bluuebunny/crossref_metadata_2025 huggingface dataset:
Peripancreatic vascular involvements of autoimmune pancreatitis
Authors: Ishikawa Takuya , Itoh Akihiro , Kawashima Hiroki , Ohno Eizaburo , Itoh Yuya , Nakamura Yosuke , Hiramatsu Takeshi , Miyahara Ryoji , Ohmiya Naoki , Haruta Jyunichi , Goto Hidemi , Hirooka Yoshiki
Published: July 2012

Background and Aim

Although peripancreatic vascular lesions are occasionally encountered in autoimmune pancreatitis (AIP), there are few reports focusing on these involvements. We aimed to investigate the peripancreatic vascular involvements associated with AIP.

Methods

We retrospectively analyzed 54 AIP patients who met the International Consensus Diagnostic Criteria for AIP between July 2003 and October 2010. All of the 54 patients were subjected to multiphasic multidetector computed tomography, and the prevalence, location and prognosis of peripancreatic vascular involvements were investigated.

Results

Of the 54 AIP patients, 24 (44.4%) exhibited involvements in the form of peripancreatic vascular lesions (stenoses of the splenic vein in 22 and of the superior mesenteric‐portal vein in 13, development of perigastric collateral circulation in 18, gastric varices with a red color sign in one and thrombosis inside the portal vein in one). Diffuse‐type AIP was associated with a significantly higher prevalence of vascular involvements compared with focal‐type AIP (P = 0.033). A total of 14 out of 16 patients who underwent corticosteroid treatment showed improvement in vascular lesions. One case followed up without corticosteroid treatment and presenting an obstruction of the splenic vein exhibited involvements in the form of an infarction and hemorrhagic cysts of the spleen and ultimately underwent distal pancreatectomy and splenectomy.

Conclusions

Autoimmune pancreatitis patients show a high prevalence of peripancreatic vascular involvements. Thus, patients with vascular involvements are suitable candidates for steroid therapy with evaluation of its potential merits and demerits, even if they are asymptomatic.
Hallucinations in severe, repeated Sydenham's chorea in an Indigenous girl in North‐West Queensland
Authors: Kuzulugil Deniz , Sheldrick Kyle , Wood Angela , Whitehall John
Published: July 2012

Sydenham's chorea is a cardinal feature of rheumatic fever. It is known by its dyskinesia and susceptibility to carditis, but associated psychiatric disorder is being recognised. This has included tics and obsessive compulsive disorder, but we report hallucinations in an indigenous girl, suffering her third bout of chorea.
Double representation of the wrist and elbow in human motor cortex
Authors: Strother Lars , Medendorp W. Pieter , Coros Alexandra M. , Vilis Tutis
Published: July 2012

Movements of the fingers, hand and arm involve overlapping neural representations in primary motor cortex (M1). Monkey M1 exhibits a core–surround organisation in which cortical representation of the hand and fingers is surrounded by representations of the wrist, elbow and shoulder. A potentially homologous organisation in human M1 has only been observed in a single study, a functional MRI (fMRI) study by [J.D. Meier, T.N. Aflalo, S. Kastner & M.S. Graziano.(2008) J Neurophysiol, 100(4), 1800–1812]. The results of their study suggested a double representation of the wrist in human M1, an unprecedented finding. Our purpose was to document and simultaneously provide evidence that would extend the presence of double representation of the wrist to that of the elbow. Using fMRI, we observed somatotopic maps in M1 and the supplementary motor area (SMA), the only other cortical area that showed robust within‐limb somatotopy during self‐timed finger, wrist and elbow movements. We observed double wrist and elbow representation that bracketed finger fMRI responses in M1 and the SMA. Our results show that the cortical locations of these double representations are well predicted by local cortical anatomy. Double representation of the wrist and elbow is important because it violates the traditional somatotopic progression in M1 but it is consistent with the representation of synergistic movements involving adjacent effectors.
Anarchy, Geography and Drift
Authors: Ferrell Jeff
Published: July 2012

Abstract: The consumerist economies of the late modern city, in combination with contemporary models of urban policing, operate to close down the public spaces of social life. In response, social groups dedicated to democratic urbanism utilize anarchic tactics of “dis‐organization” and direct action to reopen public space and to revitalize it with unregulated activity. Complicating and animating these spatial conflicts is the issue of drift. On the one hand, consumerist economies and contemporary policing strategies exacerbate urban drift, spawning the very sorts of spatial transgression they seek to control. On the other hand, many of the progressive movements that battle for open space and alternative economic arrangements themselves embrace a culture of drift, and explore drift for its anarchic and progressive potential. In this context drift can usefully be investigated as an emergent form of epistemology, community, and spatial politics.
Understanding Deception: Disentangling Skills from Conviction
Authors: Humphreys Les , Peelo Moira
Published: July 2012

Deception is often associated with economic gain and white‐collar crime. But studying deception highlights the need for criminologists and practitioners to move beyond legal definitions and conviction rates when attempting to achieve depth in understanding criminality, its motivations and possible specialisms. Further, to explore the complexity of deception requires recognition of the range of skills inherent in this modus operandi, which is better recognised as a potentially‐criminal tool found in much criminal behaviour. Theories that attempt to explain specialisation need to move on from a focus on crimes committed and give appropriate attention to skills employed.
Benefits of oral Polypodium Leucotomos extract in MM high‐risk patients
Authors: Aguilera P. , Carrera C. , Puig‐Butille J.A. , Badenas C. , Lecha M. , González S. , Malvehy J. , Puig S.
Published: July 2012

Background  UV radiation and the presence of melanocytic nevi are the main risk factors of sporadic melanoma (MM). Protection of skin by an oral photoprotective agent would have substantial benefits.

Objective  We investigated the possible role of an oral Polypodium leucotomos (PL) extract to improve systemic photoprotection in patients at risk of skin cancer analyzing the ability to decrease UV‐induced erythema. We also studied the interaction among MC1R polymorphisms and CDKN2A status with the minimal erythematous dose (MED) and their influence in the response after oral PL.

Methods  A total of 61 patients (25 with familial and/or multiple MM, 20 with sporadic MM and 16 with atypical mole syndrome without history of MM) were exposed to varying doses of artificial UVB radiation without and after oral administration of a total dose of 1080mg of PL.

Results  Oral PL treatment significantly increased the MED mean in all group patients (0.123 to 0.161 J/cm2, p<0.05). Although not significant, we noticed a stronger effect of PL on the MED of patients with familial MM compared to those with MM (U=273, p=0.06). Among the patients with familial MM, those exhibiting a mutated CDKN2A and/or polymorphisms in MC1R had the bigger differences in response to treatment with PL.

Limitations  Reduced number of patients. No control population.

Conclusions  Administration of PL leads to a significant reduction of sensitivity to UVR (p<0.05) in all patients. Dark‐eye patients and patients with higher UVR sensibility (lower basal MED) would be the most benefited from oral PL treatment.
Musculoskeletal growth in the upper arm in infants after obstetric brachial plexus lesions and its relation with residual muscle function
Authors: RUOFF JOHANNA M , VAN DER SLUIJS JOHANNES A , VAN OUWERKERK WILLEM J , JASPERS RICHARD T
Published: July 2012

Aim  Denervation after obstetric brachial plexus lesion (OBPL) is associated with reduced musculoskeletal growth in the upper arm. The aim of this study was to investigate whether reduced growth of upper arm flexor and extensor muscles is related to active elbow function and humeral length.

Method  In this study, 31 infants age less than 6 months (mean age 4.3mo; range 2.1–5.9mo; 17 males; 14 females;) with unilateral OBPL (Narakas class I, 19; II, 3; III, 2; and IV, 7) treated at the VU medical centre, in whom neurosurgical reconstruction was considered were prospectively studied using magnetic resonance imaging of both arms at a mean age of 4.3 months. Humeral length and the cross‐sectional area (CSA) of elbow flexor and extensor muscles were measured in both upper arms. Paresis of elbow function was estimated when the infants were a mean age of 4.5 months using the Gilbert score.

Results  Both flexor and extensor CSAs were significantly smaller on the affected side than on the unaffected side (88% [SD 32%], p=0.020, and 88% [SD 24%], p=0.001 respectively), as was humeral length (96% [SD 7%], p=0.005) (unaffected side 100% in all cases). There was no relation between the reduction in flexor and extensor CSA and residual muscle function. In 17 out of 31 patients, hypertrophy of flexor and/or extensor muscles was observed. Humeral length was not related to muscle parameters.

Interpretation  Denervation has different effects on muscle growth and function as well as bone growth. In young infants with an OBPL, muscle size is not a predictor of muscle function. Flexion contractures of the elbow later in childhood may not be explained by a dominance of flexor muscle mass in infants.
Gastrostomy tube feeding of children with cerebral palsy
Authors: SULLIVAN PETER
Published: July 2012

This commentary is on the original article by Dahlseng et al. on pages 938‐944 of this issue.
Relation of muscle size to function in neonatal brachial plexus palsy
Authors: YANG LYNDA J‐S
Published: July 2012

This commentary is on the original article by Ruoff et al. on pages 1050‐1056 of this issue.
Aspects of care culture in municipal care for elderly people: a hermeneutic documentary analysis of reports of abuse
Authors: Rytterström Patrik , Arman Maria , Unosson Mitra
Published: July 2012

Scand J Caring Sci; 2013; 27; 354–362

Aspects of care culture in municipal care for elderly people: a hermeneutic documentary analysis of reports of abuse

Introduction:  Care culture is an important contextual factor in care practice. Care culture refers to a process of creating meaning out of tradition, horizon and bildung. The care culture is often taken into consideration in situations that go beyond the everyday routine, such as cases of abuse. In Sweden, health care professionals are obliged to document and report any suspected bad conditions. Although the reports have the potential to communicate underlying values and assumptions about the care culture, such studies have not been performed.

Aim:  The aim of this study was to understand how elderly care abuse in institutions could be understood from a care culture perspective.

Design and methods:  A hermeneutic documentary analysis was conducted on 269 incident reports concerning suspected mistreatment of the elderly in three municipalities in Sweden. The hermeneutic analysis followed a four‐stage process: selecting and reading the text, setting out the context, closing the hermeneutic circle, and finally creating a conceptual bridge towards a critical understanding from a phenomenological lifeworld perspective.

Findings:  The care of the elderly in the municipality was based on a social culture that placed residents’ needs at the centre. Following routines were considered important in preventing mistreatment and were intended to ensure that all patients were treated fairly and equally. Care was described as task oriented and often lacking in interpersonal relations. From a phenomenological lifeworld perspective, it was interpreted that in the municipalities’ care of the elderly, there was a focus on elderly people’s freedom at the expense of the vulnerability aspects of well‐being.

Conclusion:  Raising awareness of the care culture underlying abuse could help to improve understanding of care practice. Change may be only possible when reflected on the existing perspectives underpinning the care culture, and integrate them into a broader framework for caring.
Repressed and silent suffering: consequences of childhood sexual abuse for women’s health and well‐being
Authors: Sigurdardottir Sigrun , Halldorsdottir Sigridur
Published: July 2012

Scand J Caring Sci; 2013; 27; 422–432

Repressed and silent suffering: consequences of childhood sexual abuse for women’s health and well‐being

Research results indicate that psychological trauma in childhood caused by child sexual abuse can have serious and widespread consequences for health and well‐being. The purpose of this study was to examine the consequences of childhood sexual abuse for women’s health and well‐being. The research methodology was phenomenology. Seven women with a history of childhood sexual abuse were interviewed twice with 1–6 months interval. For all the women, the abuse started when they were between 4 and 5. All of them were repeatedly violated and traumatized ever since then and were even still being victimized at the time of the interviews. The main result of the study is that time does not heal all wounds. All the women described great repressed and silent suffering in all aspects of life, and the abuse is still seriously affecting them and their loved ones. As children, they had learning problems, experienced bullying and had unexplained physical symptoms. In adulthood, they have been suffering multiple physical and psychological symptoms: five of them have fibromyalgia; all of them have been suffering chronic and widespread pain; they have all been dealing with depression and difficulty with close connections, and they all have trouble trusting others. Because they were kids, they have been using the health service to a great extent but without adequate help. It is important for health professionals to know the symptoms and consequences of childhood sexual abuse to be able to respond to adult survivors in a supportive and caring way. More effective therapeutic measures have to be developed to decrease their suffering.
Debt Dynamics and the Relationship Between Consumption and Cyclical Wealth Changes*
Authors: VEIRMAN EMMANUEL DE , DUNSTAN ASHLEY
Published: July 2012

We analyze the consumption–wealth relationship using a framework that accounts for transitory variation in wealth, and in a setting where transitory variation in household net worth is not dominated by boom and bust cycles in stock markets. We find that a transitory asset wealth increase coincides with a substantial transitory increase in consumption. In addition, we find that gross asset wealth and household debt are positively related. Both findings constitute departures from standard Permanent Income Hypothesis (PIH) theory with complete financial markets.
Towards the use of non‐psychoactive cannabinoids for prostate cancer
Authors: Pacher Pál
Published: July 2012

The palliative effects of Cannabis sativa (marijuana), and its putative main active ingredient, Δ9‐tetrahydrocannabinol (THC), which include appetite stimulation, attenuation of nausea and emesis associated with chemo‐ or radiotherapy, pain relief, mood elevation, and relief from insomnia in cancer patients, are well‐known. Because of the adverse psychoactive effects of THC, numerous recent preclinical studies have been focused on investigating other non‐psychoactive constituents of C. sativa, such as cannabidiol, for potential therapeutic use. In this issue of the British Journal of Pharmacology, De Petrocellis and colleagues present comprehensive evidence that plant‐derived cannabinoids, especially cannabidiol, are potent inhibitors of prostate carcinoma viability in vitro. They also showed that the extract was active in vivo, either alone or when administered with drugs commonly used to treat prostate cancer (the anti‐mitotic chemotherapeutic drug docetaxel (Taxotere) or the anti‐androgen bicalutamide (Casodex)) and explored the potential mechanisms behind these antineoplastic effects.

Linked Article

This article is a commentary on De Petrocellis et al., pp. 79–102 of this issue. To view this paper visit http://dx.doi.org/10.1111/j.1476‐5381.2012.02027.x
Coagulation profile of liquid‐state plasma
Authors: Gosselin Robert C. , Marshall Carol , Dwyre Denis M. , Gresens Chris , Davis Diana , Scherer Lynette , Taylor Douglas
Published: July 2012

BACKGROUND: Use of liquid plasma (LP) has been reported as early as the mid 1930s. Unlike fresh‐frozen plasma (FFP), LP is maintained at 1 to 6°C for up to 40 days after collection and processing. Despite its approved use by the US Food and Drug Administration, the coagulation profile of LP is incompletely described. In this study we evaluate the coagulation profile of LP stored up to 30 days.

STUDY DESIGN AND METHODS: LP was prepared by removing plasma from nonleukoreduced whole blood within 24 hours of collection. Three LP units from each ABO group were collected and stored at 1 to 6°C. Plasma aliquots were obtained at Postcollection Days 1 to 5, 10, 15, 20, 25, and 30 and then stored at −70°C. Each aliquot was tested for prothrombin time, activated partial thromboplastin time, and other coagulation and fibrinolytic factors.

RESULTS: There was a significant decrease in Factor (F)V, FVII, FVIII, von Willebrand factor (VWF), protein S (PS) activity, and endogenous thrombin potential on Day 15 compared with Day 1. No significant difference was observed for PS antigen, D‐dimer, or thrombin‐antithrombin complex. At least 50% activity of all measured factors was noted on Day 15, compared to Day 1. Considerable heterogeneity was observed between the different blood groups for FVII, FVIII, and VWF.

CONCLUSION: These data demonstrate that LP maintains at least 50% of factor activity and thrombin‐generating capacity up to 15 days of refrigerated storage. It may be more appropriate to limit LP storage and supplement with FFP when used for management of massively bleeding patients.
Red blood cell alloimmunization in transfused patients with myelodysplastic syndrome or chronic myelomonocytic leukemia
Authors: Sanz Cristina , Nomdedeu Meritxell , Belkaid Mohamad , Martinez Irene , Nomdedeu Benet , Pereira Arturo
Published: July 2012

BACKGROUND: Red blood cell (RBC) alloimmunization is a major problem in chronically transfused patients because of the risk of hemolytic reactions and limited availability of compatible blood. This study was aimed at determining the characteristics of RBC alloimmunization in transfusion‐dependent patients with myelodysplastic syndrome or chronic myelomonocytic leukemia (MDS/CMML).

STUDY DESIGN AND METHODS: The transfusion and clinical records of all patients with MDS/CMML seen at our hospital from 1990 to 2009 were reviewed. The cumulative incidence of RBC alloimmunization was calculated by taking death as a competing risk. Incidence rates were compared by Poisson multivariate regression.

RESULTS: A total of 272 patients were included. Median age was 74 years; 55% were men and had received a median of 33 (range, 4‐421) RBC units. Forty‐two (15%) patients formed 81 alloantibodies and seven autoantibodies. Three additional patients developed autoantibodies without alloantibodies. The incidence rate of RBC alloimmunization was 1 per 10.5 person‐years and was independent of sex, age, and MDS diagnostic category. The cumulative incidence of alloimmunization increased with the number of RBC transfusions, reaching a plateau at 19.5% after 130 RBC units. The most common antibody specificities were Kell (26 cases), E (19), c (5), and Jka (5). In 26 (62%) of the 42 alloimmunized patients, only the Rh system and Kell were involved.

CONCLUSION: RBC alloimmunization occurs in 15% of MDS/CMML patients on chronic transfusion support and mostly involves the Rh system and Kell. Transfusing these patients with extended antigen‐matched blood, including Kell and CcEe antigens, would presumably reduce the RBC immunization rate.
A Cost‐effectiveness Analysis of Dexamethasone Versus Prednisone in Pediatric Acute Asthma Exacerbations
Authors: Andrews Annie Lintzenich , Wong Kelli A. , Heine Daniel , Scott Russell W.
Published: July 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:943–948 © 2012 by the Society for Academic Emergency Medicine

Objectives:  The objective was to evaluate the cost‐effectiveness of dexamethasone versus prednisone for the treatment of pediatric asthma exacerbations in the emergency department (ED).

Methods:  This was a cost‐effectiveness analysis using a decision analysis model to compare two oral steroid options for pediatric asthma patients: 5 days of oral prednisone and 2 days of oral dexamethasone (with two dispensing possibilities: either a prescription for the second dose or the second dose dispensed at the time of ED discharge). Using estimates from published studies for rates of prescription filling, compliance, and steroid efficacy, the projected rates of ED relapse visits, hospitalizations within 7 to 10 days of the sentinel ED visit, direct costs, and indirect costs between the two arms were compared.

Results:  The rate of return to the ED per 100 patients within 7 to 10 days of the sentinel ED visit for the prednisone arm was 12, for the dexamethasone/prescription arm was 10, and for the dexamethasone/dispense arm was 8. Rates of hospitalization per 100 patients were 2.8, 2.4, and 1.9, respectively. Direct costs per 100 patients for each arm were $20,500, $17,200, and $13,900, respectively. Including indirect costs related to missed parental work, total costs per 100 patients were $22,000, $18,500, and $15,000, respectively. Total cost savings per 100 patients for the dexamethasone/prescription arm compared to the prednisone arm was $3,500 and for the dexamethasone/dispense arm compared to the prednisone arm was $7,000.

Conclusions:  This decision analysis model illustrates that use of 2 days of dexamethasone instead of 5 days of prednisone at the time of ED visit for asthma leads to a decreased number of ED visits and hospital admissions within 7 to 10 days of the sentinel ED visit and provides cost savings.
A Creative Approach to the Development of an Agenda for Knowledge Utilization: Outputs from the 11th International Knowledge Utilization Colloquium (KU 11)
Authors: Wilkinson Joyce E. , Rycroft‐Malone Jo , Davies Huw T.O. , McCormack Brendan
Published: July 2012

A group of researchers and practitioners interested in advancing knowledge utilization met as a colloquium in Belfast (KU 11) and used a “world café” approach to exploit the social capital and shared understanding built up over previous events to consider the research and practice agenda. We considered three key areas of relevance to knowledge use: (1) understanding the nature of research use, influence and impact; (2) blended and collaborative approaches to knowledge production and use; and (3) supporting sustainability and spread of evidence‐informed innovations.

The approach enabled the development of artifacts that reflected the three areas and these were analyzed using a creative hermeneutic approach.

The themes that emerged and which are outlined in this commentary are not mutually exclusive. There was much overlap in the discussions and therefore of the themes, reflecting the complex nature of knowledge translation work. The agenda that has emerged from KU 11 also reflects the participatory and creative approach in which the meeting was structured and focused, and therefore emphasizes the processual, relational and contingent nature of some of the challenges we face.

The past 20 years has seen an explosion in activity around understanding KU, and we have learned much about the difficulties. Whilst the agenda for the next decade may be becoming clearer, colloquia such as KU 11, using creative and engaging approaches, have a key role to play in dissecting, articulating and sharing that agenda. In this way, we also build an ever‐expanding international community that is dedicated to working towards increasing the chances of success for better patient care.
Host‐specific morphologies but no host races in the commensal bivalveNeaeromya rugifera
Authors: Li Jingchun , Ó Foighil Diarmaid
Published: July 2012

Speciation by host shift is one of the explicit models of ecological speciation. A prerequisite of this model is the formation of host races (sympatric populations that show host‐specific genetic structuring and phenotypes). Many members of the diverse marine bivalve superfamilyGaleommatoidea have obligate commensal relationships with invertebrate hosts. Some species have the ability to occupy multiple host species, thereby providing potential opportunities to test for the formation of host races. TheNortheastPacific galeommatoideanNeaeromya rugiferaattaches to two strikingly different hosts: the blue mud shrimpUpogebia pugettensisand the polychaete sea mouseAphroditaspp. We tested if this host difference has resulted in the formation of host races using shell morphologies and genetic markers. We found that populations from different hosts differ significantly in shell morphology. However, based on mitochondrial makers,N. rugiferashowed no distinct host‐specific genetic structuring, indicating the existence of a panmictic population. We conclude that the host‐specific morphologies these clams exhibit may reflect ecophenotypic plasticity rather than the existence of host races, but this needs to be corroborated with additional genetic data and larger sample sizes. The pronounced conchological variation withinN. rugiferacalls for further investigation of its taxonomic relationship with its poorly studied, but morphologically similar, sympatric congenerNeaeromya compressa.
Linear and Nonlinear Rheology of Mixed Polysaccharide Gels. Pt.I. Young's Modulus, Ring Extension and Uniaxial Compression Tests
Authors: Brenner Tom , Achayuthakan Piyada , Nishinari Katsuyoshi
Published: July 2012

Small and large deformation tests were performed on polysaccharide‐based gels containing konjac glucomannan, locust bean gum andκ‐carrageenan. LowpHdegradation ofκ‐carrageenan during heating led to lower gel strength. Whenκ‐carrageenan degradation was avoided, the linear‐regime rheology was dominated by theκ‐carrageenan content, and the storageYoung's modulus (E′) was found to decrease with decreasingκ‐carrageenan concentration. The large deformation behavior, however, was dominated by the konjac glucomannan concentration, and the rupture strain increased strongly with increasing konjac concentration. These two opposing trends led to a maximum in rupture stress in extension tests. No rupture was observed in compression of the gels at the polysaccharide concentrations tested. The compression force of konjac‐rich gels was lower than that observed for gels without konjac at low‐compression degrees, but it was similar to or higher at high‐compression degrees, above 60–80%, indicating the higher degree of strain hardening of konjac‐rich gels.

Practical Applications

Mixing of different polysaccharides has been used for widening the texture range, and it was shown in this report that the mixture of konjac glucomannan, locust bean gum andκ‐carrageenan in the presence of sucrose and acid can produce jellies with various textures.
Antiviral therapy for hepatitis B virus‐related decompensated cirrhosis
Authors: Wang Ji Yao
Published: July 2012

Antiviral therapy is important in patients with hepatitis B virus (HBV)‐related decompensated cirrhosis. This therapy is beneficial in most patients for the stabilization or improvement of liver disease; however, advanced cirrhosis with a high Child–Pugh or model for end‐stage liver disease (MELD) score may have progressed and does not benefit from antiviral therapy. It is important to identify patients with severe decompensated cirrhosis who will not improve under antiviral therapy and who require liver transplantation as early as possible. Entecavir (ETV) or tenofovir disoproxil fumarate (TDF) is the first‐line therapy for nucleos(t)ide analogue (NA)‐naive patients with decompensated cirrhosis due to their potent and prompt HBV suppressive effect and low rate of drug‐resistant mutations. Patients on antiviral therapy should be monitored for virological and clinical response, compliance, drug resistance and adverse effects as well as surveillance for hepatocellular carcinoma (HCC). Additional studies of TDF and ETV are necessary to determine the optimal agent(s) for treating naive patients and those with drug‐resistant decompensated cirrhosis. In order to evaluate the effectiveness of NA for the treatment of decompensated cirrhotic patients in the real world, high quality observational studies such as registration studies of antiviral therapy for HBV‐related cirrhosis and a long‐term follow‐up in China, where a large number of such patients are found, are recommended.
Suboptimal performance of simple noninvasive tests for advanced fibrosis in Chinese patients with nonalcoholic fatty liver disease
Authors: Xun Yun Hao , Fan Jian Gao , Zang Guo Qing , Liu Hong , Jiang Yan Ming , Xiang Jing , Huang Qian , Shi Jun Ping
Published: July 2012

Objective

To evaluate the diagnostic accuracy of some noninvasive fibrosis models in Chinese patients with nonalcoholic fatty liver disease (NAFLD).

Methods

Consecutive biopsy‐proven NAFLD patients were recruited from a single center from January 2005 to December 2010. Advanced fibrosis (stage 3 and 4) was defined using Kleiner criteria. The area under the receiver operating characteristic curve (AUROC) was used to compare the diagnostic accuracy of the NAFLD fibrosis score (NFS), FIB‐4 index, aspartate transaminase (AST)/platelet ratio index (APRI), AST/alanine transaminase (ALT) ratio (AAR) and body mass index (BMI)‐AAR‐Diabetes (BARD) score.

Results

Of the patients with NAFLD, 79.6% were males with a mean age of 37.1 years, mean BMI of 26.1 kg/m2 and 41.4% of them had nonalcoholic steatohepatitis, and 24 (15.8%) had advanced fibrosis. The AUROC of the FIB‐4 index, APRI, AAR, NFS and BARD score for advanced fibrosis were 0.756, 0.742, 0.670, 0.653 and 0.642 (P < 0.05 for all), respectively. A concordant negative predictive value of approximately 90% was indicated whereas the positive predictive values were modest for all tests, and only the FIB‐4 index yielded a higher positive likelihood ratio of 7.65. Using these cut‐off values of tests for excluding advanced fibrosis could reduce the use of liver biopsy in 56.6–74.3% of the patients, with a minor false negative rate of 5.3–9.9%.

Conclusions

Although slightly less accurate than liver biopsy, simple noninvasive tests can reliably exclude advanced fibrosis in Chinese NAFLD patients in our center. FIB‐4 index performs better than the other tests under examination.
Coronary artery anomalies in adults: Imaging at dual source CT coronary angiography
Authors: Laspas Fotios , Roussakis Arkadios , Mourmouris Christos , Kritikos Nikolaos , Efthimiadou Roxani , Andreou John
Published: July 2012

Congenital abnormalities of the coronary arteries have an incidence of 1%, and most of these are benign. However, a small number are associated with myocardial ischaemia and sudden death. Various imaging modalities are available for coronary artery assessment. Recently, multi‐detector CT has emerged as an accurate diagnostic tool for defining coronary artery anomalies. The purpose of this pictorial essay is to review the dual source CT appearance of congenital anomalies of the coronary arteries in adults.
Comparative analysis of plants close to houses in urban and rural areas in the littoral region of Cameroon
Authors: Priso Richard Jules , Traoré Salifou , Din Ndongo , Ouedraogo Oumarou , Dibong Siegfried Didier
Published: July 2012

Global declines in biodiversity, together with widespread degradation of ecosystem services, have led to urgent calls to safeguard. Humans maintain plants around their houses to increase their quality of life. In the present study, 90 and 30 plots of 50 m2 each were studied in urbanised and rural areas in Cameroon. In each plot, vascular plant species were identified and their coefficient of abundance–dominance was determined. Different diversity indices were calculated to compare the flora of urbanised and rural areas as well as the distribution of plants. A total of 119 species belonging to 95 genera and 45 families were sampled. Shannon–Weaver diversity index, Pielou and Sheldon values vary when taking into account not only erected or wooded plants, but also herbs and erected or wooded plants. Plots near houses in urban areas comprised weeds, ornamentals and fruits, whereas in rural areas medicinal or edible plants dominated. Based upon the results, we conclude that the use of plants as food, medicinal resources or for other purposes, might be helpful for biodiversity conservation, ecosystem services, the management of resources and to fight poverty. However, the composition of the flora is likely to change as urbanisation proceeds.
Photodynamic therapy: a review and its prospective role in the management of oral potentially malignant disorders
Authors: Saini R , Poh CF
Published: July 2012

With the unreliability of epithelial dysplasia as a predictor to determine the risk of future malignant development, subjectivity associated in evaluating dysplasia by pathologists and paucity of biomarkers that could accurately predict the progression risks in oral potentially malignant disorders (PMDs), eradication of the lesions appears to be the most desirable approach to minimize the risk of invasive cancer formation. Interventions, such as surgery and chemoprevention, have not shown promising long‐term results in the treatment of these lesions, and lack of guidelines and general consensus on their management has incited much anxiety and doubts in both patients and community clinicians. Topical photodynamic therapy (PDT) is a minimally invasive and minimally toxic technique that in recent years has shown great promise in the management of PMDs. In this review, we describe the historical developments in the field of PDT, its basic mechanisms, as well as related clinical studies, and its challenges in the management of oral PMDs. Based on its high efficacy and low side effects, its high patient acceptance/compliance, the simplicity of the procedure and its minimal pretreatment preparation, topical PDT is believed to have potential to play an important role in the management of PMDs, especially of the low‐grade dysplasia.
The wonders of the Wanderer
Authors: Clancy Jennifer A. , Deuchars Susan A. , Deuchars Jim
Published: July 2012

New findings

What is the topic for this review?

Vagus nerve stimulation is now used as a treatment for refractory epilepsy and depression, despite an incomplete understanding of the mechanisms involved.

What advances does it highlight?

We review current and potential therapeutic applications of vagus nerve stimulation and some potential mechanisms by which these effects could be mediated.

Vagus is Latin for wandering, and the vagus nerve fully deserves this name due to its extensive distribution through the body. Indeed, one of the lines of the song that accompanied the 2012 G. L. Brown Prize Lecture exaggerates this diversity, ‘My function's almost anythin’, and vagus is my name’. Alteration of vagal activity was first investigated in the 1880s as a treatment for epilepsy, and vagus nerve stimulation is now an approved treatment for refractory epilepsy and depression in the USA, despite an incomplete understanding of the mechanisms involved. Vagus nerve stimulation could be beneficial in many other conditions, including heart failure, tinnitus, chronic hiccups, Alzheimer's disease and inflammatory diseases. Inhibition of vagal activity could also be beneficial in some conditions, e.g. reducing activation of vagal respiratory afferents to treat chronic cough. This review discusses evidence underlying some current and potential therapeutic applications of vagal modulation, illustrating the wonders of the Wanderer.
The Nlrp3 inflammasome promotes myocardial dysfunction in structural cardiomyopathy through interleukin‐1β
Authors: Bracey Nathan A. , Beck Paul L. , Muruve Daniel A. , Hirota Simon A. , Guo Jiqing , Jabagi Habib , Wright Jr James R. , MacDonald Justin A. , Lees‐Miller James P. , Roach Daniel , Semeniuk Lisa M. , Duff Henry J.
Published: July 2012

New findings

What is the central question of this study?

Heart failure is associated with persistent sterile inflammation that worsens disease severity; however, the molecular mechanisms behind cytokine recruitment and their relevance in the diseased myocardium remain unknown.

What is the main finding and its importance?

We show that interleukin‐1β is activated downstream of the Nlrp3 inflammasome in calcineurin‐transgene‐induced structural heart disease. Genetic deletion of Nlrp3 abrogated inflammasome signalling and interleukin‐1β release, improving function. The role of Nlrp3 in non‐ischaemic cardiomyopathy and the utility of inflammasome antagonism have not yet been explored, revealing potential for translational application.

Heart failure is associated with a low‐grade and chronic cardiac inflammation that impairs function; however, the mechanisms by which this sterile inflammation occurs in structural heart disease remain poorly defined. Cardiac‐specific heterozygous overexpression of the calcineurin transgene (CNTg) in mice results in cardiac hypertrophy, inflammation, apoptosis and ventricular dilatation. We hypothesized that activation of the Nlrp3 inflammasome, an intracellular danger‐sensing pathway required for processing the pro‐inflammatory cytokine interleukin‐1β (IL‐1β), may contribute to myocardial dysfunction and disease progression. Here we report that Nlrp3 mRNA was increased in CNTg mice compared with wild‐type. Consistent with inflammasome activation, CNTg animals had increased conversion of pro‐caspase‐1 to cleaved and activated forms, as well as markedly increased serum IL‐1β. Blockade of IL‐1β signalling via chronic IL‐1 receptor antagonist therapy reduced cardiac inflammation and myocyte pathology in CNTg mice, resulting in improved systolic performance. Furthermore, genetic ablation of Nlrp3 in CNTg mice reduced pro‐inflammatory cytokine maturation and cardiac inflammation, as well as improving systolic performance. These findings indicate that activation of the Nlrp3 inflammasome in CNTg mice promotes myocardial inflammation and systolic dysfunction through the production of pro‐inflammatory IL‐1β. Blockade of IL‐1β signalling with the IL‐1 receptor antagonist reverses these phenotypes and offers a possible therapeutic approach in the management of heart failure.
The time course of the adaptations of human muscle proteome to bed rest and the underlying mechanisms
Authors: Brocca Lorenza , Cannavino Jessica , Coletto Luisa , Biolo Gianni , Sandri Marco , Bottinelli Roberto , Pellegrino Maria Antonietta
Published: July 2012

Key points

It is still debated whether an imbalance between production and removal of reactive oxygen species is a major trigger of disuse skeletal muscle atrophy in human limb muscles and what the underlying mechanisms are.

In the bed rest model of human disuse, redox imbalance, impairment of antioxidant defence systems and metabolic derangement occurred early, before vastus lateralis muscle atrophy developed, and persisted through 35 days of bed rest.

Down‐regulation of PGC‐1α, a master controller of muscle metabolism, and up‐regulation of SREBP‐1, a master controller of lipid synthesis, are likely to have triggered disuse adaptations through mitochondrial dysfunction, whereas AMP kinase, an energy sensor pathway, was unaltered.

The present and previous results on the same subjects suggest a causal link between muscle atrophy, impaired skeletal muscle metabolism, impaired whole body oxidative metabolism, and insulin sensitivity and moderate inflammation, which are major risk factors of physical inactivity related diseases.

Abstract  In order to get a comprehensive picture of the complex adaptations of human skeletal muscle to disuse and further the understanding of the underlying mechanisms, we participated in two bed rest campaigns, one lasting 35 days and one 24 days. In the first bed rest (BR) campaign, myofibrillar proteins, metabolic enzymes and antioxidant defence systems were found to be down‐regulated both post‐8 days and post‐35 days BR by proteomic analysis of vastus lateralis muscle samples from nine subjects. Such profound alterations occurred early (post‐8 days BR), before disuse atrophy developed, and persisted through BR (post‐35 days BR). To understand the mechanisms underlying the protein adaptations observed, muscle biopsies from the second bed rest campaign (nine subjects) were used to evaluate the adaptations of master controllers of the balance between muscle protein breakdown and muscle protein synthesis (MuRF‐1 and atrogin‐1; Akt and p70S6K), of autophagy (Beclin‐1, p62, LC3, bnip3, cathepsin‐L), of expression of antioxidant defence systems (NRF2) and of energy metabolism (PGC‐1α, SREBP‐1, AMPK). The results indicate that: (i) redox imbalance and remodelling of muscle proteome occur early and persist through BR; (ii) impaired energy metabolism is an early and persistent phenomenon comprising both the oxidative and glycolytic one; (iii) although both major catabolic systems, ubiquitin proteasome and autophagy, could contribute to the progression of atrophy late into BR, a decreased protein synthesis cannot be ruled out; (iv) a decreased PGC‐1α, with the concurrence of SREBP‐1 up‐regulation, is a likely trigger of metabolic impairment, whereas the AMPK pathway is unaltered.
Ratcheting Studies on Type 304LN Stainless Steel Elbows subjected to
Combined Internal Pressure and In-Plane Bending Moment
Authors: Vishnuvardhan S. , Raghava G. , Gandhi P. , Saravanan M. , Pukazhendhi D. M. , Goyal Sumit , Gupta Suneel K. , Bhasin Vivek , Vaze K. K.
Published: July 2012

“Ratcheting” is a phenomenon which leads to reduction in fatigue life of a structural component by loss of ductility due to cycle by cycle accumulation of plastic strain. Ratcheting occurs in a structure subjected to a combination of steady/sustained and cyclic loads such that the material response is in inelastic region. Ratcheting studies were carried out on Type 304LN stainless steel elbows, subjected to steady internal pressure and cyclic bending. The elbows filled with water were pressurized between 27.6 MPa and 39.2 MPa. Cyclic bending load, under opening and closing moments, was applied on the elbows at ambient temperature. Number of cycles corresponding to occurrence of a through-wall crack was recorded. Crack was observed in the bent portion at one of the crown locations in all the four specimens. Maximum strain was observed at the intrados and crown locations of the elbows. The ratcheting strain increased with number of cycles at crown and intrados locations. However, the strain accumulation rate decreased with number of cycles. Strain was observed to be minimum at the extrados location and the same stabilized toward the end of the tests. The specimens have failed by occurrence of through-wall axial crack accompanied by simultaneous ballooning. The ballooning was found to be varying from 3.8% to 5.8% with respect to the original circumference in the bent portion. The reduction in thickness was found to be around 12%–15%.
Tetragonal or monoclinic ZrO2 thin films from Zr-based glassy templates
Authors: Panagiotopoulos Nikolaos T. , Kovač Janez , Cvelbar Uros , Patsalas Panagiotis , Mozetič Miran , Evangelakis Georgios A.
Published: July 2012

The authors report on the selective formation of pure tetragonal or mixed tetragonal-monoclinic ZrO2 films by means of post-growth oxygen plasma treatment of Zr-based Zr–Cu ternary or quaternary metallic glassy (MG) films containing minor additions of Al, Ti, and Si. It came out that the choice of the third and/or fourth element in the MG template, in conjunction with oxygen plasma conditions and treatment time, determine the crystal structure and the surface morphology of the ZrO2 films. The authors found that the oxidation of the Zr–Cu MG template resulted in mixed tetragonal-monoclinic ZrO2 film with rather rough surface, whereas in the case of Al additions smooth surfaces of pure tetragonal or mixed tetragonal-monoclinic ZrO2 films were grown after short and long treatment times, respectively. In addition, oxygen plasma treatment of MG templates containing Ti and/or Si minor additions resulted in mixed tetragonal-monoclinic ZrO2 films, the doping element and the treatment times adjusting besides the concentration of each phase also the surface morphologies, which can vary from cones, in the case of Ti addition, to nanosponge and completely rough structures in Si ternary and Si/Ti quaternary systems, respectively. These findings suggest a quick, amenable, and low cost method of two-step industrial scale processing for selective growth of tetragonal and/or monoclinic ZrO2 with specific surface morphology.
High performance lung nodule detection schemes in CT using local and global information
Authors: Guo Wei , Li Qiang
Published: July 2012

Purpose:

A key issue in current computer‐aided diagnostic (CAD) schemes for nodule detection in CT is the large number of false positives, because current schemes use only global three‐dimensional (3D) information to detect nodules and discard useful local two‐dimensional (2D) information. Thus, the authors integrated local and global information to markedly improve the performance levels of CAD schemes.

Methods:

Our database was obtained from the standard CT lung nodule database created by the Lung Image Database Consortium (LIDC). It consisted of 85 CT scans with 111 nodules of 3 mm or larger in diameter. The 111 nodules were confirmed by at least two of the four radiologists participated in the LIDC. Twenty‐six nodules were missed by two of the four radiologists and were thus very difficult to detect. The authors developed five CAD schemes for nodule detection in CT using global 3D information (3D scheme), local 2D information (2D scheme), and both local and global information (2D + 3D scheme, 2D − 3D scheme, and 3D − 2D scheme). The 3D scheme, which was developed previously, used only global 3D information and discarded local 2D information, as other CAD schemes did. The 2D scheme used a uniform viewpoint reformation technique to decompose a 3D nodule candidate into a set of 2D reformatted images generated from representative viewpoints, and selected and used “effective” 2D reformatted images to remove false positives. The 2D + 3D scheme, 2D − 3D scheme, and 3D − 2D scheme used complementary local and global information in different ways to further improve the performance of lung nodule detection. The authors employed a leave‐one‐scan‐out testing method for evaluation of the performance levels of the five CAD schemes.

Results:

At the sensitivities of 85%, 80%, and 75%, the existing 3D scheme reported 17.3, 7.4, and 2.8 false positives per scan, respectively; the 2D scheme improved the detection performance and reduced the numbers of false positives to 7.6, 2.5, and 1.3 per scan; the 2D + 3D scheme further reduced those to 2.7, 1.9, and 0.6 per scan; the 2D − 3D scheme reduced those to 7.6, 2.1, and 0.8 per scan; and the 3D − 2D scheme reduced those to 17.3, 1.6, and 1.0 per scan.

Conclusions:

The local 2D information appears to be more useful than the global 3D information for nodule detection, particularly, when it is integrated with 3D information.
Differential RET Signaling Pathways Drive Development of the Enteric Lymphoid and Nervous Systems
Authors: Patel Amisha , Harker Nicola , Moreira-Santos Lara , Ferreira Manuela , Alden Kieran , Timmis Jon , Foster Katie , Garefalaki Anna , Pachnis Panayotis , Andrews Paul , Enomoto Hideki , Milbrandt Jeffrey , Pachnis Vassilis , Coles Mark C. , Kioussis Dimitris , Veiga-Fernandes Henrique
Published: July 2012

Cis and trans signaling mechanisms direct different developmental responses to ligands for the receptor tyrosine kinase RET.
T Cell Signaling Targets for Enhancing Regulatory or Effector Function
Authors: Pan Fan , Fan Huimin , Liu Zhongmin , Jiang Shuiping
Published: July 2012

The PD-1 receptor in effector T cells and the transcription factor Foxp3 in T
regs
are promising targets for therapies.