bluuebunny/crossref_metadata_2025 huggingface dataset:
Geochemical, metagenomic and metaproteomic insights into trace metal utilization by methane‐oxidizing microbial consortia in sulphidic marine sediments
Authors: Glass Jennifer B. , Yu Hang , Steele Joshua A. , Dawson Katherine S. , Sun Shulei , Chourey Karuna , Pan Chongle , Hettich Robert L. , Orphan Victoria J.
Published: October 2013

Microbes have obligate requirements for trace metals in metalloenzymes that catalyse important biogeochemical reactions. In anoxic methane‐ and sulphide‐rich environments, microbes may have unique adaptations for metal acquisition and utilization because of decreased bioavailability as a result of metal sulphide precipitation. However, micronutrient cycling is largely unexplored in cold (≤ 10°C) and sulphidic (> 1 mM ΣH2S) deep‐sea methane seep ecosystems. We investigated trace metal geochemistry and microbial metal utilization in methane seeps offshore Oregon and California, USA, and report dissolved concentrations of nickel (0.5–270 nM), cobalt (0.5–6 nM), molybdenum (10–5600 nM) and tungsten (0.3–8 nM) in Hydrate Ridge sediment porewaters. Despite low levels of cobalt and tungsten, metagenomic and metaproteomic data suggest that microbial consortia catalysing anaerobic oxidation of methane (AOM) utilize both scarce micronutrients in addition to nickel and molybdenum. Genetic machinery for cobalt‐containing vitamin B12 biosynthesis was present in both anaerobic methanotrophic archaea (ANME) and sulphate‐reducing bacteria. Proteins affiliated with the tungsten‐containing form of formylmethanofuran dehydrogenase were expressed in ANME from two seep ecosystems, the first evidence for expression of a tungstoenzyme in psychrophilic microorganisms. Overall, our data suggest that AOM consortia use specialized biochemical strategies to overcome the challenges of metal availability in sulphidic environments.
Creating conversations: an inclusive approach to the international networking of knowledge about education
Authors: Miles Susie
Published: October 2013

Networking has been central to human communication and social engagement for centuries, but has changed dramatically with the advent of new technology. However, the practice of networking has received little academic attention and tends to be undertheorised. This paper considers the impact of the global digital and communication divide, and the contested nature of inclusive education, on the task of promoting information sharing internationally. A summative case study is presented of a network, established to support the documentation of promising practice on inclusive education in countries with limited access to information and material resources. The case study uses autoethnographic methods to identify key principles for the development of an inclusive network. The significance of this paper is in its proposition of a working model of inclusive networking, which has potential to be developed into a theory.
Consumption of atmospheric hydrogen during the life cycle of soil‐dwelling actinobacteria
Authors: Meredith Laura K. , Rao Deepa , Bosak Tanja , Klepac‐Ceraj Vanja , Tada Kendall R. , Hansel Colleen M. , Ono Shuhei , Prinn Ronald G.
Published: October 2013

Microbe‐mediated soil uptake is the largest and most uncertain variable in the budget of atmospheric hydrogen (H2). The diversity and ecophysiological role of soil microorganisms that can consume low atmospheric abundances ofH2with high‐affinity [NiFe]‐hydrogenases is unknown. We expanded the library of atmosphericH2‐consuming strains to include four soilHarvardForestIsolate (HFI)Streptomycesspp.,Streptomyces cattleyaandRhodococcus equiby assaying for high‐affinity hydrogenase (hhyL) genes and quantifyingH2uptake rates. We find that aerial structures (hyphae and spores) are important forStreptomyces H2consumption; uptake was not observed inS. griseoflavus Tu4000 (deficient in aerial structures) and was reduced by physical disruption ofStreptomycessp.HFI8 aerial structures.H2consumption depended on the life cycle stage in developmentally distinct actinobacteria:Streptomycessp.HFI8 (sporulating) andR. equi(non‐sporulating, non‐filamentous). StrainHFI8 took upH2only after forming aerial hyphae and sporulating, whileR. equionly consumedH2in the late exponential and stationary phase. These observations suggest that conditions favouringH2uptake by actinobacteria are associated with energy and nutrient limitation. Thus,H2may be an important energy source for soil microorganisms inhabiting systems in which nutrients are frequently limited.
Computed Tomographic Anatomy of the Equine Foot
Authors: Claerhoudt S. , Bergman E. H. J. , Saunders J. H.
Published: October 2013

This study describes a detailed computed tomographic reference of the normal equine foot. Ten forefeet of five adult cadavers, without evidence of orthopaedic disease, were used. Computed tomography (CT) was performed on all feet. Two‐millimetre thick transverse slices were obtained, and sagittal and dorsal planes were reformatted. The CT images were matched with the corresponding anatomic slices. The phalanges and the distal sesamoid bone showed excellent detail. The extensor and flexor tendons (including their attachments) could be clearly evaluated. The collateral (sesamoidean) ligaments could be readily located, but were difficult to delineate at their proximal attachment. The distal digital annular ligament could only be distinguished from the deep digital flexor tendon proximal to the distal sesamoid bone, and its proximal attachment could be identified, but not its distal insertion. Small ligaments (impar ligament, chondrosesamoidean, chondrocoronal and chondrocompedal ligaments, axial and abaxial palmar ligaments of the proximal inter‐phalangeal joint) were seen with difficulty and not at all slices. The joint capsules could not be delineated from the surrounding soft tissue structures. The lateral and medial proprius palmar digital artery and vein could be visualized occasionally on some slices. The ungular cartilages, corium and hoof wall layering were seen. The nerves, the articular and fibrocartilage of the distal sesamoid bone and the chondroungular ligament could not be assessed. Computed tomography of the equine foot can be of great value when results of radiography and ultrasonography are inconclusive. Images obtained in this study may serve as reference for CT of the equine foot.
Resting ST Amplitude: Prognosis and Normal Values in an Ambulatory Clinical Population
Authors: Zarafshar Shirin , Wong Myo , Singh Nikhil , Aggarwal Sonya , Adhikarla Chandana , Froelicher V.F.
Published: October 2013

Background

There is limited data describing ST segment amplitude in apparently healthy, asymptomatic populations. We analyzed ST amplitude in the standard resting electrocardiogram (ECG) in a large, multiethnic, stable, clinical population.

Methods

We evaluated computerized ST amplitude measurements from the resting ECGs of 29,281 ambulatory outpatients collected between 1987 and 1999 at the Palo Alto, VA. With the PR interval as the isoelectric line, both elevation criteria (≥0.1 mV, ≥0.15 mV, and ≥0.2 mV) and depression criteria (≤–0.05 mV or ≤–0.1 mV), were applied. Cox–Hazard survival analysis techniques were used to demonstrate in which leads ST amplitude displacement was associated with cardiovascular (CV) death. To create a cohort without ECG patterns clearly associated with disease, we excluded ECGs with inverted T waves, wide QRS, or diagnostic Q waves and coded the remaining “normal” ECGs for ST elevation and depression to determine a normal range.

Results

The only ST amplitudes that were significantly and independently associated with time to CV death when adjusted for age, gender, and ethnicity were ST depression in all of the lateral leads (I, V4–V6). When isolated to the inferior leads, (II and AVF), no ST amplitude criteria were associated with CV death. Among the “normal ECG” subgroup the precordial leads exhibited the greatest median ST amplitudes and the most significant differences between the leads, genders and ethnicities.

Conclusions

Significant differences in ST amplitude were present in the precordial leads according to gender and ethnicity. This was particularly apparent when amplitude threshold were set for comparisons. Our findings provide the normal range for ST amplitude that when exceeded, should raise clinical concern.
Single‐incision laparoscopic partial gastrectomy for gastric submucosal tumors without compromising transumbilical stapling
Authors: Takata Akihiro , Nakajima Kiyokazu , Kurokawa Yukinori , Takahashi Tsuyoshi , Yamasaki Makoto , Miyata Hiroshi , Takiguchi Shuji , Mori Masaki , Doki Yuichiro
Published: October 2013

Introduction

Although SILS has become an increasingly popular type of surgery, its application for gastric submucosal tumors (SMT) has been only sporadically reported. We herein describe 12 recent cases with gastric SMT located in the greater curvature or anterior wall. The aim is to validate technical feasibility and safety of single‐incision laparoscopic partial gastrectomy. Thus far, this is one of the largest series of patients with gastric SMT who underwent SILS.

Methods

From July 2009 to April 2013, single‐incision laparoscopic partial gastrectomy was attempted in 12 consecutive patients with gastric SMT. Three trocars were assembled in the umbilical incision, and the lesion was mobilized and staple‐resected with endoscopic stapling devices.

Results

SILS surgery was successfully completed without any additional trocars. The median operating time was 96.5 min, and median blood loss was 7.5 mL. The median tumor size was 30 mm, with histopathologic diagnosis of gastrointestinal stromal tumor (10) and schwannoma (2). There was no immediate postoperative morbidity. During a median follow‐up of 12 months, all patients were on full regular diet without any gastrointestinal symptoms.

Conclusion

SILS with transumbilical gastric stapling is a safe and practical alternative to conventional multiport laparoscopy in patients with gastric SMT, except for cases originating in the lesser curvature and close to the cardia/ pylorus.
Involvement of the Subplate Zone in Preterm Infants with Periventricular White Matter Injury
Authors: Pogledic Ivana , Kostovic Ivica , Fallet‐Bianco Catherine , Adle‐Biassette Homa , Gressens Pierre , Verney Catherine
Published: October 2013

Studies of periventricular white matter injury (PWMI) in preterm infants suggest the involvement of the transient cortical subplate zone. We studied the cortical wall of non‐cystic and cystic PWMI cases and controls. Non‐cystic PWMI corresponded to diffuse white matter lesions, the predominant injury currently detected by imaging. Glial cell populations were analyzed in post‐mortem human frontal lobes from very preterm [24–29 postconceptional weeks (pcw)] and preterm infants (30–34 pcw) using immunohistochemistry for glial fibrillary acidic protein (GFAP), monocarboxylate transporter 1 (MCT1), ionized calcium‐binding adapter molecule 1 (Iba1), CD68 and oligodendrocyte lineage (Olig2). Glial activation extended into the subplate in non‐cystic PWMI but was restricted to the white matter in cystic PWMI. Two major age‐related and laminar differences were observed in non‐cystic PWMI: in very preterm cases, activated microglial cells were increased and extended into the subplate adjacent to the lesion, whereas in preterm cases, an astroglial reaction was seen not only in the subplate but throughout the cortical plate. There were no differences in Olig2‐positive pre‐oligodendrocytes in the subplate in PWMI cases compared with controls. The involvement of gliosis in the deep subplate supports the concept of the complex cellular vulnerability of the subplate zone during the preterm period and may explain widespread changes in magnetic resonance signal intensity in early PWMI.
Phyletic groups on networks
Authors: Wheeler Ward C.
Published: October 2013

Three additional phyletic group types, “periphyletic,” “epiphyletic”, and “anaphyletic” (in addition to Hennigian mono‐, para‐, and polyphyletic) are defined in terms of trees and phylogenetic networks (trees with directed reticulate edges) via a generalization of the algorithmic definitions of Farris. These designations concern groups defined as monophyletic on trees, but with additional gains or losses of members from network edges. These distinctions should be useful in discussion of systems with non‐vertical inheritance such as recombination between viruses, horizontal exchange between bacteria, hybridization in plants and animals, as well as human linguistic evolution. Examples are illustrated with Indo‐European language groups.
Immediate function on the day of surgery compared with a delayed implant loading process in the mandible: a randomized clinical trial over 5 years
Authors: Jokstad Asbjorn , Alkumru Hassan
Published: October 2013

Objectives

To appraise the feasibility of loading four implants with a pre‐existing denture converted to a fixed dental prosthesis (FDP) on the day of implant surgery compared with waiting for 3‐ to 4‐month healing.

Methods

Patients with an edentulous, fully healed mandible were recruited in a faculty clinic to partake in a blinded two‐arm parallel randomized controlled trial (RCT). The participants received four parallel intraforamina mandibular implants with a moderately rough titanium surface (Brånemark System Mk III or Mk IV TiUnite; Nobel Biocare AB, Göteborg, Sweden). The implants were loaded on the same day by converting the participants' pre‐existing denture in the experimental group. The implants were placed using a one‐stage surgery procedure, and the participants' pre‐existing denture were soft‐relined in the control group. For both groups, the permanent 10‐ to 12‐unit FDP consisting of a type‐3 cast precious alloy veneered with acrylic and artificial teeth was placed 3–4 months after implant surgery. All participants have been recalled annually for 5 years for appraisal of bone loss and registration of adverse events.

Results

Thirty‐five of the original 42 participants (83%) returned for clinical and radiological examinations at the 5‐year follow‐up recall. No selective dropout or specific reasons for dropout was identified in the two study arms; leaving n = 17 (Intention‐to‐treat group, ITT) in the experimental group, alternatively n = 13 as per protocol group (PP), and n = 18 participants in the control group (ITT = PP). At study commencement, five of the participants assigned to the experimental group did not receive their planned intervention. In the control group, one implant failed to osseointegrate and another failed due to bone loss after 5 years. The crestal bone level changes over 5 years were identical in the experimental and control groups, that is, 1.2 mm (SD = 0.7). There were no differences between the two study arms with regard to incidence of biological and technical adverse events.

Conclusions

Implants in the anterior mandible loaded immediately with a converted pre‐existing denture appear to yield analogous clinical outcomes compared with waiting for 3–4 months over the first 5 years following implant surgery.
Readability of websites containing information on dental implants
Authors: Jayaratne Yasas S. N. , Anderson Nina K. , Zwahlen Roger A.
Published: October 2013

It is recommended that health‐related materials for patients be written at sixth grade level or below. Many websites oriented toward patient education about dental implants are available, but the readability of these sites has not been evaluated.

Objective

To assess readability of patient‐oriented online information on dental implants.

Materials and methods

Websites containing patient‐oriented information on dental implants were retrieved using the Google search engine. Individual and mean readability/grade levels were calculated using standardized formulas. Readability of each website was classified as easy (≤6th‐grade level) or difficult (≥10th grade level).

Results

Thirty nine websites with patient‐oriented information on dental implant were found. The average readability grade level of these websites was 11.65 ± 1.36. No website scored at/below the recommended 6th grade level. Thirty four of 39 websites (87.18%) were difficult to read. The number of characters, words, and sentences on these sites varied widely.

Conclusion

All patient‐oriented websites on dental implants scored above the recommended grade level, and majority of these sites were “difficult” in their readability. There is a dire need to create patient information websites on implants, which the majority can read.
Diagnostic concordance rates in the subtyping of basal cell carcinoma by different dermatopathologists
Authors: Nedved Drew , Tonkovic‐Capin Viseslav , Hunt Edgar , Zaidi Nasir , Kucenic Michael J. , Graves Jeffery J. , Fraga Garth R.
Published: October 2013

Background

There are numerous subtypes of basal cell carcinoma (BCC). Defining the histopathologic subtype is an essential element in patient management, but there is little known data regarding interobserver precision in subtyping BCC.

Methods

We studied interobserver variance between six board‐certified dermatopathologists who subtyped 100 BCCs in a blinded fashion. We used kappa statistic to calculate the concordance in suggested subtype by different dermatopathologists. Provided diagnoses were then re‐categorized into low‐risk and high‐risk phenotypes, and kappa statistic for concordance on high‐risk BCC was determined.

Results

The overall κ statistic was 0.301, indicating fair agreement among the six observers. Superficial and fibroepithelial BCC had the highest individual kappa statistics. When subtypes were re‐classified into a two‐tier system of high‐risk and low‐risk phenotypes, there was substantial interobserver agreement on high‐risk BCC with a κ statistic of 0.699.

Conclusion

These results suggest only fair agreement among dermatopathologists on specific BCC subtypes, but substantial agreement on superficial, fibroepithelial and high‐risk BCC growth patterns. A simplified classification system comprised of superficial, fibroepithelial, nodular and infiltrative subtypes would increase interobserver precision and facilitate clinical decision‐making.
Evidence for continuous glucose monitoring: sufficient for reimbursement?
Authors: Heinemann L. , DeVries J. H.
Published: October 2013

Evidence for continuous glucose monitoring is mounting. Meta‐analyses consistently show lowering of HbA1c, and the first trial reporting a reduction in severe hypoglycaemic events in patients with hypoglycaemia unawareness has recently been presented. The more recent trials studied larger numbers of patients and may have shown better results because of improved technology. The various combinations of pump and sensor, with automated bolus calculators and low glucose suspend features, make evaluation more challenging from a reimbursement point of view, but evidence seems convincing enough to justify reimbursement for selected patient groups, including those who have shown a substantial improvement in HbA1c during a trial period, and those with hypoglycaemia unawareness who encountered severe hypoglycaemia in the recent past. More data on cost–efficacy are needed.
A multi‐country comparison of reasons for dental non‐attendance
Authors: Listl Stefan , Moeller John , Manski Richard
Published: October 2013

The purpose of this study was to describe differences across countries with respect to the reasons for dental non‐attendance by Europeans currently 50 yr of age and older. The analyses were based on retrospective life‐history data from the Survey of Health, Ageing, and Retirement in Europe and included information on various reasons why respondents from 13 European countries had never had regular dental visits in their lifetime. A series of logistic regression models was estimated to identify reasons for dental non‐attendance across different welfare‐state regimes. The highest proportion of respondents without any regular dental attendance throughout their lifetime was found for the Southern welfare‐state regime, followed by the Eastern, the Bismarckian, and the Scandinavian welfare‐state regimes. Factors such as patients’ perception that regular dental treatment is ‘not necessary’ or ‘not usual’ appear to be the predominant reason for non‐attendance in all welfare‐state regimes. The health system‐level factor ‘no place to receive this type of care close to home’ and the perception of regular dental treatment as ‘not necessary’ were more often referred to within the Southern, Eastern, and Bismarckian welfare‐state regimes than in Scandinavia. This could be relevant information for health‐care decision makers in order to prioritize interventions towards increasing rates of regular dental attendance.
The enzymes of human diphosphoinositol polyphosphate metabolism
Authors: Thomas Mark P. , Potter Barry V. L.
Published: October 2013

Diphospho‐myo‐inositol polyphosphates have many roles to play, including roles in apoptosis, vesicle trafficking, the response of cells to stress, the regulation of telomere length and DNA damage repair, and inhibition of the cyclin‐dependent kinase Pho85 system that monitors phosphate levels. This review focuses on the three classes of enzymes involved in the metabolism of these compounds: inositol hexakisphosphate kinases, inositol hexakisphosphate and diphosphoinositol‐pentakisphosphate kinases and diphosphoinositol polyphosphate phosphohydrolases. However, these enzymes have roles beyond being mere catalysts, and their interactions with other proteins have cellular consequences. Through their interactions, the three inositol hexakisphosphate kinases have roles in exocytosis, diabetes, the response to infection, and apoptosis. The two inositol hexakisphosphate and diphosphoinositol‐pentakisphosphate kinases influence the cellular response to phosphatidylinositol (3,4,5)‐trisphosphate and the migration of pleckstrin homology domain‐containing proteins to the plasma membrane. The five diphosphoinositol polyphosphate phosphohydrolases interact with ribosomal proteins and transcription factors, as well as proteins involved in membrane trafficking, exocytosis, ubiquitination and the proteasomal degradation of target proteins. Possible directions for future research aiming to determine the roles of these enzymes are highlighted.
Mapping genetic modifiers of survival in a mouse model of Dravet syndrome
Authors: Miller A. R. , Hawkins N. A. , McCollom C. E. , Kearney J. A.
Published: October 2013

Epilepsy is a common neurological disorder affecting approximately 1% of the population. Mutations in voltage‐gated sodium channels are responsible for several monogenic epilepsy syndromes. More than 800 mutations in the voltage‐gated sodium channel SCN1A have been reported in patients with generalized epilepsy with febrile seizures plus and Dravet syndrome. Heterozygous loss‐of‐function mutations in SCN1A result in Dravet syndrome, a severe infant‐onset epileptic encephalopathy characterized by intractable seizures, developmental delays and increased mortality. A common feature of monogenic epilepsies is variable expressivity among individuals with the same mutation, suggesting that genetic modifiers may influence clinical severity. Mice with heterozygous deletion of Scn1a (Scn1a+/−) model a number of Dravet syndrome features, including spontaneous seizures and premature lethality. Phenotype severity in Scn1a+/− mice is strongly dependent on strain background. On the 129S6/SvEvTac strain Scn1a+/− mice exhibit no overt phenotype, whereas on the (C57BL/6J × 129S6/SvEvTac)F1 strain Scn1a+/− mice exhibit spontaneous seizures and early lethality. To systematically identify loci that influence premature lethality in Scn1a+/− mice, we performed genome scans on reciprocal backcrosses. Quantitative trait locus mapping revealed modifier loci on mouse chromosomes 5, 7, 8 and 11. RNA‐seq analysis of strain‐dependent gene expression, regulation and coding sequence variation provided a list of potential functional candidate genes at each locus. Identification of modifier genes that influence survival in Scn1a+/− mice will improve our understanding of the pathophysiology of Dravet syndrome and may suggest novel therapeutic strategies for improved treatment of human patients.
Morphine intake and the effects of naltrexone and buprenorphine on the acquisition of methamphetamine intake
Authors: Eastwood E. C. , Phillips T. J.
Published: October 2013

Some common genetic factors appear to influence risk for drug dependence across multiple drugs of abuse. In previous research, mice that were selectively bred for higher amounts of methamphetamine consumption, using a two‐bottle choice methamphetamine drinking procedure, were found to be less sensitive to the locomotor stimulant effects of morphine and of the more selective μ‐opioid receptor agonist fentanyl, compared to mice that were bred for low methamphetamine consumption. This suggested that μ‐opioid receptor‐mediated pathways may influence genetic risk for methamphetamine consumption. We hypothesized that these differences in opioid sensitivity would impact opioid intake in the methamphetamine drinking lines and that drugs with μ‐opioid receptor activity would impact methamphetamine intake. Consumption of morphine was examined in 2, two‐bottle choice studies, one that compared morphine to quinine consumption and another that used a saccharin fading procedure. Next, naltrexone (0, 0.5, 1, 2, 5, 10 and 20 mg/kg), a μ‐opioid receptor antagonist, and buprenorphine (0, 1, 2 or 4 mg/kg), a μ‐opioid receptor partial agonist, were each examined for their effects on the acquisition of methamphetamine consumption. Low methamphetamine drinking mice consumed more morphine compared to high methamphetamine drinking mice. Naltrexone did not alter methamphetamine consumption in either selected line; however, buprenorphine reduced methamphetamine intake in the high methamphetamine drinking line. These data show that greater sensitivity to opioids is associated with greater opioid intake and warrant further investigation of drugs with μ‐opioid receptor‐specific agonist activity in genetically determined differences in methamphetamine consumption.
Understanding intractable environmental policy conflicts: the case of the village that would not fall quietly into the sea
Authors: Tebboth Mark
Published: October 2013

Coastal erosion is an emotive issue with deeply held views that are often resistant to consensual approaches to identify mutually acceptable solutions. Using the village of Happisburgh on the East Anglian coast in England as a case study, this research analyses how the issue of coastal erosion has been framed and whether the presence of different frames acts as a barrier to building consensus between stakeholders. The study uses Frame Theory and Cultural Theory to understand how the UK Government and the Coastal Concern Action Group (CCAG), a local pressure group based in Happisburgh, communicate and perceive the issue of coastal erosion. Additionally, the study explores whether the different ways of understanding coastal erosion resonate within the community itself. A multi‐method approach was used (policy discourse and media frame analysis) to identify the dominant framings of coastal erosion. The resonance of these frames was tested within the community of Happisburgh through a questionnaire with follow‐up focus groups. The study revealed that the Government discourse of coastal erosion shares many of the characteristics associated with Cultural Theory's hierarchical worldview. Conversely, CCAG's discourse can be likened to the egalitarian position. The community of Happisburgh was found to strongly agree with the discourse that is representative of an egalitarian worldview. Furthermore, there was an increased uniformity of views regarding coastal erosion compared with attitudes towards nature more generally. The study concludes that different framings act as a barrier to building consensus. Efforts should be made to develop governance solutions to tackle the explicit disagreements (revealed in this study) whilst acknowledging the more implicit origins of these differences.
Coming of age? Reflections on the centenary of women's admission to the Royal Geographical Society
Authors: Evans Sarah L , Keighren Innes M , Maddrell Avril
Published: October 2013

Women's admission to the Royal Geographical Society was at least a two‐staged affair, with a cohort of 22 women being admitted in 1892–93 before open access to women from 1913. However, whilst official membership was defined by these historic line‐in‐the‐sand ‘boundary’ moments, some aspects of women's participation within the Society were enacted in a permeable ‘frontier zone’. Both prior to, and after, fully accessing Fellowship in 1913, women were active producers of geographical knowledge – travelling, researching, writing, and teaching. Given these blurred thresholds of participation and recognition, and the complex social politics of majority/minority views on women's access to full membership, marking and celebrating the centenary of women's admission to the Society is riddled with ambiguities. What is unambiguous, however, is that the centenary presents a long‐overdue opportunity to celebrate over a hundred years of women's geographical work. It also offers a moment to pause and reflect on the status of women within the discipline today.
Thatcherism and its geographical legacies: the new map of socio‐spatial inequality in the Divided Kingdom
Authors: Hudson Ray
Published: October 2013

The 1979 election heralded a political sea change in the UK, as Thatcherite ‘Two Nation’ politics regarded inequality as evidence of a vibrant capitalism. As a result, inter‐regional inequalities were exacerbated as the effects of deindustrialisation, capacity reductions and job losses fell most heavily in the ‘North’. The lifting of restrictions on capital export precipitated the overseas relocation of private sector manufacturing, with job losses concentrated in the ‘North’. Cuts to nationalised industries were also concentrated in the ‘North’. Meanwhile the ‘South’ benefitted because of the primacy given to banking and financial services in economic policy priorities and the spatially selective concentration of Government spending on R&D and infrastructure. However, there were also widening intraregional inequalities within both ‘North’ and ‘South’, not least because of housing policies. Crucially, post‐Thatcher the neoliberal emphases on private sector growth and commodification were adopted by New Labour and Conservative–Liberal coalition governments so that socio‐spatial inequality became more deeply embedded in a Divided Kingdom.
Impact of Benzodiazepines on Functional Outcome and Occurrence of Pneumonia in Stroke: Evidence from VISTA
Authors: Frank Benedikt , Fulton Rachael L. , Lees Kennedy R. , Sanders Robert D. ,   for the VISTA Collaborators
Published: October 2013

Background

Benzodiazepines have been proposed both as a neuroprotectant and risk factor for pneumonia in acute stroke. Aims We assessed the impact of benzodiazepine exposure on the modified Rankin scale score distribution at 90 days as well as pneumonia rates among patients registered in a trials archive.

Method

We used an age, baseline National Institutes of Health Stroke Score, and thrombolysis-rate adjusted Cochran–Mantel–Haenszel test to test significance ( P) followed by proportional odds logistic regression analysis to estimate the odds ratios for improved modified Rankin scale score, and binary logistic regression to estimate the odds ratio for developing pneumonia.

Results

Data were available for 5938 patients, of whom 1800 received benzodiazepines. No association of benzodiazepine use and overall stroke outcome could be found (odds ratio 0·90, 95% confidence interval 0·82–1·00, P = 0·121). Pneumonia occurred in 12·8% of patients treated with benzodiazepines and in 13·6% of the controls (odds ratio 0·99, 95% confidence interval 0·83–1·18, P = 0·904).

Conclusion

In this nonrandomized comparison, treatment with benzodiazepines as a concomitant medication had no independent impact on stroke outcome.
Exercise-Induced Changes in Cardiovascular Function after Stroke: A Randomized Controlled Trial
Authors: Tang Ada , Eng Janice J. , Krassioukov Andrei V. , Madden Kenneth M. , Mohammadi Azam , Tsang Michael Y. C. , Tsang Teresa S. M.
Published: October 2013

Background and aims

Cardiovascular co-morbidities are prevalent after stroke, with heart disease, hypertension and impaired glucose tolerance present in the majority of cases. Exercise has the potential to mediate cardiovascular risk factors commonly present in people with stroke. This single-blinded randomized controlled trial compared the effects of high versus low intensity exercise on fitness, cardiovascular risk factors, and cardiac function after stroke.

Methods

Fifty participants (age 50–80 y, >1 y post-stroke) were randomized to a high-intensity Aerobic Exercise (AE) or low-intensity non-aerobic Balance/Flexibility (BF) program (6 months, 3 60-min sessions/week). Outcomes assessed by VO2peak (primary outcome), arterial stiffness, ambulatory capacity, hemodynamics and cardiac function using echocardiography, and lipid, glucose and homocysteine levels. Assessors were blinded to group allocation.

Results

Twenty-three (92%) of 25 AE group participants (withdrawals unrelated to the intervention) and all BF group participants completed the program. One BF group participant experienced 2 non-injurious falls during class. No other adverse events occurred. There were no changes in VO2peak in either group (AE 16·9 ±7 to 17·4 ± 7 ml•kg−1•min−1 vs. BF 16·9 ±6 to 16·6 ± 5 ml•kg−1•min−1, P = 0·45), but AE group demonstrated greater improvement in right atrial emptying fraction (AE 30 ± 22 to 37 ± 22% vs. BF 35 ± 20 to 31 ± 20%, P = 0·04). Both groups demonstrated improvements in lipid profiles, glucose and homocysteine levels, and ambulatory capacity ( P < 0·04).

Conclusions

This was the first study to examine the effects of aerobic exercise after stroke on cardiovascular hemodynamics. High-intensity exercise improved right-sided function and early myocardial relaxation. Low-intensity exercise may also benefit plasma lipid, glucose and inflammatory markers, and ambulatory capacity. This study is an important step towards understanding mechanisms by which exercise may reduce cardiovascular risk and function.
Novel Oral Anticoagulants: A Focused Review for Stroke Physicians
Authors: McGrath Emer R. , Eikelboom John W. , Kapral Moira K. , O'Donnell Martin J.
Published: October 2013

Novel oral anticoagulants provide an effective and convenient alternative to warfarin for stroke prevention in patients with atrial fibrillation. However, novel anticoagulants also present new challenges for stroke physicians, such as measurement of anticoagulant effect in emergency situations, use of thrombolysis in acute ischemic stroke, optimal timing of introduction of novel anticoagulants following acute ischemic stroke, and management of intracerebral hemorrhage. In this review, we propose pragmatic approaches to dealing with challenging management issues that will face stroke physicians who care for patients with acute stroke in the novel oral anticoagulant era.
Prognostic Value of Plasma Chitotriosidase Activity in Acute Stroke Patients
Authors: Bustamante Alejandro , Dominguez Carmen , Rodriguez-Sureda Víctor , Vilches Angel , Penalba Ana , Giralt Dolors , García-Berrocoso Teresa , Llombart Victor , Flores Alan , Rubiera Marta , Molina Carlos , Alvarez-Sabín José , Montaner Joan
Published: October 2013

Background and aims

Chitotriosidase, a component of innate immunity, constitutes a sensitive parameter of macrophage activation and its elevated plasma activity reflects an inflammatory response. Given the deleterious effects of inflammation in brain ischemia, we aimed to assess the prognostic value of chitotriosidase activity in acute stroke patients.

Methods

The study comprised 159 acute stroke patients and 51 age-matched controls. Plasma chitotriosidase activity was serially determined by fluorometric assay. Short-term neurological outcome was determined at 48 h and functional outcome at three-months. Predictors of neurological and functional outcome were determined via multivariate analysis, and the additional predictive value of chitotriosidase was tested with the Integrated Discrimination Index and the Net Reclassification Improvement.

Results

Stroke patients showed increased levels of baseline chitotriosidase activity compared to controls [114·2 (74·65–182·95) nmol/ml/h vs. 54·4 (32·7–76·4); P < 0·0001]. Chitotriosidase activity (<118·75) was found to be an independent predictor of neurological improvement at 48 h (odds ratio: 3·25; 95% confidence interval: 1·54–6·85; P = 0·002), and the addition of plasma chitotriosidase activity showed a better prediction of improvement at 48 h (Integrated Discrimination Index = 5·7%, Net Reclassification Improvement = 11·6%, P < 0·05) over the predictive model constituted only with clinical information. Although patients disabled at three-months showed higher baseline chitotriosidase levels, it was not an independent predictor of long-term disability.

Conclusions

Baseline chitotriosidase activity in acute stroke patients treated with tissue plasminogen activator (tPA) may constitute a prognostic predictor of short-term outcome, adding a moderate additional predictive value. Our results underline the deleterious role of inflammation in acute stroke patients.
Do-Not-Resuscitate (DNR) Orders in Patients with Intracerebral Hemorrhage
Authors: Silvennoinen Katri , Meretoja Atte , Strbian Daniel , Putaala Jukka , Kaste Markku , Tatlisumak Turgut
Published: October 2013

Background and purpose

Do-not-resuscitate orders may be associated with poor outcome in patients with intracerebral hemorrhage because of less active management.

Aims

We sought to characterize the practice of issuing do-not-resuscitate orders in intracerebral hemorrhage. We also aimed to identify possible differences in care according to do-not-resuscitate status.

Methods

We conducted a retrospective study of all consecutive intracerebral hemorrhage patients admitted to the Meilahti Hospital of the Helsinki University Central Hospital between January 2005 and March 2010. Data obtained from medical records allowed comparison of characteristics of patients and care of do-not-resuscitate and non-do-not-resuscitate patients as well as patients with early (within 24 h) and late (>24 h) do-not-resuscitate decisions. Logistic regression was used to identify factors independently associated with do-not-resuscitate decisions.

Results

Of our 1013 patients, a do-not-resuscitate order was issued in 368 (35%), of which 262 (73%) occurred within 24 h from admission. Advanced age (odds ratio 1.06 per year; 95% confidence interval 1.04–1.08), more severe stroke (1.09 per National Institutes of Health Stroke Scale point; 1.06–1.13), and deterioration soon after admission (5.12, 3.33–7.87) had the strongest associations with do-not-resuscitate decisions. Patients with do-not-resuscitate orders received recommended care including stroke unit care (43% vs. 64%; P < 0.001) and prophylaxis for deep venous thrombosis (45% vs. 54%; P = 0.027) less often than non-do-not-resuscitate patients. This was especially the case when the do-not-resuscitate order was issued early.

Conclusions

In addition to confirming the role of known intracerebral hemorrhage prognostic factors in do-not-resuscitate decision-making, our results demonstrate that do-not-resuscitate orders led to less active care of intracerebral hemorrhage patients.
Transcranial Direct Current Stimulation (tDCS): Does it Have Merit in Stroke Rehabilitation? A Systematic Review
Authors: Marquez Jodie , van Vliet Paulette , McElduff Patrick , Lagopoulos Jim , Parsons Mark
Published: October 2013

Transcranial direct current stimulation has been gaining increasing interest as a potential therapeutic treatment in stroke recovery. We performed a systematic review with meta-analysis of randomized controlled trials to collate the available evidence in adults with residual motor impairments as a result of stroke. The primary outcome was change in motor function or impairment as a result of transcranial direct current stimulation, using any reported electrode montage, with or without adjunct physical therapy. The search yielded 15 relevant studies comprising 315 subjects. Compared with sham, cortical stimulation did not produce statistically significant improvements in motor performance when measured immediately after the intervention (anodal stimulation: facilitation of the affected cortex: standardized mean difference = 0·05, P = 0·71; cathodal stimulation: inhibition of the nonaffected cortex: standardized mean difference = 0·39, P = 0·08; bihemispheric stimulation: standardized mean difference = 0·24, P = 0·39). When the data were analyzed according to stroke characteristics, statistically significant improvements were evident for those with chronic stroke (standardized mean difference = 0·45, P = 0·01) and subjects with mild-to-moderate stroke impairments (standardized mean difference = 0·37, P = 0·02). Transcranial direct current stimulation is likely to be effective in enhancing motor performance in the short term when applied selectively to patients with stroke. Given the range of stimulation variables and heterogeneous nature of stroke, this modality is still experimental and further research is required to determine its clinical merit in stroke rehabilitation.
Differential Clinical Characteristics and Prognosis of Patients with Longstanding Persistent Atrial Fibrillation Presenting with Recurrent Atrial Tachycardia versus Recurrent Atrial Fibrillation After First Ablation
Authors: ZHAO LIANG , WU SHAOHUI , JIANG WEIFENG , ZHOU LI , GU JUN , WANG YUANLONG , LIU YUGANG , ZHANG XIAODONG , LIU XU
Published: October 2013

Baseline Characteristics and Prognosis of LS‐AF Patients

Background

It is unknown if baseline characteristics and prognosis of patients with longstanding persistent (defined as history greater than 1 year) atrial fibrillation (LS‐AF) differ among those with either recurrent atrial tachycardia (R‐AT) or recurrent AF (R‐AF) after first ablation.

Methods

In 222 consecutive LS‐AF patients treated for R‐AT or R‐AF after first ablation, activation and entrainment mapping was used to identify R‐AT mechanism and to guide the following ablation, and the ablation endpoints for all patients included complete pulmonary vein isolation, bidirectional block of lines, and disappearance of complex fractionated atrial electrograms.

Results

There were 102 patients in the R‐AF group. LS‐AF patients with R‐AT as compared to R‐AF had shorter AF duration and recurrence interval, smaller left atrium size and left ventricular end‐diastolic diameter, and less mitral and aortic regurgitation before first ablation. During follow‐up (17.7 ± 4.0 months) after R‐AT/R‐AF ablation, 78 LS‐AF patients developed recurrent atrial tachyarrhythmia, with lower overall and recurrence as AF in R‐AT versus R‐AF groups.

Conclusions

LS‐AF patients who develop R‐AT versus R‐AF after first ablation have more favorable baseline characteristics and prognosis.
Non‐invasive in vivo dermatopathology: identification of reflectance confocal microscopic correlates to specific histological features seen in melanocytic neoplasms
Authors: Gill M. , Longo C. , Farnetani F. , Cesinaro A.M. , González S. , Pellacani G.
Published: October 2013

Background

Reflectance confocal microscopy (RCM) allows for non‐invasive, in vivo evaluation of skin lesions and it has been extensively applied in skin oncology although systematic studies on nevi characterization are still lacking.

Objective

The aim of this study was to determine whether reliable RCM correlates to histological features used to diagnose melanocytic neoplasms exist.

Methods

We blindly evaluated the RCM and histological features of 64 melanocytic neoplasms (19 non‐dysplastic nevi, 27 dysplastic nevi, 14 melanomas) and analysed the data using Spearman's rho calculation.

Results

Many histological features can be identified using RCM. Elongated rete ridges corresponded on RCM to edge papillae, whereas flattened rete ridges to several features which involve dermal–epidermal junction disruption. Bridging of junctional nesting (JN) corresponded on RCM to both JN with irregular size/shape and JN with short interconnections. While we could reliably identify dermal melanocytes, the RCM features did not reliably distinguish between benign and concerning dermal melanocytic arrangements, suggesting further refinement of dermal melanocytic RCM features is needed.

Conclusion

Reliable correlates for epidermal and junctional histological features used to diagnose melanocytic neoplasms are identifiable on RCM, suggesting harnessing histological criteria may be a reasonable method to move beyond the algorithmic approach.
Prosecutor Elections, Mistakes, and Appeals
Authors: McCannon Bryan C.
Published: October 2013

Prosecutors under common‐law tradition exercise a significant amount of discretion in the criminal justice system. In the United States, the dominant form of accountability is that prosecutors must be reelected by the voters. Recent empirical work illustrates that election concerns open up the potential for distortion in the decision making of prosecutors. Specifically, it has been shown that prosecutors take more cases to trial and plea bargain less when running for reelection. Does this hawkish behavior of prosecutors lead to inaccuracies in the criminal justice system? A panel data set of appellate decisions in western New York is analyzed. It is shown that if the initial felony conviction takes place in the six months prior to a reelection and is appealed, the probability that the appellate court upholds the lower court's decision decreases by 5.1–7.1 percentage points. Additional investigation into the types of mistakes made is done. Thus, the popular election of prosecutors results in inaccurate sentences, wrongful convictions, and, consequently, successful appeals.
Can You Buy Sperm Donor Identification? An Experiment
Authors: Cohen I. Glenn , Coan Travis G.
Published: October 2013

In the United States, most sperm donations are anonymous. By contrast, many developed nations require sperm donors to be identified, typically requiring new sperm (and egg) donors to put identifying information into a registry that is made available to a donor‐conceived child once he or she reaches the age of 18. Recently, advocates have pressed U.S. states to adopt these registries as well, and state legislatures have indicated openness to the idea. This study relies on a self‐selected convenience sample to experimentally examine the economic implications of adopting a mandatory sperm donor identification regime in the United States. Our results support the hypothesis that subjects in the treatment (nonanonymity) condition need to be paid significantly more, on average, to donate their sperm. When restricting our attention to only those subjects who would ever actually consider donating sperm, we find that individuals in the control condition are willing to accept an average of $43 to donate, while individuals in the treatment group are willing to accept an average of $74. These estimates suggest that it would cost roughly $31 per sperm donation, at least in our sample, to require donors to be identified. This price differential roughly corresponds to that of a major U.S. sperm bank that operates both anonymous and identity release programs in terms of what it pays donors.