bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidermal IL-15Rα acts as an endogenous antagonist of psoriasiform inflammation in mouse and man
Authors: Bouchaud Grégory , Gehrke Samuel , Krieg Carsten , Kolios Antonios , Hafner Jürg , Navarini Alexander A. , French Lars E. , Boyman Onur
Published: September 2013

Stromal cells at epithelial surfaces contribute to innate immunity by sensing environmental danger signals and producing proinflammatory cytokines. However, the role of stromal cells in controlling local inflammation is unknown. We show that endogenous soluble IL-15 receptor α (IL-15Rα) derived from epidermal stroma, notably keratinocytes, protects against dendritic cell/IL-15-mediated, T cell-driven skin inflammation in vivo, and is relevant to human psoriasis. Selective lack of IL-15Rα on stromal epidermal cells exacerbated psoriasiform inflammation in animals. Epidermal IL-15Rα was shed by keratinocytes via proteolytic cleavage by matrix metalloproteinases upon stimulation with proinflammatory cytokines to counteract IL-15–induced proliferation of IL-17+ αβ and γδ T cells and production of TNF, IL-23, IL-17, and IL-22 during skin inflammation. Notably, administration of soluble IL-15Rα was able to repress secretion of IL-1β, IL-6, and TNF by keratinocytes, dampen expansion of IL-17+ αβ and γδ T cells in vivo, and prevent psoriasis in two mouse models, including human xenograft AGR mice. Serum levels of soluble IL-15Rα negatively correlated with disease severity, and levels rose upon successful treatment of psoriasis in patients. Thus, stressed epidermal stromal cells use soluble IL-15Rα to dampen chronic inflammatory skin disease.
Intestinal lamina propria dendritic cells maintain T cell homeostasis but do not affect commensalism
Authors: Welty Nathan E. , Staley Christopher , Ghilardi Nico , Sadowsky Michael J. , Igyártó Botond Z. , Kaplan Daniel H.
Published: September 2013

Dendritic cells (DCs) in the intestinal lamina propria (LP) are composed of two CD103+ subsets that differ in CD11b expression. We report here that Langerin is expressed by human LP DCs and that transgenic human langerin drives expression in CD103+CD11b+ LP DCs in mice. This subset was ablated in huLangerin-DTA mice, resulting in reduced LP Th17 cells without affecting Th1 or T reg cells. Notably, cognate DC–T cell interactions were not required for Th17 development, as this response was intact in huLangerin-Cre I-Aβfl/fl mice. In contrast, responses to intestinal infection or flagellin administration were unaffected by the absence of CD103+CD11b+ DCs. huLangerin-DTA x BatF3−/− mice lacked both CD103+ LP DC subsets, resulting in defective gut homing and fewer LP T reg cells. Despite these defects in LP DCs and resident T cells, we did not observe alterations of intestinal microbial communities. Thus, CD103+ LP DC subsets control T cell homeostasis through both nonredundant and overlapping mechanisms.
Genetic population structure of European anchovy in the Mediterranean Sea and the Northeast Atlantic Ocean using sequence analysis of the mitochondrial DNA control region
Authors: Viñas Jordi , Sanz Núria , Peñarrubia Luis , Araguas Rosa-Maria , García-Marín José-Luis , Roldán Maria-Inés , Pla Carles
Published: September 2013

Viñas, J., Sanz, N., Peñarrubia, L., Araguas, R-M., García-Marín, J-L., Roldán, M-I., and Pla, C. 2014. Genetic population structure of European anchovy in the Mediterranean Sea and the Northeast Atlantic Ocean using sequence analysis of the mitochondrial DNA control region. – ICES Journal of Marine Science, 71: 391–397. The European anchovy (Engraulis encrasicolus) exhibits a complex population structure in the Mediterranean Sea and Northeast Atlantic Ocean. To resolve the population genetic structure of this species, we surveyed sequence variability in the mitochondrial (mtDNA) control region in samples (n = 563) from 13 locations in the Northeast Atlantic, the Bay of Biscay, and the Mediterranean Sea. Based on pairwise ΦSTs, SAMOVA, and multidimensional scaling, a complicated population structure composed of multiple populations emerged. Combining these results with those from previous population studies based on mitochondrial and nuclear markers, we identified nine genetically differentiated European anchovy populations: (i) Canary Islands; (ii) Cádiz; (iii) Alborán Sea; (iv) Garona; (v) Arcachon and Donostia; (vi) a large population in the northwestern Mediterranean, including Cadaqués, Gulf of Lyon, Elba, and Sicily; (vii) southern Adriatic; (viii) northern Adriatic; and (ix) Aegean Sea. We suggest that independent management strategies should be implemented for each genetically differentiated population, and, in cases where several fisheries stocks are recognized within an area of genetic homogeneity, each stock should be managed separately.
Transcriptional control by two interacting regulatory proteins: identification of the PtxS binding site at PtxR
Authors: Daddaoua Abdelali , Krell Tino , Ramos Juan-Luis
Published: September 2013

The PtxS and PtxR regulators control the expression of the glucose dehydrogenase genes from the Pgad promoter in Pseudomonas aeruginosa. These regulators bind to their cognate operators, that are separated by ∼50 nt, within the promoter region and interact with each other creating a DNA-loop that prevents RNA polymerase promoter access. Binding of the 2-ketogluconate effector to PtxS caused PtxS/PtxR complex dissociation and led to the dissolution of the repression loop facilitating the entry of the RNA polymerase and enabling the transcription of the gad gene. We have identified a hydrophobic surface patch on the PtxR putative surface that was hypothesized to correspond to the binding site for PtxS. Two surface-exposed residues in this patch, V173 and W269, were replaced by alanine. Isothermal titration calorimetry assays showed that PtxS does not interact with the mutant variants of PtxR. Electrophoretic mobility shift assay and DNAase I footprinting assays proved that both regulators bind to their target operators and that failure to interact with each other prevented the formation of the DNA-loop. In vitro transcription showed that PtxS per se is sufficient to inhibit transcription from the Pgad promoter, but that affinity of PtxS for its effector is modulated by PtxR.
On the biophysics and kinetics of toehold-mediated DNA strand displacement
Authors: Srinivas Niranjan , Ouldridge Thomas E. , Šulc Petr , Schaeffer Joseph M. , Yurke Bernard , Louis Ard A. , Doye Jonathan P. K. , Winfree Erik
Published: September 2013

Dynamic DNA nanotechnology often uses toehold-mediated strand displacement for controlling reaction kinetics. Although the dependence of strand displacement kinetics on toehold length has been experimentally characterized and phenomenologically modeled, detailed biophysical understanding has remained elusive. Here, we study strand displacement at multiple levels of detail, using an intuitive model of a random walk on a 1D energy landscape, a secondary structure kinetics model with single base-pair steps and a coarse-grained molecular model that incorporates 3D geometric and steric effects. Further, we experimentally investigate the thermodynamics of three-way branch migration. Two factors explain the dependence of strand displacement kinetics on toehold length: (i) the physical process by which a single step of branch migration occurs is significantly slower than the fraying of a single base pair and (ii) initiating branch migration incurs a thermodynamic penalty, not captured by state-of-the-art nearest neighbor models of DNA, due to the additional overhang it engenders at the junction. Our findings are consistent with previously measured or inferred rates for hybridization, fraying and branch migration, and they provide a biophysical explanation of strand displacement kinetics. Our work paves the way for accurate modeling of strand displacement cascades, which would facilitate the simulation and construction of more complex molecular systems.
Selection of visual information for lightness judgements by eye movements
Authors: Toscani Matteo , Valsecchi Matteo , Gegenfurtner Karl R.
Published: September 2013

When judging the lightness of objects, the visual system has to take into account many factors such as shading, scene geometry, occlusions or transparency. The problem then is to estimate global lightness based on a number of local samples that differ in luminance. Here, we show that eye fixations play a prominent role in this selection process. We explored a special case of transparency for which the visual system separates surface reflectance from interfering conditions to generate a layered image representation. Eye movements were recorded while the observers matched the lightness of the layered stimulus. We found that observers did focus their fixations on the target layer, and this sampling strategy affected their lightness perception. The effect of image segmentation on perceived lightness was highly correlated with the fixation strategy and was strongly affected when we manipulated it using a gaze-contingent display. Finally, we disrupted the segmentation process showing that it causally drives the selection strategy. Selection through eye fixations can so serve as a simple heuristic to estimate the target reflectance.
Reach preparation enhances visual performance and appearance
Authors: Rolfs Martin , Lawrence Bonnie M. , Carrasco Marisa
Published: September 2013

We investigated the impact of the preparation of reach movements on visual perception by simultaneously quantifying both an objective measure of visual sensitivity and the subjective experience of apparent contrast. Using a two-by-two alternative forced choice task, observers compared the orientation (clockwise or counterclockwise) and the contrast (higher or lower) of a Standard Gabor and a Test Gabor, the latter of which was presented during reach preparation, at the reach target location or the opposite location. Discrimination performance was better overall at the reach target than at the opposite location. Perceived contrast increased continuously at the target relative to the opposite location during reach preparation, that is, after the onset of the cue indicating the reach target. The finding that performance and appearance do not evolve in parallel during reach preparation points to a distinction with saccade preparation, for which we have shown previously there is a parallel temporal evolution of performance and appearance. Yet akin to saccade preparation, this study reveals that overall reach preparation enhances both visual performance and appearance.
Modelling eye movements in a categorical search task
Authors: Zelinsky Gregory J. , Adeli Hossein , Peng Yifan , Samaras Dimitris
Published: September 2013

We introduce a model of eye movements during categorical search, the task of finding and recognizing categorically defined targets. It extends a previous model of eye movements during search (target acquisition model, TAM) by using distances from an support vector machine classification boundary to create probability maps indicating pixel-by-pixel evidence for the target category in search images. Other additions include functionality enabling target-absent searches, and a fixation-based blurring of the search images now based on a mapping between visual and collicular space. We tested this model on images from a previously conducted variable set-size (6/13/20) present/absent search experiment where participants searched for categorically defined teddy bear targets among random category distractors. The model not only captured target-present/absent set-size effects, but also accurately predicted for all conditions the numbers of fixations made prior to search judgements. It also predicted the percentages of first eye movements during search landing on targets, a conservative measure of search guidance. Effects of set size on false negative and false positive errors were also captured, but error rates in general were overestimated. We conclude that visual features discriminating a target category from non-targets can be learned and used to guide eye movements during categorical search.
The relationship between visual working memory and attention: retention of precise colour information in the absence of effects on perceptual selection
Authors: Hollingworth Andrew , Hwang Seongmin
Published: September 2013

We examined the conditions under which a feature value in visual working memory (VWM) recruits visual attention to matching stimuli. Previous work has suggested that VWM supports two qualitatively different states of representation: an active state that interacts with perceptual selection and a passive (or accessory) state that does not. An alternative hypothesis is that VWM supports a single form of representation, with the precision of feature memory controlling whether or not the representation interacts with perceptual selection. The results of three experiments supported the dual-state hypothesis. We established conditions under which participants retained a relatively precise representation of a parcticular colour. If the colour was immediately task relevant, it reliably recruited attention to matching stimuli. However, if the colour was not immediately task relevant, it failed to interact with perceptual selection. Feature maintenance in VWM is not necessarily equivalent with feature-based attentional selection.
Memory and prediction in natural gaze control
Authors: Diaz Gabriel , Cooper Joseph , Hayhoe Mary
Published: September 2013

In addition to stimulus properties and task factors, memory is an important determinant of the allocation of attention and gaze in the natural world. One way that the role of memory is revealed is by predictive eye movements. Both smooth pursuit and saccadic eye movements demonstrate predictive effects based on previous experience. We have previously shown that unskilled subjects make highly accurate predictive saccades to the anticipated location of a ball prior to a bounce in a virtual racquetball setting. In this experiment, we examined this predictive behaviour. We asked whether the period after the bounce provides subjects with visual information about the ball trajectory that is used to programme the pursuit movement initiated when the ball passes through the fixation point. We occluded a 100 ms period of the ball's trajectory immediately after the bounce, and found very little effect on the subsequent pursuit movement. Subjects did not appear to modify their strategy to prolong the fixation. Neither were we able to find an effect on interception performance. Thus, it is possible that the occluded trajectory information is not critical for subsequent pursuit, and subjects may use an estimate of the ball's trajectory to programme pursuit. These results provide further support for the role of memory in eye movements.
Control of the superior colliculus by the lateral prefrontal cortex
Authors: Everling Stefan , Johnston Kevin
Published: September 2013

Several decades of patient, functional imaging and neurophysiological studies have supported a model in which the lateral prefrontal cortex (PFC) acts to suppress unwanted saccades by inhibiting activity in the oculomotor system. However, recent results from combined PFC deactivation and neural recordings of the superior colliculus in monkeys demonstrate that the primary influence of the PFC on the oculomotor system is excitatory, and stands in direct contradiction to the inhibitory model of PFC function. Although erroneous saccades towards a visual stimulus are commonly labelled reflexive in patients with PFC damage or dysfunction, the latencies of most of these saccades are outside of the range of express saccades, which are triggered directly by the visual stimulus. Deactivation and pharmacological manipulation studies in monkeys suggest that response errors following PFC damage or dysfunction are not the result of a failure in response suppression but can best be understood in the context of a failure to maintain and implement the proper task set.
Evidence for differential top-down and bottom-up suppression in posterior parietal cortex
Authors: Mirpour Koorosh , Bisley James W.
Published: September 2013

When searching for an object, we usually avoid items that are visually different from the target and objects or places that have been searched already. Previous studies have shown that neural activity in the lateral intraparietal area (LIP) can be used to guide this behaviour; responses to task irrelevant stimuli or to stimuli that have been fixated previously in the trial are reduced compared with responses to potential targets. Here, we test the hypothesis that these reduced responses have a different genesis. Two animals were trained on a visual foraging task, in which they had to find a target among a number of physically identical potential targets (T) and task irrelevant distractors. We recorded neural activity and local field potentials (LFPs) in LIP while the animals performed the task. We found that LFP power was similar for potential targets and distractors but was greater in the alpha and low beta bands when a previously fixated T was in the response field. We interpret these data to suggest that the reduced single-unit response to distractors is a bottom-up feed-forward result of processing in earlier areas and the reduced response to previously fixated Ts is a result of active top-down suppression.
Neural chronometry and coherency across speed–accuracy demands reveal lack of homomorphism between computational and neural mechanisms of evidence accumulation
Authors: Heitz Richard P. , Schall Jeffrey D.
Published: September 2013

The stochastic accumulation framework provides a mechanistic, quantitative account of perceptual decision-making and how task performance changes with experimental manipulations. Importantly, it provides an elegant account of the speed–accuracy trade-off (SAT), which has long been the litmus test for decision models, and also mimics the activity of single neurons in several key respects. Recently, we developed a paradigm whereby macaque monkeys trade speed for accuracy on cue during visual search task. Single-unit activity in frontal eye field (FEF) was not homomorphic with the architecture of models, demonstrating that stochastic accumulators are an incomplete description of neural activity under SAT. This paper summarizes and extends this work, further demonstrating that the SAT leads to extensive, widespread changes in brain activity never before predicted. We will begin by reviewing our recently published work that establishes how spiking activity in FEF accomplishes SAT. Next, we provide two important extensions of this work. First, we report a new chronometric analysis suggesting that increases in perceptual gain with speed stress are evident in FEF synaptic input, implicating afferent sensory-processing sources. Second, we report a new analysis demonstrating selective influence of SAT on frequency coupling between FEF neurons and local field potentials. None of these observations correspond to the mechanics of current accumulator models.
Characterization of self-assembled virus-like particles of ferret hepatitis E virus generated by recombinant baculoviruses
Authors: Yang Tingting , Kataoka Michiyo , Ami Yasushi , Suzaki Yuriko , Kishida Noriko , Shirakura Masayuki , Imai Masaki , Asanuma Hideki , Takeda Naokazu , Wakita Takaji , Li Tian-Cheng
Published: September 2013

Ferret hepatitis E virus (HEV), a novel hepatitis E-like virus, has been identified in ferrets in The Netherlands. Due to the lack of a cell-culture system for ferret HEV, the antigenicity, pathogenicity and epidemiology of this virus have remained unclear. In the present study, we used a recombinant baculovirus expression system to express the 112-N-terminus and 47-C-terminus-amino-acid-truncated ferret HEV ORF2 protein in insect Tn5 cells, and found that a large amount of a 53 kDa protein (F-p53) was expressed and efficiently released into the supernatant. Electron microscopic analysis revealed that F-p53 was self-assembled into virus-like particles (ferret HEV-LPs). These ferret HEV-LPs were estimated to be 24 nm in diameter, which is similar to the size of G1, G3, G4 and rat HEV-LPs derived from both the N-terminus- and C-terminus-truncated constructs. Antigenic analysis demonstrated that ferret HEV-LPs were cross-reactive with G1, G3, G4 and rat HEVs, and rat HEV and ferret HEV showed a stronger cross-reactivity to each other than either did to human HEV genotypes. However, the antibody against ferret HEV-LPs does not neutralize G3 HEV, suggesting that the serotypes of these two HEVs are different. An ELISA for detection of anti-ferret HEV IgG and IgM antibodies was established using ferret HEV-LPs as antigen, and this assay system will be useful for monitoring ferret HEV infection in ferrets as well as other animals. In addition, analysis of ferret HEV RNA detected in ferret sera collected from a breeding colony in the USA revealed the genetic diversity of ferret HEV.
Lack of the host membrane protease FtsH hinders release of the Lactococcus lactis bacteriophage TP712
Authors: Roces Clara , Wegmann Udo , Campelo Ana B. , García Pilar , Rodríguez Ana , Martínez Beatriz
Published: September 2013

The temperate bacteriophage TP712 was unable to plaque on Lactococcus lactis ΔftsH lacking the membrane protease FtsH and complementation in trans restored the WT phenotype. Absence of ftsH did not hinder phage adsorption, phage DNA delivery or activation of the lytic cycle. Thin sections revealed that TP712 virions appeared to be correctly assembled inside the ΔftsH host, but were not released. These virions were infective, demonstrating that a functional host FtsH is required by TP712 to proceed effectively with lysis of the host.
Off to Plan or Out to Lunch? Relationships between Design Characteristics and Outcomes of Strategy Workshops
Authors: Healey Mark P. , Hodgkinson Gerard P. , Whittington Richard , Johnson Gerry
Published: September 2013

Strategy workshops, also known as away days, strategy retreats and strategic ‘off‐sites’, have become widespread in organizations. However, there is a shortage of theory and evidence concerning the outcomes of these events and the factors that contribute to their effectiveness. Adopting a design science approach, in this paper we propose and test a multidimensional model that differentiates the effects of strategy workshops in terms of organizational, interpersonal and cognitive outcomes. Analysing survey data on over 650 workshops, we demonstrate that varying combinations of four basic design characteristics – clarity of goals and purpose, routinization, stakeholder involvement and cognitive effort – predict differentially these three distinct types of outcomes. Calling into question conventional wisdom on the design of workshops, we discuss the implications of our findings for integrating further the strategy process, strategy‐as‐practice and strategic cognition literatures, to enrich understanding of the factors that shape the nature and influence of contemporary strategic planning activities more generally.
Taking blood cultures from a newly established intravenous catheter in the emergency department does not increase the rate of contaminated blood cultures
Authors: Kelly Anne‐Maree , Klim Sharon
Published: September 2013

Objective

It has been suggested that blood cultures drawn from vascular catheters have a higher false positive rate than those drawn by venepuncture. In the face of institutionally imposed practice change prohibiting obtaining blood cultures from intravenous (i.v.) catheters in the ED, our aim of was to compare the rate of contaminated blood cultures between those taken from recently placed i.v. catheters and those taken by direct venepuncture.

Method

Prospective, non‐randomised, observational study comparing the rate of contaminated blood cultures for specimens taken from recently placed (<1 h) i.v. catheters and direct venepuncture in adult ED patients. Outcome of interest was the rate of false positive cultures. Analysis was by comparison of proportions (χ2‐test).

Results

Four hundred seventy‐two blood culture sets were studied. There were 65 positive cultures, of which 49 (75%; 95% confidence interval [CI], 63–85%) were classified as true positive. The overall rate of contaminated blood cultures was 3.4% (95% CI, 2.0–5.6%). There was no difference in false positive rate between blood cultures taken via venepuncture and those taken from a recently placed i.v. cannula (P = 0.52; odds ratio, 0.9; 95% CI, 0.33–2.44).

Conclusion

We found no difference in contaminated blood culture rate between recently placed i.v. catheters and direct venepuncture when infection control procedures were followed.
Between principle and compromise: We are all meat in someone else's sandwich
Authors: Nydam Kees
Published: September 2013

Clinical leadership and workforce management are high profile topics in many recent healthcare journals and frequently the focus of discussion in this sectors dynamic environment. Emergency physicians, like their cousins in other medical specialties, are required to work collaboratively within an increasingly complex system in order to optimise the clinical outcomes of their patients. This article presents a reflective analysis using a fictional character, Ulysses, who encounters traps and potholes in his journey to clinical leadership and management enlightenment.
Improvement in emergency department length of stay using an early senior medical assessment and streaming model of care: A cohort study
Authors: Asha Stephen Edward , Ajami Allan
Published: September 2013

Objective

Australian EDs are required to conform to the National Emergency Access Target (NEAT): patients must be discharged within 4 h of arrival. The aim of the present study was to determine if a model of care called Senior Assessment and Streaming (SAS) would increase the proportion of patients achieving NEAT.

Methods

Stable, ambulant patients considered to have problems that early consultant‐level assessment was likely to improve processing efficiency were streamed through a dedicated clinical area staffed by an ED physician, intern and nurse. The proportion of patients achieving NEAT were compared between days with or without SAS, adjusted for confounding variables.

Results

The 18 962 patients presented during the study, 6828 on days with SAS, 12 134 on days without. On days with SAS, there were more presentations, more admissions, lower access to ward beds and fewer staff working hours. After controlling for confounding, the odds of meeting NEAT on days with SAS was 15% higher compared with days without (odds ratio, 1.15; 95% confidence interval [CI], 1.07–1.24; P < 0.001). For the subgroups of patients admitted, discharged, triage category 3, 4, 5, or presentation 12.00–18.00 the odds of meeting NEAT on days with SAS was, respectively, 1.10 (95% CI, 0.98–1.23; P = 0.10), 1.17 (95% CI, 1.07–1.28; P < 0.001), 1.17 (95% CI, 1.08–1.27; P < 0.001) and 1.19 (95% CI, 1.06–1.35; P = 0.003). The odds of a patient not waiting to be seen on days with SAS was 28% lower compared with days without (odds ratio, 0.72; 95% CI, 0.58–0.90; P = 0.003).

Conclusion

Through the introduction of SAS, the present study has demonstrated that providing early senior medical assessment can improve an ED's ability to meet NEAT.
Licorice‐Induced Severe Hypokalemia with Recurrent Torsade de Pointes
Authors: Panduranga Prashanth , Al‐Rawahi Najib
Published: September 2013

A 38‐year‐old obese woman presented with recurrent polymorphic ventricular tachycardia secondary to persistent hypokalemia necessitating more than 40 DC shocks. All endocrine investigations for hypokalemia were negative with impression of “mysterious hypokalemia.” On repeated inquiry, a hidden history of licorice use was elicited causing persistent hypokalemia. The case highlights a life threatening complication of licorice use. In addition, it reiterates the importance of repeated history taking in a patient with undiagnosed hypokalemia and torsade de pointes which avoided a device therapy.
Right‐Ventricular Enlargement in Arrhythmogenic Right‐Ventricular Cardiomyopathy Is Associated with Decreased QRS Amplitudes and T‐Wave Negativity
Authors: Zusterzeel Robbert , ter Bekke Rachel M.A. , Volders Paul G.A. , Leijten Farah M.M. , van den Wijngaard Arthur , Serroyen Jan , Gorgels Anton P.M.
Published: September 2013

Background

Arrhythmogenic right‐ventricular cardiomyopathy (ARVC) can lead to RV dilatation. We hypothesized that electrocardiographic characteristics including QRS amplitudes in the extremity‐ and precordial leads, the S amplitude in lead V1, and extent of T‐wave negativity over the precordial leads are related to RV dilatation in this condition.

Methods

In 42 ARVC patients and 42 controls, we correlated total QRS amplitude in the extremity leads (∑QRSext), precordial leads (∑QRSprec) and in all leads (∑QRStot : summation of ∑QRSext and ∑QRSprec), S amplitude in lead V1 and the extent of T‐wave inversion in the precordial leads (V1 vs. beyond V1) with RV end diastolic diameter (RVEDD) by echocardiography.

Results

In the ARVC group, the mean age was 46 ± 14 years, 31 patients were male, 28 had an implantable cardioverter defibrillator (ICD), and 7 had a LV ejection fraction (EF) < 55%. The control group was age‐ and gender matched to the ARVC cohort. In contrast to controls, the ∑QRSext (regression coefficient (RC), −0.29; P = 0.020), ∑QRSprec (RC, −0.20; P = 0.015), and ∑QRStot (RC, −0.14; P = 0.009) were lower with RV dilatation in ARVC. S amplitude in lead V1 was not related to RV diameter (RC, −0.98; P = 0.088). Precordial T‐wave inversion beyond lead V1 (V2‐V6) was associated with a larger RV diameter (RC, 8.58; P = 0.012).

Conclusions

Summed QRS amplitudes in the extremity and precordial leads, and T‐wave inversion beyond lead V1 are associated with RV dilatation in patients with ARVC.
Vagal Enhancement Linking Abnormal Blood Pressure Response and Subendocardial Ischemia in Hypertrophic Cardiomyopathy
Authors: Kawasaki Tatsuya , Sugihara Hiroki
Published: September 2013

An abnormal blood pressure response to exercise has been reported to be associated with left ventricular subendocardial ischemia in patients with hypertrophic cardiomyopathy (HCM), but the underlying mechanism remains unclear. We report a case of HCM with an abnormal blood pressure response and subendocardial ischemia, in which the analysis of heart rate variability revealed exercise‐induced vagal enhancement. The present case highlights the possible mechanism linking abnormal blood pressure response and left ventricular subendocardial ischemia in patients with HCM.
EKG Pattern of Brugada Syndrome and Sudden Infant Death Syndrome—Is It Time to Review the Diagnostic Criteria? Case Report and Review of Literature
Authors: Franco Emiliana , Dias Andre , Teresa Daniele , Hebert Kathy
Published: September 2013

Brugada Syndrome (BrS) is a cardiac disorder characterized by incomplete right bundle‐branch block and ST elevations in the anterior precordial leads especially V1–V3, associated with an increased risk for sudden cardiac death (SCD) in young adults. Our case describes a patient with family history of sudden infant death syndrome (SIDS) who presented with a Brugada pattern unmasked by severe hyperkalemia and diabetic ketoacidosis. Several studies have concluded there may be a genetic link among SIDS, SDC, and BrS resulting from mutations in cardiac ion channel‐related genes. Recognizing SIDS as part of the diagnostic criteria for BrS would help us identifying a significant number of families susceptible to develop SCD (as well as SIDS).
Inhibitors of the Arachidonic Acid Cascade: Interfering with Multiple Pathways
Authors: Meirer Karin , Steinhilber Dieter , Proschak Ewgenij
Published: September 2013

Modulators of the arachidonic acid cascade have been in the focus of research for treatments of inflammation and pain for several decades. Targeting this complex pathway experiences a paradigm change towards the design and development of multi‐target inhibitors, exhibiting improved efficacy and less undesired side effects. This minireview summarizes recent developments in the field of designed multi‐target ligands of the arachidonic acid cascade. In addition to the well‐known dual inhibitors of 5‐lipoxygenase and cyclooxygenase‐2 such as licofelone, very recent developments are discussed. Especially, multi‐target inhibitors interfering with the cytochrome P450 pathway via inhibition of soluble epoxide hydrolase seem to offer a novel opportunity for development of novel anti‐inflammatory drugs.
Correlation between Global Longitudinal Strain and QRS Voltage on Electrocardiogram in Patients with Left Ventricular Hypertrophy
Authors: Beladan Carmen C. , Popescu Bogdan A. , Calin Andreea , Rosca Monica , Matei Florin , Gurzun Maria‐Magdalena , Popara Anca V. , Curea Fabiana , Ginghina Carmen
Published: September 2013

Purpose

Left ventricular hypertrophy (LVH) is as an independent risk factor. Discrepancies were reported between LV mass (LVM) estimated by echocardiography and electrocardiography (ECG) findings. We hypothesized that QRS voltage criteria may reflect not only anatomical changes (LVM) but also changes in LV function and we tested the relationship between QRS voltage and echocardiographic parameters of LV function in patients (pts) with different types of LVH.

Methods

We prospectively enrolled pts with LVH and preserved ejection fraction (LVEF >50%): 20 pts with isolated arterial hypertension, HTN, 20 pts with severe aortic stenosis, AS (indexed aortic valve area <0.6 cm2/m2), and 20 pts with symmetric hypertrophic cardiomyopathy, HCM. Standard 12‐lead ECG (including Sokolow and Cornell voltage indices) and a comprehensive two‐dimensional (2D) echocardiography were performed in all. Left ventricular mass was calculated according to Devereux formula. Global longitudinal strain (GLS) was assessed by speckle tracking echocardiography.

Results

A significant correlation was found between both ECG indices and LVM assessed by echocardiography. Moreover, significant correlations were found between Sokolow–Lyon voltage and LVEF (r = 0.26; P = 0.03), GLS (r = 0.59; P < 0.001) and E/e' average (r = 0.43; P < 0.001). Cornell voltage index correlated significantly only with GLS. In multivariable analysis GLS emerged as the only independent correlate of both Sokolow–Lyon (ß = 0.6, P < 0.001) and Cornell voltage indices (ß = 0.45, P < 0.001).

Conclusion

These findings suggest that in pts with LVH, ECG should no longer be used only as a surrogate method for LVM estimation (structural changes only), but rather as an investigation complementary to imaging, incorporating information on overall LV remodeling (changes in structure and function).
Cassava stems: a new resource to increase food and fuel production
Authors: Zhu Wanbin , Lestander Torbjörn A. , Örberg Håkan , Wei Maogui , Hedman Björn , Ren Jiwei , Xie Guanghui , Xiong Shaojun
Published: September 2013

Given the growing global population, mankind must find new ways to lower competition for land between food and fuel production. Our findings for cassava suggest that this important crop can substantially increase the combined production of both food and fuel. Cassava stems have previously been overlooked in starch and energy production. These food‐crop residues contain about 30% starch (dry mass) mostly in the xylem rather than phloem tissue. Up to 15% starch of the stem dry mass can be extracted using simple water‐based techniques, potentially leading to an 87% increase in global cassava starch production. The integration of biofuel production, using residues and wastewater from starch extraction, may bring added value. The cassava roots on which biofuels and other products are based can be replaced by cassava stems without land use expansion, making root starch available as food for additional 30 million people today.
Transonic, thermodilution, or ionic dialysance to manage vascular access: Which method is best?
Authors: Badr Bouchra , Bories Pierre , Marais Richard , Frat Béatrice , Seigneuric Bruno , Longlune Nathalie , Kamar Nassim , Maggioni Sébastien , Rostaing Lionel
Published: September 2013

Regularly monitoring blood flow through a vascular access (Qa) can predict a dysfunction and dramatically reduce the number of thromboses. The aim of our study was to compare two integrated access flow devices, thermodilution (Qa‐BTM: BTM®, Fresenius Medical Care, Bad Homburg, Germany) and ionic dialysance (Qa‐ID: OCM®, Fresenius Medical Care, Bad Homburg, Germany), with the “gold standard” saline dilution (Qa‐T: Transonic®, Systems Inc., Ithaca, NY, USA). Measurements were performed sequentially and were repeated in the first 90 minutes of a single dialysis session in 24 long‐term hemodialysis patients with a vascular access. Bland–Altman, linear regression (r2), and intraclass correlation coefficients (ICC) assessed reproducibility, correlations, and concordance between the techniques. Average access flow for Qa‐T was 1549 (± 844) mL/minute, Qa‐BTM was 1530 (± 856) mL/minute (P = NS), and Qa‐ID was 1619 (± 1085) mL/minute (P = NS). Respectively, ICC, (r2), and bias were 0.99, (0.98), and −19 mL/minute for Qa‐BTM, and 0.75, (0.65), and +69 mL/minute for Qa‐ID. The limits of agreement were −287 to +250 mL/minute for Qa‐BTM and −1647 to +1785 mL/minute for Qa‐ID. Reproducibility of thermodilution and ionic dialysance, expressed as relative differences, was not significantly different from saline dilution. Recirculation, measured by saline dilution, was 0% (0–4%), the same as the 0% measured by thermodilution, with correct placement of bloodlines and corrected for cardiopulmonary recirculation. The integrated access flow measurement devices, thermodilution and ionic dialysance, are reasonable alternatives to using saline dilution to measure Qa: Thermodilution showed better precision and correlation. They are reliable, make monitoring of vascular access easier, incur no extra costs, and use no additional consumables.
Objectively measured and self‐reported nonadherence among Jordanian patients receiving hemodialysis
Authors: Khalil Amani A. , Darawad Mohammad Waleed
Published: September 2013

This study assessed nonadherence behavior to diet and fluid restrictions and examined the association between nonadherence behavior and demographic and clinical characteristics among Jordanian adults with end‐stage renal disease receiving hemodialysis. A descriptive, correlational, cross‐sectional design was used. The patients were interviewed within the first 90 minutes of dialysis session using the Dialysis Dietary and Fluid Nonadherence questionnaire (DDFQ). Demographic and clinical data were gathered from the patients and the medical records. The objective markers of dietary and fluid nonadherence (potassium, phosphorus, blood urea nitrogen, and interdialytic weight gain) were followed for the last 3 months, and average values were calculated. Diet and fluid nonadherence was common among Jordanian hemodialysis patients as 17–80% were nonadherent using different measures. Significant strong associations were found between the DDFQ subscales, and significant moderate associations between DDFQ and objective markers of dietary and fluid nonadherence. Youth, male gender, smokers, prolonged dialysis vintage, and less residual renal function were associated with nonadherence regardless of the measures used. There was substantial consistency between the DDFQ and objective measures of dietary and fluid nonadherence among Jordanian adults with end‐stage renal disease receiving hemodialysis. Future interventional research should incorporate DDFQ and objective markers to measure dietary and fluid nonadherence and health‐related outcomes.
Calcific mitral stenosis in the hemodialysis patient
Authors: Sequeira Adrian , Morris Liam , Patel Brijesh , Duvall Lucas , Gali Deepa , Menendez Denisse , Alexander Guy
Published: September 2013

The dialysis patient is prone to elevations in the calcium phosphorus product and hyperparathyroidism, which contributes to valvular and vascular calcification. We present the case of a young lady on chronic dialysis that developed mitral calcification complicated by severe mitral stenosis, caseous calcification and retinal embolization. She subsequently required mitral valve replacement.
Randomized, Multicenter, Comparative Study of NEURO versus CIMT in Poststroke Patients with Upper Limb Hemiparesis: The NEURO-VERIFY Study
Authors: Abo Masahiro , Kakuda Wataru , Momosaki Ryo , Harashima Hiroaki , Kojima Miki , Watanabe Shigeto , Sato Toshihiro , Yokoi Aki , Umemori Takuma , Sasanuma Jinichi
Published: September 2013

Background

Many poststroke patients suffer functional motor limitation of the affected upper limb, which is associated with diminished health-related quality of life.

Aims

The aim of this study is to conduct a randomized, multicenter, comparative study of low-frequency repetitive transcranial magnetic stimulation combined with intensive occupational therapy, NEURO (NovEl intervention Using Repetitive TMS and intensive Occupational therapy) versus constraint-induced movement therapy in poststroke patients with upper limb hemiparesis.

Methods

In this randomized controlled study of NEURO and constraint-induced movement therapy, 66 poststroke patients with upper limb hemiparesis were randomly assigned at 2:1 ratio to low-frequency repetitive transcranial magnetic stimulation plus occupational therapy (NEURO group) or constraint-induced movement therapy (constraint-induced movement therapy group) for 15 days. Fugl–Meyer Assessment and Wolf Motor Function Test and Functional Ability Score of Wolf Motor Function Test were used for assessment.

Results

No differences in patients' characteristics were found between the two groups at baseline. The Fugl–Meyer Assessment score was significantly higher in both groups after the 15-day treatment compared with the baseline. Changes in Fugl–Meyer Assessment scores and Functional Ability Score of Wolf Motor Function Test were significantly higher in the NEURO group than in the constraint-induced movement therapy group, whereas the decrease in the Wolf Motor Function Test log performance time was comparable between the two groups (changes in Fugl–Meyer Assessment score, NEURO: 5·39 ± 4·28, constraint-induced movement therapy: 3·09 ± 4·50 points; mean ± standard error of the mean; P < 0·05) (changes in Functional Ability Score of Wolf Motor Function Test, NEURO: 3·98 ± 2·99, constraint-induced movement therapy: 2·09 ± 2·96 points; P < 0·05).

Conclusions

The results of the 15-day rehabilitative protocol showed the superiority of NEURO relative to constraint-induced movement therapy; NEURO improved the motion of the whole upper limb and resulted in functional improvement in activities of daily living.
18‐month outcomes of a community‐based treatment for childhood obesity
Authors: Foster G. D. , Sundal D. , Lent M. R. , McDermott C. , Jelalian E. , Vojta D.
Published: September 2013

Background

Few studies have evaluated community‐based interventions for childhood obesity and even fewer provide efficacy data 1 year later.

Objectives

This study assessed changes in relative weight 1 year after a 6‐month treatment for childhood obesity.

Methods

Participants were 155 overweight/obese children/adolescents and their caregivers. The primary outcome was change in child percent over body mass index (BMI) from 6 to 18 months. The primary outcome was also assessed from 0 to 18 months and changes in secondary outcomes (BMI z‐score, guardian weight, health‐related quality of life [HRQoL]) were examined from 6–18 to 0–18 months.

Results

From 6 to 18 months, there were no significant changes in any outcome. From 0 to 18 months, there were improvements in BMI z‐score (P < 0.001), HRQoL (P < 0.001) and guardian weight (P = 0.02).

Conclusions

Changes in relative weight and HRQoL observed after 6 months persisted 1 year later. The programme produced reductions in BMI z‐score and obesity prevalence but not in percent over BMI from 0 to 18 months.
Role of insulin sensitivity and beta cell function in the development of periodontal disease in adults without diabetes
Authors: Timonen Petra , Saxlin Tuomas , Knuuttila Matti , Suominen Anna Liisa , Jula Antti , Tervonen Tellervo , Ylöstalo Pekka
Published: September 2013

Aim

The goal of this study was to explore whether insulin resistance and beta cell function are related to periodontal pocket formation, indicative of infectious periodontal disease in non‐smoking adults without manifest diabetes.

Material and Methods

We analysed data from a Health 2000 Survey consisting of dentate subjects without any indication of diabetes, aged between 30 and 64, who had never smoked and who had participated in the Follow‐up Study on Finnish Adults' Oral Health about 4 years later (n = 157). The Homeostasis Model Assessment Indices were used to measure insulin resistance (HOMA‐IR) and β‐cell function (HOMA‐B). The development of periodontal disease was measured by means of the incidence of deepened periodontal pockets (4 mm deep or deeper) during the follow‐up period. Incidence rate ratios (IRR) were estimated using Poisson regression models.

Results

Both HOMA‐IR and HOMA‐B indices were associated with periodontal pocket formation during the 4‐year follow‐up.

Conclusion

The results of this follow‐up study suggest that impaired glucose metabolism measured as insulin resistance and altered beta cell function predict the breakdown of periodontal tissues. Further studies about their role in the pathogenesis of periodontal diseases are needed.
Are obesity and overweight associated with gingivitis occurrence in Brazilian schoolchildren?
Authors: Nascimento Gustavo G. , Seerig Lenise M. , Vargas‐Ferreira Fabiana , Correa Fernanda O. B. , Leite Fábio R. M. , Demarco Flávio F.
Published: September 2013

Aim

This cross‐sectional study aimed to assess the relationship between weight status and gingival inflammation in Brazilian schoolchildren aged 8‐ to 12‐year old, when controlling for potential confounders.

Methods

Overall, 1211 children aged 8‐ to 12‐year old from public and private schools in Southern Brazil were selected by a two‐stage cluster method. Questionnaires were used to assess socio‐demographic data and oral hygiene habits. Oral examination evaluated presence of plaque and gingival bleeding. Anthropometric measures were collected to obtain body mass index. Multivariate Poisson regression was used for data analysis (Prevalence Ratio/95% Confidence Interval).

Results

Prevalence of gingivitis was 44.0%. Mean and median values of gingival bleeding sites were 3.10 and 2.0 respectively. Obese/overweight children totalized 34.6%. In multivariate adjusted analysis, sex (PR 0.86; 95%CI 0.75;0.98), maternal schooling (PR 1.09; 95% CI 1.01;1.18), plaque (PR 1.37; 95% CI 1.26;1.50), dental caries experience (PR 1.16; 95% CI 1.01;1.36) and bleeding during tooth brushing (PR 1.27; 95% CI 1.11;1.48) were associated with the outcome. In the sex‐stratified analysis, overweight/obese boys presented a greater risk for gingivitis (PR 1.22 95% CI 1.01;1.48).

Conclusions

Gingivitis was not associated with obesity/overweight in the total sample. Gender differences seem to influence the relationship between gingivitis and obesity/overweight; a stronger association was noted among boys than girls.