bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors for nephrology outpatient care and recurrence of acute kidney injury (AKI) after an in‐hospital AKI episode
Authors: Xie Mingyang , Iqbal Sameena
Published: October 2014

Acute kidney injury (AKI) is associated with increased long‐term risk of end‐stage kidney disease (ESKD) and mortality. Nephrology care following discharge from hospital may improve survival through prevention of recurrent AKI events. In this study, we examined the factors that were associated with outpatient nephrology follow‐up after the development of AKI on patients who had a nephrology in‐hospital consultation and were discharged from McGill University Health Centre between January 1, 2006 and December 31, 2010. The associated factors for AKI‐free survival postdischarge were assessed applying multivariate Cox hazard proportional models. Of 170 patients, only 22% of the AKI admissions studied were booked with nephrology follow‐up after discharge. The unadjusted hazard ratio (HR) of outpatient nephrology care postdischarge was 1.82 (95% confidence interval [CI] 0.93–3.56) for AKI‐free survival postdischarge. The adjusted HR was 2.04 (95% CI 1.01–4.12) when we adjusted for follow‐up with other medical clinics, significant stage 4 and stage 5 chronic kidney disease and diabetes status. Patients with less comorbidities and higher serum creatinine on discharge received outpatient nephrology care. Nephrology outpatient care is associated with decreased risk of recurrence of AKI after discharge from hospital.
Eyeing the complications of hemodialysis in the eye
Authors: Jindal Nidhi , Misra Madhukar
Published: October 2014

The effect of hemodialysis (HD) on intraocular pressure (IOP) is variable and the exact mechanisms are not clear. Increased, decreased, as well as unchanged IOP has been described during HD in various case reports and studies. Patients with certain types of glaucoma and aqueous outflow obstruction of any other cause might be more susceptible to increase in IOP. This can cause severe eye pain, blurry vision, and headaches, causing significant morbidity for such dialysis patients. Certain changes in dialysis prescription may help relieve the above symptoms. There is a lack of awareness among nephrologists about the effects of HD on IOP. This may be especially relevant in the African American patients who besides having a higher risk of developing end‐stage renal disease also have a higher risk of developing glaucoma. Recognition as well as management of signs and symptoms of elevated IOP in the dialysis population is significant morbidity and unnecessary work‐up.
Parent's information seeking in acute childhood illness: what helps and what hinders decision making?
Authors: Neill Sarah J. , Jones Caroline H.D. , Lakhanpaul Monica , Roland Damian T. , Thompson Matthew J. ,   the ASK SNIFF research team
Published: October 2014

Context

Acute illness is a universal experience in early childhood. Parents find it difficult to determine whether or not their child requires medical care and seek information to inform their decision making. Little is known about parents' information seeking behaviour and what helps or hinders their decision making.

Objective

This study aimed to explore parents' use of information resources during decision making in acute childhood illness at home.

Design/Method

This exploratory qualitative study used focus groups and interviews to collect data from parents of children under 5 years of age.

Setting and participants

Twenty‐seven parents were recruited in the East Midlands, UK, in South Asian and Gypsy/Travelling communities, a Children's Centre and a private sector day nursery.

Findings

Parents' pre‐consultation information seeking was dominated by the internet, albeit with limited success. Parents liked easy to access, professionally validated and simple messages with access to more detailed information. Some parents always sought information through personal contact, whilst others did so when independent information seeking failed. When consulting a healthcare professional, parents liked to be given information to refer to later, although the information received varied. Importantly, neither hard copy nor the internet was accessible for parents with low levels of literacy.

Discussion and conclusions

Although there is a wealth of information parents can access independently, our findings indicate a need for easy access to clearly signposted, professionally validated resources and available in a range of formats provided through different delivery systems. One size does not fit all.
Surgical Treatment of Traumatic Myositis Ossificans of the Extensor Carpi Radialis Muscle in a Dog
Authors: Morton Bridget A. , Hettlich Bianca F. , Pool Roy R.
Published: October 2014

Objectives

To report clinical signs, diagnostic imaging findings, and outcome in a dog with traumatic myositis ossificans of the origin of the extensor carpi radialis muscle.

Study Design

Clinical report.

Animals

An 8‐month‐old intact female Irish Setter Dog.

Methods

After radiographic and computed tomographic evaluation of an osseous proliferation arising from the cranial cortex of the right distal humeral diaphysis, the protruding bone was surgically removed and evaluated by histopathology.

Results

Traumatic myositis ossificans was successfully treated with surgical removal of the osseous proliferation resulting in improved postoperative range of motion of the right elbow joint. There was no evidence of lameness or abnormal bone regrowth associated with the surgical site radiographically at follow up.

Conclusion

Surgical removal of a traumatic myositis ossificans lesion resulted in full return to function in a young, competitive show dog.
Primary syphilis in HIV‐negative patients is on the rise in Greece: epidemiological data for the period 2005–2012 from a tertiary referral centre in Athens, Greece
Authors: Kanelleas A. , Stefanaki C. , Stefanaki I. , Bezrondii G. , Paparizos V. , Arapaki A. , Kripouri Z. , Antoniou C. , Nicolaidou E.
Published: October 2014

Background

Epidemiological data on primary syphilis in Greece are limited.

Objective

The purpose of the present study was to investigate the trends of the disease in Greece during the last few years and whether they are in accordance with the trends in other European countries and the United States of America.

Methods

We conducted a retrospective analysis based on records of patients who visited the Sexually Transmitted Infections Unit of ‘A. Sygros’ Hospital in Athens, Greece, during the period 2005–2012. Our hospital is a tertiary referral centre for sexually transmitted infections covering an area of more than four million people, which is almost half the population of Greece. We documented the total annual number of patients, the male to female ratio, sexual orientation, patients’ ethnic origin and education level.

Results

We reviewed the records of 1185 patients with a confirmed diagnosis of primary syphilis. The total number of patients with primary syphilis has risen from 111 in 2005 to 158 in 2012, an increase of 42.3%. The mean annual number is 148. The mean male to female ratio is 4.76 : 1, with a peak value of 8.50 : 1 in 2011. The majority of patients are of Greek origin, ranging from 67.4% to 87.2%. Within the male patients group, it seems that the percentage of men having sex with men has risen steadily from 2005 (20.7%) up to 2010 (59.1%) with a decline in 2012 (46.0%). The mean value over 8 years is 45.0%.

Conclusion

Primary syphilis in Greece is on the rise. Τhe majority of our patients are Greek, despite immigrant influx. Men clearly outnumber women, representing more than 80% of the total number of patients. Furthermore, there seems to be a trend towards predominance of men having sex with men as the core group among male patients.
Local adaptation and divergence in colour signal conspicuousness between monomorphic and polymorphic lineages in a lizard
Authors: McLean C. A. , Moussalli A. , Stuart‐Fox D.
Published: October 2014

Population differences in visual environment can lead to divergence in multiple components of animal coloration including signalling traits and colour patterns important for camouflage. Divergence may reflect selection imposed by different receivers (conspecifics, predators), which depends in turn on the location of the colour patch. We tested for local adaptation of two genetically and phenotypically divergent lineages of a rock‐inhabiting lizard, Ctenophorus decresii, by comparing the visual contrast of colour patches to different receivers in native and non‐native environments. The lineages differ most notably in male throat coloration, which is polymorphic in the northern lineage and monomorphic in the southern lineage, but also differ in dorsal and lateral coloration, which is visible to both conspecifics and potential predators. Using models of animal colour vision, we assessed whether lineage‐specific throat, dorsal and lateral coloration enhanced conspicuousness to conspecifics, increased crypsis to birds or both, respectively, when viewed against the predominant backgrounds from each lineage. Throat colours were no more conspicuous against native than non‐native rock but contrasted more strongly with native lichen, which occurs patchily on rocks inhabited by C. decresii. Conversely, neck coloration (lateral) more closely matched native lichen. Furthermore, although dorsal coloration of southern males was consistently more conspicuous to birds than that of northern males, both lineages had similar absolute conspicuousness against their native backgrounds. Combined, our results are consistent with local adaptation of multiple colour traits in relation to multiple receivers, suggesting that geographic variation in background colour has influenced the evolution of lineage‐specific coloration in C. decresii.
Systematic derivation of an Australian standard for Tall Man lettering to distinguish similar drug names
Authors: Emmerton Lynne , Rizk Mariam F.S. , Bedford Graham , Lalor Daniel
Published: October 2014

Rationale, aims and objectives

Confusion between similar drug names can cause harmful medication errors. Similar drug names can be visually differentiated using a typographical technique known as Tall Man lettering. While international conventions exist to derive Tall Man representation for drug names, there has been no national standard developed in Australia. This paper describes the derivation of a risk‐based, standardized approach for use of Tall Man lettering in Australia, and known as National Tall Man Lettering.

Method

A three‐stage approach was applied. An Australian list of similar drug names was systematically compiled from the literature and clinical error reports. Secondly, drug name pairs were prioritized using a risk matrix based on the likelihood of name confusion (a four‐component score) vs. consensus ratings of the potential severity of the confusion by 31 expert reviewers. The mid‐type Tall Man convention was then applied to derive the typography for the highest priority drug pair names.

Results

Of 250 pairs of confusable Australian drug names, comprising 341 discrete names, 35 pairs were identified by the matrix as an ‘extreme’ risk if confused. The mid‐type Tall Man convention was successfully applied to the majority of the prioritized drugs; some adaption of the convention was required.

Conclusion

This systematic process for identification of confusable drug names and associated risk, followed by application of a convention for Tall Man lettering, has produced a standard now endorsed for use in clinical settings in Australia. Periodic updating is recommended to accommodate new drug names and error reports.
Nurses' self‐reported medication competence in relation to their pharmacovigilant activities in clinical practice
Authors: Johansson‐Pajala Rose‐Marie , Martin Lene , Fastbom Johan , Jorsäter Blomgren Kerstin
Published: October 2014

Rationale, aims and objectives

Adverse drug reactions (ADRs) represent a major health problem and previous studies show that nurses can have an active role in promoting medication safety. The aim of this study was to describe and evaluate nurses' self‐reported competence and pharmacovigilant activities in clinical practice and also to explore the impact of age, education, workplace and nursing experience on these matters.

Methods

This cross‐sectional study was based on a questionnaire covering areas related to nurses' medication competence, including knowledge, assessment and information retrieval, and pharmacovigilant activities within these areas, for example, the detection and assessment of ADRs. A 45‐item questionnaire was 2013 sent out to 296 nurses in different settings and counties in Sweden. They were selected on the basis of having applied to a university course including pharmacovigilance during 2008–2011. One hundred twenty‐four had participated in the courses (exposed) and 172 had applied to the courses but not participated (unexposed).

Results

Completed questionnaires were obtained from 75 exposed (60%) and 93 unexposed (54%) nurses. Overall nurses rated themselves high in medication competence but low in pharmacovigilant activities. Significant (P ≤ 0.001) differences between groups were observed regarding medication competence. The exposure of completed dedicated courses in pharmacovigilance was the strongest factor for self‐reported medication competence when adjusted for age, other education, workplace and experience. No significant differences between the groups were found regarding the number of pharmacovigilant activities during the 6 months prior to answering the questionnaire.

Conclusion

Dedicated university courses improved nurses' self‐reported competence in pharmacovigilance but did not increase the number of related activities. Education per se seems to be not sufficient to generate pharmacovigilant activities among nurses.
Validation of Persian rapid estimate of adult literacy in dentistry
Authors: Pakpour Amir H. , Lawson Douglas M. , Tadakamadla Santosh K. , Fridlund Bengt
Published: October 2014

Aim

The aim of the present study was to establish the psychometric properties of the Rapid Estimate of adult Literacy in Dentistry‐99 (REALD‐99) in the Persian language for use in an Iranian population (IREALD‐99).

Methods

A total of 421 participants with a mean age of 28 years (59% male) were included in the study. Participants included those who were 18 years or older and those residing in Quazvin (a city close to Tehran), Iran. A forward–backward translation process was used for the IREALD‐99. The Test of Functional Health Literacy in Dentistry (TOFHLiD) was also administrated. The validity of the IREALD‐99 was investigated by comparing the IREALD‐99 across the categories of education and income levels. To further investigate, the correlation of IREALD‐99 with TOFHLiD was computed. A principal component analysis (PCA) was performed on the data to assess unidimensionality and strong first factor. The Rasch mathematical model was used to evaluate the contribution of each item to the overall measure, and whether the data were invariant to differences in sex. Reliability was estimated with Cronbach's α and test–retest correlation.

Results

Cronbach's alpha for the IREALD‐99 was 0.98, indicating strong internal consistency. The test–retest correlation was 0.97. IREALD‐99 scores differed by education levels. IREALD‐99 scores were positively related to TOFHLiD scores (rh = 0.72, P < 0.01). In addition, IREALD‐99 showed positive correlation with self‐rated oral health status (rh = 0.31, P < 0.01) as evidence of convergent validity. The PCA indicated a strong first component, five times the strength of the second component and nine times the third. The empirical data were a close fit with the Rasch mathematical model. There was not a significant difference in scores with respect to income level (P = 0.09), and only the very lowest income level was significantly different (P < 0.01).

Conclusions

The IREALD‐99 exhibited excellent reliability on repeated administrations, as well as internal consistency. The IREALD‐99 can be used for the basic screening of oral health literacy among the Iranian population.
Hydrogen sulfide regulates abiotic stress tolerance and biotic stress resistance in Arabidopsis
Authors: Shi Haitao , Ye Tiantian , Han Ning , Bian Hongwu , Liu Xiaodong , Chan Zhulong
Published: October 2014

Hydrogen sulfide (H2S) is an important gaseous molecule in various plant developmental processes and plant stress responses. In this study, the transgenic Arabidopsis thaliana plants with modulated expressions of two cysteine desulfhydrases, and exogenous H2S donor (sodium hydrosulfide, NaHS) and H2S scavenger (hypotaurine, HT) pre‐treated plants were used to dissect the involvement of H2S in plant stress responses. The cysteine desulfhydrases overexpressing plants and NaHS pre‐treated plants exhibited higher endogenous H2S level and improved abiotic stress tolerance and biotic stress resistance, while cysteine desulfhydrases knockdown plants and HT pre‐treated plants displayed lower endogenous H2S level and decreased stress resistance. Moreover, H2S upregulated the transcripts of multiple abiotic and biotic stress‐related genes, and inhibited reactive oxygen species (ROS) accumulation. Interestingly, MIR393‐mediated auxin signaling including MIR393a/b and their target genes (TIR1, AFB1, AFB2, and AFB3) was transcriptionally regulated by H2S, and was related with H2S‐induced antibacterial resistance. Moreover, H2S regulated 50 carbon metabolites including amino acids, organic acids, sugars, sugar alcohols, and aromatic amines. Taken together, these results indicated that cysteine desulfhydrase and H2S conferred abiotic stress tolerance and biotic stress resistance, via affecting the stress‐related gene expressions, ROS metabolism, metabolic homeostasis, and MIR393‐targeted auxin receptors.
Predicting Key Change Events in Emotionally Focused Couple Therapy
Authors: Dalgleish Tracy L. , Johnson Susan M. , Burgess Moser Melissa , Wiebe Stephanie A. , Tasca Giorgio A.
Published: October 2014

In emotionally focused couple therapy (EFT), the blamer‐softening event helps individuals express and respond to partners’ unmet attachment needs. This study examined the impact of this event in relation to attachment at intake and changes in marital satisfaction from pre‐ to posttherapy. Thirty‐two couples were provided an average of 21 sessions of EFT. Hierarchical linear modeling revealed that the occurrence of a softening event significantly predicted increased marital satisfaction. Furthermore, the occurrence of a softening event significantly moderated the relationship between attachment avoidance at intake and change in marital satisfaction from pre‐ to posttherapy. For couples who had a softening event, partners with higher levels of attachment avoidance were less likely to have positive changes in marital satisfaction.
The metabolic impact of β‐hydroxybutyrate on neurotransmission: Reduced glycolysis mediates changes in calcium responses and KATP channel receptor sensitivity
Authors: Lund Trine M. , Ploug Kenneth B. , Iversen Anne , Jensen Anders A. , Jansen‐Olesen Inger
Published: October 2014

Glucose is the main energy substrate for neurons, and ketone bodies are known to be alternative substrates. However, the capacity of ketone bodies to support different neuronal functions is still unknown. Thus, a change in energy substrate from glucose alone to a combination of glucose and β‐hydroxybutyrate might change neuronal function as there is a known coupling between metabolism and neurotransmission. The purpose of this study was to shed light on the effects of the ketone body β‐hydroxybutyrate on glycolysis and neurotransmission in cultured murine glutamatergic neurons. Previous studies have shown an effect of β‐hydroxybutyrate on glucose metabolism, and the present study further specified this by showing attenuation of glycolysis when β‐hydroxybutyrate was present in these neurons. In addition, the NMDA receptor‐induced calcium responses in the neurons were diminished in the presence of β‐hydroxybutyrate, whereas a direct effect of the ketone body on transmitter release was absent. However, the presence of β‐hydroxybutyrate augmented transmitter release induced by the KATP channel blocker glibenclamide, thus giving an indirect indication of the involvement of KATP channels in the effects of ketone bodies on transmitter release.

image

Energy metabolism and neurotransmission are linked and involve ATP‐sensitive potassium (KATP) channels. However, it is still unclear how and to what degree available energy substrate affects this link. We investigated the effect of changing energy substrate from only glucose to a combination of glucose and R‐β‐hydroxybutyrate in cultured neurons. Using the latter combination, glycolysis was diminished, NMDA receptor‐induced calcium responses were lower, and the KATP channel blocker glibenclamide caused a higher transmitter release.
Individualistic attitudes toward attractive rewards in older people: An experimental study using ultimatum games
Authors: Inaba Midori
Published: October 2014

This study used an ultimatum game to test the hypothesis that older individuals make more selfish offers when bargaining for highly attractive rewards, regardless of the impacts of others' responses on reward size. Both older and younger individuals separately participated in the experiment and made offers as allocators. The effects of four factors (age, certainty of the allocators' own reward depending on the recipient's response, the recipient's response, and type of rewards to be shared) on participants' offers and expectations of recipients' replies were observed. Older participants demanded higher shares for themselves than younger participants, even under the low certainty condition in the highly attractive reward scenario. Particularly in this scenario, older participants increased their portions immediately after receiving rejections. Moreover, they consistently expected the recipients to accept their offers regardless of the proposed distribution amount or bargaining conditions. It was implied that the high attractiveness of the rewards made it difficult for older individuals to predict the recipient's view of their proposals and thus contributed to them making selfish proposals.
Psychological Treatment for Vaginal Pain: Does Etiology Matter? A Systematic Review and Meta-Analysis
Authors: Flanagan Esther , Herron Katherine A. , O’Driscoll Ciarán , Williams Amanda C. de C.
Published: October 2014

Introduction

Classification of vaginal pain within medical or psychiatric diagnostic systems draws mainly on the presumed presence or absence (respectively) of underlying medical etiology. A focus on the experience of pain, rather than etiology, emphasizes common ground in the aims of treatment to improve pain and sexual, emotional, and cognitive experience. Thus, exploring how vaginal pain conditions with varying etiology respond to psychological treatment could cast light on the extent to which they are the same or distinct.

Aim

To examine the combined and relative efficacy of psychological treatments for vaginal pain conditions.

Methods

A systematic search of EMBASE, MEDLINE, PsycINFO, and CINAHL was undertaken. Eleven randomized controlled trials were entered into a meta-analysis, and standardized mean differences and odds ratios were calculated. Effect sizes for individual psychological trial arms were also calculated.

Main Outcome Measures

Main outcome measures were pain and sexual function.

Results

Equivalent effects were found for psychological and medical treatments. Effect sizes for psychological treatment arms were comparable across vaginal pain conditions.

Conclusions

Effectiveness was equivalent regardless of presumed medical or psychiatric etiology, indicating that presumed etiology may not be helpful in selecting treatment. Research recommendations and clinical implications are discussed.
Oxford School of Sexual Medicine: How Are We Doing?
Authors: Lowenstein Lior , Reisman Yacov , Tripodi Francesca , Dean John , Shechter Arik , Porst Hartmut
Published: October 2014

Introduction

Since 2007, the European Society of Sexual Medicine has held an annual 2-week educational residential program at Oxford. The Oxford School of Sexual Medicine provides knowledge and skills learning opportunities for healthcare professionals.

Aim

The aim of the current study was to evaluate the impact of Oxford School courses on the daily practice and medical careers of fellows from different countries.

Methods

All participants in the Oxford School programs were invited to anonymously complete a self-administered questionnaire.

Main Outcome Measures

The questionnaire comprised three sections: socio-demographic characteristics of the respondents; four Likert-scale score items inquiring about professional background; and 17 closed and two open questions to evaluate the impact of Oxford School on the respondents’ practices. Differences in proportions of categorical variables between respondent subgroups were assessed using Pearson χ2 test.

Results

The mean age of the 54 fellows who participated in the study was 44 years (range 28–63 years), 71% were men and 29% were women. Fifty (92%) were physicians, two (4%) psychologists, and two (4%) were sex therapists. Following participation in the Oxford School course, significantly more participants reported spending 50% or more of their clinical time practicing sexual medicine than prior to the course (59% [32] vs. 27% [15], P < 0.001, Figure 1); and significantly more reported spending 50% or more of their working time in clinical research (54% [29] vs. 33% [18], P < 0.001, Figure 2). Forty-six fellows (85%) reported current participation in teaching activities, compared with only 29 (54%) prior to participating in the Oxford School course.

Conclusion

Educational activities in sexual medicine, such as the Oxford School, may contribute to the advancement of clinical practice, teaching activities, and clinical research of healthcare providers who are interested in sexual medicine.
Enfranchisement, Malapportionment, and Institutional Change in Great Britain, 1832–1868
Authors: Kam Christopher
Published: October 2014

This article examines why after 35 years of repeatedly rejecting the secret ballot, the British House of Commons enacted it with the Ballot Act of 1872. Drawing on roll‐call votes, I show that parliamentary opposition to the secret ballot was invariant between 1832 and 1867. In 1867, however, the Second Reform Act significantly extended the electoral franchise and substantially redistributed parliamentary seats; the House elected immediately following these changes to pass the Ballot Act of 1872. I show that a key reason for the change in the House's attitude on the ballot was that anti‐ballot MPs whom the redistribution threatened to expose to electoral competition were disproportionately likely to retire prior to the 1868 election. These results imply that it was the anticompetitive effects inherent in the gross malapportionment of the older electoral system rather than the restricted nature of the franchise that insulated MPs from public pressure and kept parliamentary opinion on the secret ballot in stasis. This is a useful lesson because while almost all modern democracies operate on a universal adult suffrage, many continue to be marked by significant malapportionment.
The diagnosis of gastro‐esophageal reflux disease cannot be made with barium esophagograms
Authors: Saleh C. M. G. , Smout A. J. P. M. , Bredenoord A. J.
Published: October 2014

Background

For over 50 years, barium studies have been used to diagnose gastro‐esophageal reflux disease (GERD), but the value of this test is controversial. Our study aimed to determine if barium esophagograms can be used to diagnose GERD.

Methods

Barium esophagograms and pH‐impedance measurement were performed in 20 subjects with reflux symptoms. pH‐impedance measurements were used as gold standard for the diagnosis of GERD. Gastro‐esophageal reflux measured with the barium study was defined as a positive outcome.

Key Results

50% of patients presented gastro‐esophageal reflux on the barium esophagogram. No significant differences were observed in acid exposure time between subjects with (median: 7.4%; interquartile range, IQR: 8.4%) or without reflux at barium esophagography (median: 5.95%; IQR: 13.05%; p > 0.05). Nor did we find differences in median proximal extent of reflux measured with impedance monitoring between patients with a positive (median: 6.7%; IQR: 1.95%) and negative barium study (median: 7.1%; IQR: 0.68%; p > 0.05). Patients with reflux on barium esophagogram did not have a positive symptom association probability more often than those who did not have reflux at barium esophagography. Lastly, there were no differences in numbers of acid, weakly acidic or total reflux episodes between those with positive or negative barium esophagogram (p > 0.05). No correlations were found between the maximum proximal extent of gastro‐esophageal reflux during esophagography and pH‐impedance parameters.

Conclusions & Inferences

Presence or absence of gastro‐esophageal reflux during barium esophagography does not correlate with incidence or extent of reflux observed during 24‐h pH‐impedance monitoring and is not of value for the diagnosis of GERD.
Anthocyanin leaf markings are regulated by a family of R2R3‐MYB genes in the genus Trifolium
Authors: Albert Nick W. , Griffiths Andrew G. , Cousins Greig R. , Verry Isabelle M. , Williams Warren M.
Published: October 2014

Anthocyanin pigments accumulate to form spatially restricted patterns in plants, particularly in flowers, but also occur in vegetative tissues. Spatially restricted anthocyanin leaf markings are poorly characterised in plants, but are common in forage legumes.

We hypothesised that the molecular basis for anthocyanin leaf markings in Trifolium spp. is due to the activity of a family of R2R3‐MYB genes.

R2R3‐MYB genes were identified that are associated with the two classic pigmentation loci in T. repens. The R locus patterns ‘red leaf’, ‘red midrib’ and ‘red fleck’ are conditioned by a single MYB gene, RED LEAF. The ‘diffuse red leaf’ trait is regulated by the RED LEAF DIFFUSE MYB gene. The V locus was identified through mapping two V‐linked traits, ‘V‐broken yellow’ (Vby) and ‘red leaflet’ (Vrl). Two highly similar R2R3‐MYB genes, RED V‐a and RED V‐b, mapped to the V locus and co‐segregated with the RED V pigmentation pattern. Functional characterisation of RED LEAF and RED V was performed, confirming their function as anthocyanin regulators and identifying a C‐terminal region necessary for transactivation.

The mechanisms responsible for generating anthocyanin leaf markings in T. repens provide a valuable system to compare with mechanisms that regulate complex floral pigmentation.
Duplication and expression of CYC2‐like genes in the origin and maintenance of corolla zygomorphy in Lamiales
Authors: Zhong Jinshun , Kellogg Elizabeth A.
Published: October 2014

Duplication, retention, and expression of CYCLOIDEA2 (CYC2)‐like genes are thought to affect evolution of corolla symmetry. However, exactly what and how changes in CYC2‐like genes correlate with the origin of corolla zygomorphy are poorly understood.

We inferred and calibrated a densely sampled phylogeny of CYC2‐like genes across the Lamiales and examined their expression in early diverging (EDL) and higher core clades (HCL).

CYC2‐like genes duplicated extensively in Lamiales, at least six times in core Lamiales (CL) around the Cretaceous–Paleogene (K–Pg) boundary, and seven more in EDL relatively more recently. Nested duplications and losses of CYC2‐like paralogs are pervasive but may not correlate with transitions in corolla symmetry. We found evidence for dN/dS (ω) variation following gene duplications. CYC2‐like paralogs in HCL show differential expression with higher expression in adaxial petals.

Asymmetric expression but not recurrent duplication of CYC2‐like genes correlates with the origin of corolla zygomorphy. Changes in both cis‐regulatory and coding domains of CYC2‐like genes are probably crucial for the evolution of corolla zygomorphy. Multiple selection regimes appear likely to play important roles in gene retention. The parallel duplications of CYC2‐like genes are after the initial diversification of bumble bees and Euglossine bees.
Parallel evolution of jugal structures in Devonian athyridide brachiopods
Authors: Guo Wen , Sun Yuanlin , Baliński Andrzej
Published: October 2014

Here, we describe Sinathyris crassa gen. et sp. nov., a new early Emsian (Early Devonian) athyridide brachiopod with a double spiralium from the Guangxi Province of southern China. Unlike the majority of genera of the subfamily Helenathyridinae, which possess accessory spiral lamellae developed directly from the jugal branches, the form described here shows these lamellae arising from a distally bifurcating jugal stem. These differences suggest that the double spiralium in S. crassa might have appeared independently from the double spiralium of the helenathyridins. To test the subfamily assignment of Sinathyris gen. nov., we carried out phylogenetic analyses, which indicate that the new genus is more appropriately referred to the Didymothyridinae. The cladistic analyses of the athyridides indicate that double spiralia have developed independently among these brachiopods at least five times during their evolutionary history.
Do all children with suicidal ideation receive a significant psychiatric intervention?
Authors: Waseem Muhammad , Diaz‐Guerrero Raquel Joselyn , Cosme Rosario , Ain Yumna , Leber Mark , Gerber Linda M.
Published: October 2014

Background

In most physicians' minds, suicidal ideation carries with it an ominous prognosis requiring intensive evaluation and treatment. The aim of this study was therefore to determine the proportion of children identified with suicide ideation who received a significant psychiatric intervention.

Methods

Medical records were reviewed for psychiatric interventions of all children presenting to the emergency department (ED) with behavioral disorders between 2004 and 2007, for whom a psychiatry consultation was obtained. Suicidal children were those who had expressed suicidal ideation. Significant psychiatric intervention was defined as one of the following: hospitalization in a psychiatric facility, period of observation in the ED (≥12 h), use of restraints, and prescription of psychiatric medication. Suicidal labeling was considered appropriate if one or more of the aforementioned interventions were recommended by a psychiatrist. The presence of psychiatric intervention was compared with that in children who presented with a behavioral disorder, not labeled as suicidal. Chi‐squared or Fisher's exact test, whenever appropriate, was used to evaluate the association between suicide status and intervention.

Results

A total of 160 children (27.1%) were labeled as suicidal, and 431 (72.9%) with a behavioral disorder were classified as non‐suicidal. A total of 244/431 (56.6%) in the non‐suicidal group had a significant psychiatric intervention compared to 79/160 (49.4%) in the suicidal ideation group (P = 0.116). This 49.4% is significantly different from an a priori assumption that 100% of children with suicidal ideation would have a significant psychiatric intervention.

Conclusion

More than half (50.6%) of the children presenting with a label of suicidal ideation did not receive significant psychiatric intervention. This study calls into question the accuracy of suicide labeling in children referred to the ED.
Regulatory dynamism of environmental mobilization in urban China
Authors: Johnson Thomas R.
Published: October 2014

In China, urban middle class mobilization against potential pollution risk has become increasingly common. This article examines this phenomenon through a detailed case study of a 2009 anti‐waste incinerator campaign in the Panyu District of Guangzhou, which culminated in a sizeable public protest and government U‐turn. This episode revealed tension between the narrow, state‐centered regulatory model fixated on end‐of‐pipe pollution control, and a much broader decentered approach advocated – and practiced – by project opponents, which incorporated public consultation and much greater emphasis on upstream waste reduction and sorting. In the process, the Panyu campaign progressed beyond a case of “regulation by escalation,” whereby beneficial regulations are belatedly enforced following populist pressure. Instead, it transformed into an open dialogue between a plurality of actors, including citizens, journalists, experts, and officials, about what regulation should constitute and who should determine acceptable levels of risk. By focusing on the processes through which regulatory issues emerged and changed during the Panyu campaign, this article highlights the regulatory dynamism of environmental mobilization in a context of regulatory uncertainty, and campaigns against “locally unwanted land uses” more broadly.
Menthol cigarette smoking in theCOPDGene cohort: Relationship withCOPD, comorbidities andCTmetrics
Authors: Park Seoung Ju , Foreman Marilyn G. , Demeo Dawn L. , Bhatt Surya P. , Hansel Nadia N. , Wise Robert A. , Soler Xavier , Bowler Russell P.
Published: October 2014

Background and objective

Menthol cigarettes contain higher levels of menthol to produce a characteristic mint flavour and cooling sensation. Compared with non‐menthol cigarettes, little information exists on the effects of menthol cigarette smoking on clinical and radiological characteristics of chronic obstructive pulmonary disease (COPD). The main objective of the present study was to examine associations between menthol cigarette use and the risk ofCOPDand its characteristics, such as exacerbation, comorbidities and computed tomography (CT) abnormalities.

Methods

We analysed the data from 5699 current smokers in the COPDGene cohort to evaluate whether lung function, comorbidities, exacerbations andCTparameters were different between menthol and non‐menthol cigarette smokers.

Results

There were 3758 (65.9%) who reported use of menthol cigarettes. Multivariable regression analysis revealed that younger age, female gender and African‐American ethnicity were significantly associated with smoking of menthol cigarettes. No significant associations were found between menthol cigarette use andCOPD, majorCTfindings or comorbidities, such as cardiovascular disease, congestive heart failure, peripheral vascular disease, cerebrovascular disease, hypertension, diabetes, gastro‐oesophageal reflux and osteoporosis; however, menthol cigarette smokers were more likely to experience a severe exacerbation ofCOPDduring longitudinal follow‐up (odds ratio 1.29; 95% confidence interval: 1.01–1.54) compared with the non‐menthol cigarette smokers.

Conclusions

These results confirm that menthol cigarettes are not safer than traditional cigarettes and suggest that menthol cigarette smokers may have more frequent severe exacerbations than non‐menthol cigarette smokers.
Ambiguous words: Post‐lapsarian language in Paradise Lost
Authors: Haydon Liam D.
Published: October 2014

This article considers the differences between fallen and unfallen language in Paradise Lost. The poem presents divine language as perfect, intuitive and possessing a direct correlation between word and thing. The Falls of both Satan and mankind break that correlation, introducing multivalency, and the ability to dissimilate, into language. Satan rebels, in part, by emphasizing the open‐ness of language in a series of puns and contestations over the proper naming of things. Conversely, although Adam and Eve both pun after the Fall, this is done almost unconsciously as a mark of, rather than exultation in, the Fall. Paradise Lost, too, is enmeshed in this fallen language; I argue that it self‐consciously deploys the features of post‐lapsarian language (puns, ambiguity, multivalency) in order to express the limits of its own expression, pointing to its own failure to reproduce sacred song. In Paradise Lost, the glorious achievement is not in overcoming this multivalence, but in expressing it at all. In doing so, it invites its fit audience to recognize the limits of their own language and understanding, and find in those very limits a renewed desire to strive towards the unattainable perfection that the poem seeks to fleetingly capture.
Attitude toward rapid HIV testing in a Dental School Clinic
Authors: Durall Piedad Suarez , Enciso Reyes , Rhee Jiho , Mulligan Roseann
Published: October 2014

Detection of HIV infection provides an opportunity for transmission reduction and lifesaving treatment strategies. This study examined patients’ willingness to take a routine, rapid oral HIV test if offered at a dental school clinic. For fifteen days in 2011, an anonymous survey containing demographic information and willingness to be tested questions was offered to all patients awaiting treatment. A total of 383 of 443 people approached, answered the questionnaire (40.2% Hispanic, 27.2% Caucasian, and 19.3% African American) with 58.8% indicating that they had been previously tested for HIV (as compared to the California mean of 39.2%). Patients were highly likely to participate (84.0% of Hispanics, 63.6% of Caucasians, 80.0% of African Americans and 66.7% of Asians) in a free HIV rapid test when given the opportunity. Of respondents never tested before, 62.6% reported a willingness to be tested in this study. HIV screening in a dental clinic during routine visits may allow new undiagnosed cases to be detected with subsequent referral into medical treatment.
Ex vivo assessment of cellular immune function – applications in patient care and clinical studies
Authors: Lindemann M.
Published: October 2014

Cellular ex vivo assays have a broad range of applications in patient care and clinical studies, especially when they are standardized and highly sensitive. As compared to analyses by molecular genetics such as the single nucleotide polymorphism (SNP) testing, they are usually more global. These assays partly mimic the in vivo situation, relying on a complex interaction of various immune cells. For example, they can be used to determine modulation of alloresponses by treatment or underlying disease, diagnose and quantify primary and secondary cellular immunodeficiency, follow‐up vaccination responses, measure adoptive transfer of virus‐specific immunity via hematopoietic stem cell or liver transplantation, assess allergy, antimicrobial immunity and also rare effector/memory cells directed against tumor antigens. This review will first shortly describe various cellular in vitro methods and then present applications, summarizing some own studies performed within the last 18 years.
Active Learning and Threshold Concepts in Multiple Testing that can Further Develop Student Critical Statistical Thinking
Authors: White Desley
Published: October 2014

Two practical activities are described, which aim to support critical thinking about statistics as they concern multiple outcomes testing. Formulae are presented in Microsoft Excel spreadsheets, which are used to calculate the inflation of error associated with the quantity of tests performed. This is followed by a decision‐making exercise, where an Excel calculator is used to adjust for multiple outcomes prior to deciding whether or not an intervention has been successful.
Prevalence of platelet‐specific antibodies and efficacy of crossmatch‐compatible platelet transfusions in refractory patients
Authors: Jia Y. , Li W. , Liu N. , Zhang K. , Gong Z. , Li D. , Wang L. , Wang D. , Jing Y. , Wang J. , Shan X.
Published: October 2014

Background

The development of specific antibodies against human leukocyte antigen (HLA) and/or human platelet antigen (HPA) could induce platelet transfusion refractoriness especially in patients receiving multiple platelet transfusions. A retrospective analysis was conducted to evaluate the prevalence of platelet‐specific antibodies and the efficacy of crossmatch‐compatible platelet transfusions in these recipients.

Study Design and Methods

All enrolled patients were refractory to random single‐donor apheresis Platelet (PLT) units. Enzyme‐linked immunosorbent assay (ELISA) was used to detect anti‐HLA and anti‐HPA antibodies in serum. For those patients with antibodies, the PLT crossmatch assays were performed to select the compatible PLTs with a commercial solid‐phase adherence kit.

Results

A total of 193 patients were included and 29·02% of which was HLA and/or HPA antibody‐positive. There were no significant differences in antibody‐positive rates among AML/CML, ALL/CLL, MDS, SAA and ITP groups, but they are statistically significantly higher than other groups (P = 0·0035). Of those antibody‐positive patients, there were 41 (73·21%) patients with only HLA antibodies, 11 (19·64%) patients with only HPA antibodies and 4 (7·14%) patients with both HLA and HPA antibodies. A total of 43 random PLT units and 88 crossmatch‐compatible PLT units were administered. The mean (±SD) corrected count increment (CCI) was 8700 (±4500) after crossmatch‐compatible unit transfusion, significantly higher than 3600 (±2400) for random PLT units (P < 0·001).

Conclusions

HLA and/or HPA alloimmunisation is an important factor to cause refractoriness to platelet transfusions. Crossmatch‐compatible platelet transfusion is an effective method in those patients refractory to random platelet transfusions.
The contribution of unimproved water and toilet facilities to pregnancy‐related mortality in Afghanistan: analysis of the Afghan Mortality Survey
Authors: Gon Giorgia , Monzon‐Llamas Laura , Benova Lenka , Willey Barbara , Campbell Oona M. R.
Published: October 2014

Objective

To estimate the effect of unimproved household water and toilet facilities on pregnancy‐related mortality in Afghanistan.

Methods

The data source was a population‐based cross‐sectional study, the Afghan Mortality Survey 2010. Descriptive, univariate and multivariate logistic regression analyses were carried out, comparing 69 pregnancy‐related deaths (cases) and 15386 surviving women (non‐cases) who had a live birth or stillbirth between 2007 and 2010.

Results

After adjusting for confounders, households with unimproved water access had 1.91 the odds of pregnancy‐related mortality [95% confidence interval (CI) 1.11–3.30] compared to households with improved water access. We also found an association between unimproved toilet facilities and pregnancy‐related mortality (OR = 2.25; 95% CI 0.71–7.19; P‐value = 0.169), but it was not statistically significant.

Conclusions

Unimproved household water access was an important risk factor for pregnancy‐related mortality in Afghanistan. However, we were unable to discern whether unimproved water source is a marker of unhygienic environments or socio‐economic position. There was weak evidence for the association between unimproved toilet facilities and pregnancy‐related mortality; this association requires confirmation from larger studies.