bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Associated with Anemia among Children Aged 6–23 Months Attending Growth Monitoring at Tsitsika Health Center, Wag-Himra Zone, Northeast Ethiopia
Authors: Woldie Haile , Kebede Yigzaw , Tariku Amare
Published: May 2015

Background. Globally, about 47.4% of children under five are suffering from anemia. In Ethiopia, 60.9% of children under two years are suffering from anemia. Anemia during infancy and young childhood period is associated with poor health and impaired cognitive development, leading to reduced academic achievement and earnings potential in their adulthood life. However, there is scarcity of information showing the magnitude of iron deficiency anemia among young children in Ethiopia. Therefore, this study aimed at assessing prevalence and associated factors of iron deficiency anemia among children under two (6–23 months).Methods. Institution based cross-sectional study was carried out from March to May, 2014, at Tsitsika Health Center in Wag-Himra Zone, Northeast Ethiopia. Systematic random sampling technique was employed. Automated hemoglobin machine was used to determine the hemoglobin level. Socioeconomic and demographic data were collected by using a pretested and structured questionnaire. Binary logistic regression analysis was used to identify associated factors and odds ratio with 95% CI was computed to assess the strength of association.Results. Total of 347 children participated in this study. The overall prevalence of anemia was 66.6%. In multivariate logistic regression analysis, male sex (AOR = 3.1 (95% CI: 1.60–5.81)), 9–11 months of age (AOR = 9.6 (95% CI: 3.61–25.47)), poor dietary diversity (AOR = 3.2 (95% CI: 1.35–7.38)), stunting (AOR = 2.7 (95% CI: 1.20–6.05)), diarrhea (AOR = 4.9 (1.63–14.59)), no formal education (AOR = 2.6 (95% CI: 1.26–5.27)), early initiation of complementary food (AOR = 11.1 (95% CI: 4.08–30.31)), and lowest wealth quintile (AOR = 3.0 (95% CI: 1.01–8.88)) were significantly associated with anemia.Conclusion. The overall prevalence of anemia among children who aged 6–23 months has sever public health importance in the study area. Integrated efforts need to be prioritized to improve health as well as appropriate infant and young child feeding practice among children under.
Improved Diagnostic Multimodal Biomarkers for Alzheimer’s Disease and Mild Cognitive Impairment
Authors: Martínez-Torteya Antonio , Treviño Víctor , Tamez-Peña José G.
Published: May 2015

The early diagnosis of Alzheimer’s disease (AD) and mild cognitive impairment (MCI) is very important for treatment research and patient care purposes. Few biomarkers are currently considered in clinical settings, and their use is still optional. The objective of this work was to determine whether multimodal and nonpreviously AD associated features could improve the classification accuracy between AD, MCI, and healthy controls, which may impact future AD biomarkers. For this, Alzheimer’s Disease Neuroimaging Initiative database was mined for case-control candidates. At least 652 baseline features extracted from MRI and PET analyses, biological samples, and clinical data up to February 2014 were used. A feature selection methodology that includes a genetic algorithm search coupled to a logistic regression classifier and forward and backward selection strategies was used to explore combinations of features. This generated diagnostic models with sizes ranging from 3 to 8, including well documented AD biomarkers, as well as unexplored image, biochemical, and clinical features. Accuracies of 0.85, 0.79, and 0.80 were achieved for HC-AD, HC-MCI, and MCI-AD classifications, respectively, when evaluated using a blind test set. In conclusion, a set of features provided additional and independent information to well-established AD biomarkers, aiding in the classification of MCI and AD.
CouldHistoplasma capsulatumBe Related to Healthcare-Associated Infections?
Authors: Carreto-Binaghi Laura Elena , Damasceno Lisandra Serra , Pitangui Nayla de Souza , Fusco-Almeida Ana Marisa , Mendes-Giannini Maria José Soares , Zancopé-Oliveira Rosely Maria , Taylor Maria Lucia
Published: May 2015

Healthcare-associated infections (HAI) are described in diverse settings. The main etiologic agents of HAI are bacteria (85%) and fungi (13%). Some factors increase the risk for HAI, particularly the use of medical devices; patients with severe cuts, wounds, and burns; stays in the intensive care unit, surgery, and hospital reconstruction works. Several fungal HAI are caused byCandidaspp., usually from an endogenous source; however, cross-transmission via the hands of healthcare workers or contaminated devices can occur. Although other medically important fungi, such asBlastomyces dermatitidis,Paracoccidioides brasiliensis, andHistoplasma capsulatum, have never been considered nosocomial pathogens, there are some factors that point out the pros and cons for this possibility. Among these fungi,H. capsulatuminfection has been linked to different medical devices and surgery implants. The filamentous form ofH. capsulatummay be present in hospital settings, as this fungus adapts to different types of climates and has great dispersion ability. Although conventional pathogen identification techniques have never identifiedH. capsulatumin the hospital environment, molecular biology procedures could be useful in this setting. More research onH. capsulatumas a HAI etiologic agent is needed, since it causes a severe and often fatal disease in immunocompromised patients.
Definition of Prostaglandin E2–EP2 Signals in the Colon Tumor Microenvironment That Amplify Inflammation and Tumor Growth
Authors: Ma Xiaojun , Aoki Tomohiro , Tsuruyama Tatsuaki , Narumiya Shuh
Published: May 2015

Inflammation in the colon contributes significantly to colorectal cancer development. While aspirin reduces the colorectal cancer risk, its action mechanism, especially in inflammation in tumor microenvironment, still remains obscure. Here, we examined this issue by subjecting mice deficient in each prostaglandin (PG) receptor to colitis-associated cancer model. Deficiency of PGE receptor subtype EP2 selectively reduced, and deficiency of EP1 and EP3 enhanced, the tumor formation. EP2 is expressed in infiltrating neutrophils and tumor-associated fibroblasts in stroma, where it regulates expression of inflammation- and growth-related genes in a self-amplification manner. Notably, expression of cytokines such as TNFα and IL6, a chemokine, CXCL1, a PG-producing enzyme, COX-2, and Wnt5A was significantly elevated in tumor lesions of wild-type mice but this elevation was significantly suppressed in EP2-deficient mice. Intriguingly, EP2 stimulation in cultured neutrophils amplified expression of TNFα, IL6, CXCL1, COX-2, and other proinflammatory genes synergistically with TNFα, and EP2 stimulation in cultured fibroblasts induced expression of EP2 itself, COX-2, IL6, and Wnt genes. EP2 expression in infiltrating neutrophils and tumor-associated fibroblasts was also found in clinical specimen of ulcerative colitis-associated colorectal cancer. Bone marrow transfer experiments suggest that EP2 in both cell populations is critical for tumorigenesis. Finally, administration of a selective EP2 antagonist potently suppressed tumorigenesis in this model. Our study has thus revealed that EP2 in neutrophils and tumor-associated fibroblasts promotes colon tumorigenesis by amplifying inflammation and shaping tumor microenvironment, and suggests that EP2 antagonists are promising candidates of aspirin-alternative for chemoprevention of colorectal cancer. Cancer Res; 75(14); 2822–32. ©2015 AACR.
Cancer Immunotherapy: More Is (Much) Better
Authors: Yarden Yosef , Sela Michael
Published: May 2015

Although antibodies against EGFR and HER2 are used to treat cancer, only some patients respond and resistance often emerges. Jacobsen and colleagues present in this issue experimental evidence favoring replacement of the currently applied monoclonal antibodies with oligoclonal mixtures of six synergistic antibodies, simultaneously engaging EGFR, HER2, and also HER3. Clin Cancer Res; 21(18); 4030–2. ©2015 AACR.

See related article by Jacobsen et al., p. 4110
Diagnostic Frequency Ratios Are Insufficient to Measure Laboratory Precision with The Bethesda System for Reporting Thyroid Cytopathology
Authors: Fazeli Roghayeh , Schneider Eric B. , Ali Syed Z. , Zeiger Martha A. , Olson Matthew T.
Published: May 2015

Objective: Diagnostic frequency ratios such as the atypia of undetermined significance (AUS):malignant ratio are touted to be useful for laboratory precision benchmarking. We therefore sought to examine their reproducibility and usefulness at a tertiary hospital. Methods: We reviewed thyroid fine-needle aspirates (FNA) submitted to our institution from outside laboratories and evaluated the ability of diagnostic frequency ratios to capture the complexity of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Specifically, we evaluated the ability of the AUS:malignant ratio to describe the frequencies of the other TBSRTC diagnoses. Results: A total of 2,784 cases from 19 laboratories were included. The use of the AUS category varied the most. There was insufficient reflection of the non-AUS nonmalignant TBSRTC diagnostic frequencies in our analysis, and these results do not appear to arise from observer variability in the outside laboratories. Conclusion: Diagnostic frequency ratios are not reproducible in our experience and fail to describe the other TBSRTC categories. As such, they are unlikely to prove sufficient for benchmarking laboratory precision with TBSRTC.
Interaction between Erythrocyte Phospholipid Fatty Acids Composition and Variants of Inflammation-Related Genes on Type 2 Diabetes
Authors: Li Kelei , Huang Tao , Zheng Ju-Sheng , Sun Jianqin , Chen Yanqiu , Xie Hua , Xu Danfeng , Wan Jianbo , Li Duo
Published: May 2015

Aims: The present study aimed to investigate the interaction between erythrocyte phospholipid (PL) fatty acids and variants of inflammation-related genes in a Chinese population. Methods: A total of 622 patients with type 2 diabetes mellitus (T2DM) and 293 healthy subjects were included. Determination of erythrocyte PL fatty acids composition and genotyping of single nucleotide polymorphisms were conducted by standard methods. Results: A significant interaction of rs7305618 on HNFIA with C18:2n-6 and C20:4n-6 was observed: T allele carriers (TT + CT) had a higher risk of T2DM than noncarriers only when they had a higher level of C18:2n-6 or C20:4n-6, and the odds ratios (ORs) were 2.59 (95% CI 1.58-4.24; p for interaction = 0.005) and 2.49 (95% CI 1.47-4.24; p for interaction = 0.021), respectively. A significant interaction of rs8078723 at the intergenic region between PSMD3 and CSF3 with C20:5n-3 was observed: C allele carriers (CC + CT) had a lower risk of T2DM than noncarriers only when they had a higher level of C20:5n-3, and the OR was 0.44 (95% CI 0.26-0.73; p for interaction = 0.014). Conclusions: rs7305618 and rs8078723 were associated with the risk of T2DM in a Chinese population and were modulated by erythrocyte PL fatty acids composition.
Clinical Analysis of Patients with Primary Blepharospasm: A Report of 100 Cases in China
Authors: Huang Xiao-Feng , Wang Kai-Yue , Liang Zhan-Hua , Du Rong-Rong , Zhou Li-Na
Published: May 2015

Purpose: This study explored the clinical characteristics, diagnosis and treatments of primary blepharospasm. Methods: In this retrospective analysis, 100 patients with blepharospasm were enrolled. Data were collected from medical records and face-to-face interviews with patients and their families. Results: The age of onset was 56.4 ± 2.7 (range, 32-76 years). The duration between onset and accurate diagnosis was 38.7 ± 36.0 months (range, 2-120 months). Dry eyes occurred in 54% of the patients. The initial diagnostic accuracy was 10%. Dry eye syndrome, conjunctivitis/keratitis and myasthenia gravis caused the most confusion in the differential diagnosis. Regular botulinum toxin type A injections improved both eyelid spasms and subjective ocular symptoms in all patients. Conclusions: Regular botulinum toxin type A injections improved both eyelid spasms and subjective ocular symptoms in blepharospasm patients. The differentiation of primary blepharospasm differentiation from dry eye syndrome, conjunctivitis/keratitis and myasthenia gravis must be improved.
The Multitarget Ligand 3-Iodothyronamine Modulates β-Adrenergic Receptor 2 Signaling
Authors: Dinter Juliane , Khajavi Noushafarin , Mühlhaus Jessica , Wienchol Carolin Leonie , Cöster Maxi , Hermsdorf Thomas , Stäubert Claudia , Köhrle Josef , Schöneberg Torsten , Kleinau Gunnar , Mergler Stefan , Biebermann Heike
Published: May 2015

Background: 3-Iodothyronamine (3-T1AM), a signaling molecule with structural similarities to thyroid hormones, induces numerous physiological responses including reversible body temperature decline. One target of 3-T1AM is the trace amine-associated receptor 1 (TAAR1), which is a member of the rhodopsin-like family of G protein-coupled receptors (GPCRs). Interestingly, the effects of 3-T1AM remain detectable in TAAR1 knockout mice, suggesting further targets for 3-T1AM such as adrenergic receptors. Therefore, we evaluated whether β-adrenergic receptor 1 (ADRB1) and 2 (ADRB2) signaling is affected by 3-T1AM in HEK293 cells and in human conjunctival epithelial cells (IOBA-NHC), where these receptors are highly expressed endogenously. Methods: A label-free EPIC system for prescreening the 3-T1AM-induced effects on ADRB1 and ADRB2 in transfected HEK293 cells was used. In addition, ADRB1 and ADRB2 activation was analyzed using a cyclic AMP assay and a MAPK reporter gene assay. Finally, fluorescence Ca2+ imaging was utilized to delineate 3-T1AM-induced Ca2+ signaling. Results: 3-T1AM (10-5- 10-10M) enhanced isoprenaline-induced ADRB2-mediated Gs signaling but not that of ADRB1-mediated signaling. MAPK signaling remained unaffected for both receptors. In IOBA-NHC cells, norepinephrine-induced Ca2+ influxes were blocked by the nonselective ADRB blocker timolol (10 µM), indicating that ADRBs are most likely linked with Ca2+ channels. Notably, timolol was also found to block 3-T1AM (10-5M)-induced Ca2+ influx. Conclusions: The presented data support that 3-T1AM directly modulates β-adrenergic receptor signaling. The relationship between 3-T1AM and β-adrenergic signaling also reveals a potential therapeutic value for suppressing Ca2+ channel-mediated inflammation processes, occurring in eye diseases such as conjunctivitis.
Decreased 6-Sulfatoxymelatonin Excretion in Male GH-Deficient Children and Adolescents
Authors: Fideleff Hugo L. , Fideleff Gabriel , Boquete Hugo R. , Suárez Martha , Azaretzky Miriam , Brunetto Oscar
Published: May 2015

Aim: To evaluate melatonin secretion in a group of untreated and treated male growth hormone (GH)-deficient children and adolescents. Methods: We studied 44 male subjects: 8 untreated GH-deficient patients (GHDnt), 16 treated GH-deficient patients (GHDt) and 20 healthy children and adolescents as control group (CG). We measured urinary 6-sulfatoxymelatonin (6-SM) in total (24-hour samples), nocturnal (18.00-8.00 h) and diurnal samples (8.00-18.00 h). Levels of 6-SM were expressed as micrograms excreted per time interval and Δ values (difference between nighttime and daytime values). Results: Significant differences were observed among the 3 groups of pediatric subjects studied for total 6-SM (p < 0.0001), nocturnal 6-SM (p < 0.0001) and Δ values (p < 0.0001). Subsequent analysis showed significantly higher levels for total 6-SM, nocturnal 6-SM and nighttime-daytime Δ in the CG versus the GHDnt (p < 0.01) and in the CG versus the GHDt group (p < 0.01). No significant correlations were found between 6-SM excretion and insulin-like growth factor-1 values in the children and adolescents studied. Conclusions: GH-deficient patients showed lower levels of 6-SM. Our findings provide a different insight to a further understanding of some chronobiological disorders involved in GH deficiency in children.
Primary Large-Cell Neuroendocrine Carcinoma of the Breast Occurring in a Pre-Menopausal Woman
Authors: Yoshimura Noriko , Sasada Tatsunari , Yonehara Shuji
Published: May 2015

Background: Primary large-cell neuroendocrine carcinoma of the breast (LCNEC-breast) in pre-menopausal women is extremely rare. Case report: A 34-year-old woman presented with a mass in the left breast that was diagnosed as neuroendocrine carcinoma by needle biopsy. Computed tomography revealed no lymph node swelling or distant organ metastasis. Left mastectomy and sentinel lymph node biopsy were performed and metastasis to the axial lymph node was detected. Left axillary lymph node dissection was performed and histopathological and immunohistochemical examination revealed that the tumor was an LCNEC-breast, which was 6.0 cm in size and positive for the neuroendocrine markers (neuron-specific enolase, chromogranin A, and synaptophysin). The tumor cells were hormone-receptor positive and HER2 negative. The patient refused any adjuvant hormonal therapy, chemotherapy or radiotherapy. She has been followed up for 4 years without medication, and no recurrence has been noted. Conclusion: We present a case of LCNEC-breast in a 34-year-old woman. Our case represents the youngest woman with LCNEC-breast reported in the English literature.
Factors in Early-Life Programming of Reproductive Fitness
Authors: Sominsky Luba , Fuller Erin A. , Hodgson Deborah M.
Published: May 2015

Fertility rates have been declining worldwide, with a growing number of young women suffering from infertility. Infectious and inflammatory diseases are important causes of infertility, and recent evidence points to the critical role of the early-life microbial environment in developmental programming of adult reproductive fitness. Our laboratory and others have demonstrated that acute exposure to an immunological challenge early in life has a profound and prolonged impact on male and female reproductive development. This review presents evidence that perinatal exposure to immunological challenge by a bacterial endotoxin, lipopolysaccharide, acts at all levels of the hypothalamic-pituitary-gonadal axis, resulting in long-lasting changes in reproductive function, suggesting that disposition to infertility may begin early in life.
Impact of Melatonin on Zeitgeber Time-Dependent Changes in Cell Proliferation and Apoptosis in the Adult Murine Hypothalamic-Hypophyseal System
Authors: Fredrich Michaela , Christ Elmar , Derouiche Amin , Korf Horst-Werner
Published: May 2015

Background/Aims: Cell proliferation and apoptosis are known to adjust neuroendocrine circuits to the photoperiod. The latter is communicated by melatonin, the hormone secreted by the pineal organ. The present study investigated zeitgeber time (ZT)-dependent changes in cell proliferation and apoptosis in the adult murine neuroendocrine system and their regulation by melatonin. Methods: Adult melatonin-proficient (C3H/HeN) and melatonin-deficient (C57Bl/6J) mice, as well as melatonin-proficient (C3H/HeN) mice with targeted deletion of both melatonin receptor types (MT1 and MT2) were adapted to a 12-hour light, 12-hour dark photoperiod and were sacrificed at ZT00, ZT06, ZT12, and ZT18. Immunohistochemistry for Ki67 and activated caspase-3 served to identify and quantify proliferating and apoptotic cells in the median eminence (ME), hypophyseal pars tuberalis, and pars distalis (PD). Results: ZT-dependent changes in cell proliferation and apoptosis were found exclusively in melatonin-proficient mice with functional MTs. Cell proliferation in the ME and PD showed ZT-dependent changes indicated by an increase at ZT12 (ME) and a decrease at ZT06 (PD). Apoptosis showed ZT-dependent changes in all regions analyzed, indicated by an increase at ZT06. Proliferating and apoptotic cells were found in nearly all cell types residing in the regions analyzed. Conclusions: Our results indicate that ZT-dependent changes in cell proliferation are counterbalanced by ZT-dependent changes in apoptosis exclusively in melatonin-proficient mice with functional MTs. Melatonin signaling appears to be crucial in both the generation and timing of proliferation and apoptosis that serve the high rate of physiological cell turnover in the adult neuroendocrine system.
Impact of bridging with perioperative low-molecular-weight heparin on cardiac and bleeding outcomes of stented patients undergoing non-cardiac surgery
Authors: Musumeci Giuseppe , Lettieri Corrado , Limbruno Ugo , Senni Michele , Guagliumi Giulio , Valsecchi Orazio , Angiolillo Dominick , Rossini Roberta , Capodanno Davide
Published: May 2015

When patients with coronary stents undergo non-cardiac surgery, bridging therapy with low-molecular-weight heparin (LMWH) is not infrequent in clinical practice. However, the efficacy and safety of this approach is poorly understood. This was a retrospective analysis of patients with coronary stent(s) on any antiplatelet therapy undergoing non-cardiac surgery between March 2003 and February 2012. The primary efficacy endpoint was the 30-day incidence of major adverse cardiac or cerebrovascular events (MACCE), defined as the composite of cardiac death, myocardial infarction, acute coronary syndrome leading to hospitalisation, or stroke. The primary safety endpoint was the 30-day composite of Bleeding Academic Research Consortium (BARC) bleedings ≥ 2. Among 515 patients qualifying for the analysis, LMWH bridging was used in 251 (49 %). At 30 days, MACCE occurred more frequently in patients who received LMWH (7.2 % vs 1.1 %, p=0.001), driven by a higher rate of myocardial infarction (4.8 % vs 0 %, p< 0.001). This finding was consistent across several instances of statistical adjustment and after the propensity matching of 179 pairs. Patients bridged with LMWH also experienced a significantly higher risk of BARC bleedings ≥ 2 (21.9 % vs 11.7 %, p=0.002) compared to those who were not, which remained significant across different methods of statistical adjustment and propensity matching. In conclusion, LMWH bridging in patients with coronary stents undergoing surgery is a common and possibly harmful practice, resulting in worse ischaemic outcomes at 30 days, and a significant risk of bleeding.
Thromboembolic events, recurrent bleeding and mortality after resuming anticoagulant following gastrointestinal bleeding
Authors: Chai-Adisaksopha Chatree , Hillis Christopher , Monreal Manuel , Witt Daniel , Crowther Mark
Published: May 2015

Gastrointestinal (GI) bleeding commonly complicates anticoagulant therapy. We aimed to systematically review the published literature to determine the risk of thromboembolism, recurrent GI bleeding and mortality for patients on long-term anticoagulation who experience GI bleeding based on whether anticoagulation therapy was resumed. We performed a systematic review of phase III randomised controlled trials and cohort studies in patients with atrial fibrillation or venous thromboembolism who received oral anticoagulant. We searched MEDLINE, EMBASE and CENTRAL (from 1996-July 2014), conferences abstracts (from January 2006-July 2014) and www.clinicaltrials.gov (up to the last week of July 2014) with no language restriction. Two reviewers independently performed study selection, data extraction and study quality assessment. A total of three studies were included in the meta-analysis. The resumption of warfarin was associated with a significant reduction in thromboembolic events (hazard ratio [HR] 0.68, 95 % confidence interval [CI] 0.52 to 0.88, p < 0.004, I2=82 %). There was an increase in recurrent GI bleeding but not statistically significant for patients who restarted warfarin compared to those who did not (HR 1.20, 95 % CI 0.97 to 1.48, p = 0.10, I2 = 0 %). Resumption of warfarin was associated with significant reduction in mortality (HR 0.76, 95 % CI 0.66 to 0.88, p < 0.001, I2 = 87 %). This meta-analysis demonstrates that resumption of warfarin following interruption due to GI bleeding is associated with a reduction in thromboembolic events and mortality without a statistically significant increase in recurrent GI bleeding.

Institution where the work was performed: McMaster University, Hamilton, Ontario, Canada.
Discharge Hospice Referral and Lower 30-Day All-Cause Readmission in Medicare Beneficiaries Hospitalized for Heart Failure
Authors: Kheirbek Raya E. , Fletcher Ross D. , Bakitas Marie A. , Fonarow Gregg C. , Parvataneni Sridivya , Bearden Donna , Bailey Frank A. , Morgan Charity J. , Singh Steven , Blackman Marc R. , Zile Michael R. , Patel Kanan , Ahmed Momanna B. , Tucker Rodney O. , Brown Cynthia J. , Love Thomas E. , Aronow Wilbert S. , Roseman Jeffrey M. , Rich Michael W. , Allman Richard M. , Ahmed Ali
Published: May 2015

Background—

Heart failure (HF) is the leading cause for hospital readmission. Hospice care may help palliate HF symptoms but its association with 30-day all-cause readmission remains unknown.

Methods and Results—

Of the 8032 Medicare beneficiaries hospitalized for HF in 106 Alabama hospitals (1998–2001), 182 (2%) received discharge hospice referrals. Of the 7850 patients not receiving hospice referrals, 1608 (20%) died within 6 months post discharge (the hospice-eligible group). Propensity scores for hospice referral were estimated for each of the 1790 (182+1608) patients and were used to match 179 hospice-referral patients with 179 hospice-eligible patients who were balanced on 28 baseline characteristics (mean age, 79 years; 58% women; 18% non-white). Overall, 22% (1742/8032) died in 6 months, of whom 8% (134/1742) received hospice referrals. Among the 358 matched patients, 30-day all-cause readmission occurred in 5% and 41% of hospice-referral and hospice-eligible patients, respectively (hazard ratio associated with hospice referral, 0.12; 95% confidence interval, 0.06–0.24). Hazard ratios (95% confidence intervals) for 30-day all-cause readmission associated with hospice referral among the 126 patients who died and 232 patients who survived 30-day post discharge were 0.03 (0.04–0.21) and 0.17 (0.08–0.36), respectively. Although 30-day mortality was higher in the hospice referral group (43% versus 27%), it was similar at 90 days (64% versus 67% among hospice-eligible patients).

Conclusions—

A discharge hospice referral was associated with lower 30-day all-cause readmission among hospitalized patients with HF. However, most patients with HF who died within 6 months of hospital discharge did not receive a discharge hospice referral.
CYP2C19
Metabolizer Status and Clopidogrel Efficacy in the Secondary Prevention of Small Subcortical Strokes (SPS3) Study
Authors: McDonough Caitrin W. , McClure Leslie A. , Mitchell Braxton D. , Gong Yan , Horenstein Richard B. , Lewis Joshua P. , Field Thalia S. , Talbert Robert L. , Benavente Oscar R. , Johnson Julie A. , Shuldiner Alan R.
Published: May 2015

Background

The role of the

CYP
2C19

genotype on clopidogrel efficacy has been studied widely, with data suggesting reduced clopidogrel efficacy in loss‐of‐function variant carriers taking clopidogrel after percutaneous coronary intervention; however, data are limited regarding the association between

CYP
2C19

genetic variants and outcomes in stroke patients. We investigated whether

CYP
2C19

metabolizer status affects the risk of recurrent stroke or major bleeding in subcortical stroke patients taking dual antiplatelet therapy with aspirin and clopidogrel.

Methods and Results

CYP
2C19*2

and

CYP
2C19*17

were genotyped in 522 patients treated with dual antiplatelet therapy from the Secondary Prevention of Small Subcortical Strokes (
SPS
3) study.

CYP
2C19

metabolizer status was inferred from genotype, and associations with the risk of recurrent stroke and major bleeding were assessed in the overall cohort and by race/ethnic group with logistic regression modeling. In the overall cohort, there were no differences in outcomes by

CYP
2C19

metabolizer status (recurrent stroke, odds ratio 1.81 [95% CI 0.76 to 4.30]; major bleeding, odds ratio 0.67 [95% CI 0.22 to 2.03]). In white participants, those with

CYP
2C19

intermediate or poor metabolizer status had higher odds of recurrent stroke (odds ratio 5.19 [95% CI 1.08 to 24.90]) than those with extensive or ultrarapid metabolizer status, but there was no evidence of difference in major bleeding.

Conclusions

There were significant differences in recurrent stroke by
CYP2C19
genotype‐inferred metabolizer status in white subcortical stroke patients receiving dual antiplatelet therapy with aspirin and clopidogrel, consistent with cardiovascular studies on

CYP
2C19

and clopidogrel; however, the bleeding risk that led to early termination of the antiplatelet arm of the
SPS
3 trial does not appear to be explained by

CYP
2C19

genotype. This study was relatively underpowered; therefore, these findings should be interpreted with caution and warrant replication.

Clinical Trial Registration

URL
:
www.clinicaltrials.gov
. Unique identifier:
NCT
00059306.
Echo Shaping Using Sums of Damped Complex Sinusoids
Authors: Putnam Lance
Published: May 2015

Feedback delay lines are the basis of myriad audio effects and reverberation schemes. The feedback delay line, by itself, is limited to producing an infinite sequence of exponentially decaying echoes. We introduce a new type of linear time-invariant echo effect whose impulse response is a generalized sum of damped complex sinusoids. This permits echo responses to be shaped as simple sinusoids, Fourier-based waveforms, and many other complex, possibly nonperiodic, patterns that would not be feasible with other existing methods. Additionally, because the response is complex-valued, it can be used to produce auto-panning echo effects with many kinds of spatial trajectories. The effect is computationally efficient and straightforward to implement, as it only requires a parallel combination of feedback delay lines.
The Coral of Death
Authors: Ottaviani Alessandro
Published: May 2015

The aim of this essay is to show the existence of a substantial discontinuity between the Kunst- und Wunderkammern phenomenon and the practice of both eclectic and specialised collecting in the 18th century. A more detailed examination of the cases of fossils and corals, particularly the way they wove in and out of the differing rationales of collecting in the 17th and 18th centuries, brings to light how elusive their relationship was with the history of the notion of temporality. Subsequently, Lamarck and Darwin were to provide a conclusion to the temporality debate when they completed the historisation of nature.
TRMM LIS Climatology of Thunderstorm Occurrence and Conditional Lightning Flash Rates*
Authors: Cecil Daniel J. , Buechler Dennis E. , Blakeslee Richard J.
Published: May 2015

The Lightning Imaging Sensor (LIS) on the Tropical Rainfall Measuring Mission (TRMM) satellite has previously been used to build climatologies of mean lightning flash rate across the global tropics and subtropics. This new work explores climatologies of thunderstorm occurrence as seen by LIS and the conditional mean flash rates when thunderstorms do occur. The region where thunderstorms are seen most often by LIS extends slightly farther east in central Africa than the corresponding region with the highest total mean annual flash rates. Presumably this reflects a difference between more frequent thunderstorm initiation in the east and upscale growth as storms move westward. There are some differences between locations with the greatest total lightning flash counts and those where thunderstorms occur most often. The greatest conditional mean flash rates—considering only those TRMM orbits that do have lightning in a given grid box—are found in subtropical regions. The highest values are in Argentina, with the central United States, Pakistan, eastern China, and the east coast of Australia also having particularly high values.
Simulation Activity in Otolaryngology Residencies
Authors: Deutsch Ellen S. , Wiet Gregory J. , Seidman Michael , Hussey Heather M. , Malekzadeh Sonya , Fried Marvin P.
Published: May 2015

Objectives

Simulation has become a valuable tool in medical education, and several specialties accept or require simulation as a resource for resident training or assessment as well as for board certification or maintenance of certification. This study investigates current simulation resources and activities in US otolaryngology residency programs and examines interest in advancing simulation training and assessment within the specialty.

Study Design

Web‐based survey.

Setting

US otolaryngology residency training programs.

Subjects and Methods

An electronic web‐based survey was disseminated to all US otolaryngology program directors to determine their respective institutional and departmental simulation resources, existing simulation activities, and interest in further simulation initiatives. Descriptive results are reported.

Results

Responses were received from 43 of 104 (43%) residency programs. Simulation capabilities and resources are available in most respondents’ institutions (78.6% report onsite resources; 73.8% report availability of models, manikins, and devices). Most respondents (61%) report limited simulation activity within otolaryngology. Areas of simulation are broad, addressing technical and nontechnical skills related to clinical training (94%). Simulation is infrequently used for research, credentialing, or systems improvement. The majority of respondents (83.8%) expressed interest in participating in multicenter trials of simulation initiatives.

Conclusion

Most respondents from otolaryngology residency programs have incorporated some simulation into their curriculum. Interest among program directors to participate in future multicenter trials appears high. Future research efforts in this area should aim to determine optimal simulators and simulation activities for training and assessment as well as how to best incorporate simulation into otolaryngology residency training programs.
A Method for Applying Fatigue Science to Accident Investigation
Authors: Price Jana M. , Coury Bruce G.
Published: May 2015

The detrimental effects of fatigue on the safe operation of vehicles or the execution of critical tasks in transportation systems (e.g., monitoring pipeline systems or maintaining vehicles) have been well established. However, estimates of the percentage of transportation accidents attributed to fatigue has varied greatly, and much of that variability can be attributed to the methods used to investigate and document accident causes or risk factors. In addition, using research findings in accident investigation can be very difficult, and establishing that fatigue played a role in an accident illustrates very well the challenges of relating research to practice. In this chapter we will discuss how fatigue research has informed accident investigation and how findings from accidents and incidents can guide future research and policy decisions. The chapter will (a) establish the seriousness of the fatigue problem in transportation accidents and incidents; (b) provide insights into the difficulties associated in determining whether fatigue is a contributing or causal factor in an event; (c) describe, in detail, a methodology that can be used to identify fatigue factors in accident investigation; and (d) illustrate how accident investigations where fatigue is well documented can inform the research community and lead to design and policy changes that will mitigate fatigue and help improve transportation safety.
CXCL14 and MCP1 are potent trophic factors associated with cell migration and angiogenesis leading to higher regenerative potential of dental pulp side population cells
Authors: Hayashi Y , Murakami M , Kawamura R , Ishizaka R , Fukuta O , Nakashima M
Published: May 2015

Introduction

The release of trophic factors from mesenchymal stem cells (MSCs) is critical for tissue regeneration. A systematic investigation of the regenerative potential of trophic factors from different MSCs, however, has not been performed. Thus, in the present study, the regenerative potential of conditioned medium (CM) from dental pulp, bone marrow, and adipose tissue-derived CD31− side population (SP) cells from an individual source was compared in an ectopic tooth transplantation model.

Methods

The tooth root transplantation in an ectopic site model was used for investigation of the regenerative potential and trophic effects in vivo. Either pulp CD31− SP cell populations (1×106 cells) at the third to fourth passage or 5 μg/ml of CM from dental pulp, bone marrow, and adipose stem cells from four different individuals were injected into the root with collagen TE. Each root was transplanted subcutaneously in 5-week-old severe combined immunodeficiency mice. Each root with surrounding tissue was harvested for histology on days 7, 21, and 28 and for Western blot analysis and real-time reverse transcription-polymerase chain reaction (RT-PCR) analysis on day 28. Furthermore, the trophic factors responsible for the regenerative potential were identified as the upregulated genes present in pulp CD31− SP cells when compared with the genes in both bone marrow and adipose CD31− SP cells by using microarray analysis, real-time RT-PCR, and Western blot analysis.

Results

Transplantation of pulp CM yielded increased volume of pulp regeneration, more bromodeoxyuridine (BrdU)-positive migrated cells, and fewer caspase 3-positive cells in the regenerated pulp compared with the others. Pulp CM also demonstrated significantly increased cell migration, anti-apoptosis, and angiogenesis in C2C12 cells. Higher expression of CXCL14 and MCP1 in pulp SP cells suggested candidate trophic factors. The stimulatory effects on both migration and angiogenesis of CXCL14 and MCP1 were demonstrated in vitro. In the regenerated tissue, BrdU-positive migrated cells expressed CXCR4 and CCR2, receptors for CXCL14 and MCP1, respectively.

Conclusions

The higher regenerative potential of pulp SP cells may be due to potent trophic factors, including CXCL14 and MCP1, which promote migration and angiogenesis.
Is Insulin Action in the Brain Relevant in Regulating Blood Glucose in Humans?
Authors: Dash Satya , Xiao Changting , Morgantini Cecilia , Koulajian Khajag , Lewis Gary F.
Published: May 2015

Purpose:

In addition to its direct action on the liver to lower hepatic glucose production, insulin action in the central nervous system (CNS) also lowers hepatic glucose production in rodents after 4 hours. Although CNS insulin action (CNSIA) modulates hepatic glycogen synthesis in dogs, it has no net effect on hepatic glucose output over a 4-hour period. The role of CNSIA in regulating plasma glucose has recently been examined in humans and is the focus of this review.

Methods and Results:

Intransal insulin (INI) administration increases CNS insulin concentration. Hence, INI can address whether CNSIA regulates plasma glucose concentration in humans. We and three other groups have sought to answer this question, with differing conclusions. Here we will review the critical aspects of each study, including its design, which may explain these discordant conclusions.

Conclusions:

The early glucose-lowering effect of INI is likely due to spillover of insulin into the systemic circulation. In the presence of simultaneous portal and CNS hyperinsulinemia, portal insulin action is dominant. INI administration does lower plasma glucose independent of peripheral insulin concentration (between ∼3 and 6 h after administration), suggesting that CNSIA may play a role in glucose homeostasis in the late postprandial period when its action is likely greatest and portal insulin concentration is at baseline. The potential physiological role and purpose of this pathway are discussed in this review. Because the effects of INI are attenuated in patients with type 2 diabetes and obesity, this is unlikely to be of therapeutic utility.
The Desert of Anatopism: War in the Age of Globalization
Authors: Williams Brian J.
Published: May 2015

This essay argues that forces of globalization have changed how American combatants define their identities within and against a foreign environment. Building on notions that soldiers construct identity by rendering foreign landscapes as Other, this piece considers how familiarity within the combat zone traumatically destabilizes the attempts to delineate self and enemy. This essay examines textual and film representations of the first and second Gulf Wars, highlighting the increasing presence of anatopisms—items jarringly dislocated from their proper “expected” spaces. Focusing particularly on Evan Wright’s Generation Kill, this piece investigates the consequences of American soldiers’ encounters with the global familiar—goods and spaces within the war zone that unsettle distinctions due to the homogenizing forces of the global market. Encounters with the global familiar, the essay argues, may lead to new acts of solidarity between combatants, but they also hold the potential to compound the traumas of combat and produce new acts of violence.
To the question of correction of staff number of institutions of correctional system of the Russian Federation
Authors: Каляшин Андрей , Kalyashin Andrey
Published: May 2015

The author of the article investigates the reduction of staff number of the correctional system within the framework of modernization of Russia, and also considers the issues related with its realization. The positive experience of Federal Penitentiary Service of Russia in headcount optimization is described. The article presents methods of budget cuts while maintaining the number of employees in the institutions and bodies of the correctional system.
Heritage protection authorities and their powers
Authors: Мартыненко Игорь , Martynenko Igor
Published: May 2015

The article outlines the features of the legislation on the protection of historical and cultural heritage of the Russian Federation, considered the powers of government agencies to oversee compliance with the law on the protection of cultural heritage.
The Dentists' Health Support Trust
Authors: O'Connor Rory
Published: May 2015

This article discusses the Dentists' Health Support Trust and how it helps all members of the dental team if they have any mental health or substance misuse issues
The older dental patient and the role of the dental nurse
Authors: Hellyer Paul
Published: May 2015

In this article, Paul Hellyer explains the age changes taking place in the UK population, discusses what it might mean to be an ‘older patient’ and describes how dental nurses can make visits to the dentist easier for them
Safeguarding vulnerable adults: the role of the dental team
Authors: Griffith Richard
Published: May 2015

The dental team have a professional duty to safeguard vulnerable adults from abuse under the General Dental Council's (2013) Standards for the Dental Team. In this article, Richard Griffith sets out how the Care Act 2014 seeks to improve the safeguarding of vulnerable adults and the dental team's role in that process
Nursing of acute renal failure following ibuprofen toxicity in a dog: a patient care report
Authors: Visser Cassandra , Dixon Tonya
Published: May 2015

A 7-month-old male (neutered) Australian Shepherd canine presented with vomiting and an altered, depressed demeanour, about 20–60 minutes after ingesting 22–24, 200 mg ibuprofen tablets. This article describes the long-term nursing care provided to a dog with ibuprofen toxicity. Aspects of veterinary nursing include intravenous and urinary catheter maintenance, as well as monitoring of a patient on IV fluids. Proper care in these areas can lead to improved patient outcome, due to reduced secondary issues such as infection and fluid overload. This article focuses more on nursing care rather than how to diagnose and veterinary decisions.
Diversity of the Eastern Hardwood Resource and How This Diversity Influences Timber Utilization
Authors: Luppold William , Pugh Scott
Published: May 2015

The eastern hardwood resource is often associated with high-quality sawtimber used in the production of grade products, but this segment of the resource accounts for approximately 20 percent of the cubic volume of all live trees. By contrast, 17 percent of the hardwood timber volume is classified as cull trees, and an additional 14 percent is low-quality sawlog-size growing stock. The remainder of the resource is midgrade sawtimber-size growing stock and smaller-diameter poletimber. This article first examines definitions and terms useful in understanding the structural component of the hardwood resource and then examines this resource and important hardwood roundwood markets on a regional basis. The quality of hardwood timber varies considerably by region. The East Central and Mid-Atlantic contain lower cull volume on a percentage basis in part because of large quantities of yellow-poplar. The Northern and East Central regions contain the greatest volume of high-quality sawtimber and produce relatively large quantities of hardwood lumber. The Southern region contains a large volume of hardwood timber, but much of this timber base is low quality or cull; still, this resource is highly utilized by a variety of industries, including grade hardwood sawmills. The West Central region can also be characterized as low quality but contains a third of the black walnut sawtimber in the United States. The Plains region contains the lowest volume of hardwood timber, and the widespread geographic distribution of this timber outside of Minnesota may make use of this material for most areas of this region uneconomical.
Empire Crime, Rendition and Guantánamo Bay: The Case of David Hicks
Authors: Poynting Scott
Published: May 2015

This article argues that a concept of “empire crime” can usefully extend that of state crime to better comprehend the unlawful “extraordinary rendition”, detention without trial and torture associated with the US naval base at Guantánamo Bay and other sites where imperial “exceptions” to US and international law are claimed and practiced. Other nation states have been complicit in this regime — the UK, Canada and Australia among them. Their state crimes in this respect are inextricably part of the “empire crime” of the US-led empire of capital. This article considers one case in detail: that of David Hicks, one of the two Australians rendered to and detained at Guantánamo Bay with the connivance of the Australian and other states. The US state has variously denied, rationalized, exceptionalised and blamed the victims of the state crimes in this regime, and the Australian and other states involved have falsely denied knowledge and otherwise followed suit.
‘Realising the (troubled) family’, ‘crafting the neoliberal state’
Authors: Crossley Stephen
Published: May 2015

This article examines the development of the ‘troubled families’ narrative that emerged following the riots in England in 2011, drawing on the work of Pierre Bourdieu and Loïc Wacquant. Their work is briefly discussed before the current concern about ‘troubled families’ is located in its wider historical and political context. The response to the riots and the emergence and development of the official concept of ‘troubled families’ is then examined. It is argued that the establishment and subsequent expansion of the Troubled Families programme was part of a wider process of neoliberal state-crafting that was undertaken by the coalition government, and which is likely to be continued under the new Conservative administration in the United Kingdom (UK). The article pays particular attention to the centrality of ‘the family’ in this neoliberal restructuring and adds to the emerging literature on neoliberal forms of governing families in the UK at the current time.