bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunohistochemical analysis of KBA.62 in 18 neurothekeomas: a potential marker for differentiating neurothekeoma, but a marker that may lead to confusion with melanocytic tumors
Authors: Suarez Andrea , High Whitney A.
Published: October 2013

Background

Neurothekeoma represents a neoplasm of uncertain histogenesis that often occurs on the head and neck of younger individuals. Distinguishing neurothekeoma from other tumors, particularly malignancies such as melanoma, can be difficult given the variable presence of nuclear atypia, mitoses and extension into fat or skeletal muscle. KBA.62 represents an anti‐melanoma monoclonal antibody that marks approximately 93% of melanomas. This study sought to evaluate KBA.62 expression in neurothekeomas, both as means of affirming the diagnosis and as a potential confounding factor in excluding a melanocytic process.

Methods

Eighteen neurothekeomas from 17 patients were analyzed by light microscopy and immunohistochemistry. Immunohistochemistry was performed with KBA.62, S100 and CD10 antibodies. The diagnosis of neurothekeoma was confirmed by at least two dermatopathologists.

Results

All cases showed similar light microscopic and immunohistochemical features. With the exception of two cases, cells expressed CD10 and exhibited morphologic features consistent with neurothekeoma. All 18 cases were S100 immunonegative. The epithelioid cells of all neurothekeomas were KBA.62 immunopositive, including both of two neurothekeomas occurring in the same patient.

Conclusions

In this study 100% of neurothekeomas tested were KBA.62 positive, admittedly to varying degrees, suggesting the utility of this reagent as being supportive of the diagnosis of neurothekeoma.
Sea urchin spines in the stratum corneum: an early finding related to trauma
Authors: Short Jack H. , Sulit Daryl J.
Published: October 2013

Penetrating trauma from sea urchin (Echinoidea) spines has been shown to cause numerous cutaneous reactions, ranging from initial pain that rapidly dissipates and resolves to chronic inflammation and formation of characteristic sea urchin granulomas. Many of these skin‐colored or violaceous papules and nodules form weeks to months after injury, and may be surgically excised. Histopathologic examination commonly shows well‐defined granulomas, the majority of which represent sarcoidal‐type granulomas. Other microscopic patterns, such as foreign body reactions and chronic inflammation, have also been shown. Retained spine fragments are birefringent on polarized microscopic examination and are most likely found in the dermal layer. Herein, we describe a case of traumatic sea urchin cutaneous injury with a unique early cutaneous trauma reaction in a young male who lived in Hawaii. Histopathologic exam was significant for retained spines in the layer of the stratum corneum, but no signs of granulomatous inflammation were observed. This case report emphasizes the unique features of our case and reviews the common clinical and histopathologic features of sea urchin cutaneous reactions.
Assessing the influence of geography, land cover and host species on the local abundance of a generalist brood parasite, the brown‐headed cowbird
Authors: Cummings Katherine , Veech Joseph A.
Published: October 2013

Aim

The brown‐headed cowbird is an obligate brood parasite known to exploit a large number of host species and use a variety of habitats. Much attention has been directed towards uncovering the fundamental factors that affect cowbird abundance; however, no study has evaluated these factors in the context of a biogeographic‐scale analysis that takes into account spatial autocorrelation. Our primary objective was to compare the relative influence of geography, land cover and host species on the local abundance of cowbirds.

Location

Great Plains region of the USA.

Methods

We used data from the North American Breeding Bird Survey and the National Land Cover Database to examine the relationships between cowbird abundance and host species, land cover composition and geographic location of a survey route. Multiple regression models were developed for various combinations of these factors. To control for spatial autocorrelation, we used SAM 4.0 (Spatial Analysis in Macroecology) software to implement simultaneous autoregressive modelling of the error term. We then used a model comparison approach to identify the factors that most influence cowbird abundance.

Results

Among all models examined, host species richness was the single most strong predictor and the sole statistically significant predictor. Cowbird abundance increased with host species richness but did not change in any significant way with non‐host passerine richness or abundance of host species. Models with land cover variables tended to have the poorest fit to the cowbird abundance data.

Main conclusions

Our results suggest that cowbirds may be attracted to areas with greater host richness and/or recruit better in such areas, although our data did not allow direct examination of either process. In a greater context, our study demonstrates the utility of a spatially based and geographically extensive analysis in finding range‐wide factors that affect the local abundance of a species.
Developmental expression pattern of two zebrafish rxfp3 paralogue genes
Authors: Fiengo Marcella , del Gaudio Rosanna , Iazzetti Giovanni , Di Giaimo Rossella , Minucci Sergio , Aniello Francesco , Donizetti Aldo
Published: October 2013

In mammals, the RXFP3 is the cognate receptor of the relaxin‐3 peptide (RLN3). In teleosts, many different orthologue genes for RXFP3 are present. In particular, two paralogue genes, rxfp3‐2a and rxfp3‐2b, likely encode the receptors for the Rln3a peptide. The transcription of these two rxfp3 genes is differentially regulated early during zebrafish embryogenesis. Indeed, reverse transcription–polymerase chain reaction analyses show that the rxfp3‐2b transcript is always present during embryo development, while the rxfp3‐2a transcript is detectable only at larval stage. By in situ hybridization experiments on embryos and larvae, the rxfp3‐2b transcript was revealed in the brain and in the retinal ganglion cell layer and thymus. Particularly in the brain, many territories are involved in the rxfp3‐2b expression, among them the optic tectum, thalamus, preoptic area, different nerve nuclei, habenula and pineal gland. The RXFP3 spatiotemporal expression pattern appears to be conserved between Danio rerio and mammals, as also previously showed for the corresponding ligand, the RLN3. Interestingly, the brain areas expressing the rxfp3‐2b receptor gene are involved in the visual system, emotional behaviors and circadian rhythm and could be functionally related to the neurotransmitter Rln3a‐expressing territories.
Serum ferritin level is higher in poorly controlled patients with Type 2 diabetes and people without diabetes, aged over 55 years
Authors: Batchuluun B. , Matsumata T. , Batchuluun B. , Erdenebileg N. , Tsagaantsooj G. , Boldbaatar K. , Khasag A.
Published: October 2013

Aims

Diabetes mellitus has been increasing in Mongolia. There is also growing concern about the relationship between iron stores and the severity of Type 2 diabetes. In this study, we aimed to evaluate serum ferritin level among Mongolian individuals with and without diabetes.

Methods

Of 254 participants, a total of 99 previously diagnosed patients with Type 2 diabetes and the same numbers of subjects without diabetes were enrolled and invited to a physical examination (BMI, central obesity, blood pressure) and fasting blood tests (fasting blood glucose, HbA1c, serum ferritin, C‐reactive protein, aspartate aminotransferase, alanine transferase).

Results

Serum ferritin was higher in the patients with Type 2 diabetes compared with the control group without diabetes, with a significant difference in the female groups (341.6 ± 67.2 and 159.1 ± 36.8 ng/ml respectively, P = 0.019). Of the patients with Type 2 diabetes, 43.4% had hyperferritinaemia, and 21.2% of the individuals without diabetes had hyperferritinaemia. In the group with Type 2 diabetes, serum ferritin level was significantly higher in the group of women whose HbA1c was ≥ 53 mmol/mol (7.0%) compared with the other group of women whose HbA1c was < 53 mmol/mol (7.0%) (562.1 ± 122.1 and 220.5 ± 78.7 ng/ml respectively, P = 0.025). We also found that the subjects without diabetes, aged over 55 years, are at risk of increased serum ferritin.

Conclusion

Poorly controlled patients with Type 2 diabetes and people without diabetes of over 55 years of age are likely to be at a higher risk of developing hyperferritinaemia. Thus, regular assessments of serum ferritin might be important for those who are at risk of hyperferritnaemia for prevention and an early intervention.
Incidence and predictors of hospitalization for tendon rupture in Type 2 diabetes: the Fremantle Diabetes Study
Authors: Zakaria M. H. B. , Davis W. A. , Davis T. M. E.
Published: October 2013

Aims

To determine the incidence and predictors of tendon ruptures requiring hospitalization of representative patients with Type 2 diabetes.

Methods

A total of 1296 patients from the longitudinal observational Fremantle Diabetes Study, Phase I, and 5159 de‐identified age‐ and sex‐matched control subjects without diabetes from the same urban area were studied. The patients' mean (sd) age was 64.0 (11.3) years and 48.6% of them were male. Their median (interquartile range) diabetes duration was 4.0 (1.0–9.0) years. The main outcome assessed was any tendon rupture requiring hospitalization in the Fremantle Diabetes Study subjects and the matched control subjects. Independent predictors of spontaneous ruptures in the patients from the Fremantle Diabetes Study were assessed using Cox proportional hazards modelling.

Results

The incidence rate ratio for any tendon rupture requiring hospitalization in patients vs control subjects was 1.44 (95% CI 1.10–1.87; P = 0.005). Independent predictors of spontaneous ruptures in patients were BMI [hazard ratio 1.05 (95% CI 1.002–1.10] for 1 kg/m2 increase; P = 0.010] and alcohol consumption [hazard ratio 1.52 (95% CI 1.11–2.09) for √1 standard drink/day increase; P = 0.010]. Adjustment of the incidence rate ratio for overall rupture requiring hospitalization for these variables using the BMI and alcohol consumption data from the contemporary Australian general population suggested it could be as high as 1.84.

Conclusions

There is a greater risk of tendon rupture requiring hospitalization in people with Type 2 diabetes. Alcohol consumption and adiposity are potentially modifiable risk factors of spontaneous ruptures in patients with diabetes.
Association between lung capacity measurements and abnormal glucose metabolism: findings from the Crossroads study
Authors: Yu D. , Simmons D.
Published: October 2013

Aim

To examine the association between lung function and metabolic syndrome/Type 2 diabetes.

Methods

A total of 1454 adults from rural Victoria, Australia, from randomly selected households included in the Crossroads study, provided spirometric measurements including forced vital capacity, forced expiratory volume in 1 s, predicted percentage value of forced expiratory volume in 1 s and forced vital capacity predicted percentage value. Assessments also included HbA1c, metabolic syndrome components and a 75‐g oral glucose tolerance test. The area under the receiver‐operating characteristic curves for waist circumference were compared with those for combinations of waist circumference and raw spirometric measures (forced vital capacity and forced expiratory volume in 1 s) for identifying metabolic syndrome or Type 2 diabetes.

Results

Partipants with a greater number of metabolic syndrome components were more likely to have reduced lung function, particularly if Type 2 diabetes was present: the predicted value of forced expiratory volume in 1 s decreased by 5–6% for participants with 2–4 metabolic syndrome components, and by 9% for those with Type 2 diabetes. The risk of metabolic syndrome or Type 2 diabetes was inversely associated with higher spirometry values (forced expiratory volume in 1 s percentage predicted value: odds ratio for 2–4 metabolic syndrome components 0.36–0.21 in women and 0.32–0.30 men; the odds ratio for Type 2 diabetes was 0.36 in women and 0.28 in men). Receiver‐operating characteristic curve analysis for identifying metabolic syndrome and Type 2 diabetes revealed significant differences between the area under the receiver‐operating characteristic curve with waist circumference alone and that for the combination of waist circumference with lung capacity measures.

Conclusion

Pulmonary function is lower in people with metabolic syndrome and Type 2 diabetes. Spirometry variables are independent predictors of metabolic syndrome and Type 2 diabetes.
The effect of diabetic neuropathy on foot bones: a systematic review and meta‐analysis
Authors: Barwick A. L. , de Jonge X. A. K. Janse , Tessier J. W. , Ho A. , Chuter V. H.
Published: October 2013

Aims

It is proposed that diabetic neuropathy may affect peripheral bone. Direct innervation of bone as well as neural control over its vascular supply and muscular influences may be affected by diabetes‐induced peripheral neuropathies. Associated changes to bone may contribute to the occurrence of foot bone pathology in this population. This systematic review aims to examine the literature related to the effect of diabetic neuropathy on foot bones.

Methods

Studies examining relationships between neuropathy and indicators of bone health (e.g. bone mineral density) in populations with diabetes were sought. Relevant publications were obtained from searches in MEDLINE, CINAHL and Embase in the period up to March 2013. Meta‐analysis was performed using a random effects model in the statistical package Stata version 12.1.

Results

Ten studies met the inclusion criteria and were included in the narrative synthesis. All studies were cross‐sectional or case–control in design. Four of the 10 included studies found results indicating poorer bone health in those with diabetes and neuropathy compared with those with diabetes without neuropathy. Seven of the 10 studies were able to be included in a meta‐analysis. The mean pooled effect was –0.36 (95% CI –0.76 to 0.04; P = 0.08), indicating a non‐significant trend towards poorer bone health in those with diabetic neuropathy.

Conclusions

We did not find a significant relationship between presence of neuropathy in those with diabetes and poorer peripheral bone health. However, methodological limitations of the included studies mean further research is required to investigate this theoretical relationship.
More Than You Can Handle: Decentralization and Spending Ability of Peruvian Municipalities
Authors: Loayza Norman V. , Rigolini Jamele , Calvo‐González Oscar
Published: October 2013

This article builds on a comprehensive dataset for Peru that merges municipal fiscal accounts with information about municipalities’ characteristics such as population, poverty, education, and local politics to analyze the leading factors affecting the ability of municipalities to execute the allocated budget. According to the existing literature and the Peruvian context, we divide these factors into four categories: the budget size and allocation process; local capacity; local needs; and political economy constraints. While we do find that all four factors affect decentralization, the largest determinant of spending ability is the adequacy of the budget with respect to local capacity. The results confirm the need for decentralization to be implemented gradually over time in parallel with strong capacity building efforts.
Customer segmentation issues and strategies for an automobile dealership with two clustering techniques
Authors: Tsai Chih‐Fong , Hu Ya‐Han , Lu Yu‐Hsin
Published: October 2013

Companies can use customer segmentation to group customers with similar characteristics together and identify the differences between groups to develop marketing strategies. This study investigates the problem of customer segmentation in relation to automotive customer relationship management and presents a real case study of an automobile dealer in Taiwan. Although several past studies have adopted different clustering techniques with which to group customer attributes, few have simultaneously considered customer transaction behaviour and customer satisfaction variables. In addition, most previous work has used only a single clustering method for customer segmentation, which results in unreliable results and leads to inadequate marketing decisions. Therefore, in this study, we consider two clustering techniques, k‐means and expectation maximization, and compare their results for correctness. The experimental results show that four customer groups are identified with both clustering methods: loyal, potential, VIP and churn customer groups. Based on the segmentation results, several customized marketing strategies aimed at each of the four customer groups are suggested to improve the quality of services for effective customer relationship management.
Variants in the 1q21 risk region are associated with a visual endophenotype of autism and schizophrenia
Authors: Goodbourn P. T. , Bosten J. M. , Bargary G. , Hogg R. E. , Lawrance‐Owen A. J. , Mollon J. D.
Published: October 2013

Deficits in sensitivity to visual stimuli of low spatial frequency and high temporal frequency (so‐called frequency‐doubled gratings) have been demonstrated both in schizophrenia and in autism spectrum disorder (ASD). Such basic perceptual functions are ideal candidates for molecular genetic study, because the underlying neural mechanisms are well characterized; but they have sometimes been overlooked in favor of cognitive and neurophysiological endophenotypes, for which neural substrates are often unknown. Here, we report a genome‐wide association study of a basic visual endophenotype associated with psychological disorder. Sensitivity to frequency‐doubled gratings was measured in 1060 healthy young adults, and analyzed for association with genotype using linear regression at 642 758 single nucleotide polymorphism (SNP) markers. A significant association (P = 7.9 × 10−9) was found with the SNP marker rs1797052, situated in the 5′‐untranslated region of PDZK1; each additional copy of the minor allele was associated with an increase in sensitivity equivalent to more than half a standard deviation. A permutation procedure, which accounts for multiple testing, showed that the association was significant at the α = 0.005 level. The region on chromosome 1q21.1 surrounding PDZK1 is an established susceptibility locus both for schizophrenia and for ASD, mirroring the common association of the visual endophenotype with the two disorders. PDZK1 interacts with N‐methyl‐d‐aspartate receptors and neuroligins, which have been implicated in the etiologies of schizophrenia and ASD. These findings suggest that perceptual abnormalities observed in two different disorders may be linked by common genetic elements.
Political discourses of climate change and migration: resettlement policies in the Maldives
Authors: Kothari Uma
Published: October 2013

There is general agreement that migration is likely to play an increasingly crucial role in adaptation to climate change. However, as this paper argues, technocratic and de‐politicised discourses of climate change have often been invoked to conceal underlying political agendas in which environmental concerns are drawn upon to justify unfavourable government policies of mobility and resettlement. This paper examines the politics of climate change discourse through an analysis of resettlement policies in the Maldives where the government is proposing the consolidation of a population dispersed over 200 islands onto 10–15 islands. However, this initiative is not new. The government has long thought it economically, rather than environmentally, unsustainable to provide services and resources to a dispersed population, and has for many years muted policies to move people in order to reduce the costs on government. Today, the same initiatives are gaining renewed leverage by being couched in environmental terms. Without denying the realities of the negative consequences of climate change for small island states, this article explores the political imperatives that are influencing discussions of climate change and migration, and specifically how environmental discourses are being mobilised to re‐introduce previously unpopular resettlement and migration policies.
What's in a name? A UK Arctic policy framework for 2013
Authors: Depledge Duncan
Published: October 2013

The UK Government has committed itself to releasing a ‘policy framework’ for the Arctic in 2013. This decision was taken in response to the recommendations of the parliamentary inquiry undertaken by the Environmental Audit Committee in 2012. The timing is significant, coming amid broader debates about whether the UK needs an Arctic Strategy. The Government insists that a ‘policy framework’ is not the same as a ‘strategy’, yet the decision to prepare such a document still signals a departure from the status quo. This commentary considers what the Government means by a ‘policy framework’, how this differs from a ‘strategy’, and why such a document is needed now.
Copleston and Chinese Philosophy
Authors: Ryden Edmund
Published: October 2013

Chad Trainer argues that Frederick Copleston S.J. was wrong to expand the notion of philosophy from Western (Greek) philosophy to include Eastern philosophies.1 He believes that while in Hawai'i Copleston changed his mind to accept what Trainer calls ‘aphoristic writings, mystically inspired tracts and exegetical exercises’ as philosophy, even though to do so resulted in contradicting his earlier published views.2 In the following paper I will to some extent agree with Trainer's opinion about Copleston. However, based solely on Chinese material, I will explore why it is possible to draw a distinction between Chinese and Greek thought, what that distinction implies and whether the term ‘philosophy’ can be justifiably expanded to Chinese thought.
Evaluation of the Sysmex XT‐4000i for the automated body fluid analysis
Authors: Lehto T. M. , Leskinen P. , Hedberg P. , Vaskivuo T. E.
Published: October 2013

Introduction

Body fluid (BF) analysis is traditionally performed using microscopy, which is time‐consuming and labor‐intensive and has wide interobserver variability. Automation has been suggested to improve these elements.

Methods

Body fluid mode of the Sysmex XT‐4000i was used to analyze 51 cerebrospinal fluid (CSF) and 81 BF samples. white blood cell (WBC) count (cell/μL), WBC differential (MN% and PMN%), and turnaround time (TAT) were compared with manually performed microscopic counting.

Results

Within‐run imprecision of BF (CV%) was 2.8–19.3. Functional sensitivity was 18 cell/μL (CV% 19.3). The accuracy of WBC count was moderate with CSF samples (rs = 0.55) and good with BF samples (rs = 0.95). The TAT of BF and CSF samples decreased with samples without high HF‐BF count when analyzed with XT‐4000i.

Conclusion

The BF mode of Sysmex XT‐4000i was found to be accurate and precise with samples where the WBC count was >200 cell/μL. Our results indicate that Sysmex XT‐4000i can help to reduce TAT of BF sample analysis and decrease work effort in a laboratory. However, automatically performed cell counting cannot replace microscopic analysis in samples with abnormal findings.
Exploration of Time-Course Combinations of Outcome Scales for Use in a Global Test of Stroke Recovery
Authors: Goldie Fraser C. , Fulton Rachael L. , Dawson Jesse , Bluhmki Erich , Lees Kennedy R.
Published: October 2013

Background

Clinical trials for acute ischemic stroke treatment require large numbers of participants and are expensive to conduct. Methods that enhance statistical power are therefore desirable.

Aims

We explored whether this can be achieved by a measure incorporating both early and late measures of outcome (e.g. seven-day NIH Stroke Scale combined with 90-day modified Rankin scale).

Methods

We analyzed sensitivity to treatment effect, using proportional odds logistic regression for ordinal scales and generalized estimating equation method for global outcomes, with all analyses adjusted for baseline severity and age. We ran simulations to assess relations between sample size and power for ordinal scales and corresponding global outcomes. We used R version 2·12·1 (R Development Core Team. R Foundation for Statistical Computing, Vienna, Austria) for simulations and SAS 9·2 (SAS Institute Inc., Cary, NC, USA) for all other analyses.

Results

Each scale considered for combination was sensitive to treatment effect in isolation. The mRS90 and NIHSS90 had adjusted odds ratio of 1·56 and 1·62, respectively. Adjusted odds ratio for global outcomes of the combination of mRS90 with NIHSS7 and NIHSS90 with NIHSS7 were 1·69 and 1·73, respectively. The smallest sample sizes required to generate statistical power ≥80% for mRS90, NIHSS7, and global outcomes of mRS90 and NIHSS7 combined and NIHSS90 and NIHSS7 combined were 500, 490, 400, and 380, respectively.

Discussion

When data concerning both early and late outcomes are combined into a global measure, there is increased sensitivity to treatment effect compared with solitary ordinal scales. This delivers a 20% reduction in required sample size at 80% power. Combining early with late outcomes merits further consideration.
Review of Lipid and Lipoprotein(a) Abnormalities in Childhood Arterial Ischemic Stroke
Authors: Sultan Sally M. , Schupf Nicole , Dowling Michael M. , DeVeber Gabrielle A. , Kirton Adam , Elkind Mitchell S. V.
Published: October 2013

National organizations recommend cholesterol screening in children to prevent vascular disease in adulthood. There are currently no recommendations for cholesterol and lipoprotein (a) testing in children who experience an arterial ischemic stroke. While dyslipidemia and elevated lipoprotein (a) are associated with ischemic stroke in adults, the role of atherosclerotic risk factors in childhood arterial ischemic stroke is not known. A review of the literature was performed from 1966 to April 2012 to evaluate the association between childhood arterial ischemic stroke and dyslipidemia or elevated lipoprotein (a). Of 239 citations, there were 16 original observational studies in children (with or without neonates) with imaging-confirmed arterial ischemic stroke and data on cholesterol or lipoprotein (a) values. Three pairs of studies reported overlapping subjects, and two were eliminated. Among 14 studies, there were data on cholesterol in 7 and lipoprotein (a) in 10. After stroke, testing was performed at >three-months in nine studies, at ≤three-months in four studies, and not specified in one study. There were five case-control studies: four compared elevated lipoprotein (a) and one compared abnormal cholesterol in children with arterial ischemic stroke to controls. A consistent positive association between elevated lipoprotein (a) and stroke was found [Mantel-Haenszel OR 4.24 (2.94–6.11)]. There was no association in one study on total cholesterol, and a positive association in one study on triglycerides. The literature suggests that elevated lipoprotein (a) may be more likely in children with arterial ischemic stroke than in control children. The absence of confirmatory study on dyslipidemia should be addressed with future research.
Establishment of an Effective Acute Stroke Telemedicine Program for Australia: Protocol for the Victorian Stroke Telemedicine Project
Authors: Cadilhac Dominique A. , Moloczij Natasha , Denisenko Sonia , Dewey Helen , Disler Peter , Winzar Bruce , Mosley Ian , Donnan Geoffrey A. , Bladin Christopher
Published: October 2013

Rationale

Urgent treatment of acute stroke in rural Australia is problematic partly because of limited access to medical specialists. Utilization of telemedicine could improve delivery of acute stroke treatments in rural communities.

Aim

The study aims to demonstrate enhanced clinical decision making for use of thrombolysis within 4·5 h of ischemic stroke symptom onset in a rural setting using a telemedicine specialist support model.

Design

A formative program evaluation research design was used. The Victorian Stroke Telemedicine program was developed and will be evaluated over five stages to ensure successful implementation. The phases include: (a) preimplementation phase to establish the Victorian Stroke Telemedicine program including the clinical pathway, data collection tools, and technology processes; (b) pilot clinical application phase to test the pathway in up to 10 patients; (c) modification phase to refine the program; (d) full clinical implementation phase where the program is maintained for one-year; and (e) a sustainability phase to assess project outcomes over five-years. Qualitative (clinician interviews) and quantitative data (patient, clinician, costs, and technology processes) are collected in each phase.

Study outcomes

The primary outcome is to achieve a minimum 10% absolute increase in eligible patients treated with thrombolysis. Secondary outcomes are utilization of the telestroke pathway and improvements in processes of stroke care (e.g., time to brain scan). We will report door to telemedicine consultation time, length of telemedicine consultation, clinical utility and acceptability from the perspective of clinicians, and 90-day patient outcomes.

This research will provide evidence for an effective telestroke program for use in regional Australian hospitals.
Gender Differences in the Age-Stratified Prevalence of Risk Factors in Korean Ischemic Stroke Patients: A Nationwide Stroke Registry-Based Cross-Sectional Study
Authors: Park Tai Hwan , Ko Youngchai , Lee Soo Joo , Lee Kyung Bok , Lee Jun , Han Moon-Ku , Park Jong-Moo , Kim Dong-Eog , Cho Yong-Jin , Hong Keun-Sik , Kim Joon-Tae , Cho Ki-Hyun , Kim Dae-Hyun , Cha Jae-Kwan , Yu Kyung-Ho , Lee Byung-Chul , Yoon Byung-Woo , Lee Ji Sung , Lee Juneyoung , Gorelick Philip B. , Bae Hee-Joon
Published: October 2013

Background

Although ethnic or cultural differences affect prevalence of cardiovascular risk factors, limited information is available about the age- and gender-stratified prevalence of the risk factors in Asian stroke population.

Aims and hypothesis

We assessed gender- and age-stratified prevalences of major risk factors in Korean stroke patients, and assumed that the gender differences are attenuated by adjustment with lifestyle factors.

Methods

Using the nationwide hospital-based stroke registry, we identified 9417 ischemic stroke patients admitted between April 2008 and January 2011. Prevalence of hypertension, diabetes, hyperlipidemia, atrial fibrillation, prior stroke, and coronary heart disease was assessed in both genders by age groups. We analyzed gender differences of the prevalence among the age groups by calculating prevalence ratio, and further explored the influence of lifestyle factors on the gender difference in multivariable analyses.

Results

Hypertension and hyperlipidemia were more common in men until middle age, but after that more common in women, whereas diabetes was more common in women after 65 years of age. Atrial fibrillation increased steadily with age in both genders but was more common in women through all age groups. Prior stroke and coronary heart disease showed inconsistent gender differences. Gender differences in hypertension and diabetes among the age groups were attenuated by adjustment with accompanying risk factors including lifestyle factors.

Conclusion

Korean women with stroke had more hypertension and hyperlipidemia after middle age, more diabetes after 65 years, and more atrial fibrillation throughout all ages. Strategies to control risk factors in women at risk for stroke are eagerly needed.
Body Mass Index and Acute Ischemic Stroke Outcomes
Authors: Saini M. , Saqqur M. , Shuaib A.
Published: October 2013

Background

The impact of body mass index on acute ischemic stroke outcomes is unclear.

Aims and/or hypothesis

We sought to determine the effect of body mass index on short-term (90 days) acute ischemic stroke outcomes.

Methods

Data were extracted for patients with acute ischemic stroke and records of body mass index at baseline from the Virtual International Stroke Trials Archive database. Multivariate logistic regression and Cox proportional hazard analysis were used to analyze effect of body mass index on poor functional outcome (modified Rankin Scale >2) and mortality, respectively, within 90 days of stroke's onset.

Results

Of the 4811 patients (mean age 68·8 ± 12·2 years) included in the study, 2002 (41·6%) were overweight, and 1095 (22·8%) were obese. Overweight (body mass index 25–29·9 kg/m2) was associated with decreased mortality (hazard ratios 0·59; 95% confidence interval 0·51–0·68; P < 0·01) and decrease in poor functional outcome (odds ratio 0·74; 95% confidence interval 0·64–0·85; P < 0·01) following acute ischemic stroke. The association of body mass index with stroke outcomes was dependent on age, gender, and use of thrombolytic therapy.

Conclusions

Being overweight or obese is associated with a better functional outcome and reduced mortality in patients of acute ischemic stroke. However, the definition of an ‘optimal’ body mass index, in relation to stroke outcomes, may be affected by age, gender, and use of thrombolytic therapy.
Insiders or outsiders? Mental health service users' journeys towards full citizenship
Authors: Hamer Helen P. , Finlayson Mary , Warren Helen
Published: October 2013

The present study explores the journeys towards full citizenship for those using mental health services as they lobbied to be included as full citizens with the same rights and responsibilities as others in society. Qualitative data were collected through semistructured interviews with 17 service users, five government representatives, and seven registered mental health nurses. A conceptual framework of citizenship containing four domains – the extent, content, depth and acts of citizenship – was used to analyse the data. This paper reports the findings from the service users' data in the first domain, the extent of citizenship, defined as the rules and norms of inclusion and exclusion. The degree to which the service user participants were accepted as full citizens with the same civil, political, and social rights as others was contingent on their ability to adopt their society's rules and norms and appear as ‘normal’ citizens. Participants often experienced being ‘othered’ and excluded from the many rights and responsibilities of citizenship due to society's perception that service users lack certain attributes of normal, productive citizens. Participants reported that being labelled with a mental illness led to them being marginalized and ostracized, thus placing conditions and barriers on their citizenship status. Findings show that in response to experiencing conditional citizenship, participants shaped their behaviour to assimilate with other citizens. As well, they engaged in practices of inclusion to challenge and broaden the social rules and norms in order to be accepted without disavowing their differences.
The Consequences of Substituting Sand with Used Copper Slag in Construction
Authors: Kua Harn Wei
Published: October 2013

Using waste copper slag (CS) as a replacement for sand in concrete mixture is becoming popular in Singapore and around the world. What are the consequences of this material substitution? Will this result in lower environmental impact? This work used attributional and consequential life cycle assessments to evaluate the net results of replacing sand with CS. Impacts were assessed with respect to embodied energy and greenhouse gas emissions (global warming potential; GWP). It was found that embodied energy and GWP of using a combination of 0.13 kilograms (kg) of CS and 0.9 kg of sand are higher than those of 1 kg of sand. If CS replaces sand and the leftover sand replaces crushed rock sand, the net embodied energy and GWP may also increase. Landfilling the waste CS is similar to recycling it as a building material, in terms of embodied energy incurred and GWPs. Finally, four lessons from these findings were used to suggest a few integrated sustainable resource management policies for the building material and shipping industries.
Prospective antifungal therapy (PATH) alliance®: focus on mucormycosis
Authors: Kontoyiannis Dimitrios P. , Azie Nkechi , Franks Billy , Horn David L.
Published: October 2013

Mucormycosis is increasingly encountered in immunosuppressed patients, such as those with haematological malignancies or stem cell transplantation. We present a descriptive analysis of 121 cases of mucormycosis from the Prospective Antifungal Therapy Alliance® registry (July 2004 to December 2008). Patients with proven or probable mucormycosis were enrolled and followed prospectively for 12 weeks. The most common underlying disease and site of infection were haematologic malignancy (61.2%) and lungs (46.3%) respectively. Rhizopus (n = 63; 52.1%) was the most commonly isolated species, followed by Mucor (n = 28; 23.1%), other or unknown (n = 17; 14.0%), Rhizomucor (n = 9; 7.4%) and Lichtheimia (n = 4; 3.3%). The 12‐week Kaplan–Meier survival probability for all patients was 0.41; however, there was large variation in survival probabilities between species, with highest survival probability observed for Lichtheimia (0.5), followed by Rhizopus (0.47), Mucor (0.40), unknown Mucormycetes species (0.40), other Mucormycetes species (0.17) and Rhizomucor (0.15). Prior use of voriconazole decreased 12‐week survival probability. Survival probability was higher in patients receiving amphotericin B by Day 3 (0.72) vs. those who started amphotericin B therapy after Day 3 (0.33). The low survival probability observed underscores the importance of further studies of mucormycosis. Optimal treatment selection and timing may improve prognosis.
Regulation of hormonal responses of sweet pepper as affected by salinity and elevated CO2 concentration
Authors: Piñero María Carmen , Houdusse Fabrice , Garcia‐Mina Jose M. , Garnica María , del Amor Francisco M.
Published: October 2013

This study examines the extent to which the predicted CO2‐protective effects on the inhibition of growth, impairment of photosynthesis and nutrient imbalance caused by saline stress are mediated by an effective adaptation of the endogenous plant hormonal balance. Therefore, sweet pepper plants (Capsicum annuum, cv. Ciclón) were grown at ambient or elevated [CO2] (400 or 800 µmol mol–1) with a nutrient solution containing 0 or 80 mM NaCl. The results show that, under saline conditions, elevated [CO2] increased plant dry weight, leaf area, leaf relative water content and net photosynthesis compared with ambient [CO2], whilst the maximum potential quantum efficiency of photosystem II was not modified. In salt‐stressed plants, elevated [CO2] increased leaf NO3– concentration and reduced Cl– concentration. Salinity stress induced ABA accumulation in the leaves but it was reduced in the roots at high [CO2], being correlated with the stomatal response. Under non‐stressed conditions, IAA was dramatically reduced in the roots when high [CO2] was applied, which resulted in greater root DW and root respiration. Additionally, the observed high CK concentration in the roots (especially tZR) could prevent downregulation of photosynthesis at high [CO2], as the N level in the leaves was increased compared with the ambient [CO2], under salt‐stress conditions. These results demonstrate that the hormonal balance was altered by the [CO2], which resulted in significant changes at the growth, gas exchange and nutritional levels.
Robust future‐oriented technology portfolios: Black–Litterman approach
Authors: Shin Juneseuk , Coh Byoung‐Youl , Lee Changyong
Published: October 2013

We propose a new way of constructing more robust technology portfolios to overcome the weaknesses of previous technology portfolios based either on the judgments of experts or on quantitative data such as patents. Instead of using historical data, the method of nonlinear forecasting enables us to forecast the future number of patent citations and accordingly, to use the forecast as a quantitative proxy for future returns and risks of technologies. Using the Black–Litterman portfolio model, we improve the accuracy of inputs by combining the future views of experts with the future returns and risks of technologies. As a consequence of this, the portfolio becomes strongly future‐oriented. With our approach, corporate managers use both experts and data more effectively to build robust technology portfolios. In particular, our method is of great help for companies launching new businesses because the method avoids heavy dependency on internal experts with little knowledge about emerging technologies. A company entering the molecular amplification instrument market is exemplified herein.
Technology alliances in emerging economies: persistence and interrelation in European firms' alliance formation
Authors: Jacob Jojo , Belderbos René , Gilsing Victor
Published: October 2013

We analyse the patterns and determinants of technology alliance formation with partner firms from emerging economies with a focus on European firms' alliance strategies. We examine to what extent European firms' alliance formation with partners based in emerging economies is persistent – that is, to what extent prior collaborative experience determines new alliance formation – and we compare this pattern with alliance formation with developed country partners. Second, we examine to what extent prior engagement in international alliances with partners from developed countries increases the propensity to form technology alliances with partners based in emerging economies, and vice versa (interrelation). We find that both persistence and interrelation effects are present, and that they are generally not weaker for emerging economy alliances. Alliance formation with Indian and Chinese firms is significantly more likely if firms have prior alliance experience with Japanese firms. The findings suggest that building on their prior international alliance experience firms extend their alliance portfolios across both developed and emerging economies, increasing the geographical diversity of their alliance portfolios.
TheIndigenousAetas ofBataan,Philippines: Extraordinary genetic origins, modern history and land rights
Authors: McHenry Mark P. , Anwar‐McHenry Julia , Balilla Vincent S. , Parkinson Riva Marris
Published: October 2013

TheAetaMagbukún ofBataan inLuzon, thePhilippines remain one of the least known and documentedIndigenous tribes. They retain primarily subsistence hunter‐gathering strategies to supply their basic needs. They also strive for recognition of their ancestral connection with, and rights to inhabit their ancestral forest domains, which is threatened by the expansion of agriculture and urban development by non‐Aetas, primarily the majorityTagalog population. TheAeta continue to endure dispossession, poverty and political discrimination through decades of protracted land rights processes. This review explores the potential use of recent genetic evidence in anthropology and human geography to legitimize theAeta's status asIndigenous people and contradict the perspective of some governments in theAsiaPacific region who question the existence ofIndigenous peoples generally, often from fear of land tenure and associated political repercussions. The acquisition and use of genetic research onIndigenous populations is both socially and politically contested through fear of the potential to jeopardize sovereignty claims and lead to biologically‐based discrimination. However, the full implications of the potential use of genetic research to legitimizeIndigenous status, as described within this research, has yet to be thoroughly explored. By exploring both the genetic and anthropological evidence using a case study of theIndigenousAeta, this paper provides a unique approach to building a case forIndigenous rights, occupation, use of ancestral lands, self‐determination, and ultimately, recognition asIndigenous people.
Reactivation of Chagas disease in a bone marrow transplant patient: case report and review of screening and management
Authors: Guiang K.M.U. , Cantey P. , Montgomery S.P. , Ailawadhi S. , Qvarnstrom Y. , Price T. , Blodget E.
Published: October 2013

We report a patient with an autologous stem cell transplant and history of residence in a Chagas disease (CD) endemic area who developed Chagas reactivation after induction for transplantation. We recommend that patients at risk for CD be screened before transplantation, and patients found to have chronic infection be monitored for reactivation post transplant.
Efficacy of Deferasirox for the treatment of iron overload in Chinese thalassaemia major patients: results from a prospective, open‐label, multicentre clinical trial
Authors: Lai Y.‐R. , Liu R.‐R. , Li C.‐F. , Huang S.‐L. , Li Q. , Habr D. , Martin N. , Shen Z.‐X.
Published: October 2013

Objective

To assess the efficacy and safety of deferasirox in Chinese thalassaemia major (TM) patients

Background

EPIC (Evaluation of Patients' Iron Chelation with Exjade®) was a large multi‐national study and, notably, the first clinical trial of an iron chelator registered with the Chinese State Food and Drug Administration.

Methods

Efficacy and safety of deferasirox were compared in Chinese (n = 117) and non‐Chinese (n = 998) TM patients. Deferasirox was initiated at 20 mg kg−1 day−1, with titration increments of 5−10 mg kg−1day−1, based on serum ferritin trends and safety parameters.

Results

At baseline, Chinese patients were younger than non‐Chinese (mean age 6·8 versus 19·5 years), with higher median serum ferritin (4519 vs 3058 ng mL−1). Over 1 year, mean actual deferasirox dose was similar for Chinese and non‐Chinese patients (24·6 and 24·0 mg kg−1 day−1, respectively); median serum ferritin did not change significantly from baseline in Chinese patients (+340 ng mL−1, P = 0·102) and significantly decreased in non‐Chinese patients (−220 ng mL−1; P < 0·001). In the 1‐year extension in Chinese patients, (mean actual deferasirox dose 33·6 mg kg−1 day−1), median serum ferritin decreased (−756 ng mL−1; P = 0·0397), with a numerically higher reduction in patients aged ≥6 to  < 12 than <6 years (−982 vs −457 ng mL−1, respectively). The safety profile of deferasirox in Chinese patients was similar to the overall population with respect to clinically‐relevant findings.

Conclusion

Age and deferasirox exposure influenced study findings, supporting the need for longer‐term treatment and dose escalation to ≥30 mg kg−1 day−1 to achieve neutral or negative iron balance in heavily iron overloaded and younger Chinese patients.
A Method Using Optical Contactless Displacement Sensors to Measure Vibration Stress of Small-Bore Piping
Authors: Maekawa Akira , Tsuji Takashi , Takahashi Tsuneo , Noda Michiyasu
Published: October 2013

In nuclear power plants, vibration stress of piping is frequently evaluated to prevent fatigue failure. A simple and fast measurement method is attractive to evaluate many piping systems efficiently. In this study, a method to measure the vibration stress using optical contactless displacement sensors was proposed, the prototype instrument was developed, and the instrument practicality for the method was verified. In the proposed method, light emitting diodes (LEDs) were used as measurement sensors and the vibration stress was estimated by measuring the deformation geometry of the piping caused by oscillation, which was measured as the piping curvature radius. The method provided fast and simple vibration estimates for small-bore piping. Its verification and practicality were confirmed by vibration tests using a test pipe and mock-up piping. The stress measured by both the proposed method and an accurate conventional method using strain gauges were in agreement, and it was concluded that the proposed method could be used for actual plant piping systems.