenuate an SE. On the other hand, SE triggers a surge of endogenous adenosine, which may initiate secondary events leading to epileptogenesis. Two new findings point into this direction: (1) Elevated adenosine triggers changes in the epigenome; and (2) SE triggers transient changes in ADK expression, which have been linked to neurogenesis. Although the ADK/adenosine system is an attractive target for the attenuation of an SE, the same system may also trigger downstream events related to epileptogenesis.
The neurophysiologic types of nonconvulsive status epilepticus:EEGpatterns of different phenotypes
Authors: Sutter Raoul , Kaplan Peter W.
Published: September 2013

Proceeding from the proposed classification of status epilepticus syndromes byShorvon in 1994, we performed a systematic search for reports presenting electroencephalography (EEG) patterns of nonconvulsive status epilepticus (NCSE) on all syndromes in the classification, where possible. Using the online medical search enginePubMed for 22 different search strategies,EEGpatterns supporting a diagnosis ofNCSEwere sought. From a total of 4,328 search results, 123 cases with correspondingEEGpatterns could be allocated to underlying epilepsy syndromes. Based on the characteristicEEGpatterns found for the differentNCSEsyndromes, we present a synthesis of the significantEEGmorphologies and evolutions in the individualNCSEsyndromes.
Gene therapy in status epilepticus
Authors: Walker Matthew C. , Schorge Stephanie , Kullmann Dimitri M. , Wykes Robert C. , Heeroma Joost H. , Mantoan Laura
Published: September 2013

Gene therapy in human disease has expanded rapidly in recent years with the development of safer and more effective viral vectors, and presents a novel approach to the treatment of epilepsy. Studies in animals models have demonstrated that overexpression of inhibitory peptides can modify seizure threshold, prevent the development of epilepsy, and modify established epilepsy. More recently there has been a flurry of studies using optogenetics in which light‐activated channels expressed in neurons can transiently change neuronal excitability on exposure to light, thereby enabling the development of closed loop systems to detect and stop seizure activity. The treatment of status epilepticus presents its own challenges. Because of both the delay in gene expression following transfection and also the necessity of using focal transfection, there are a limited number of situations in which gene therapy can be used in status epilepticus. One such condition is epilepsia partialis continua (EPC). We have used gene therapy in a model of EPC and have shown that we can “cure” the condition. Recent evidence suggesting that gene therapy targeting subcortical regions can modify generalized or more diffuse epilepsies, indicates that the range of situations in status epilepticus in which gene therapy could be used will expand.
FIRES and IHHE: Delineation of the syndromes
Authors: Nabbout Rima
Published: September 2013

Idiopathic hemiconvulsion hemiplegia and epilepsy syndrome (IHHE) and febrile infection–related epilepsy syndrome (FIRES) are rare epileptic syndromes characterized by the occurrence of status epilepticus in a previously healthy child during or closely after a febrile episode. In both syndromes, there is no evidence of central nervous system infection (encephalitis) and the etiology remains unclear. Treatment is disappointing, particularly in FIRES, except for a response to ketogenic diet (KD) in half of patients. In IHHS, children develop hemispheric brain atrophy with contralateral hemiplegia, epilepsy, and a variable degree of cognitive deficit. Patients with FIRES develop refractory epilepsy with severe cognitive deficit affecting the temporal and frontal lobe functions. The role of inflammation is hypothesized with a vicious circle involving inflammation and seizure activity facilitated by brain maturation putting them under the concept of “acute encephalopathy with inflammation‐mediated status epilepticus.”
Multimodal invasive monitoring in status epilepticus: What is the evidence it has a place?
Authors: Helbok Raimund , Claassen Jan
Published: September 2013

The underlying pathophysiology of status epilepticus (SE) remains mostly invisible to the clinician in the intensive care unit (ICU) setting. In animal studies associated hemodynamic and brain neurochemical changes have been well described. In the last decade, bedside invasive neuromonitoring techniques allow the assessments of changes in focal and global cerebral physiology associated with ictal activity on the tissue level in humans. Recent studies demonstrate that laboratory research insufficiently replicates the complexity of the human condition. Herein we summarize the current knowledge gained from human studies integrating cortical electrographic and brain tissue metabolic and hemodynamic information into the current pathophysiologic concept of SE in humans. With increasing experience gained by the use of extended neuromonitoring, we are more and more able to understand associated hemodynamic and brain neurochemical changes in patients with SE. In the future, this information can potentially provide integrated pathophysiologic end points into SE treatment concepts.
Trafficking of NMDA receptors during status epilepticus: Therapeutic implications
Authors: Wasterlain Claude G. , Naylor David E. , Liu Hantao , Niquet Jerome , Baldwin Roger
Published: September 2013

We used two models of status epilepticus (SE) to study trafficking of N‐methyl‐d‐aspartate (NMDA) receptors. SE is associated with increased surface expression of NR1 subunits of NMDA receptors, and with an increase of NMDA synaptic and extrasynaptic currents suggesting an increase in number of functional NMDA receptors on dentate granule cells. The therapeutic implications of these results are discussed.
Neuroactive steroids for the treatment of status epilepticus
Authors: Rogawski Michael A. , Loya Carlos M. , Reddy Kiran , Zolkowska Dorota , Lossin Christoph
Published: September 2013

Benzodiazepines are the current first‐line standard‐of‐care treatment for status epilepticus but fail to terminate seizures in about one third of cases. Synaptic GABAA receptors, which mediate phasic inhibition in central circuits, are the molecular target of benzodiazepines. As status epilepticus progresses, these receptors are internalized and become functionally inactivated, conferring benzodiazepine resistance, which is believed to be a major cause of treatment failure. GABAA receptor positive allosteric modulator neuroactive steroids, such as allopregnanolone, also potentiate synaptic GABAA receptors, but in addition they enhance extrasynaptic GABAA receptors that mediate tonic inhibition. Extrasynaptic GABAA receptors are not internalized, and desensitization of these receptors does not occur during continuous seizures in status epilepticus models. Here we review the broad‐spectrum antiseizure activity of allopregnanolone in animal seizure models and the evidence for its activity in models of status epilepticus. We also demonstrate that allopregnanolone inhibits ongoing behavioral and electrographic seizures in a model of status epilepticus, even when there is benzodiazepine resistance. Parenteral allopregnanolone may provide an improved treatment for refractory status epilepticus.
Cognitive behavior therapy for depression in people with epilepsy: A systematic review
Authors: Gandy Milena , Sharpe Louise , Perry Kathryn Nicholson
Published: September 2013

Cognitive behavioral therapy (CBT) is a recommended treatment for depression in people with epilepsy (PWE); however, a recentCochrane review found that there was insufficient evidence that any psychological therapy is effective. This conclusion provides little help to clinicians who provide interventions for depressedPWE. The aim of this review was to systematically and qualitatively review the literature on the efficacy ofCBTfor depression inPWEbased on randomized controlled trials (RCTs) and case series. We aim to determine patterns in the literature to inform the type ofCBT, if any, that should be offered toPWEwho are depressed. DatabasesMEDLINE,PsycINFO, and theCochraneEBMReviews were searched viaOVID. Selection criteria included the following: (1) participants with epilepsy; (2) use ofCBT; (3) valid depression outcome measure; and (4) published in peer‐reviewed journal inEnglish. Inclusions of studies were assessed by two independent researchers. We identified 14 outcome papers for 13CBTtrials including 6 randomized controlled trials (RCTs) and 7 case series. Positive effects ofCBTon depression were reported in three of sixRCTs. A review of their content revealed that all effectiveRCTs specifically tailoredCBTto improve depression. Conversely, two of threeRCTs that failed to find depression‐related effects focused on improving seizure‐control. This pattern was also observed in the case series. Although limited in number and having methodologic limitations, the treatment studies included in our review suggest that interventions tailored toward improving depression are possibly efficacious, whereas those that focus on improving seizure control do not appear to be. However, this review highlights that there is need for furtherRCTs in this area in order to confirm the possible efficacy ofCBTfor depression inPWE.
The carrier prevalence of severe combined immunodeficiency, lavender foal syndrome and cerebellar abiotrophy in Arabian horses in South Africa
Authors: Tarr C. J. , Thompson P. N. , Guthrie A. J. , Harper C. K.
Published: September 2013

Reasons for performing study

The carrier prevalence of severe combined immunodeficiency (SCID), lavender foal syndrome (LFS) and cerebellar abiotrophy (CA) in Arabian foals in South Africa was determined in order to quantify the potential impact of these conditions locally. Furthermore, the carrier prevalence of SCID prior to and following the introduction of a genetic test was compared to evaluate the effect of testing in the population.

Objectives

To estimate the carrier prevalence of SCID, LFS and CA in registered purebred Arabians born in South Africa in the 2004/5 and 2009/10 foaling seasons and compare the changes in prevalence in these disorders between the 2 groups of foals.

Study design

Cross‐sectional survey.

Methods

Samples were collected from individuals randomly selected from 2 populations of purebred Arabian foals born during the 2004/5 and 2009/10 foaling seasons. Genetic testing for SCID, LFS and CA was performed on DNA extracts using specific polymerase chain reactions, with the products being analysed using fragment analysis on a genetic analyser.

Results

The carrier prevalence of LFS and CA for the 2009/10 season was 11.7% (95% confidence interval [CI] 7.6–17.0%) and 5.1% (95% CI 2.5–9.1%), respectively, with no statistically significant change in prevalence between the 2004/5 and 2009/10 foaling seasons. However, the carrier prevalence of SCID was found to have decreased significantly from 6.4% (95% CI 4.8–8.3%) in the 2004/5 foals to 3.4% (95% CI 2.2–5.1%) in the 2009/10 foals (P = 0.009).

Conclusions

The results of this study indicate that genetic screening of Arabian horses for SCID may have played a role in significantly reducing the carrier prevalence within the breeding population and thereby reducing the birth of clinically affected individuals. This study provides an indication of the positive effect of genetic screening for specific conditions in horses.
Characterizing drought stress and trait influence on maize yield under current and future conditions
Authors: Harrison Matthew T. , Tardieu François , Dong Zhanshan , Messina Carlos D. , Hammer Graeme L.
Published: September 2013

Global climate change is predicted to increase temperatures, alter geographical patterns of rainfall and increase the frequency of extreme climatic events. Such changes are likely to alter the timing and magnitude of drought stresses experienced by crops. This study used new developments in the classification of crop water stress to first characterize the typology and frequency of drought‐stress patterns experienced by European maize crops and their associated distributions of grain yield, and second determine the influence of the breeding traits anthesis‐silking synchrony, maturity and kernel number on yield in different drought‐stress scenarios, under current and future climates. Under historical conditions, a low‐stress scenario occurred most frequently (ca. 40%), and three other stress types exposing crops to late‐season stresses each occurred in ca. 20% of cases. A key revelation shown was that the four patterns will also be the most dominant stress patterns under 2050 conditions. Future frequencies of low drought stress were reduced by ca. 15%, and those of severe water deficit during grain filling increased from 18% to 25%. Despite this, effects of elevated CO2 on crop growth moderated detrimental effects of climate change on yield. Increasing anthesis‐silking synchrony had the greatest effect on yield in low drought‐stress seasonal patterns, whereas earlier maturity had the greatest effect in crops exposed to severe early‐terminal drought stress. Segregating drought‐stress patterns into key groups allowed greater insight into the effects of trait perturbation on crop yield under different weather conditions. We demonstrate that for crops exposed to the same drought‐stress pattern, trait perturbation under current climates will have a similar impact on yield as that expected in future, even though the frequencies of severe drought stress will increase in future. These results have important ramifications for breeding of maize and have implications for studies examining genetic and physiological crop responses to environmental stresses.
Post‐Traumatic Stress Disorder in U.S. Soldiers With Post‐Traumatic Headache
Authors: Rosenthal Jacqueline F. , Erickson Jay C.
Published: September 2013

Objective

To determine the impact of post‐traumatic stress disorder (PTSD) on headache characteristics and headache prognosis in U.S. soldiers with post‐traumatic headache.

Background

PTSD and post‐concussive headache are common conditions among U.S. Army personnel returning from deployment. The impact of comorbid PTSD on the characteristics and outcomes of post‐traumatic headache has not been determined in U.S. Army soldiers.

Methods

A retrospective cohort study was conducted among 270 consecutive U.S. Army soldiers diagnosed with post‐traumatic headache at a single Army neurology clinic. All subjects were screened for PTSD at baseline using the PTSD symptom checklist. Headache frequency and characteristics were determined for post‐traumatic headache subjects with and without PTSD at baseline. Headache measures were reassessed 3 months after the baseline visit, and were compared between groups with and without PTSD.

Results

Of 270 soldiers with post‐traumatic headache, 105 (39%) met screening criteria for PTSD. There was no significant difference between subjects with PTSD and those without PTSD with regard to headache frequency (17.2 vs 15.7 headache days per month; P = .15) or chronic daily headache (58.1% vs 52.1%; P = .34). Comorbid PTSD was associated with higher headache‐related disability as measured by the Migraine Disability Assessment Score. Three months after the baseline neurology clinic visit, the number of subjects with at least 50% reduction in headache frequency was similar among post‐traumatic headache cases with and without PTSD (25.9% vs 26.8%).

Conclusion

PTSD is prevalent among U.S. Army soldiers with post‐traumatic headache. Comorbid PTSD is not associated with more frequent headaches or chronic daily headache in soldiers evaluated at a military neurology clinic for chronic post‐traumatic headache. Comorbid PTSD does not adversely affect short‐term headache outcomes, although prospective controlled trials are needed to better assess this relationship.
Catastrophic Reversible Cerebral Vasoconstriction Syndrome Associated With Serotonin Syndrome
Authors: John Seby , Donnelly Megan , Uchino Ken
Published: September 2013

Objectives

To report fulminant cases of reversible cerebral vasoconstriction syndrome (RCVS) in the setting of serotonin syndrome.

Background

RCVS is characterized by acute onset of severe headaches, with or without neurologic deficit, with evidence of reversible cerebral vasoconstriction. It is often benign, and prognosis is generally considered favorable. In the largest prospective study on RCVS, only 4% of patients were disabled from strokes and there were no fatalities.

Methods

We report a case series.

Results

We report 2 women with history of depression on selective serotonin re‐uptake inhibitors who presented with thunderclap headache and dizziness, respectively. Through the course of hospitalization, both patients developed rigidity, diaphoresis, fever, tachycardia with labile blood pressures and clonus on examination. Since there was a recent addition/increase in a known serotonergic agent, they met criteria for serotonin syndrome. Cerebrovascular imaging in both patients revealed severe multi‐focal vessel narrowing. The first patient developed large bi‐hemispheric ischemic infarcts and increased intra‐cranial pressure that was refractory to management, and she eventually expired. The second patient developed bilateral parieto‐occipital strokes and decerebrate posturing. Her course slowly stabilized, and she was eventually discharged with residual left‐sided hemiparesis. Repeat cerebrovascular imaging 1 month later showed normal vessels. In both patients, intra‐arterial nicardipine infusion improved angiographic appearance of stenoses, consistent with RCVS.

Conclusions

Both cases satisfied the Sternbach criteria for serotonin syndrome. Fatality in case 1 prevents demonstration of reversal of cerebral vasoconstriction, but improvement of arterial diameters with intra‐arterial calcium channel blockers in both cases suggests that both had RCVS. Serotonergic agents are known triggers of RCVS, but the concurrent presence of serotonin syndrome likely precipitated the malignant course in our patients. Severe clinical and angiographic manifestations should be considered as part of the spectrum of RCVS.
Therapeutic strategy for patients with bleeding rectal varices complicating liver cirrhosis
Authors: Yoshino Kiyoko , Imai Yukinori , Nakazawa Manabu , Chikayama Taku , Ando Satsuki , Sugawara Kayoko , Hamaoka Kazuhiro , Inao Mie , Oka Masashi , Mochida Satoshi
Published: September 2013

Aim

Although rupture of rectal varices is rarely encountered, it may provoke massive and fatal hemorrhage in patients with liver cirrhosis. We examined the clinical features of patients showing bleeding from rectal varices to establish a suitable therapeutic strategy for the lesions.

Methods

Twelve cirrhotic patients with bleeding rectal varices were enrolled. Surgical suture, endoscopic variceal ligation (EVL) or balloon tamponade was performed to achieve the initial hemostasis. Then, the feeding and drainage vessels of the varices were evaluated by computed tomography, and additional procedures were undertaken: EVL was performed when the sizes of the varices and feeding vessels were small. In contrast, in patients with varices of large sizes, balloon‐occluded retrograde transvenous obliteration (B‐RTO) was performed when single or two drainage vessels were identified, while endoscopic injection sclerotherapy (EIS) using ethanolamine oleate was carried out for varices with three or more drainage vessels.

Results

The Child–Pugh class was grade A in four, B in six and C in two patients. Eleven patients had received previous therapy for esophageal varices. Initial hemostasis was achieved by surgical suture in three patients, EVL in one patient and balloon tamponade in two patients. EVL, EIS and B‐RTO were carried out as additional procedures in seven, three and one patient, respectively. Rebleeding from the rectal varices occurred in only one patient who underwent EVL as an additional procedure.

Conclusion

Bleeding from rectal varices was controlled satisfactorily by the therapeutic strategy of selecting EVL, EIS or B‐RTO as an additional therapy according to the size and hemodynamics of the varices.
Influence of splenectomy in patients with liver cirrhosis and hypersplenism
Authors: Nomura Yoriko , Kage Masayoshi , Ogata Toshirou , Kondou Reiichirou , Kinoshita Hisafumi , Ohshima Kouichi , Yano Hirohisa
Published: September 2013

Aim

Splenectomy improves hypersplenic thrombocytopenia in cirrhotic patients with hypersplenism. However, the long‐term influence of splenectomy has not been clarified. We examined whether splenectomy improved liver fibrosis and caused immunological changes.

Methods

We collected liver and spleen specimens and peripheral blood (PB) from 26 patients with hepatitis C virus‐related liver cirrhosis. An immunohistochemical examination of CD4, CD8, forkhead box P3, granzyme B and transforming growth factor‐β1, and Masson‐trichrome stain were performed in spleen and liver tissues and in seven cases of follow‐up liver biopsy sections obtained after splenectomy. We obtained PB before and at various intervals after splenectomy. We also examined the ratio of CD4+ and CD8+ lymphocytes in PB using flow cytometry.

Results

We observed improvements in liver fibrosis in four biopsy specimens obtained after splenectomy, in which fibrotic areas significantly decreased from 19.5% to 8.2% (P < 0.05). Increases were also observed in the ratio of CD8+ cells in PB after splenectomy, which resulted in a significant decrease in the CD4+/CD8+ ratio (P < 0.001). The carcinogenic rate in patients with a CD4+ : CD8+ ratio that decreased by more than 0.5 at 1 month after splenectomy was significantly lower than that in patients with a ratio that decreased by less than 0.5 (P < 0.05).

Conclusion

Splenectomy may improve liver fibrosis and cause beneficial immunological changes in cirrhotic patients with hepatitis. Improvements in antitumor mechanisms can be also expected.
Implications of combined ovariectomy and glucocorticoid (dexamethasone) treatment on mineral, microarchitectural, biomechanical and matrix properties of rat bone
Authors: Govindarajan Parameswari , Khassawna Thaqif , Kampschulte Marian , Böcker Wolfgang , Huerter Britta , Dürselen Lutz , Faulenbach Miriam , Heiss Christian
Published: September 2013

Osteoporosis is one of the deleterious side effects of long‐term glucocorticoid therapy. Since the condition is particularly aggressive in postmenopausal women who are on steroid therapy, in this study we have attempted to analyse the combined effect of glucocorticoid (dexamethasone) treatment and cessation of oestrogen on rat bone. The dual aim was to generate osteoporotic bone status in a short time scale and to characterise the combination of glucocorticoid–postmenopausal osteoporotic conditions. Sprague Dawley rats (N = 42) were grouped randomly into three groups: untreated control, sham‐operated and ovariectomized–steroid (OVX‐Steroid) rats. Control animals were euthanized with no treatment [Month 0 (M0)], while sham and OVX‐Steroid rats were monitored up to 1 month (M1) and 3 months (M3) post laparotomy/post OVX‐Steroid treatment. Histology, dual‐energy X‐ray absorptiometry (DXA), micro‐computed tomography (micro‐CT), and biomechanical andmRNAexpression analysis of collagenous, non‐collagenous matrix proteins and osteoclast markers were examined. The study indicated enhanced osteoclastogenesis and significantly lower bone mineral density (BMD) in the OVX‐Steroid rats withZ‐scores below −2.5, reduced torsional strength, reduced bone volume (BV/TV%), significantly enhanced trabecular separation (Tb.S), and less trabecular number (Tb.N) compared with sham rats. Osteoclast markers, cathepsin K and MMP 9 were upregulated along with Col1α1 and biglycan with no significant expression variation in fibronectin, MMP 14, LRP‐5, Car II and TNC. These results show higher bone turnover with enhanced bone resorption accompanied with reduced torsional strength in OVX‐Steroid rats; and these changes were attained within a short timeframe. This could be a useful model which mimics human postmenopausal osteoporosis that is associated with steroid therapy and could prove of value both in disease diagnosis and for testing generating and testing biological agents which could be used in treatment.
Selection of Ferroelectric Ceramics for Transducers and Electrical Energy Storage Devices
Authors: Vats Gaurav , Vaish Rahul , Bowen Chris R.
Published: September 2013

The selection of an optimal ferroelectric material according to the user requirements is a crucial as well as onerous task; examples of such requirements include high efficiency, sensitivity, wide operating temperature, and frequency range, compact size, low cost and low loss, etc. In this study, quality function deployment (QFD) in combination with multiple attribute decision‐making (MADM) is employed for material selection. Pb(1‐x)Lax)(ZryTi(1‐y))O3 [PLZT (7/60/40)] (lead‐based) and (K0.44Na0.52Li0.04)‐(Nb0.84Ta0.1Sb0.06)O3 (KNN‐LT‐LS) (lead‐free) are found to be the top‐ranked piezoelectric ceramics for transducer applications. PLZT (7/60/40) (lead‐based) and 0.7Bi0.5Na0.5TiO3‐0.2Bi0.5K0.5TiO3‐0.1(Bi0.5Li0.5)TiO3 (lead‐free) are found to be best materials for energy storage applications.
Effect of mechanically damaged starch on wheat flour, noodle and steamed bread making quality
Authors: Liu Chong , Li Limin , Hong Jing , Zheng Xueling , Bian Ke , Sun Yu , Zhang Jie
Published: September 2013

Wheat flour was ground in an ultrafine pulveriser to obtain different levels of damaged starch (DS). The effect of DS content on physicochemical properties of flour and quality attributes of Chinese noodles and northern‐style Chinese steamed bread were investigated. Results showed that the degree of starch damage raised from 6.54% to 12.06% as grinding intensity increased from 0 to 130 Hz (P < 0.05). The falling number, sedimentation value, starch pastes' viscosity, dough proofing stability were negatively, while water absorption, pastes thermal stability, the degree of starch pastes and dough level were positively correlated with DS content, respectively (P < 0.05). The increase in DS content from 6.54% to 8.86% did not lead to a deterioration of texture characteristic, which might be attributed to the slight declining in hardness while enhancing in springiness and cohesiveness. The flour with DS content of 6.54–9.66% was suitable for steamed bread making.
Proteolysis texture and microstructure of low‐fat Tulum cheese affected by exopolysaccharide‐producing cultures during ripening
Authors: Oluk Aylin C. , Güven Mehmet , Hayaloglu Ali A.
Published: September 2013

The objective of the study was to determine the effects of exopolysaccharide (EPS)‐producing or non‐EPS‐producing starters on proteolysis, physical and microstructural characteristics of full‐fat or low‐fat Tulum cheeses during ripening. For this purpose, Tulum cheese was manufactured using full‐ or low‐fat milk with EPS‐producing and non‐EPS‐producing starter cultures. Chemical composition, proteolysis, texture profiles and microstructure of the cheeses were studied during 90 days of ripening. Urea‐PAGE of water‐insoluble and RP‐HPLC peptide profiles of water‐soluble fractions of the cheeses showed that the use of starters resulted in different degradation patterns in all cheeses during ripening. Although β‐casein exhibited similar degradation patterns in all cheeses, small differences are present in αs1‐casein degradation during ripening. Reducing fat in Tulum cheese changed the RP‐HPLC peptide profile of the cheeses. The use of EPS‐producing cultures improved the textural characteristics and changed the microstructure and proteolysis of low‐fat Tulum cheese.
Immune complexes and persistent high levels of serum vitamin B12
Authors: Remacha A. F. , Zapico E. , Sarda M. P. , Rojas E. , Simó M. , Remacha J. , Homs R. , Queralto J. M.
Published: September 2013

Introduction

Patients with persistent high levels of serum vitamin B12 were often referred to Hematology departments. In this study, characteristic of patients with serum vitamin B12 levels higher than 2500 pmol/L (high B12) were studied.

Methods

Prevalence of high B12 was evaluated during a 10‐month period. Samples with high B12 were incubated with polyethylene glycol (PEG) and a new measurement of vitamin B12 was carried out using the supernatant. As a pilot study, 26 frozen samples with high B12 were evaluated for changes in vitamin B12 after PEG. Moreover, a prospective study was carried out during three consecutive months. Size exclusion chromatography was employed to demonstrate the presence of immune complexes (ICs) with plasma vitamin B12‐binding proteins in some serum samples with high B12.

Results

Prevalence of high B12 was 1.3%. Results from 26 frozen samples and from a prospective study (28 cases) showed that undergoing vitamin B12 treatment was the main cause of high B12. However, ICs were detected in 10 frozen samples and in seven cases (25%) of the prospective study, respectively. Serum vitamin B12 decreased to normal values after precipitation with PEG, and size exclusion chromatography confirmed ICs. An association with autoimmune or hematological disorders was observed.

Conclusions

In patients with repeatedly high B12 levels, ICs were detected in approximately 25% of samples. Precipitation with PEG is an easy method to confirm the presence of ICs and to evaluate serum vitamin B12 levels in these patients.
Job satisfaction and subjective well‐being among Czech nurses
Authors: Gurková Elena , Haroková Sylvie , Džuka Jozef , Žiaková Katarína
Published: September 2013

The aim of the present study was to investigate the relationship between domains of the job satisfaction and components of subjective well‐being in nurses. A convenience sample of hospital nurses was recruited from six hospitals in Czech Republic. Data were collected using a set of questionnaires that included the McCloskey/Mueller Satisfaction Scale, the Positive Affect Scale, the Negative Affect Scale and the Personal Well‐being Index. We confirmed low association between job satisfaction and subjective well‐being of nurses. Satisfaction with extrinsic rewards, co‐workers and family/work balance accounted for only a small percentage of variance in cognitive component of subjective well‐being. Positive affect was predicted by interaction opportunities and scheduling. Negative affect was predicted by interaction opportunities and scheduling and intention to leave the actual workplace. Low percentage of the variance suggests that subjective well‐being is not strongly influenced by job satisfaction.
A systematic review of the experience of older women living and coping with type 2 diabetes
Authors: Li Jiemin , Drury Vicki , Taylor Beverley
Published: September 2013

This paper reports on a systematic review that sought to answer the research question: what is the experience of women living and coping with type 2 diabetes? A range of relevant terms were identified and electronic databases were searched. Only qualitative studies that explored the meaning of living and coping with type 2 diabetes and that included adult women aged ≥ 18 years were considered. We found evidence that women are challenged by their multi‐caregiving roles and the complexities of managing their diabetes simultaneously. For female patients with diabetes, holistic care and individual psycho‐education programmes appear to be facilitate more effective and successful diabetes management. In addition, carer programmes that provide information so that family and friends can support and assist the woman with diabetes are required.
A multinational study of self‐compassion and human immunodeficiency virus‐related anxiety
Authors: Kemppainen J. , Johnson M.O. , Phillips J.C. , Sullivan K.M. , Corless I.B. , Reid P. , Iipinge S. , Chaiphibalsarisdi P. , Sefcik E. , Chen W.‐T. , Kirksey K. , Voss J. , Rivero‐Méndez M. , Tyer‐Viola L. , Dawson Rose C. , Webel A. , Nokes K. , Portillo C. , Holzemer W.L. , Eller L. , Nicholas P. , Wantland D. , Brion J. , Beamon E.R.
Published: September 2013

Aim

This study represents an initial effort at examining the association between the construct of self‐compassion and human immunodeficiency virus (HIV)‐related anxiety in a multinational population with HIV disease.

Background

Previous studies have found that self‐compassion is a powerful predictor of mental health, demonstrating positive and consistent linkages with various measures of affect, psychopathology and well‐being, including anxiety.

Methods

Cross‐sectional data from a multinational study conducted by the members of the International Nursing Network for HIV Research (n = 1986) were used. The diverse sample included participants from Canada, China, Namibia, the United States of America and the territory of Puerto Rico. Study measures included the anxiety subscale of the Symptom Checklist‐90 instrument, the Brief Version Self‐Compassion Inventory and a single item on anxiety from the Revised Sign and Symptom Checklist.

Findings

Study findings show that anxiety was significantly and inversely related to self‐compassion across participants in all countries. We examined gender differences in self‐compassion and anxiety, controlling for country. Levels of anxiety remained significantly and inversely related to self‐compassion for both males (P = 0.000) and females (P = 0.000). Levels of self‐compassion and anxiety varied across countries.

Conclusions

Self‐compassion is a robust construct with cross‐cultural relevance. A culturally based brief treatment approach aimed at increasing self‐compassion may lend itself to the development of a cost effective adjunct treatment in HIV disease, including the management of anxiety symptoms.
The rationale of acid suppression in the treatment of acid‐related disease.
Authors: Mohamed AH , Hunt RH
Published: September 2013

Acid‐related disorders such as gastric and duodenal ulcers and gastro‐ oesophageal reflux disease have a high prevalence. Traditionally, acid suppression has proved to be the most effective means by which to heal these disorders, but relapse rates are high after cessation of treatment. Recently, Helicobacter pylori infection has been shown to modify several aspects of gastric function. Eradication of H. pylori infection virtually abolishes duodenal ulcer recurrence, implicating this organism in the pathogenesis of peptic ulcers and initiating a whole new strategy in the management of these acid‐related disorders. More potent degrees of acid suppression result in faster healing. Moderate acid suppression, as occurs with H2‐receptor antagonists, can heal just as many ulcers if treatment is continued for longer. The combination of proton pump inhibitors and antibiotics have successfully eradicated H. pylori in duodenal ulcer patients. Both H2‐receptor antagonists and the proton pump inhibitors have satisfactory safety profiles. Due to their superiority in symptom relief, and in the healing of duodenal and gastric ulcers and erosive oesophagitis, and due to their ability to eradicate H. pylori infection in combination with antibiotics, the proton pump inhibitors will probably become accepted as first‐line therapy for the treatment of acid‐related diseases.
The interaction of proton pump inhibitors with cytochromes P450.
Authors: Tucker GT
Published: September 2013

An understanding of the role of human cytochromes (CYPs) P450 in the metabolism of proton pump inhibitors (PPIs) is important in assuring the safety of these drugs. Species' differences in the metabolism of PPIs tend to overestimate the risk of some forms of toxicity in humans. Therefore, information on metabolism by human enzymes is essential for the prediction of drug interactions, or the lack of them. Although extrapolation from population mean data to the individual patient should be made with care, available data indicate that the use of PPIs, omeprazole, lansoprazole and particularly pantoprazole, should be relatively free of clinically‐significant drug interactions. This finding may reflect the level of therapeutic dosages for PPIs, and their short elimination half‐lives with respect to exposure to drug‐ metabolizing enzymes. Concern about low‐grade induction of CYPIA‐ mediated procarcinogen metabolism suggests a need for vigilance on the long‐term use of PPIs.
Safety of proton pump inhibitors‐‐an overview.
Authors: Arnold R
Published: September 2013

Drug‐induced achlorhydria in experimental animals results in excessive hypergastrinaemia, ECL‐cell hyperplasia and ECL‐cell carcinoidosis. However, these events have not been observed in long‐term studies in patients receiving proton pump inhibitors. Serum gastrin levels increase only modestly during acute and long‐term treatment. It is concluded that monitoring of serum gastrin levels and of fundic ECL cells is of no clinical relevance even during long‐term therapy with proton pump inhibitors. The clinically available proton pump inhibitors such as pantoprazole, omeprazole and lansoprazole are well tolerated, with a low incidence of side‐effects. Minor and serious side‐effects classified as possibly related to proton pump therapy have been described in up to 2.5% of patients. This is the same order of magnitude as that found in patients treated with H2‐receptor blockers and in placebo‐treated controls. In most cases, therefore, the observed side‐effects are unrelated to the intake of proton pump inhibitors. Minor adverse events include headache, diarrhoea, dizziness, pruritus and rash. Proton pump inhibitors are metabolized mainly in the liver via the cytochrome P450 system and interactions with drugs metabolized by the same system are possible. Evidence is becoming available which suggests that pantoprazole may have less potential to interact with the cytochrome P450 system than the other proton pump inhibitors. In the case of diazepam metabolism, pantoprazole had the least effect on prolongation of the diazepam effect. This may well be an advantage in the clinical use of the drug.
Comparison of the biomechanical properties of a ventral cervical intervertebral anchored fusion device with locking plate fixation applied to cadaveric canine cervical spines
Authors: Schöllhorn Bernhard , Bürki Alexander , Stahl Christina , Howard Judith , Forterre Franck
Published: September 2013

Objective

To evaluate fixation properties of a new intervertebral anchored fusion device and compare these with ventral locking plate fixation.

Study Design

In vitrobiomechanical evaluation.

Animals

Cadaveric canine C4–C7 cervical spines (n = 9).

Methods

Cervical spines were nondestructively loaded with pure moments in a nonconstraining testing apparatus to induce flexion/extension while angular motion was measured. Range of motion (ROM) and neutral zone (NZ) were calculated for (1) intact specimens, (2) specimens after discectomy and fixation with a purpose‐built intervertebral fusion cage with integrated ventral fixation, and (3) after removal of the device and fixation with a ventral locking plate.

Results

Both fixation techniques resulted in a decrease in ROM and NZ (P < .001) compared with the intact segments. There were no significant differences between the anchored spacer and locking plate fixation.

Conclusion

An anchored spacer appears to provide similar biomechanical stability to that of locking plate fixation.