bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of surgeon volume on the morbidity and costs of radical cystectomy in the USA: a contemporary population‐based analysis
Authors: Leow Jeffrey J. , Reese Stephen , Trinh Quoc‐Dien , Bellmunt Joaquim , Chung Benjamin I. , Kibel Adam S. , Chang Steven L.
Published: March 2014

Objectives

To evaluate the relationship between surgeon volume of radical cystectomy (RC) and postoperative morbidity, and to assess the economic burden of bladder cancer in the USA.

Methods

We captured all patients who underwent RC (International Classification of Diseases, ninth revision, code 57.71) between 2003 and 2010, using a nationwide hospital discharge database. Patient, hospital and surgical characteristics were evaluated. The annual volume of RCs performed by the surgeons was divided into quintiles. Multivariable regression models were developed, adjusting for clustering and survey weighting, to evaluate the outcomes, including 90‐day major complications (Clavien grade III–V) and direct patient costs. We adjusted for clustering and weighting to achieve a nationally representative analysis.

Results

The weighted cohort included 49 792 patients who underwent RC, with an overall 90‐day major complication rate of 16.2%. Compared with surgeons performing one RC annually, surgeons performing ≥7 RCs each year had 45% lower odds of major complications (odds ratio [OR] 0.55; P < 0.001) and lower costs by $1690 (P = 0.02). Results were consistent when we analysed surgeon volume as a continuous variable and when we examined the surgeons with the highest volumes (≥28 cases annually), which showed markedly lower odds of major complications compared with the surgeons with the lowest volumes (OR 0.45, 95% CI 0.31–0.67; P < 0.001). Compared with patients who did not have any complications, those who had a major complication were associated with significantly higher 90‐day median direct hospital costs ($43 965 vs $24 341; P < 0.001).

Conclusions

We showed that there was an inverse relationship between surgeon volume and the development of postoperative 90‐day major complication rates as well as direct hospital costs. Centralisation of RC to surgeons with higher volumes may reduce the development of postoperative major complications, thereby decreasing the burden of bladder cancer on the healthcare system.
Flux‐Limited Diffusion for Multiple Scattering in Participating Media
Authors: Koerner D. , Portsmouth J. , Sadlo F. , Ertl T. , Eberhardt B.
Published: March 2014

For the rendering of multiple scattering effects in participating media, methods based on the diffusion approximation are an extremely efficient alternative to Monte Carlo path tracing. However, in sufficiently transparent regions, classical diffusion approximation suffers from non‐physical radiative fluxes which leads to a poor match to correct light transport. In particular, this prevents the application of classical diffusion approximation to heterogeneous media, where opaque material is embedded within transparent regions. To address this limitation, we introduce flux‐limited diffusion, a technique from the astrophysics domain. This method provides a better approximation to light transport than classical diffusion approximation, particularly when applied to heterogeneous media, and hence broadens the applicability of diffusion‐based techniques. We provide an algorithm for flux‐limited diffusion, which is validated using the transport theory for a point light source in an infinite homogeneous medium. We further demonstrate that our implementation of flux‐limited diffusion produces more accurate renderings of multiple scattering in various heterogeneous datasets than classical diffusion approximation, by comparing both methods to ground truth renderings obtained via volumetric path tracing.
The nickel dose–response relationship by filaggrin genotype (FLG)
Authors: Ross‐Hansen Katrine , Johansen Jeanne D. , Vølund Aage , Menné Torkil , Thyssen Jacob P.
Published: March 2014

Background

On skin contact, nickel accumulates in the stratum corneum, where it is probably bound to proteins and amino acids. One probable contributor is filaggrin, which binds nickel avidly. Filaggrin gene (FLG) null mutations lead to a complete lack of filaggrin production from the affected allele, and have been associated with an increased risk of nickel contact sensitization in German and Danish adults.

Objectives

To investigate whether the experimental nickel elicitation threshold level differed between heterozygous FLG mutation and non‐mutation carriers.

Method

Thirteen nickel‐sensitized female patients, seven heterozygous mutation carriers and six non‐mutation carriers (genotyped for R501X, 2282del4, or R2447X), were patch tested and performed a repeated open application test (ROAT) with a nickel sulfate dilution series. Logistic threshold dose–response analyses were used to test for differences between the two groups.

Results

No difference was found in the dose–response relationship between FLG mutation and non‐mutation carriers.

Conclusions

On the basis of this small patient study, it appears that the elicitation threshold level for nickel is independent of FLG null mutation single‐allele carrier status.
The allergic emergency – management of severe allergic reactions
Authors: Werner‐Busse Alexandra , Zuberbier Torsten , Worm Margitta
Published: March 2014

Anaphylaxis is characterized by the sudden onset of acute allergic symptoms involving two or more organ systems. An acute allergic emergency is a challenge for physicians due to its life‐threatening potential. The incidence of anaphylactic reactions has increased in recent years. Most frequent elicitors of mast cell and primarily histamine dependent anaphylactic reactions are food, insect venom or drugs. Allergic ­reactions are graded into four groups according to the classification by Ring and Messmer; grade I is defined by the onset of cutaneous symptoms only whereas grade IV is characterized by cardiovascular shock as well as cardiac and/or respiratory arrest.

The treatment of allergic reactions should be guided by the severity of the reaction. Initially an intramuscular epinephrine injection into the lateral thigh should be given if cutaneous, mucosal and cardiovascular/respiratory symptoms occur. Additionally, the patient should receive intravenous antihistamines and corticosteroids. For self‐treatment in the case of an allergic emergency, oral antihistamines and corticosteroids should be prescribed to the patient.
Video capsule endoscopy is successful and effective in outpatients with implantable cardiac devices
Authors: Stanich Peter P. , Kleinman Bryan , Betkerur Kavita , Mehta Oza Nishaki , Porter Kyle , Meyer Marty M.
Published: March 2014

Background and Aim

Implantable cardiac devices are a relative contraindication to video capsule endoscopy (VCE) because of concerns regarding interference. As a result of a lack of alternatives, some centers have adopted protocols to allow for VCE in these patients. There are minimal published descriptions of the gastrointestinal outcomes of these procedures. We investigated the completion rate and diagnostic yield of VCE carried out in outpatients with implantable cardiac devices.

Methods

We carried out a retrospective review of all VCE from April 2010 through March 2013 at our center. Patients that underwent VCE through a specialized protocol for outpatients with implantable cardiac devices were identified. The protocol used telemetry for cardiac monitoring during battery lifespan of the VCE. Demographic data, procedure indications, results and any procedural events were collected.

Results

Twenty‐one patients met the study criteria, with 16 (76%) pacemakers, four (19%) implantable cardioverter defibrilla tors and one (5%) implantable hemodynamic monitor. Two (10%) devices were adjusted prior to VCE. Twenty (95%) were completed to the colon, with a median gastric transit time of 18 min and a small bowel transit time of 216 min. The procedure was diagnostic in 13 (62%) patients. One (5%) capsule retention event occurred. No cardiac events or video capture disturbances occurred.

Conclusions

Video capsule endoscopy done on outpatients with implantable cardiac devices through a cardiac monitoring protocol resulted in a satisfactory completion rate and high diagnostic yield with no adverse cardiac events. A large prospective trial is needed to confirm these novel results.
Salvage therapy with pegylated liposomal doxorubicin, bortezomib, cyclophosphamide, and dexamethasone in relapsed/refractory myeloma patients
Authors: Romano Alessandra , Chiarenza Annalisa , Conticello Concetta , Cavalli Maide , Vetro Calogero , Di Raimondo Cosimo , Cunsolo Rosario , Palumbo Giuseppe Alberto , Di Raimondo Francesco
Published: March 2014

Objectives

In vitro studies have shown synergistic anti‐myeloma effects of bortezomib combined with alkylating agents or anthracycline. We tested safety and efficacy of the combination of bortezomib, doxorubicin cyclophosphamide, and dexamethasone (ABCD) in the treatment of relapsed/refractory myeloma.

Methods

ABCD consisted of bortezomib given intravenous (IV) at dosage 1.3 mg/m2, dexamethasone 40 mg IV on days 1, 4, 8, and 15, pegylated liposomal doxorubicin (PLD) 20 mg IV on days 1 and 15, plus cyclophosphamide 100 mg/d per os for 15 d. Between January 2008 and February 2009, 24 patients received a median of four 28‐d ABCD cycles (range 1–6). All patients had been already treated with a median of two previous lines of treatment (range 1–6): 38% were resistant to previous therapies and 62% were relapsed.

Results

Clinical response was observed in 12 patients (50%), including 29% of very good partial remissions or better. Side effects included hematological toxicity (31% any grade), grades 3–4 thrombocytopenia (9%), grades 3–4 anemia (17%). Non‐hematological toxicity affected 32% of administered cycles and included gastrointestinal disturbances (54%), peripheral neuropathy (8%), and infections (8%). After a median follow‐up of 21.5 months (range 2–44 months), median of progression‐free survival (PFS) was 8.7 months and median overall survival was 22.5 months. Achieving at least partial response within the second cycle was associated with a better PFS (19.5 months vs. 3.5 months), P = 0.03, HR 0.35 (CI 95% 0.13–0.90).

Conclusion

ABCD is safe and effective for relapsed/refractory MM subjects previously treated with novel agents.
PML‐RARA fusion resulting from a cryptic insertion of RARA gene into PML gene without the reciprocal RARA‐PML fusion: clinical, cytogenetic, and molecular characterization and prognosis
Authors: Fan Hongxin , Ortega Veronica , Fanasch Hilal M. , Wang Yao , Holder Kenneth N. , Higgins Russell A. , Mendiola Christina , Mohamed Gihan , Vadlamudi Kumari , Velagaleti Gopalrao
Published: March 2014

We describe a case of acute promyelocytic leukemia in a 61‐yr‐old woman with a cryptic insertion of RARA gene into PML gene. Using a combination of cytogenetic and molecular methods, we confirmed the insertion and presence of the PML‐RARA transcript and lack of the reciprocal RARA‐PML transcript. Although such cryptic insertions leading to a PML‐RARA fusion have been previously reported, we show that such variant insertions, based on our case, appear to have the same prognostic significance as the classical t(15;17)(q22;q21).
β‐Catenin regulates membrane potential in muscle cells by regulating the α2 subunit of Na,K‐ATPase
Authors: Zhao Congying , Zhang Jing , Li Kexin , Yang Jianming , Yu Huimin , Duan Shumin , Jiang Kewen , Li Xiaoming
Published: March 2014

Muscle β‐catenin has been shown to play a role in the formation of the neuromuscular junction (NMJ). Our previous studies showed that muscle‐specific conditional knockout of β‐catenin (HSA‐β‐cat−/−) results in early postnatal death in mice. To understand the underlying mechanisms, we investigated the electrophysiological properties of muscle cells from HSA‐β‐cat−/− and control mice, and found that, in the absence of muscle β‐catenin, the resting membrane potential (RMP) depolarised in muscle cells from the diaphragm, gastrocnemius and extensor digitorum longus muscles. Furthermore, in a primary line of mouse myoblasts (C2C12 cells) transfected with small‐interfering RNAs targeting β‐catenin, the RMP was depolarised as well. Finally, the expression levels of the α2 subunit of sodium/potassium adenosine triphosphatase were reduced by β‐catenin knockdown in vitro or deletion in vivo. These results suggest a possible mechanism underlying the depolarised RMP in the absence of muscle β‐catenin, and provide additional evidence supporting a role for β‐catenin in the development of NMJs.
Staying awake – a genetic region that hinders α2adrenergic receptor agonist‐induced sleep
Authors: Gelegen Cigdem , Gent Thomas C. , Ferretti Valentina , Zhang Zhe , Yustos Raquel , Lan Fei , Yang Qianzi , Overington Dorothy W. U. , Vyssotski Alexei L. , van Lith Hein A. , Wisden William , Franks Nicholas P.
Published: March 2014

How external stimuli prevent the onset of sleep has been little studied. This is usually considered to be a non‐specific type of phenomenon. However, the hypnotic drug dexmedetomidine, an agonist at α2adrenergic receptors, has unusual properties that make it useful for investigating this question. Dexmedetomidine is considered to produce an ‘arousable’ sleep‐like state, so that patients or animals given dexmedetomidine become alert following modest stimulation. We hypothesized that it might be more difficult to make mice unconscious with dexmedetomidine if there was a sufficient external stimulus. Employing a motorized rotating cylinder, which provided a continuous and controlled arousal stimulus, we quantitatively measured the ability of such a stimulus to prevent dexmedetomidine loss of righting reflex in two inbred strains of mice (C57BL/6 and 129X1). We found that whereas the C57BL/6 strain required a strong stimulus to prevent dexmedetomidine‐induced hypnosis, the 129X1 strain stayed awake even with minimal stimuli. Remarkably, this could be calibrated as a simple threshold trait, i.e. a binary ‘yes–no’ response, which after crossing the two mouse strains behaved as a dominant‐like trait. We carried out a genome‐wide linkage analysis on the F2progeny to determine if the ability of a stimulus to prevent dexmedetomidine hypnosis could be mapped to one or more chromosomal regions. We identified a locus on chromosome 4 with an associated Logarithm of Odds score exceeding the pre‐established threshold level. These results show that complex traits, such as the ability of a stimulus to reverse drug‐induced hypnosis, may have precise genetic determinants.
Phenotypic variation and selective mortality as major drivers of recruitment variability in fishes
Authors: Johnson Darren W. , Grorud‐Colvert Kirsten , Sponaugle Su , Semmens Brice X.
Published: March 2014

An individual's phenotype will usually influence its probability of survival. However, when evaluating the dynamics of populations, the role of selective mortality is not always clear. Not all mortality is selective, patterns of selective mortality may vary, and it is often unknown how selective mortality compares or interacts with other sources of mortality. As a result, there is seldom a clear expectation for how changes in the phenotypic composition of populations will translate into differences in average survival. We address these issues by evaluating how selective mortality affects recruitment of fish populations. First, we provide a quantitative review of selective mortality. Our results show that most of the mortality during early life is selective, and that variation in phenotypes can have large effects on survival. Next, we describe an analytical framework that accounts for variation in selection, while also describing the amount of selective mortality experienced by different cohorts recruiting to a single population. This framework is based on reconstructing fitness surfaces from phenotypic selection measurements, and can be employed for either single or multiple traits. Finally, we show how this framework can be integrated with models of density‐dependent survival to improve our understanding of recruitment variability and population dynamics.
Parent and family stress factors predict health‐related quality in pediatric patients with new‐onset epilepsy
Authors: Wu Yelena P. , Follansbee‐Junger Katherine , Rausch Joseph , Modi Avani
Published: March 2014

Objective

To examine the influence of parent and family general and epilepsy‐related stress on longitudinal generic and epilepsy‐specific health‐related quality of life (HRQOL)for children with new‐onset epilepsy, while controlling for demographic characteristics, disease factors, and antiepileptic drug (AED) adherence.

Methods

This prospective, longitudinal study included 124 children with new‐onset epilepsy (mean age 7.2 years, standard deviation [SD] 2.9 years). Parents completed questionnaires on parenting stress, perceived stigma, fears and concerns, andHRQOLat 1, 13, and 25 months after diagnosis. Adherence to AEDs was assessed using electronic monitors. A medical chart review was conducted at each visit to obtain seizure and side effect data.

Results

Higher levels of general and epilepsy‐specific parent and family stress, fears and concerns, and perceived stigma negatively affected child generic and epilepsy‐specificHRQOL, above and beyond disease and demographic factors. General parenting and family stress affected child generic and epilepsy‐specificHRQOLmore in the first year of disease management than at 2 years after diagnosis. Higher fears and concerns predicted higher epilepsy‐specificHRQOLat 13 months postdiagnosis, whereas 2 years postdiagnosis, higher fears and concerns predicted lower epilepsy‐specificHRQOL. Several demographic (i.e., age) and disease‐related variables (i.e., side effects andAEDadherence) influenced child generic and epilepsy‐specificHRQOL. Although some findings were consistent across generic and epilepsy‐specificHRQOLmeasures, others were unique.

Significance

Modifiable parent factors (i.e., general and disease‐specific parent and family stress, perceived stigma) impactHRQOLfor children with new‐onset epilepsy differently over the first 2 years postdiagnosis. Psychosocial interventions to improveHRQOLwithin the first year postdiagnosis should address parenting and family stress, overall coping, and anticipatory guidance on managing epilepsy. Interventions targeting adherence, perceived stigma, and fears and concerns could improveHRQOL. Promoting parent management of stress, fears/concerns, and perceived stigma may lead to improved childHRQOLoutcomes.

A PowerPoint slide summarizing this article is available for download in the Supporting Information sectionhere.
The effect of amygdala kindling on neuronal firing patterns in the lateral thalamus in the GAERS model of absence epilepsy
Authors: Çarçak Nihan , Zheng Thomas , Ali Idrish , Abdullah Ahmad , French Chris , Powell Kim L. , Jones Nigel C. , van Raay Leena , Rind Gil , Onat Filiz , O'Brien Terence J.
Published: March 2014

Objective

The co‐occurrence of absence and mesial temporal lobe epilepsy is rare in both humans and animal models. Consistent with this, rat models of absence epilepsy, including genetic absence epilepsy rats from Strasbourg (GAERS), are resistant to experimental temporal lobe epileptogenesis, in particular by amygdala kindling. Structures within the cortical‐thalamocortical system are critically involved in the generation and maintenance of the electrographic spike‐and‐wave discharges (SWDs) that characterize absence seizures. Using in vivo electrophysiologic recordings, this study investigated the role of thalamocortical circuitry in the generalization of amygdala‐kindling induced seizures in the GAERS and the nonepileptic control (NEC) strain of Wistar rats.

Methods

GAERS and NEC rats were implanted with a stimulating electrode in amygdala and stimulated at afterdischarge threshold twice daily to a maximum number of 30 stimulations. Thereafter extracellular single neuron recordings were performed in vivo under neuroleptanesthesia in the thalamocortical network.

Results

In NEC rats, amygdala kindling induced convulsive class V seizures and altered characteristics of neuronal activity in the thalamic reticular nucleus (TRN), in particular decreased firing rates and increased burst firing patterns. Less marked changes were seen in other regions examined: the ventroposteromedial nucleus of thalamus (VPM), the CA3 region of the hippocampus, and the deep layers (V/VI) of the cortex. GAERS did not progress beyond class II seizures, with a matched number of kindling stimulations, and the thalamic neuronal firing alterations observed in NEC rats were not seen.

Significance

These data suggest that the TRN plays an important role in kindling resistance in GAERS and is central to the control of secondary generalization of limbic seizures.

A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.
Divergent phenological response to hydroclimate variability in forested mountain watersheds
Authors: Hwang Taehee , Band Lawrence E. , Miniat Chelcy F. , Song Conghe , Bolstad Paul V. , Vose James M. , Love Jason P.
Published: March 2014

Mountain watersheds are primary sources of freshwater, carbon sequestration, and other ecosystem services. There is significant interest in the effects of climate change and variability on these processes over short to long time scales. Much of the impact of hydroclimate variability in forest ecosystems is manifested in vegetation dynamics in space and time. In steep terrain, leaf phenology responds to topoclimate in complex ways, and can produce specific and measurable shifts in landscape forest patterns. The onset of spring is usually delayed at a specific rate with increasing elevation (often called Hopkins' Law; Hopkins, 1918), reflecting the dominant controls of temperature on greenup timing. Contrary with greenup, leaf senescence shows inconsistent trends along elevation gradients. Here, we present mechanisms and an explanation for this variability and its significance for ecosystem patterns and services in response to climate. We use moderate‐resolution imaging spectro‐radiometer (MODIS) Normalized Difference Vegetation Index (NDVI) data to derive landscape‐induced phenological patterns over topoclimate gradients in a humid temperate broadleaf forest in southern Appalachians. These phenological patterns are validated with different sets of field observations. Our data demonstrate that divergent behavior of leaf senescence with elevation is closely related to late growing season hydroclimate variability in temperature and water balance patterns. Specifically, a drier late growing season is associated with earlier leaf senescence at low elevation than at middle elevation. The effect of drought stress on vegetation senescence timing also leads to tighter coupling between growing season length and ecosystem water use estimated from observed precipitation and runoff generation. This study indicates increased late growing season drought may be leading to divergent ecosystem response between high and low elevation forests. Landscape‐induced phenological patterns are easily observed over wide areas and may be used as a unique diagnostic for sources of ecosystem vulnerability and sensitivity to hydroclimate change.
Response of non‐nativeEuropean terrestrial gastropods to novel climates correlates with biogeographical and biological traits
Authors: Capinha César , Rödder Dennis , Pereira Henrique Miguel , Kappes Heike
Published: March 2014

Aim

Anticipating the propensity of species to persist outside the climatic conditions in which they are observed is important in assessing the uncertainty in climate‐matching when applied to different locations or times. By using data from 27European terrestrial gastropods (slugs and snails) established in new regions, we measured (1) the degree of climate match between native and non‐native ranges and (2) the diversity of novel climatic conditions inhabited. We then tested for species traits as predictors of the patterns found.

Location

Worldwide.

Methods

We projected the occurrences of each species onto the climatic space defined by the two main axes of a principal components analysis. On the basis of the convex hull of native occurrences, we measured the proportion of non‐native occurrences in novel climates and the diversity of the newly occupied climates. Generalized estimating equations were used to test for associations between climatic responses and species traits, while considering phylogenetic relatedness and introduction effort.

Results

Approximately half of the species had a large proportion (> 25%) of non‐native occurrences in novel climates. Climate mismatch was significantly higher for species with narrow native climatic niches, native ranges elongated in a north–south direction or native ranges with the southern limit at lower latitudes. Slugs occupied a higher diversity of novel climatic conditions than snails.

Main conclusions

Climate matching showed varying levels of accuracy in predicting the non‐native ranges of the studied species. Lower accuracy appeared to be mainly related to low levels of distributional equilibrium in native ranges. In addition, coarse‐scale predictions for species that are able to take advantage of microclimatic variability – as appears to be the case with slugs – may be challenging. We conclude that species traits can contribute to understanding uncertainties in climate‐matching exercises.
Water (in)security: securing the right to water
Authors: Loftus Alex
Published: March 2014

This paper rereads debates over water security and insecurity through the tools of critical geographical scholarship. It seeks to demonstrate the value of such a critical perspective in achieving access to water for all. While rejecting a simplistic dismissal of mainstream discourses on water security, the paper notes the failure to adequately politicise the processes and relationships that reproduce water inequalities. Finding lessons in recent writings on political ecology, the hydro‐social cycle and on the right to water, the paper concludes with a Gramscian claim to build from the fragmented but situated knowledges implicit in struggles to achieve democratic access to water.
Isotopic analysis of island House Martins Delichon urbica indicates marine provenance of nutrients
Authors: Cross Adam D. P. , Hentati‐Sundberg Jonas , Österblom Henrik , McGill Rona A. R. , Furness Robert W.
Published: March 2014

The presence of one of the largest colonies of House Martins in Europe on the small island of Stora Karlsö, Sweden, led us to investigate the source of their food by analysis of stable isotopes of carbon and nitrogen. Carbon isotopic values of House Martin nestlings were the same as those of Common Guillemot Uria aalge nestlings fed on marine fish, but differed from local Collared Flycatcher Ficedula albicollis nestlings fed on woodland insects. We infer that these House Martins fed their chicks almost exclusively on insects that had used nutrients derived from seabirds, indicating a dependence on the presence of a large seabird colony. We suggest by extension that some populations of island passerines of high conservation importance may also be dependent on nutrient subsidies from seabird colonies.
Outcome analysis of ultrasound‐guided prostate biopsy procedure: a retrospective audit comparing associate consultant and nurse specialist in urology to determine the effectiveness and safety of a nurse‐led prostate biopsy clinic
Authors: Jones Sandie , Purnendu Majumdar , Christian Seipp
Published: March 2014

The incidence of prostate cancer continues to rise and is now the most common cancer in men in Wales and in the UK (Cancer Research UK, 2010). More men are being referred via the urgent suspected cancer (USC) pathway for further investigations than ever before. Pressure on urology departments from government targets and cancer waiting times has led to the need to find pioneering ways to meet these demands, while maintaining high standards of care. This article presents a retrospective audit that compared the practice of a nurse specialist to a urologist while undertaking transrectal ultrasound with prostatic biopsies, the definitive investigation in the detection of prostate cancer. Results have shown that the nurse‐led service is equivalent to that of the urologist in cancer detection and morbidity rates. The audit has shown that the nurse‐led prostate biopsy clinic is both effective and safe in practice. In addition, the service has reduced the waiting times for patients needing this procedure to less than a week.
Obesity, central adiposity and cardiometabolic risk factors in children and adolescents: a family‐based study
Authors: Ali O. , Cerjak D. , Kent J. W. , James R. , Blangero J. , Zhang Y.
Published: March 2014

Objective

The objective of this study was to assess genetic and phenotypic correlations of obesity‐related cardiometabolic risk factors in a family‐based cohort.

Methods

Anthropometric, body composition and biochemical measurements were collected on 999 members of 111 extended Midwestern US families of Northern European origin. Forward stepwise regression was used to identify which of Tanner stage, sex, Tanner stage by sex, body fat mass index, body fat percentage (dual‐energy X‐ray absorptiometry), visceral fat (VF)/subcutaneous fat (SubQF) (computed tomography scans for adults or magnetic resonance imaging for children), VF, SubQF, body mass index (BMI)% and waist to height ratio most influence homeostasis model assessment (HOMA), high‐density lipoprotein cholesterol (HDL‐c), plasma triglycerides (TG) and low‐density lipoprotein cholesterol (LDL‐c).

Results

In children and adolescents, subcutaneous adiposity was the most significant covariate for HOMA (P < 0.001) and TG (P = 0.001), and BMI percentile for HDL‐c (P = 0.002) and LDL‐c (P < 0.001). In adults, waist–height ratio (P < 0.001), VF/SubQF ratio (P = 0.001) and BMI (P = 0.02) were most significant for HOMA; VF (P < 0.001) and BMI (P = 0.02) for TG and VF for LDL‐c (P = 0.001).

Conclusion

Subcutaneous adiposity at the waist is a more significant predictor of metabolic syndrome traits in children and adolescents than it is in adults.
Breathprints of childhood obesity: changes in volatile organic compounds in obese children compared with lean controls
Authors: Alkhouri N. , Eng K. , Cikach F. , Patel N. , Yan C. , Brindle A. , Rome E. , Hanouneh I. , Grove D. , Lopez R. , Hazen S. L , Dweik Raed A.
Published: March 2014

Objective

The objective of this study was to investigate changes in volatile organic compounds (VOCs) in exhaled breath in overweight/obese children compared with their lean counterparts.

Study design

Single exhaled breath was collected and analyzed per protocol using selective ion flow tube mass spectrometry (SIFT‐MS).

Results

Sixty overweight/obese children and 55 lean controls were included. Compared with the lean group, the obese group was significantly older (14.1 ± 2.8 vs. 12.1 ± 3.0 years), taller (164.8 ± 10.9 vs. 153.3 ± 17.1 cm) and more likely to be Caucasian (60% vs. 35.2%); P < 0.05 for all. A comparison of the SIFT‐MS results of the obese group with the lean group revealed differences in concentration of more than 50 compounds. A panel of four VOCs can identify the presence of overweight/obesity with excellent accuracy. Further analysis revealed that breath isoprene, 1‐decene, 1‐octene, ammonia and hydrogen sulfide were significantly higher in the obese group compared with the lean group (P value < 0.01 for all).

Conclusion

Obese children have a unique pattern of exhaled VOCs. Changes in VOCs observed in this study may help to gain insight into pathophysiological processes and pathways leading to the development of childhood obesity.
Development and validation of the Liverpool infant bronchiolitis severity score: a research protocol
Authors: van Miert Clare , Abbott Janice , Verheoff Francine , Lane Steven , Carter Bernie , McNamara Paul
Published: March 2014

Aim

To develop and validate a bronchiolitis severity scoring instrument for use by nurses and other healthcare professions.

Background

Bronchiolitis is a viral lower respiratory tract infection of infancy. In industrialized countries, admission rates have increased over the last decade with up to 3% of all infants born being admitted to hospital. A small number of these hospitalized infants will require admission to critical care for either invasive or non‐invasive ventilation. During the seasonal epidemic, the number of unplanned admissions to critical care with bronchiolitis substantially increases.

Design

We will use a mixed methods study design.

Methods

We will use scale development and psychometric methods to develop a scoring instrument and to test the instrument for content, construct and criterion validity and reliability in several different clinical locations. This study protocol has been reviewed and approved by the NHS National Research Ethics Service, January 2011.

Discussion

There is an urgent need to develop a valid and reliable severity scoring instrument sensitive to clinical changes in the infant, to facilitate clinical decision‐making and help standardize patient care. Furthermore, a valid and reliable scoring instrument could also be used as a proxy patient‐reported outcome measure to evaluate the efficacy of clinical interventions in randomized controlled trials.
Range‐wide ecological niche comparisons of parasite, hosts and dispersers in a vector‐borne plant parasite system
Authors: Lira‐Noriega Andrés , Peterson A. Townsend
Published: March 2014

Aim

To test whether the distribution of the mistletoe Phoradendron californicum is mediated by host distributions (host niche hypothesis, HNH), or by factors such as the mistletoe's autecology (parasite niche hypothesis, PNH) or that of its vectors (vector niche hypothesis, VNH). Our null hypothesis is that the ecological niche of the mistletoe will not be distinct from that of its hosts or vectors; alternatively, mistletoe infections might appear in hosts only in regions where host distributions overlap suitable conditions for the parasite.

Location

Sonoran and Mojave deserts, western North America.

Methods

We used ecological niche modelling approaches to summarize suitable environmental conditions for hosts infected and uninfected with mistletoes, as well as for avian dispersers during winter and throughout the year. We compared ecological niches among pairs of species using background similarity tests in relation to the climatic conditions available and accessible to each species.

Results

Niche comparisons supported all PNH expectations, but none of the predictions of HNH or VNH.

Main conclusions

Hosts and dispersers of mistletoes generally have distinct ecological niches; mistletoe infections occur in non‐random environmental subsets of host and disperser ecological niches; mistletoe infections in different hosts, however, occur under similar climatic conditions. Hence, in this system, the parasite has a rather strictly circumscribed ecological niche, and host species become infected with mistletoe only where they overlap its suitable areas.
Sensory subtypes in children with autism spectrum disorder: latent profile transition analysis using a national survey of sensory features
Authors: Ausderau Karla K. , Furlong Melissa , Sideris John , Bulluck John , Little Lauren M. , Watson Linda R. , Boyd Brian A. , Belger Aysenil , Dickie Virginia A. , Baranek Grace T.
Published: March 2014

Background

Sensory features are highly prevalent and heterogeneous among children with ASD. There is a need to identify homogenous groups of children with ASD based on sensory features (i.e. sensory subtypes) to inform research and treatment.

Methods

Sensory subtypes and their stability over 1 year were identified through latent profile transition analysis (LPTA) among a national sample of children with ASD. Data were collected from caregivers of children with ASD ages 2–12 years at two time points (Time 1 N = 1294; Time 2 N = 884).

Results

Four sensory subtypes (Mild; Sensitive‐Distressed; Attenuated‐Preoccupied; Extreme‐Mixed) were identified, which were supported by fit indices from the LPTA as well as current theoretical models that inform clinical practice. The Mild and Extreme‐Mixed subtypes reflected quantitatively different sensory profiles, while the Sensitive‐Distressed and Attenuated‐Preoccupied subtypes reflected qualitatively different profiles. Further, subtypes reflected differential child (i.e. gender, developmental age, chronological age, autism severity) and family (i.e. income, mother's education) characteristics. Ninety‐one percent of participants remained stable in their subtypes over 1 year.

Conclusions

Characterizing the nature of homogenous sensory subtypes may facilitate assessment and intervention, as well as potentially inform biological mechanisms.
Which Fundamentals Drive Exchange Rates? A Cross‐Sectional Perspective
Authors: SARNO LUCIO , SCHMELING MAIK
Published: March 2014

Standard present‐value models suggest that exchange rates are driven by expected future fundamentals, implying that exchange rates contain information about future fundamentals. We test this key empirical prediction of present‐value models in a sample of 35 currency pairs ranging from 1900 to 2009. Employing a variety of tests, we find that exchange rates have strong and significant predictive power for nominal fundamentals (inflation, money balances, nominal GDP), whereas predictability of real fundamentals and risk premia is much weaker and largely confined to the post–Bretton Woods era. Overall, we uncover ample evidence that future macrofundamentals drive current exchange rates.
Economic Policy and the Great Depression in a Small Open Economy
Authors: PAYNE JONATHAN , UREN LAWRENCE
Published: March 2014

We use a standard New Keynesian model of a small open economy, extended to include a government sector, to investigate the Great Depression in Australia. A calibrated model with a fixed exchange rate regime, similar to the gold standard, does well in replicating the dynamics of output during the interwar period. We then ask to what extent shocks to the economy would have been moderated by adopting modern‐day policies. We find that if policymakers had adopted a flexible exchange rate with a Taylor rule policy that output fluctuations during the Great Depression would have been moderated by up to 25%. Changes in government fiscal policy would also have moderated output fluctuations, but by a slightly smaller amount. Overall, we find that improved policy could have reduced output fluctuations by almost 50%.
Liquidity Coinsurance and Bank Capital
Authors: CASTIGLIONESI FABIO , FERIOZZI FABIO , LÓRÁNTH GYÖNGYI , PELIZZON LORIANA
Published: March 2014

Banks can deal with their liquidity risk by holding liquid assets (self‐insurance), by participating in interbank markets (coinsurance), or by using flexible financing instruments, such as bank capital (risk sharing). We use a simple model to show that undiversifiable liquidity risk, that is, the liquidity risk that banks are unable to coinsure on interbank markets, represents an important risk factor affecting their capital structures. Banks facing higher undiversifiable liquidity risk hold more capital. We posit that, empirically, banks that are more exposed to undiversifiable liquidity risk are less active on interbank markets. Therefore, we test for the existence of a negative relationship between bank capital and interbank market activity and find support in a large sample of U.S. commercial banks.
Making sense of the amyloid precursor protein: its tail tells an interesting tale
Authors: Cappai Roberto
Published: March 2014

Read the full article ‘The Aβ ‐clearance protein transthyretin, like neprilysin, is epigenetically regulated by the amyloid precursor protein intracellular domain’ on page 419
Situated Interpretations of Nationalism, Imperialism, and Cosmopolitanism: Revisiting the Writings ofLiang in the Encounter Between Worlds
Authors: Zhang Chenchen
Published: March 2014

The idea of the nation has been considered to have delivered political modernity from its nativeEurope to the rest of the world. The same applies, though more implicitly, to those paradoxes inherent to the nationalist ideology – that between universalism and national particularity and that between liberal nationalism and imperialism. This article seeks to complicate these theses by looking at the interpretations of nationalism, imperialism, and cosmopolitanism provided byLiangQichao, one of the most influentialChinese intellectuals in early twentieth century, during his exile inJapan when increasingly exposed to the encounter between worlds. This reading also engages with the wider debates on modernity/modernities in non‐Western societies through showing that neither the “consumers of modernity” approach nor the “creative adaptations” approach can be easily applied here. I argue that the various tensions, contingencies and historical situatedness inLiang's accounts of the nation‐state structure represent and constitute the paradox of the structure itself. They also shed light on contemporary debates about the limits of our political imagination in the misnamed “global politics” beyond the false opposition between nationalism and cosmopolitanism.
Management of shortened dental arches and periodontal health: 5‐year results of a randomised trial
Authors: Walter M. H. , Marré B. , Vach K. , Strub J. , Mundt T , Stark H. , Pospiech P. , Wöstmann B. , Heydecke G. , Kern M. , Hartmann S. , Luthardt R. , Huppertz J. , Wolfart S. , Hannak W.
Published: March 2014

In a multicentre randomised trial (German Research Association, grants DFG WA 831/2‐1 to 2‐6, WO 677/2‐1.1 to 2‐2.1.; controlled‐trials.com ISRCTN97265367), patients with complete molar loss in one jaw received either a partial removable dental prosthesis (PRDP) with precision attachments or treatment according to the SDA concept aiming at pre‐molar occlusion. The objective of this current analysis was to evaluate the influence of different treatments on periodontal health. Linear mixed regression models were fitted to quantify the differences between the treatment groups. The assessment at 5 years encompassed 59 patients (PRDP group) and 46 patients (SDA group). For the distal measuring sites of the posterior‐most teeth of the study jaw, significant differences were found for the plaque index according to Silness and Löe, vertical clinical attachment loss (CAL‐V), probing pocket depth (PPD) and bleeding on probing. These differences were small and showed a slightly more unfavourable course in the PRDP group. With CAL‐V and PPD, significant differences were also found for the study jaw as a whole. For CAL‐V, the estimated group differences over 5 years amounted to 0·27 mm (95% CI 0·05; 0·48; P = 0·016) for the study jaw and 0·25 mm (95% CI 0·05; 0·45; P = 0·014) for the distal sites of the posterior‐most teeth. The respective values for PPD were 0·22 mm (95% CI 0·03; 0·41; P = 0·023) and 0·32 mm (95% CI 0·13; 0·5; P = 0·001). It can be concluded that even in a well‐maintained patient group statistically significant although minor detrimental effects of PRDPs on periodontal health are measurable.
Diabetic retinopathy: loss of neuroretinal adaptation to the diabetic metabolic environment
Authors: Abcouwer Steven F. , Gardner Thomas W.
Published: March 2014

Diabetic retinopathy (DR) impairs vision of patients with type 1 and type 2 diabetes, associated with vascular dysfunction and occlusion, retinal edema, hemorrhage, and inappropriate growth of new blood vessels. The recent success of biologic treatments targeting vascular endothelial growth factor (VEGF) demonstrates that treating the vascular aspects in the later stages of the disease can preserve vision in many patients. It would also be highly desirable to prevent the onset of the disease or arrest its progression at a stage preceding the appearance of overt microvascular pathologies. The progression of DR is not necessarily linear but may follow a series of steps that evolve over the course of multiple years. Abundant data suggest that diabetes affects the entire neurovascular unit of the retina, with an early loss of neurovascular coupling, gradual neurodegeneration, gliosis, and neuroinflammation occurring before observable vascular pathologies. In this article, we consider the pathology of DR from the point of view that diabetes causes measurable dysfunctions in the complex integral network of cell types that produce and maintain human vision.
Multitrophic diversity effects depend on consumer specialization and species‐specific growth and grazing rates
Authors: Filip Joanna , Bauer Barbara , Hillebrand Helmut , Beniermann Anna , Gaedke Ursula , Moorthi Stefanie D.
Published: March 2014

Ecosystem functioning is affected by horizontal (within trophic groups) and vertical (across trophic levels) biodiversity. Theory predicts that the effects of vertical biodiversity depend on consumer specialization. In a microcosm experiment, we investigated ciliate consumer diversity and specialization effects on algal prey biovolume, evenness and composition, and on ciliate biovolume production. The experimental data was complemented by a process‐based model further analyzing the ecological mechanisms behind the observed diversity effects. Overall, increasing consumer diversity had no significant effect on prey biovolume or evenness. However, consumer specialization affected the prey community. Specialist consumers showed a stronger negative impact on prey biovolume and evenness than generalists. The model confirmed that this pattern was mainly driven by a single specialist with a high per capita grazing rate, consuming the two most productive prey species. When these were suppressed, the prey assemblage became dominated by a less productive species, consequently decreasing prey biovolume and evenness. Consumer diversity increased consumer biovolume, which was stronger for generalists than for specialists and highest in mixed combinations, indicating that consumer functional diversity, i.e. more diverse feeding strategies, increased resource use efficiency. Overall, our results indicate that consumer diversity effects on prey and consumers strongly depend on species‐specific growth and grazing rates, which may be at least equally important as consumer specialization in driving consumer diversity effects across trophic levels.

Synthesis

In a microcosm experiment, we investigated multitrophic consumer diversity and specialization effects using ciliate consumers and microalgal prey. Consumer diversity increased consumer biovolume, which was highest in combinations containing both generalists and specialists. Specialist consumers showed a stronger negative effect on prey biovolume and evenness than generalists. These experimental data were supported by a process‐based model, indicating that the large effect of the specialists was based on high per capita grazing rate on the two most productive prey species. Species‐specific traits such as growth and grazing rates were equally important for multitrophic diversity effects than consumer specialization.
A Pediatric Case of Multiple Palisaded Encapsulated Neuromas of the Palms and Soles
Authors: Omori Yasutaka , Tanito Katsumi , Ito Keigo , Itoh Munenari , Saeki Hidehisa , Nakagawa Hidemi
Published: March 2014

Palisaded encapsulated neuroma (PEN) usually presents as a solitary, skin‐colored papule on the face in middle‐aged adults. We present a rare pediatric case of multiple PEN of the palms and soles. DNA analysis of the RET proto‐oncogene in our patient showed no mutations in exons 13, 15, and 16.