bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediabetes in Patients with Stroke or Transient Ischemic Attack: Prevalence, Risk and Clinical Management
Authors: Fonville Susanne , Zandbergen Adrienne A.M. , Koudstaal Peter J. , den Hertog Heleen M.
Published: June 2014

Background: The prevalence of diabetes is emerging worldwide and is an important modifiable risk factor for stroke. People with prediabetes, an intermediate metabolic state between normal glucose metabolism and diabetes, have a tenfold increased risk of developing diabetes compared to those with a normal glucose metabolism. Prediabetes is comprised of impaired fasting glucose and/or impaired glucose tolerance and/or disturbed glycosylated hemoglobin levels. Prediabetes is highly prevalent in nondiabetic patients with transient ischemic attack (TIA) or ischemic stroke and nearly doubles their risk of stroke. This offers new options for secondary stroke prevention. Summary: Several detection methods exist for identifying (pre)diabetes, including fasting plasma glucose, 2-hour postload glucose and glycosylated hemoglobin levels. The concordance between these tests is not 100%, and they seem to be complementary. Screening for (pre)diabetes after stroke with fasting plasma glucose levels alone is insufficient, and 2-hour postload glucose and/or glycosylated hemoglobin levels should be determined as well. The prevalence of prediabetes in previously nondiabetic patients with a recent TIA or stroke ranges from 23 to 53%. This high prevalence in the acute phase after stroke can be transient or persistent, representing undiagnosed abnormal glucose metabolism. Impaired fasting glucose and impaired glucose tolerance have different pathophysiological mechanisms, including hepatic insulin resistance and muscle insulin resistance, respectively. Prediabetes seems to be a modest predictor for stroke, but doubles the risk for recurrent stroke. The relation between prediabetes after stroke and functional outcome is still unknown. However, it is most likely that prediabetes is a risk factor for a poor clinical outcome after stroke. There is a growing recognition that patients with prediabetes should be treated more aggressively. Both lifestyle and pharmacological interventions are possible treatment strategies. They are at least equally effective in preventing progression to diabetes. Lifestyle changes are difficult to maintain over a long period. The evidence of pharmacological interventions on stroke or other cardiovascular diseases is limited though and is still subject of several clinical trials. Conclusions: As the prevalence of prediabetes is growing rapidly, prediabetes might become one of the most important modifiable therapeutic targets in both primary and secondary prevention.
Impact of Liver Biopsy on the Decision to Treat Patients with Chronic Hepatitis B Genotype D Virus Infection
Authors: Al-Qahtani Ahmed Ali , Al-Ashgar Hamad Ibrahim , Al Mana Hadeel , Al-Ahdal Mohammed Noreen , Soliman Ali Ali , Hasanain Ahmed Farouk , Helmy Ahmed
Published: June 2014

Objectives: Patients with chronic hepatitis B virus (HBV) may exhibit significant liver pathology despite alanine aminotransferase (ALT) and HBV DNA levels below the cutoff values advised by treatment guidelines. We evaluated candidacy for HBV therapy when baseline histopathological changes are taken into consideration. Methods: Clinical, biochemical, serological, virological, and histopathological (METAVIR score) data of 117 patients with HBeAg-negative chronic HBV genotype D were collected and analyzed. Results: Significant pathology (≥F2 and/or ≥A2) and fibrosis (≥F2 ± ≥A2) were found in 73 (62.4%) and 59 (50.4%) patients, respectively. Based on HBV DNA (>2,000 IU/ml) and ALT levels >2 × 40 U/l (the standard cutoff value), only 31 (26.5%) patients were candidates for therapy. This increased to 58 (49.6%) patients when the new ALT cutoff values (30 U/l for males, and 19 U/l for females) were applied. Relying on either ≥F2 and/or A ≥2 or ≥F2 ± ≥A2 increases the treatment candidacy to 73 (62.4%) and 59 (50.4%) patients, respectively. Also, when compared with standard ALT cutoff values, applying both new ALT cutoff values with either significant pathology or fibrosis increases treatment candidacy to 28 (23.9%) and 42 (35.9%) patients, respectively. Conclusion: Liver pathology is more reliable than ALT and HBV DNA in the decision to treat patients with HBeAg-negative chronic HBV genotype D.
Prevalence of Transmitted HIV-1 Drug Resistance Remains Low in Guangxi, China, Eight Years after Scale-Up of Highly-Active Antiretroviral Therapy
Authors: Li Guojian , Liang Shujia , Harrison Tim J. , Tang Zhenzhu , Shen Zhiyong , Wang Xueyan , Wu Xinghua , Liu Wei , Liang Fuxiong , Feng Liushuai , Yang Jinye , Fang Zhongliao
Published: June 2014

Objectives: Highly-active antiretroviral therapy (HAART) was scaled up in Guangxi, China in 2005. The number of individuals receiving free HAART increased dramatically from June 2010 under the Guangxi Government's anti-HIV programme. We aimed to determine the prevalence of HIV-transmitted drug resistance (TDR) of Guangxi. Methods: HIV-positive, antiretroviral-naive individuals were recruited from the east (Hezhou), south (Qinzhou), west (Baise), north (Guilin) and centre (Laibin) of Guangxi. The pol gene of the virus from the individuals was analysed. Results: The overall prevalence of HIV TDR was 3.2% (7/216, 95% CI 0.9-5.5). The prevalence rates in Baise, Guilin, Hezhou, Qinzhou and Laibin are 4.9% (2/41, 95% CI -1.7 to 11.5), 2.3% (1/44, 95% CI -2.1 to 5.7), 4.7% (2/43, 95% CI -1.6 to 11.0), 2.6% (1/38, 95% CI -2.5 to 7.7) and 2.0% (1/50, 95% CI -1.9 to 5.9), respectively. No significant difference in the prevalence was found among them. No factors were found to be associated with TDR, including CD4 cell counts, viral loads and genotypes. The subtypes CRF01_AE, CRF07_BC, CRF08_BC and B were found. Subtype CRF08_BC is the predominant subtype in Baise while CRF01_AE is the predominant subtype elsewhere in Guangxi. Conclusions: The prevalence of TDR in antiretroviral-naive patients in Guangxi remains low 8 years after scale-up of HAART.
High Rates of Human Immunodeficiency Virus Type 1 Mutational Profiles by Single-Genome Amplification after 48-Hour Propagation in Peripheral Blood Mononuclear Cells at Different Levels of Cell Activation
Authors: Russo Cristiano Teodoro , Alkmim Wagner , Munerato Patricia , Zukurov Jean , Maricato Juliana T. , Sucupira M. Cecília , Diaz Ricardo S. , Janini Luiz Mário
Published: June 2014

Human immunodeficiency virus type 1 (HIV-1) genetic diversity is one of the most important features of HIV-1 infections and the result of error accumulation during reverse transcription and of high viral turnover. HIV-1 reverse transcription is influenced by factors such as the level of nucleotides and/or the cellular activation state. HIV-1 diversity was investigated after 48 h of viral propagation in peripheral blood mononuclear cells (PBMCs) obtained from healthy donors in three different cell culture conditions: (1) resting PBMCs, (2) simultaneous infection and PBMC activation, and (3) PBMC activation 72 h before infection. Cellular DNA was extracted and proviruses of each culture condition were amplified. Single-genome PCR clones were obtained and the protease and reverse transcriptase of the pol gene were sequenced. An elevated number of nucleotide substitutions in all three culture conditions were observed. In condition 1, the mutational rate observed ranged from 1.0 × 10-3 to 2.1 × 10-2, the genetic diversity was 0.6%, and hypermutation was observed in 7.1% of sequenced clones. In condition 2, the mutational rate ranged from 1.0 × 10-3 to 1.0 × 10-2, the genetic diversity was 0.8%, and hypermutation affected 6.7% of clones. In condition 3, the mutational rate ranged from 2.8 × 10-3 to 1.1 × 10-2, the genetic diversity was 1%, and 5.9% of clones were hypermutated. Substitutions occurred more frequently in some specific nucleotide stretches, and a common pattern for substitutions in all the different conditions was identified. There was a significant accumulation of mutations during the initial periods of in vitro HIV-1 propagation irrespective of culture conditions. The rapid accumulation of virus diversity might represent a viral strategy when colonizing new hosts. Complementary studies are necessary to allow for a better understanding of the initial periods of infection, which represent a crucial event related to disease progression.
Head Position and Cerebral Blood Flow Velocity in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis
Authors: Olavarría Verónica V. , Arima Hisatomi , Anderson Craig S. , Brunser Alejandro M. , Muñoz-Venturelli Paula , Heritier Stephane , Lavados Pablo M.
Published: June 2014

Background: Patients with acute ischemic stroke (AIS) have impaired vasomotor reactivity, especially in the affected cerebral hemisphere, such that they may depend directly on systemic blood pressure to maintain perfusion to vulnerable ‘at risk' penumbral tissue. As the sitting up position may affect cerebral perfusion by decreasing cerebral blood flow (CBF) in salvageable tissue, positioning AIS patients with their head in a lying flat position could increase CBF through collateral circulation or gravitational force. We wished to quantify the effect of different head positions on mean flow velocity (MFV) by transcranial Doppler ultrasonography (TCD) in AIS patients to assess the potential for benefit (or harm) of head positioning in a clinical trial. Methods: We performed a systematic review and meta-analysis of observational studies with TCD to evaluate differences in cerebral MFV between the lying flat and sitting up head positions in AIS. For each study and each comparison, we obtained the mean value of changes in MFV and its variance. Results: A total of 303 studies were identified, but 298 were excluded for varying reasons; 4 papers met the inclusion criteria and 57 patients were included in the meta-analysis for calculation of the overall mean difference in MFV. We found a significant increase in MFV from a bed angle of 30 to 15° (4.6 cm/s, 95% confidence interval, CI, 2.9-6.2, p < 0.001) and from 30 to 0° (8.3 cm/s, 95% CI 5.3-11.3, p < 0.001) in the affected hemisphere but not on the normal side in AIS patients. Conclusions: In AIS patients, MFV increased significantly in the side affected by the stroke but not in the unaffected side when they were positioned in a lying flat head position at 0 or 15° compared to an upright head position at 30°. The clinical significance of these findings is now undergoing further randomized evaluation in the international multicenter Head Position in Acute Stroke Trial (HeadPoST).
Ondansetron for Food Protein-Induced Enterocolitis Syndrome
Authors: Miceli Sopo Stefano , Battista Andrea , Greco Monica , Monaco Serena
Published: June 2014

Recently, a study on 5 patients [Holbrook et al.: J Allergy Clin Immunol 2013;132:1219-1220] documented the efficacy of the intravenous administration of ondansetron in children with acute symptoms due to food protein-induced enterocolitis syndrome (FPIES). We report on the experience at our institution using ondansetron during oral food challenge (OFC) in 5 children affected by FPIES. In all 5 cases, the use of intramuscular ondansetron led to a complete and rapid resolution of symptoms within 15 min. Intramuscular administration, without the need for intravenous access for an infusion or steroid administration, enables this therapy to be easily performed, even at home (i.e. out of a hospital setting). A home treatment with ondansetron cannot be considered as an alternative to a medical examination with eventual treatment in hospital, which is advised after any acute episode of FPIES. We consider ondansetron to be very useful in the management of acute FPIES. Further study is required to confirm its efficacy.
Unbalanced Baseline in School-Based Interventions to Prevent Obesity: Adjustment Can Lead to Bias - a Systematic Review
Authors: Sichieri Rosely , Cunha Diana Barbosa
Published: June 2014

Background/Aims: Cluster designs favor unbalanced baseline measures. The aim of the present study was to determine the frequency of unbalanced baseline BMI on school-based randomized controlled trials (RCT) aimed at obesity reduction and to evaluate the analysis strategies. We hypothesized that the adjustment of unbalanced baseline measures may explain the great discrepancy among studies. Methods: The source of data was the Medline database content from January 1995 until May 2012. Our search strategy combined key words related to school-based interventions with such related to weight and was not limited by language. The participants' ages were restricted to 6-18 years. Results: We identified 146 school-based studies on obesity prevention (or overweight or excessive weight change). Of the 146 studies, 36 were retained for the analysis after excluding reviews, feasibility studies, other outcomes, and repeated publications. 13 (35%) of the reviewed studies had statistically significant (p < 0.05) unbalanced measures of BMI at baseline. 11 studies with BMI balanced at baseline adjusted for the baseline BMI, whereas no baseline adjustment was applied to the 5 unbalanced studies. Conclusion: Adjustment for the baseline BMI is frequently done in cluster randomized studies, and there is no standardization for this procedure. Thus, procedures that disentangle the effects of group, time and changes in time, such as mixed effects models, should be used as standard methods in school-based studies on the prevention of weight gain.
A Lack of Association between Polymorphisms of Three Positional Candidate Genes (CLASP2, UBP1, and FBXL2) and Canine Disorder of Sexual Development (78,XX; SRY-Negative)
Authors: Salamon Sylwia , Nowacka-Woszuk Joanna , Szczerbal Izabela , Dzimira Stanisław , Nizanski Wojciech , Ochota Malgorzata , Switonski Marek
Published: June 2014

A disorder of sexual development (DSD) of dogs with a female karyotype, missing SRY gene, and presence of testicles or ovotestes is quite commonly diagnosed. It is suggested that this disorder is caused by an autosomal recessive mutation; however, other models of inheritance have not been definitely ruled out. In an earlier study it was hypothesized that the mutation may reside in a pericentromeric region of canine chromosome 23 (CFA23). Three positional candidate genes (CLASP2, UBP1, and FBXL2) were selected in silico in the search for polymorphisms in 7 testicular or ovotesticular XX DSD dogs, 8 XX DSD dogs of unknown cause (SRY-negative, with enlarged clitoris and unknown histology of gonads), and 29 normal female dogs as a control group. Among the 15 molecularly studied dogs with enlarged clitoris there were 3 new cases of testicular or ovotesticular XX DSD and 4 new cases of XX DSD with unknown cause (histology of the gonads unknown). Altogether, 11 (including 10 novel) polymorphisms in 5′- and 3′-flanking regions of the studied genes were found. The distribution analysis of these polymorphisms showed no association with the DSD phenotypes. Thus, it was concluded that the presence of the causative mutation for testicular or ovotesticular XX DSD in the pericentromeric region of CFA23 is unlikely.
Nuclear Architecture and Chromatin Dynamics in Interphase Nuclei of Arabidopsis thaliana
Authors: Del Prete Stefania , Arpón Javier , Sakai Kaori , Andrey Philippe , Gaudin Valérie
Published: June 2014

The interphase cell nucleus is extraordinarily complex, ordered, and dynamic. In the last decade, remarkable progress has been made in deciphering the functional organisation of the cell nucleus, and intricate relationships between genome functions (transcription, DNA repair, or replication) and various nuclear compartments have been revealed. In this review, we describe the architecture of the Arabidopsis thaliana interphase cell nucleus and discuss the dynamic nature of its organisation. We underline the need for further developments in quantitative and modelling approaches to nuclear organization.
Morphogenesis and Patterning of the Phallus and Cloaca in the American Alligator, Alligator mississippiensis
Authors: Gredler Marissa L. , Seifert Ashley W. , Cohn Martin J.
Published: June 2014

In most animals, reproduction by internal fertilization is facilitated by an intromittent organ, such as the penis in amniote vertebrates. Recent progress has begun to uncover the mechanisms of mammalian external genital development; however, comparatively little is known about the development of the reptilian penis and clitoris. Here, we describe the development of the phallus and cloaca in the American alligator, Alligator mississippiensis. The embryonic precursor of the penis and clitoris is the genital tubercle, which forms by the budding of genital mesenchyme beneath the ventral body wall ectoderm, adjacent to the cloacal membrane. The cloacal lips develop from another pair of outgrowths, the lateral swellings. Early development of the alligator phallus, cloaca, and urogenital ducts generally resembles that of other reptiles, suggesting that differences in adult reptilian phallus and cloacal anatomy arise at later stages. The phallic sulcus is derived from the cloacal endoderm, indicating that the crocodilian sulcus is functionally and developmentally homologous to the mammalian urethra. Initial external genital outgrowth and patterning occur prior to temperature-dependent sex determination. Our analysis of alligator phallus and cloaca development suggests that modifications of an ancestral program of urogenital development could have generated the morphological diversity found in the external genitalia of modern amniotes.
Synonymy of Reinholdina deelemanorum Giachino & Moravec, 2009 (Coleoptera: Leiodidae: Cholevinae: Leptodirini)
Authors: Lakota Ján , Hlaváč Peter , Lohaj Roman , Čeplík Dávid
Published: June 2014

Reinholdina deelemanorum Giachino & Moravec, 2009 is a junior synonym of Parapropus neumanni Müller, 1911. The genus Reinholdina Giachino & Moravec, 2009 is placed in the synonymy with Parapropus Ganglbauer, 1899.
Description of Abursanema iranicum n. gen., n. sp. (Nematoda: Hexatylina, Sphaerularioidea) from Iran and its phylogenetic relationships
Authors: Yaghoubi Ali , Pourjam Ebrahim , Pedram Majid , Siddiqi Mohammad Rafiq , Atighi Mohammad Reza
Published: June 2014

Abursanema iranicum n. gen., n. sp. is described and illustrated based on morphological, morphometric and molecular characters. The new genus is characterized by its smooth outer and annulated inner cuticle, having two incisures in lateral field, lacking stylet knobs, having pyriform terminal bulb with stem-like extension projecting into the intestine and lacking of bursa in male. The new genus belongs to the family Paurodontidae. It most closely resembles the genera Paurodontoides and Paurodontus, but has affinities based on male characters with Gymnotylenchus of the family Neotylenchidae too. From Paurodontoides, it differs by the absence of stylet knobs and having six sectors in the head framework. Compared to Paurodontus, the new genus differs by the absence of stylet knobs, structure of the pharynx and absence of a bursa in male. It differs from Gymnotylenchus mainly by lacking of stylet knobs, presence of a basal pharyngeal bulb with an extension into the intestine and in the structure of the spicules. Molecular phylogenetic studies of the new genus using 706 bp partial sequences of the 28S rDNA D2/D3 segment revealed it forming a clade with two species of Sphaerularia in both Bayesian Inference (BI) and maximum likelihood (ML) analyses with 1.00 Bayesian posterior probability (BPP) and 0.96 bootstrap support values (BS). Using 942 bp partial sequences of 18S ribosomal RNA gene, the new genus formed a clade with a species of Deladenus with 0.86 BPP and 0.62 BS in BI and ML methods, respectively. With both BI and ML methods, this clade forms a larger highly supported clade with two species of Sphaerularia.
Global conversations about social justice
Authors: Norberg Katarina , Arlestig Helene , Angelle Pamela S
Published: June 2014

This qualitative study investigated the social justice practices of four principals − two from the United States and two from Sweden. The purpose of the study was to enhance our understanding of school leaders’ actions as they work to promote socially just practices in different national contexts. Principals were interviewed to examine their perceptions of what social justice leaders do, how they make sense of social justice, what helps and hinders the work of social justice, and how they learned to become social justice leaders. Findings from the principals’ interviews are presented as a fictional conversation to illustrate similarities and points of departure in social justice practice between the two countries. Principals emphasized the proactive nature of social justice leadership, demonstrated through decision-making, strategic planning, and daily interactions. The importance of giving voice to those who cannot speak for themselves, holding high expectations for all students, and the importance of modeling positive values was underscored. Conclusions from this study illustrate that social justice leadership in practice, despite the national context, offers more commonalities than differences.
Understanding social justice leadership
Authors: Slater Charles , Potter Ian , Torres Nancy , Briceno Fernando
Published: June 2014

This article is an examination of two social justice leaders, one in Costa Rica and one in England. It is part of the International Study of Leadership Development Network, a multi-nation study of social justice and educational leadership. A brief discussion of the philosophy of social justice and an examination of the macro and micro context in each of the countries set the stage to understand the social perspective of the two school leaders. Interviews were conducted to construct a narrative to illuminate their views of social justice. A comparison of the leaders found more similarities than differences even though the settings in each country were quite different. They both felt that it was important to challenge inequities in society and demand that the government provide for all citizens; they emphasized respect for students; and, to some extent, they grounded their beliefs in faith. These narratives can be valuable for both practitioners and researchers to learn from the conceptions of social justice and the challenges of these leaders. Illuminating the agency of a school leader in one national context may stir the possibility of emancipation in another context.
A high-need Azeri school
Authors: Sharvashidze Nino , Bryant Miles
Published: June 2014

This article contributes to the International Study of Leadership Development Network initiative to identify high-need schools around the globe by focusing on a small minority ethnic school in the country of Georgia. It will be clear in this article that the challenges the Karajala School administrator faces in this former Soviet bloc school stand as an example of the educational disadvantages common to rural minority ethnic schools in Georgia and to many small rural schools in former Soviet bloc nations. The Karajala School is populated with Azeri students and is located in an isolated agrarian village. In the Republic of Georgia, both conditions are markers of a high-need school. The national Ministry of Education struggles to develop educational resources for the educators and students in these types of schools. School principals are woefully ill-prepared to implement modern reforms in education. Even with its new facility, modernized classrooms, indoor restrooms, and a central heating system, Karajala remains a high-need school. This article provides a portrait of this school, identifies the factors that make it a high-need school, links the properties of this type of school to matters of social justice, and identifies the challenges that this school must overcome to address expectations of educational quality and justice.
High-need schools in Australia
Authors: Gurr David , Drysdale Lawrie , Clarke Simon , Wildy Helen
Published: June 2014

In this article, we report on our initial work with the International School Leadership Development Network. In doing so, we present two cases of principals leading high-need schools, and conclude with some key observations in relation to what is distinctive about leading these schools. The first case features a principal leading a suburban school in the large metropolitan city of Melbourne prepared by Drysdale and Gurr. This school is the result of the closure and amalgamation of several failing secondary schools, in what was termed a ‘regeneration project’. The second, prepared by Wildy and Clarke, is a personal account of a principal coping with leading a small school serving an Aboriginal community in a remote location (the nearest shop is 303 km away via an unsealed dirt road).
Studying relational spaces in secondary school: Applying a spatial framework for the study of borderlands and relational work in school improvement processes
Authors: Frelin Anneli , Grannäs Jan
Published: June 2014

This article introduces a theoretical framework for studying school improvement processes such as making school environments safer. Using concepts from spatial theory, in which distinctions between mental, social and physical space are applied makes for a multidimensional analysis of processes of change. In a multilevel case study, these were combined with task perception analysis, where all categories of personnel and management in the school were studied. The results indicated the significance of borderlands in the school for helping students, of organizational transgressions aimed at ‘making things work’ and of social spaces created in the borderlands that contributed to the necessary social glue in the school. This theoretical framework offers alternative and fruitful lenses which can enrich studies of school improvement processes.
Nicknames in Prison: Meaning and Manipulation in Inmate Monikers
Authors: Black Sharon , Wilcox Brad , Platt Brad
Published: June 2014

AbstractEach prison yard is a microcosm of society: a community with its own culture and hierarchy. Prison nicknames are a matter of social negotiation, a common everyday phenomenon with a multiplex nature. One of the authors of this article is currently serving a sentence and has supplied examples based on his own observations and informal interviews with other inmates who were willing to give him information they would not usually confide to outsiders. Knowing and using nicknames (1) gives a sense of unity among prison peers, while (2) representing their individuality, and (3) facilitating communication among them. Nicknames can be friendly, showing peer approval and in-group unity. They can also be cruel and vicious. Nicknames can be bestowed due to appearance, personality, preferences, background, or experience. They are also used for in-group communication about hidden activities or identities.
A Note on Psychological Disorders Named After Cities
Authors: Lawrence Abel Ernest
Published: June 2014

AbstractThis note surveys behavioral syndromes named after cities. Ten such syndromes are examined and are categorized in terms of their tourism, hostage taking, and metaphorical associations.
GPs Meet Rare Lung Disorders Task Force factsheet: childhood interstitial lung disease
Authors: de Jongste Johan C.
Published: June 2014

Definition

Childhood interstitial lung disease (chILD) includes a range of rare disorders of the lung parenchyma (and, sometimes, airways) that have certain clinical features in common. Specific conditions within chILD include surfactant protein B or C deficiency, alveolar capillary dysplasia with misalignment of lung veins, pulmonary interstitial glycogenosis, neuroendocrine cell hyperplasia, hypersensitivity pneumonitis, eosinophilic pneumonia, lymphocytic interstitial pneumonia, alveolar proteinosis, granulomatosis with polyangiitis, sarcoidosis, lung alveolar proteinosis, and Langerhans’ cell histiocytosis. chILD may complicate other disorders including inflammatory bowel disease and liver disease. In many children with chILD, no specific diagnosis can be made.

Key messages

Think about chILD if a child has chronic, unremitting tachypnoea, retractions, crackles and failure to thrive. Symptoms of early chILD are very unspecific and may be missed unless there is a high level of suspicion.

Refer the patient to a specialist centre in paediatric pulmonology.

Follow your patient longitudinally in collaboration with the reference centre, and be alert to comorbidities, complications of disease or treatment, or signs of recurrent or worsening lung disease.
Childhood asthma phenotypes in the twenty-first century
Authors: John Henderson A.
Published: June 2014

A substantial proportion of asthma has its origins in childhood but attempts to identify modifiable exposures that trigger asthma inception have yielded disappointing results. It is increasingly recognised that asthma may not be a single disease entity but instead consists of a number of phenotypes that share common features perhaps with different aetiologies and pathophysiological pathways leading to disease.

The aim of this review is to describe approaches to defining asthma phenotypes on the basis of clinical and epidemiological data and to consider the clinical implications of the phenotypes described. Differences in clinical features (atopy, lung function, prognosis) have been associated with phenotypes derived from unsupervised statistical approaches to phenotype definitions. Greater understanding of the genetic pathways underpinning asthma has also led to some insights into asthma endotypes that manifest as different clinical phenotypes. However, the challenge to translate these findings into interventions to change the natural history of asthma has yet to be overcome. Technological advances are driving the creation of massive data resources that can be brought to bear on this problem. Whether they will finally solve the problem of phenotypic complexity in asthma remains to be discovered. If they do, the possibility of personalised interventions for asthma may eventually be realised.
Adaptive evolution and divergent expression of heat stress transcription factors in grasses
Authors: Yang Zefeng , Wang Yifan , Gao Yun , Zhou Yong , Zhang Enying , Hu Yunyun , Yuan Yuan , Liang Guohua , Xu Chenwu
Published: June 2014

Background

Heat stress transcription factors (Hsfs) regulate gene expression in response to heat and many other environmental stresses in plants. Understanding the adaptive evolution of Hsf genes in the grass family will provide potentially useful information for the genetic improvement of modern crops to handle increasing global temperatures.

Results

In this work, we performed a genome-wide survey of Hsf genes in 5 grass species, including rice, maize, sorghum, Setaria, and Brachypodium, by describing their phylogenetic relationships, adaptive evolution, and expression patterns under abiotic stresses. The Hsf genes in grasses were divided into 24 orthologous gene clusters (OGCs) based on phylogeneitc relationship and synteny, suggesting that 24 Hsf genes were present in the ancestral grass genome. However, 9 duplication and 4 gene-loss events were identified in the tested genomes. A maximum-likelihood analysis revealed the effects of positive selection in the evolution of 11 OGCs and suggested that OGCs with duplicated or lost genes were more readily influenced by positive selection than other OGCs. Further investigation revealed that positive selection acted on only one of the duplicated genes in 8 of 9 paralogous pairs, suggesting that neofunctionalization contributed to the evolution of these duplicated pairs. We also investigated the expression patterns of rice and maize Hsf genes under heat, salt, drought, and cold stresses. The results revealed divergent expression patterns between the duplicated genes.

Conclusions

This study demonstrates that neofunctionalization by changes in expression pattern and function following gene duplication has been an important factor in the maintenance and divergence of grass Hsf genes.
A qualitative analysis of information sharing for children with medical complexity within and across health care organizations
Authors: Quigley Laura , Lacombe-Duncan Ashley , Adams Sherri , Moore Hepburn Charlotte , Cohen Eyal
Published: June 2014

Background

Children with medical complexity (CMC) are characterized by substantial family-identified service needs, chronic and severe conditions, functional limitations, and high health care use. Information exchange is critically important in high quality care of complex patients at high risk for poor care coordination. Written care plans for CMC are an excellent test case for how well information sharing is currently occurring. The purpose of this study was to identify the barriers to and facilitators of information sharing for CMC across providers, care settings, and families.

Methods

A qualitative study design with data analysis informed by a grounded theory approach was utilized. Two independent coders conducted secondary analysis of interviews with parents of CMC and health care professionals involved in the care of CMC, collected from two studies of healthcare service delivery for this population. Additional interviews were conducted with privacy officers of associated organizations to supplement these data. Emerging themes related to barriers and facilitators to information sharing were identified by the two coders and the research team, and a theory of facilitators and barriers to information exchange evolved.

Results

Barriers to information sharing were related to one of three major themes; 1) the lack of an integrated, accessible, secure platform on which summative health care information is stored, 2) fragmentation of the current health system, and 3) the lack of consistent policies, standards, and organizational priorities across organizations for information sharing. Facilitators of information sharing were related to improving accessibility to a common document, expanding the use of technology, and improving upon a structured communication plan.

Conclusions

Findings informed a model of how various barriers to information sharing interact to prevent optimal information sharing both within and across organizations and how the use of technology to improve communication and access to information can act as a solution.
Malawer limb salvage surgery for the treatment of scapular chondrosarcoma
Authors: Chang Fei , Liu Guang-Yao , Zhang Qiao , Lin Gang , Huang Hong , Duan De-Sheng , Wang Jin-Cheng
Published: June 2014

Chondrosarcoma is a common malignant bone tumor, which accounts for 20% of all malignant bone tumors. It often occurs in the long bones, but the incidence of scapular chondrosarcoma is rare. Here, we describe a case of a large chondrosarcoma occurring in the scapula which was treated with Malawer limb salvage surgery. The patient retained considerable limb function after complete removal of the tumor tissue as assessed at the follow-up visit two years and ten months following surgery.
Higher platelet cytochrome oxidase specific activity in surviving than in non-surviving septic patients
Authors: Lorente Leonardo , Martín María M , López-Gallardo Esther , Iceta Ruth , Blanquer José , Solé-Violán Jordi , Labarta Lorenzo , Díaz César , Jiménez Alejandro , Montoya Julio , Ruiz-Pesini Eduardo
Published: June 2014

Introduction

In a previous study with 96 septic patients, we found that circulating platelets in 6-months surviving septic patients showed higher activity and quantity of cytochrome c oxidase (COX) normalized by citrate synthase (CS) activity at moment of severe sepsis diagnosis than non-surviving septic patients. The objective of this study was to estimate whether COX specific activity during the first week predicts 1-month sepsis survival in a larger cohort of patients.

Methods

Using a prospective, multicenter, observational study carried out in six Spanish intensive care units with 198 severe septic patients, we determined COX activity per proteins (COXact/Prot) in circulating platelets at day 1, 4 and 8 of the severe sepsis diagnosis. Endpoints were 1-month and 6-months mortality.

Results

Survivor patients (n = 130) showed higher COXact/Prot (P < 0.001) than non-survivors (n = 68) at day 1, 4 and 8 of severe sepsis diagnosis. More than a half of the 6-months survivor patients showed an increase in their COXact/Prot from day 1 to 8. However, most of the 1-month non-survivors exhibited a decrease in their COXact/Prot from day 1 to 8. Multiple logistic regression analyses showed that of platelet COXact/Prot > 0.30 mOD/min/mg at day 1 (P = 0.002), 4 (P = 0.006) and 8 (P = 0.02) was associated independently with 1-month mortality. Area under the curve of COXact/Prot at day 1, 4 and 8 to predict 30-day survival were 0.70 (95% CI = 0.63-0.76; P < 0.001), 0.71 (95% CI = 0.64-0.77; P < 0.001) and 0.71 (95% CI = 0.64-0.78; P < 0.001), respectively.

Conclusions

The new findings of our study, to our knowledge the largest series reporting data about mitochondrial function during follow-up in septic patients, were that septic patients that survive 1-month have a higher platelet cytochrome oxidase activity at moment of sepsis diagnosis and during the first week than non-survivors, and that platelet cytochrome oxidase activity at moment of sepsis diagnosis and during the first week could be used as biomarker to predict the clinical outcome in septic patients.
Insulator function and topological domain border strength scale with architectural protein occupancy
Authors: Van Bortle Kevin , Nichols Michael H , Li Li , Ong Chin-Tong , Takenaka Naomi , Qin Zhaohui S , Corces Victor G
Published: June 2014

Background

Chromosome conformation capture studies suggest that eukaryotic genomes are organized into structures called topologically associating domains. The borders of these domains are highly enriched for architectural proteins with characterized roles in insulator function. However, a majority of architectural protein binding sites localize within topological domains, suggesting sites associated with domain borders represent a functionally different subclass of these regulatory elements. How topologically associating domains are established and what differentiates border-associated from non-border architectural protein binding sites remain unanswered questions.

Results

By mapping the genome-wide target sites for several Drosophila architectural proteins, including previously uncharacterized profiles for TFIIIC and SMC-containing condensin complexes, we uncover an extensive pattern of colocalization in which architectural proteins establish dense clusters at the borders of topological domains. Reporter-based enhancer-blocking insulator activity as well as endogenous domain border strength scale with the occupancy level of architectural protein binding sites, suggesting co-binding by architectural proteins underlies the functional potential of these loci. Analyses in mouse and human stem cells suggest that clustering of architectural proteins is a general feature of genome organization, and conserved architectural protein binding sites may underlie the tissue-invariant nature of topologically associating domains observed in mammals.

Conclusions

We identify a spectrum of architectural protein occupancy that scales with the topological structure of chromosomes and the regulatory potential of these elements. Whereas high occupancy architectural protein binding sites associate with robust partitioning of topologically associating domains and robust insulator function, low occupancy sites appear reserved for gene-specific regulation within topological domains.
Life history traits of the Chinese minnow Rhynchocypris oxycephalus in the upper branch of Yangtze River, China
Authors: Liang Yangyang , Sui Xiaoyun , Chen Yifeng , Jia Yintao , He Dekui
Published: June 2014

Background

Study of the life history traits of any species plays an essential role for understanding their relationship with the surrounding environment and scientific management. The Chinese minnowRhynchocypris oxycephalus, an ecologically and economically important species which was widely distributed in East Asia, is currently diminishing. In the present study, we depicted the main life history traits ofR. oxycephalusfor the first time.

Results

A total of 442 individuals were collected from April 2012 to March 2013, with total length (TL) ranging from 32.2 to 158.0 mm. The otolith (lapillus) was proved suitable for age determination. Moreover, the results from marginal increment ratio (MIR) analyses demonstrated its unusual growth pattern: two pairs of opaque and transparent bands were formed each year, which might provide some implications for the age determination of other species. The maximum age for females (4 years) was higher than for males (3 years), while 1- and 2-year-old individuals dominated the population. Both females and males reached maturity at 1 year, and the TL at first maturity was 78.8 mm for females and 60.3 mm for males. Obvious sexual dimorphism was observed as females growing faster and larger than males after maturity. As a multiple spawner,R. oxycephalusreleases batches of eggs from April to August. The fecundity ofR. oxycephaluswas higher, and the size of eggs was larger than that of its closely related species.

Conclusions

R. oxycephalusis a short-lived, fast-growing, highly fecund, and early-maturing species; therefore, even a short recovery time after overexploitation or disturbance would be of great use for their restoration. Some life history traits ofR. oxycephalusdemonstrate obvious differences with its closely related species, indicating that latitude and local environment conditions are important selective forces for this species.
Editorial: Dialing down inflammation: LRRC33 regulates Toll-like receptor signaling
Authors: Janowski Ann M , Sutterwala Fayyaz S
Published: June 2014

Discussion on the role of histone modification in regulating expression of LRRC33, and its subsequent effect on TLR activation.
Persistence of Fortune: Accounting for Population Movements, There Was No Post-Columbian Reversal
Authors: Chanda Areendam , Cook C. Justin , Putterman Louis
Published: June 2014

Using data on place of origin of today's country populations and the indicators of level of development in 1500 used by Acemoglu, Johnson, and Robinson (2002), we confirm a reversal of fortune for colonized countries as territories, but find persistence of fortune for people and their descendants. Persistence results are at least as strong for three alternative measures of early development, for which reversal for territories, however, fails to hold. Additional exercises lend support to Glaeser et al.'s (2004) view that human capital is a more fundamental channel of influence of precolonial conditions on modern development than is quality of institutions. (JEL J11, J24, N10, N30, O15, O43, R11)
Growth and Capital Flows with Risky Entrepreneurship
Authors: Sandri Damiano
Published: June 2014

We show that the behavior of entrepreneurs facing incomplete financial markets and risky investment can explain why accelerations of productivity growth in developing countries tend to be associated with current account improvements. Under uninsurable investment risk, entrepreneurs have to largely rely on self-financing so that, when productivity growth rises, entrepreneurs increase saving to finance new investment. The key insight is that saving has to increase more than investment to also allow for the accumulation of precautionary assets that entrepreneurs hold for self-insurance against investment risk. Numerical simulations show that this net saving increase can generate a current account improvement in line with the empirical evidence. (JEL E21, E22, F32, F41, F43, G32, L26)
The Global Welfare Impact of China: Trade Integration and Technological Change
Authors: di Giovanni Julian , Levchenko Andrei A. , Zhang Jing
Published: June 2014

This paper evaluates the global welfare impact of China's trade integration and technological change in a multi-country quantitative Ricardian-Heckscher-Ohlin model. We simulate two alternative growth scenarios: a “balanced” one in which China's productivity grows at the same rate in each sector, and an “unbalanced” one in which China's comparative disadvantage sectors catch up disproportionately faster to the world productivity frontier. Contrary to a well-known conjecture (Samuelson 2004), the large majority of countries experience significantly larger welfare gains when China's productivity growth is biased toward its comparative disadvantage sectors. This finding is driven by the inherently multilateral nature of world trade. (JEL F14, F43, 019, 033, 047, P24, P33)
Accounting for Crises
Authors: Nagar Venky , Yu Gwen
Published: June 2014

We provide among the first empirical evidence, consistent with recent macro global game crisis models, that shows that the precision of public signals can coordinate crises. In these models, self-fulfilling crises independent of fundamentals can occur only when publicly disclosed signals of fundamentals have high precision; poor fundamentals are the sole driver of crises only in low precision settings. We exploit a key publicly disclosed signal of fundamentals, namely accounting data, for 68 currency and systemic banking crises in 17 countries. We find that precrisis accounting signals of fundamentals are significantly lower only in low-precision countries. (JEL D82, E44, G01, G14, G21 L25, M40)
Public Communication and Information Acquisition
Authors: Chahrour Ryan
Published: June 2014

This paper models the tradeoff, perceived by central banks and other public actors, between providing the public with useful information and the risk of overwhelming it with excessive communication. An information authority chooses how many signals to provide regarding an aggregate state and agents respond by choosing how many signals to observe. When agents desire coordination, the number of signals they acquire may decrease in the number released. The optimal quantity of communication is positive but does not maximize agents' acquisition of information. In contrast to a model without information choice, the authority always prefers to provide more precise signals. (JEL D82, D83, E52, E58)
Amortization and destruction of the surface layer of rubberized shafts in leather-working machines
Authors: Дарда Игорь , Darda Igor , Кочетков Алексей , Kochetkov Aleksey , Сумзина Лариса , Sumzina Larisa
Published: June 2014

In the course of rubber bowl amortization, the surface wears outs in the contact zone due to a number of factors, the most significant of which are related to the mechanical, physical and / or chemical, and other aspects of the leather working process, and are coupled with high humidity and corrosion environment. From a theoretical and practical perspectives, it is the fatigue wear, which causes hardware fault and makes repair and restoration inevitable. The authors carry out an experimental evaluation of the surface thickness.
Research into transient periodic processes of wastewater cyclotank aerobic treatment with biological sludge
Authors: Лебедев Владимир , Lebedev Vladimir , Губанов Николай , Gubanov Nikolay , Тыгер Любовь , Tyger Lyubov
Published: June 2014

The authors consider the theoretical pre-conditions for developing a model of transient periodic processes of communal wastewater aerobic treatment. The logical-mathematical model is based on the patters of cell growth kinetics and biochemical transformations of organic substances in the course of cell metabolism regulated by enzyme catalysis. The authors introduce the concept of the temporal structure of the operation cycle, consider the restrictions on the length of operations, the peculiarities of process description determined by individual phases of the process and parameter integration conditions observed during different phases.