bluuebunny/crossref_metadata_2025 huggingface dataset:
The Embodied World: Creation Metaphors in the Ancient Near East
Authors: Simkins Ronald A.
Published: January 2014

An insight from anthropology is that the human body may serve as a symbol of society. In the ancient Near East, including in Israel, the body mediated symbolic relationship between of people's experience of their physical and social worlds. This essay will argue that that this complex symbolic relationship between the body and the world formed the basis of the ancient Near Eastern understanding of creation. Because the body functioned as a model for the world, the procreation of the human body (microcosm) offered an appropriate analogy for understanding the creation of the world and society (macrocosm). The essay will focus on a variety of creation metaphors from Mesopotamia, Egypt, and Israel to construct a heuristic model of creation that will delineate the symbolic relationship between the body and the world.
Swallowing Disorders in the Ambulatory Medical Setting
Authors: Mahboubi Hossein , Verma Sunil P.
Published: January 2014

Objectives

The aims of this cross‐sectional study were to explore the nationwide number and demographics of patient visits due to dysphagia and to investigate potential differences in their management between otolaryngologists and other physicians in the outpatient setting.

Study Design

Cross‐sectional.

Setting

National Ambulatory Medical Care Survey.

Subjects and Methods

The data sets from 2007 to 2010 were queried to extract all cases with dysphagia as a reason for visit. Data regarding demographics, imaging studies, nonmedication therapies, diagnoses, medications, and patient disposition were compared between otolaryngologists, primary care physicians, and other specialists.

Results

Annually, 1,875,187 (95% confidence interval [CI], 1,443,876‐2,307,204) outpatient visits were due to dysphagia, comprising 0.19% of all visits (95% CI, 0.14%‐0.23%) and 1.55% (95% CI, 1.10%‐2.0%) of the visits to otolaryngologists. The visits were mostly distributed between primary care physicians and other specialists, while 16.4% (95% CI, 11.3%‐21.6%) visited an otolaryngology office. Otolaryngologists, primary care physicians, and other specialists ordered imaging studies in 22.8%, 10.2%, and 24.0% (P =. 02); performed aerodigestive‐specific procedures in 20.8%, 4.0%, and 36.2% (P <. 0001); and referred the patient to another physician in 5.8%, 14.8%, and 2.8% (P =. 003) of the visits, respectively.

Conclusions

Almost 0.2% of office visits to physicians have a complaint of dysphagia. Otolaryngologists are involved in the care of a minority of these visits. The differences in the management of dysphagic patients may be due to different etiologies of the disease.
The Incidence of Premalignant and Malignant Disease in Reinke's Edema
Authors: Lim Shueh , Sau Phoebe , Cooper Lorna , McPhaden Allan , Mackenzie Kenneth
Published: January 2014

Reinke's edema is a benign lesion of the vocal folds affecting the subepithelial space. As part of a study of the management of Reinke's edema, we aimed to determine the prevalence of dysplasia and malignancy in histologically proven Reinke's edema. A retrospective analysis of all laryngeal biopsies performed in north Glasgow, United Kingdom, between 2001 and 2010 was carried out. Clinical and pathological data from patients with histologically confirmed Reinke's edema were recorded with specific respect to the reporting of dysplasia and malignancy. From the 10‐year cohort, a total of 3902 laryngeal biopsies were performed. In total, 189 patients (18 males and 171 females) had histologically proven Reinke's edema. Of this cohort, 170 (90%) had no dysplasia, 16 (8%) had mild dysplasia, 2 (1%) had moderate dysplasia, and 1 (<1%) had severe dysplasia. There was no malignancy reported. In our predominantly female smoking population, the epithelium appears to differentiate to benign Reinke's edema rather than malignancy. Patients can be reassured with regard to the low risk of malignancy in classic Reinke's edema.
The Subsistence Marketplace Initiative
Authors: Narayan Deepa
Published: January 2014

The subsistence marketplace initiative is a marvelous endeavor, it is a program that combines three critical aspects well – research, action, and communication -- which are so essential for research impact. Its bottom up approach is sound. The challenge is scaling up for big impact and bring systemic change in an environment of deepening and entrenched inequality. This is essential for our collective survival: current practices and greed have resulted in economies collapsing in the western world with huge consequences for the choices we make, for our values, ethics, and vision of the kind of world we want to live in.
Analysis of curaua/glass hybrid interlayer laminates
Authors: Angrizani Clarissa C , Cioffi Maria OH , Zattera Ademir J , Amico Sandro C
Published: January 2014

This study compares the mechanical properties of curaua, glass and hybrid curaua/glass laminates evaluated experimentally with those obtained theoretically using commercial software for composites. Hybrids laminates were produced varying the fiber layer stacking sequence with the aim of optimizing the combination of vegetable and synthetic fibers. Composites were compression molded using eight layers of glass and/or curaua fiber mats and mechanically tested as per ASTM standards. The combination of curaua and glass fibers produced a material with intermediate properties and, depending on the type of mechanical loading and the stacking sequence, some hybrids showed properties close to the pure glass fiber composites. Furthermore, hybrid composites with glass layers closer to the surfaces showed the best overall results.
Determination of the optimal flax fibre preparation for use in unidirectional flax–epoxy composites
Authors: Baets J , Plastria D , Ivens J , Verpoest I
Published: January 2014

The specific stiffness of flax fibres is comparable to that of glass fibres. However, the application of flax fibres in composites still poses two important problems. The orientation of the fibres in the composite is not impeccable and the fibre–matrix adhesion is too weak. This research focuses on the former. To produce a continuous yarn for the textile industry, technical flax fibres are spun. The twisting of the fibres increases the yarn strength but the orientation of the fibres with regard to the fibre axis decreases. Experiments show that the slightly twisted yarns and the spun yarns possess the best processability but have lower mechanical properties than untwisted ribbons. The values fit very well to certain models which predict stiffness with regard to the twist angle.
Interfacial adhesion of glass fibre reinforced polypropylene–maleic anhydride modified polypropylene copolymer composites
Authors: Zhai Zhe , Liu Zheng , Feng Lajun , Liu Shu
Published: January 2014

In this work, the interfacial adhesion between the glass fibre and polypropylene–maleic anhydride modified polypropylene copolymer has been studied using a microbond test. The interfacial shear strength of the composite increased from 6.58 to 14.85 MPa, with the increase of the content of maleic anhydride modified polypropylene from 0 to 5% in the matrix composition. Oxygen plasma and γ-aminopropyltrimethoxysilane surface treatments were also introduced to modify the surface chemistry of the glass fibre. Compared with γ-aminopropyltrimethoxysilane surface treatment and the control, the interfacial adhesion of the composites of oxygen plasma was stronger in the same content of maleic anhydride modified polypropylene. This trend matches the law of surface morphology, which was imaged by scanning electron microscope. And there was no transcrystallisation at the interface of fibre and matrix resin, and no crystalline morphology change on the matrix resin by a polarised optical microscope.
Prediction of prestress losses in RC beams externally strengthened with prestressed CFRP sheets/plates
Authors: Wang Wen-Wei , Dai Jian-Guo , Harries Kent A , Zhang Lei
Published: January 2014

This paper presents an analytical model for predicting the short and long-term prestress losses in reinforced concrete (RC) beams strengthened with prestressed carbon fiber reinforced polymer (CFRP) sheets/plates. The long-term prestress loss model is developed by treating the strengthened beam as two sub-elements: an RC beam and a prestressed CFRP sheet/plate, connected through an adhesive bonding layer. Through force equilibrium and displacement compatibility of the two sub-elements, the influences of concrete shrinkage, concrete creep as well the interlayer slip between the RC beam and the CFRP sheet/plate on the prestress losses of CFRP are modeled using an incremental model. For a post-tensioned system with strong end anchorages, closed-form solutions for the prestress losses due to creep and shrinkage of concrete are obtained. The reliability of the proposed analytical model is validated through comparisons with previous test results reported by the authors and others research groups. The maximum difference between the experimentally observed values and the predicted values for the long-term prestress losses was found to be only 2.2% of the initial prestress of the CFRP.
Changing the Lens
Authors: Sandercock Leonie , Attili Giovanni
Published: January 2014

This paper discusses an action research project in which the making and screening of a film was conceived as a catalyst for social change in a deeply divided community. The context is the history of segregation of Indigenous peoples and settlers in Canada. Is there a decolonizing role for planning, beginning with the work of healing and reconciliation? And, is there a role for film as a methodological tool in such a process? Our findings suggest a very necessary role for therapeutic planning, albeit with caveats; and, that film can be an effective catalyst for creating this therapeutic space.
A miniature tension sensor to measure surgical suture tension of deformable musculoskeletal tissues during joint motion
Authors: Kiriyama Yoshimori , Matsumoto Hideo , Toyama Yoshiaki , Nagura Takeo
Published: January 2014

The aim of this study was to develop a new suture tension sensor for musculoskeletal soft tissue that shows deformation or movements. The suture tension sensor was 10 mm in size, which was small enough to avoid conflicting with the adjacent sensor. Furthermore, the sensor had good linearity up to a tension of 50 N, which is equivalent to the breaking strength of a size 1 absorbable suture defined by the United States Pharmacopeia. The design and mechanism were analyzed using a finite element model prior to developing the actual sensor. Based on the analysis, adequate material was selected, and the output linearity was confirmed and compared with the simulated result. To evaluate practical application, the incision of the skin and capsule were sutured during simulated total knee arthroplasty. When conventional surgery and minimally invasive surgery were performed, suture tensions were compared. In minimally invasive surgery, the distal portion of the knee was dissected, and the proximal portion of the knee was dissected additionally in conventional surgery. In the skin suturing, the maximum tension was 4.4 N, and this tension was independent of the sensor location. In contrast, the sensor suturing the capsule in the distal portion had a tension of 4.4 N in minimally invasive surgery, while the proximal sensor had a tension of 44 N in conventional surgery. The suture tensions increased nonlinearly and were dependent on the knee flexion angle. Furthermore, the tension changes showed hysteresis. This miniature tension sensor may help establish the optimal suturing method with adequate tension to ensure wound healing and early recovery.
Neighborhood Ethnic Diversity and Trust
Authors: Schmid Katharina , Ramiah Ananthi Al , Hewstone Miles
Published: January 2014

This research reported here speaks to a contentious debate concerning the potential negative consequences of diversity for trust. We tested the relationship between neighborhood diversity and out-group, in-group, and neighborhood trust, taking into consideration previously untested indirect effects via intergroup contact and perceived intergroup threat. A large-scale national survey in England sampled White British majority ( N = 868) and ethnic minority ( N = 798) respondents from neighborhoods of varying degrees of diversity. Multilevel path analyses showed some negative direct effects of diversity for the majority group but also confirmed predictions that diversity was associated indirectly with increased trust via positive contact and lower threat. These indirect effects had positive implications for total effects of diversity, cancelling out most negative direct effects. Our findings have relevance for a growing body of research seeking to disentangle effects of diversity on trust that has so far largely ignored the key role of intergroup contact.
Mismatch or Cumulative Stress
Authors: Nederhof Esther , Ormel Johan , Oldehinkel Albertine J.
Published: January 2014

In the study reported here, the main question we investigated was whether attention style could be a conditional adaptation. We organized participants of the TRacking Adolescents’ Individual Lives Survey (TRAILS; N = 2,230) into shifters, sustainers, and two comparison groups, depending on their performance on a shifting- and a sustained-attention task at age 11 years. Compared with sustainers, shifters reported more pre- and perinatal risk factors and more childhood stress, and they adopted a faster life-history strategy. These differences were not found between the comparison groups, who performed well or poorly on both tasks, which suggests that specialization for either sustained or shifting attention is the key to conditional adaptation. In a subsample ( n = 860), we found that stress did not increase depression risk in shifters, whereas a mismatch between early and recent stress predicted depression in sustainers. Cumulative stress predicted depression in the comparison group. These results suggest that shifters retain high levels of plasticity throughout life, whereas sustainers’ adapted their phenotype early in life to the expected mature environment.
“That’s Not Just Beautiful—That’s Incredibly Beautiful!”
Authors: Brummelman Eddie , Thomaes Sander , Orobio de Castro Bram , Overbeek Geertjan , Bushman Brad J.
Published: January 2014

In current Western society, children are often lavished with inflated praise (e.g., “You made an incredibly beautiful drawing!”). Inflated praise is often given in an attempt to raise children’s self-esteem. An experiment (Study 1) and naturalistic study (Study 2) found that adults are especially inclined to give inflated praise to children with low self-esteem. This inclination may backfire, however. Inflated praise might convey to children that they should continue to meet very high standards—a message that might discourage children with low self-esteem from taking on challenges. Another experiment (Study 3) found that inflated praise decreases challenge seeking in children with low self-esteem and has the opposite effect on children with high self-esteem. These findings show that inflated praise, although well intended, may cause children with low self-esteem to avoid crucial learning experiences.
Tomography and blood vessels in Hughes syndrome
Authors: Stojanovich L , Djokovic A
Published: January 2014

Antiphospholipid antibody syndrome (APS) or Hughes syndrome is a multisystem autoimmune disorder that is characterized by venous and arterial thrombosis and/or pregnancy complications (miscarriage and fetal death, preeclampsia, placental insufficiency, and fetal growth restriction), and positive serologic tests for anticardiolipin antibodies (aCL), lupus anticoagulant (LA), or antibodies against beta2-glycoprotein I (anti-ß2GPI) either of IgG or IgM isotype. APS is characterized by accelerated atherosclerosis that, together with an increased tendency toward thrombosis, leads to the occurrence of various vascular events. Timely diagnosis of vascular changes, preferably in the subclinical phase, is required both because of their severity and the high mortality rate. Detection of arterial and venous changes is performed by various invasive and noninvasive diagnostic methods. Computed tomographic angiography (CTA) seems to be the most precise method with low exposure time, giving clinicians an opportunity for early diagnosis and timely treatment of APS patients.
The Arcane of Cinchona and the New Granada Expedition: the multi-dimensional mind of José Celestino Mutis (1732–1808)
Authors: Herranz Jaime Pascual
Published: January 2014

José Celestino Mutis y Bosio was a Spanish physician, naturalist, astronomer, priest, theologian and mathematician, and one of the icons of the Enlightment Age both in Spain and the American Continent. As the Viceroy’s personal doctor, he travelled to the territory of New Granada in what is now Colombia. Mutis was the creator and first leader of the Royal Botanic Expedition of New Granada to study South American wildlife, discovering thousands of new species. He also launched several Public Health measures in the Santa Fe area, helping to introduce a vaccination campaign. Mutis was the first person to introduce Newtonian physics in the Spanish America and he established the first Observatory in the New World which is still in use. He was deeply admired and recognized as a prominent scientist by great personalities of his time including Carl von Linée and Alexander von Humboldt.
Immunotherapies influence the influenza vaccination response in multiple sclerosis patients: an explorative study
Authors: Olberg Henning K , Cox Rebecca J , Nostbakken Jane K , Aarseth Jan H , Vedeler Christian A , Myhr Kjell-Morten
Published: January 2014

Background:

The immunogenicity of influenza vaccines in MS patients undergoing immunomodulatory treatment is not well studied.

Objectives:

This explorative study investigated the influence of immunomodulatory treatment on MS patients receiving pandemic H1N1 (swine flu) vaccination in 2009 and seasonal influenza vaccination in 2010.

Methods:

We investigated the immune response to pandemic H1N1 vaccination among 113 MS patients and 216 controls during the pandemic of 2009. We also investigated the serological response to seasonal influenza vaccination (2010 – 2011 season) among 49 vaccinated and 62 non-vaccinated MS patients, versus 73 controls. We evaluated these vaccine responses by haemagglutination inhibition assay.

Results:

MS patients receiving immunomodulatory treatment had reduced protection (27.4%), compared to controls (43.5%) ( p = 0.006), after pandemic H1N1 vaccination (2009). The rates of protection were not influenced by interferon beta treatment (44.4% protected), but were reduced among patients receiving glatiramer acetate (21.6%), natalizumab (23.5%), and mitoxantrone (0.0%). A similar pattern emerged after MS patients received a seasonal influenza vaccination in 2010.

Conclusions:

These findings suggest that MS patients receiving immunomodulatory therapies other than interferon beta should be considered for a vaccine response analysis and perhaps be offered a second dose of the vaccine, in cases of insufficient protection.
Risks of picture archiving and communication systems
Authors: Strickland Nicola H
Published: January 2014

Picture archiving and communication systems (PACS), and their associated digital technologies, have revolutionized the provision of radiological healthcare in the UK over the last ten years. Imaging has become almost completely electronic and paperless as a consequence, resulting in numerous very substantial patient benefits. Many of the associated risks differ from those which existed when radiological imaging was analogue and film-based, and can potentially occur at many stages of the PACS pathway, ranging from the initial PACS tender document and contract, to the system network, hardware and software, and their maintenance. A comprehensive awareness of the potential risks associated with the whole process of digital imaging enables safeguards to be put in place effectively to guard against any risks which might be harmful to patient care. It is important also to heighten public understanding of what the real risks of PACS are, and the precautions taken to prevent them, so that unfounded fears of digital technology are not falsely given credence, when the benefits of PACS are now central to the whole of efficient modern medicine and surgery.
The uncanny valley: Transformations of the body and debates about sexualization
Authors: Attwood Feona
Published: January 2014

Themes of transformation recur in a wide range of media and more broadly in self-help and makeover culture which invites us to join in with a process of endless improvement that Meredith Jones has described as ‘always-becoming’. The visual effects that are achieved through CGI (computer-generated imagery), Photoshop and 3D printing technologies, as well as a multitude of body modification practices can also be considered as part of a battery of techniques that are widely seen as tools of transformation. This article considers how these techniques are bound up with the interruption of ideas about how girls and women should look and behave, and, more broadly, about age-appropriate appearance and behaviour. It asks how we might consider current debates about the sexualization of culture in this broader context where self-presentation is so closely tied to representational practices and where representational regimes are being radically transformed.
Sleep, radical hospitality, and makeover’s anti-matter
Authors: Jones Meredith
Published: January 2014

Sleep has long been associated with transformation. Here I review how this manifests in fairytale, science fiction, and managerial/corporate approaches to sleep. I argue that, in line with neoliberal sensibilities that overvalue action, self-control and self-transformation, sleep is increasingly understood not as a state of rest, release, or dreaming but as an active mode of being that needs to be analysed, controlled, used to improve production, and indeed acted within. In the second part of the article I introduce two contemporary texts that work with sleep in transgressive ways: Julia Leigh’s 2011 feature film Sleeping Beauty and Philipp Lachenmann’s 12 minute video SHU (Blue Hour Lullaby). Both works deploy sleep to explore spaces of stasis, of hollowness, and to express what I call the anti-matter of the neoliberal imperative to ‘Just Do It.’
Video blogging as a vehicle of transformation: Exploring the intersection between trans identity and information technology
Authors: Raun Tobias
Published: January 2014

This article explores the intersection between trans identity and technology as it manifests in trans video blogs on YouTube. Taking my point of departure in eight case-study vloggers I analyse the different ways that the vlog can work as a medium of transformation. The vlogs engender the ongoing process of ‘becoming’ man/woman/trans by inscribing the vlogger in multiple and intersubjective reflections, being visible to themselves and others as an image. I argue that the co-production of trans identity in/through the vlog takes the shape of a mirror, a digital diary or autobiography, and as artistic explorations and communications. The article demonstrates how vloggers take advantage of the multimodality of the medium to tell stories of trans that can animate and motivate others to dare to be visible or claim an identity as trans.
Cardiorespiratory Impact of Transesophageal Endoscopic Mediastinoscopy Compared With Cervical Mediastinoscopy
Authors: Navarro-Ripoll Ricard , Córdova Henry , Rodríguez-D’Jesús Antonio , Boada Marc , Rodríguez de Miguel Cristina , Beltrán Mireia , Cubas Georgina , Perdomo Juan , Llach Josep , Balust Jaume , Gimferrer Josep M. , Fernández-Esparrach Gloria , Martínez-Pallí Graciela
Published: January 2014

Background. Transesophageal natural-orifice transluminal endoscopic surgery (NOTES) mediastinoscopy has been described as a feasible, less-invasive alternative to video-assisted mediastinoscopy (VAM). We aimed to investigate hemodynamic and respiratory effects during transesophageal NOTES mediastinoscopy compared with VAM. Patients and methods. This was a short-survival experiment in 20 female pigs randomized to NOTES (n = 10) or VAM (n = 10) mediastinoscopy. In the NOTES group, an endoscopist accessed the mediastinum through a 5-cm submucosal tunnel in the esophageal wall, and CO2 was used to create the pneumomediastinum. Conventional VAM was carried out by thoracic surgeons. A 30-minute systematic exploration of the mediastinum was then performed, including invasive monitoring for hemodynamic and respiratory data. Blood samples were drawn for gas analyses. Results. All experiments except 2 in the NOTES group (one because of technical difficulties, the other because of thoracic lymphatic duct lesion) were completed as planned, and animals survived 24 hours. Also, 3 animals in the NOTES group presented a tension pneumothorax that was immediately recognized and percutaneously drained. VAM and NOTES animals showed similar pulmonary and systemic hemodynamic behavior during mediastinoscopy. Pulmonary gas exchange pattern was mildly impaired during the NOTES procedure, showing lower partial arterial oxygen pressure associated with higher airway pressures (more important in animals that presented with pneumothorax). Conclusions. NOTES mediastinoscopy induces minimal deleterious respiratory effects and hemodynamic changes similar to conventional cervical VAM and could be feasible when performed under strict hemodynamic and respiratory surveillance. Notably, serious complications caused by the injury of pleura are more frequent in NOTES, which mandates an improvement in technique and suitable equipment.
Surgical simulation flexor tendon repair using Thiel cadavers: a comparison with formalin embalmed cadavers and porcine models
Authors: Hassan S. , Eisma R. , Malhas A. , Soames R. , Harry L.
Published: January 2014

The aim of this study was to compare Thiel-embalmed cadavers with formalin-embalmed cadavers and porcine models in the surgical simulation repair of a Zone II flexor tendon division. Nine participants were recruited to the study. The models were assessed using a five-point scale. Assessment was divided into tissue quality, surgical approach and identification of structures. Thiel cadavers rated consistently higher compared with the formalin and porcine models (mean 37 SD 2, 22 SD 6 and 23 SD 5, respectively). Thiel cadavers recorded an average tendon glide of 21 mm SD 5, formalin cadavers 2 mm SD 2 and the porcine model 6 mm SD 2. We have demonstrated the benefit of Thiel embalming, with flexibility of tissues allowing testing of the repair of a flexor tendon in a realistic anatomical model.

Level of evidence: Level V.
Strategies to secure surgical research funding: fellowships and grants
Authors: Chan James K , Shalhoub Joseph , Gardiner Matthew D , Suleman-Verjee Liaquat , Nanchahal Jagdeep
Published: January 2014

Summary

Innovation and advances in surgery are entirely dependent on research. Fellowships and grants are the principal means by which surgical research projects are funded. However, these are scarce and highly competitive. This article offers guidance through the application process for the aspiring academic surgeon. Approaching the application in a timely and structured manner, seeking advice from current and previous award-holders and members of review panels, and obtaining preliminary data are key ingredients to success.
Vaccine-derived poliomyelitis and postpolio syndrome: an Italian Cutter Incident
Authors: Lusi Elena Angela , Guarascio Paolo
Published: January 2014

Post-polio syndrome is a condition characterized by increased muscle weakness, atrophy, fatigue and pain developing several years after the acute polio event. We describe a 52-year-old patient who experienced post-polio syndrome; he had contracted acute paralytic poliomyelitis at 12 months of age, shortly after the third dose of Salk polio vaccine.
Transplantation for children with acute myeloid leukemia: a comparison of outcomes with reduced intensity and myeloablative regimens
Authors: Bitan Menachem , He Wensheng , Zhang Mei-Jie , Abdel-Azim Hisham , Ayas Mouhab Fakhreddine , Bielorai Bella , Carpenter Paul A. , Cairo Mitchell S. , Diaz Miguel Angel , Horan John T. , Jodele Sonata , Kitko Carrie L. , Schultz Kirk R. , Kletzel Morris , Kasow Kimberly A. , Lehmann Leslie E. , Mehta Parinda A. , Shah Nirali , Pulsipher Michael A. , Prestidge Tim , Seber Adriana , Shenoy Shalini , Woolfrey Ann E. , Yu Lolie C. , Davies Stella M.
Published: January 2014

Key Points

Reduced intensity and myeloablative regimen results in comparable survival after allogeneic transplantation.
Targeting EGFR signalling in chronic lung disease: therapeutic challenges and opportunities
Authors: Vallath Sabari , Hynds Robert E. , Succony Laura , Janes Sam M. , Giangreco Adam
Published: January 2014

Chronic respiratory diseases, including pulmonary fibrosis, chronic obstructive pulmonary disease (COPD) and lung cancer, are the second leading cause of death among Europeans. Despite this, there have been only a few therapeutic advances in these conditions over the past 20 years. In this review we provide evidence that targeting the epidermal growth factor receptor (EGFR) signalling pathway may represent a novel therapeutic panacea for treating chronic lung disease. Using evidence from human patient samples, transgenic animal models, and cell and molecular biology studies we highlight the roles of this signalling pathway in lung development, homeostasis, repair, and disease ontogeny. We identify mechanisms underlying lung EGFR pathway regulation and suggest how targeting these mechanisms using new and existing therapies has the potential to improve future lung cancer, COPD and pulmonary fibrosis patient outcomes.
COPD and microalbuminuria: a 12-year follow-up study
Authors: Romundstad Solfrid , Naustdal Thor , Romundstad Pål Richard , Sorger Hanne , Langhammer Arnulf
Published: January 2014

Chronic obstructive pulmonary disease (COPD), low lung function independent of diagnosis and markers of inflammation are all associated with increased morbidity and mortality. Microalbuminuria, reflecting endothelial dysfunction, could be a relevant inflammatory marker of potential systemic effects of COPD. We hypothesised that there was a positive association between microalbuminuria and mortality in individuals with COPD.

We conducted a 12-year follow-up study of 3129 participants in the second survey of the Nord-Trøndelag Health Study (HUNT), Norway. At baseline, albuminuria was analysed in three urine samples and spirometry was performed. Among the participants, 136 had COPD and microalbuminuria, defined as a urinary albumin/creatinine ratio between 2.5 and 30.0 mg·mmol−1. The main outcome measures were hazard ratio of all-cause mortality according to microalbuminuria.

Compared to those with COPD without microalbuminuria, the adjusted hazard ratio for all-cause mortality in those with COPD and microalbuminuria was 1.54, 95% CI 1.16–2.04. This result was similar after excluding cardiovascular disease at baseline. Classifying COPD severity by Global Initiative for Chronic Obstructive Lung Disease, there was a positive association trend with increasing severity stages.

Microalbuminuria is associated with all-cause mortality in individuals with COPD and could be a relevant tool in identification of patients with poor prognosis.
Pulmonary arterial compliance and exercise capacity after pulmonary endarterectomy
Authors: Ghio Stefano , Morsolini Marco , Corsico Angelo , Klersy Catherine , Mattiucci Gabriella , Raineri Claudia , Scelsi Laura , Vistarini Nicola , Oltrona Visconti Luigi , D’Armini Andrea Maria
Published: January 2014

Patients with chronic thromboembolic pulmonary hypertension (CTEPH), despite successful pulmonary endarterectomy (PEA), can continue to suffer from a limitation in exercise capacity. The objective of this study was to assess whether pulmonary arterial compliance is a predictor of exercise capacity after PEA.

Right heart haemodynamics, treadmill incremental exercise test, spirometry, carbon monoxide transfer factor, arterial blood gas and echocardiographic examinations were retrospectively analysed in a population of CTEPH patients who underwent PEA at a single centre. Baseline and 3-month haemodynamic data were available in 296 patients; 5-year follow-up data were available in 68 patients.

In a multivariable model the following parameters were found to be independent predictors of exercise capacity after surgery: age, sex, pulmonary arterial compliance, tricuspid annular plane excursion, arterial oxygen tension and carbon monoxide transfer factor (p<0.0001); the model showed good discrimination (Harrell’s c=0.84) and calibration (shrinkage coefficient=0.91). Poor exercise capacity at 3 months was loosely associated with higher death rate during subsequent survival (Harrell’s c=0.61).

In conclusion, after successful PEA, reduced pulmonary arterial compliance is an important determinant of exercise capacity in association with the age and sex of the patients, and the extent of recovery of both cardiac and respiratory function. However, exercise capacity does not explain a large proportion of the effect of surgery on subsequent survival.
Preserved function and reduced angiogenesis potential of the quadriceps in patients with mild COPD
Authors: Gagnon Philippe , Lemire Bruno B , Dubé Annie , Saey Didier , Porlier Alexandra , Croteau Marilie , Provencher Steeve , Debigaré Richard , Maltais François
Published: January 2014

Background

Little is known about limb muscle abnormalities in mild COPD. Inactivity and systemic inflammation could play a role in the development of limb muscle dysfunction in COPD. The objective of the present study was to characterize quadriceps function, enzymatic activities and morphometry, levels of plasma inflammatory markers and physical activity levels in daily life (PAdl) in patients with mild COPD (GOLD 1).

Methods

Mid-thigh muscle cross-sectional area (MTCSA), quadriceps strength, endurance, fiber-type distribution, capillarity, pro-angiogenesis factors (VEGF-A, angiopoietin I and II) and muscle oxidative capacity were assessed in 37 patients with mild COPD and 19 controls. Systemic inflammatory markers (CRP, IL-6, TNF-α, Fibrinogen, SP-D) and PAdl were assessed.

Results

MTCSA, quadriceps strength and endurance were not different between COPD and controls. Capillarity and muscle oxidative capacity were all preserved in mild COPD. Reduced pro-angiogenesis factor mRNA expression was seen in COPD. The level of moderately active intensity (>3 METs) was significantly lower in mild COPD and, in multiple regression analyses, the level of physical activity was a determinant of muscle oxidative capacity and capillarization. No between-group differences were found regarding muscle oxidative stress while circulating IL-6 levels were elevated in mild COPD.

Conclusions

The quadriceps muscle function was preserved in mild COPD although a reduced potential for angiogenesis was found. The reduced level of daily activities and evidence of systemic inflammation in these individuals suggest that these factors precede the development of overt limb muscle dysfunction in COPD.
Transcriptome sequencing and phylogenomic resolution within Spalacidae (Rodentia)
Authors: Lin Gong-Hua , Wang Kun , Deng Xiao-Gong , Nevo Eviatar , Zhao Fang , Su Jian-Ping , Guo Song-Chang , Zhang Tong-Zuo , Zhao Huabin
Published: January 2014

Background

Subterranean mammals have been of great interest for evolutionary biologists because of their highly specialized traits for the life underground. Owing to the convergence of morphological traits and the incongruence of molecular evidence, the phylogenetic relationships among three subfamilies Myospalacinae (zokors), Spalacinae (blind mole rats) and Rhizomyinae (bamboo rats) within the family Spalacidae remain unresolved. Here, we performedde novotranscriptome sequencing of four RNA-seq libraries prepared from brain and liver tissues of a plateau zokor (Eospalax baileyi) and a hoary bamboo rat (Rhizomys pruinosus), and analyzed the transcriptome sequences alongside a published transcriptome of the Middle East blind mole rat (Spalax galili). We characterize the transcriptome assemblies of the two spalacids, and recover the phylogeny of the three subfamilies using a phylogenomic approach.

Results

Approximately 50.3 million clean reads from the zokor and 140.8 million clean reads from the bamboo ratwere generated by Illumina paired-end RNA-seq technology. All clean reads were assembled into 138,872 (the zokor) and 157,167 (the bamboo rat) unigenes, which were annotated by the public databases: the Swiss-prot, Trembl, NCBI non-redundant protein (NR), NCBI nucleotide sequence (NT), Gene Ontology (GO), Cluster of Orthologous Groups (COG), and Kyoto Encyclopedia of Genes and Genomes (KEGG). A total of 5,116 nuclear orthologous genes were identified in the three spalacids and mouse, which was used as an outgroup. Phylogenetic analysis revealed a sister group relationship between the zokor and the bamboo rat, which is supported by the majority of gene trees inferred from individual orthologous genes, suggesting subfamily Myospalacinae is more closely related to subfamily Rhizomyinae. The same topology was recovered from concatenated sequences of 5,116 nuclear genes, fourfold degenerate sites of the 5,116 nuclear genes and concatenated sequences of 13 protein coding mitochondrial genes.

Conclusions

This is the first report of transcriptome sequencing in zokors and bamboo rats, representing a valuable resource for future studies of comparative genomics in subterranean mammals. Phylogenomic analysis provides a conclusive resolution of interrelationships of the three subfamilies within the family Spalacidae, and highlights the power of phylogenomic approach to dissect the evolutionary history of rapid radiations in the tree of life.
Comparison of two data collection processes in clinical studies: electronic and paper case report forms
Authors: Le Jeannic Anaïs , Quelen Céline , Alberti Corinne , Durand-Zaleski Isabelle
Published: January 2014

Background

Electronic Case Report Forms (eCRFs) are increasingly chosen by investigators and sponsors of clinical research instead of the traditional pen-and-paper data collection (pCRFs). Previous studies suggested that eCRFs avoided mistakes, shortened the duration of clinical studies and reduced data collection costs.

Methods

Our objectives were to describe and contrast both objective and subjective efficiency of pCRF and eCRF use in clinical studies. A total of 27 studies (11 eCRF, 16 pCRF) sponsored by the Paris hospital consortium, conducted and completed between 2001 and 2011 were included. Questionnaires were emailed to investigators of those studies, as well as clinical research associates and data managers working in Paris hospitals, soliciting their level of satisfaction and preferences for eCRFs and pCRFs. Mean costs and timeframes were compared using bootstrap methods, linear and logistic regression.

Results

The total cost per patient was 374€ ±351 with eCRFs vs. 1,135€ ±1,234 with pCRFs. Time between the opening of the first center and the database lock was 31.7 months Q1 = 24.6; Q3 = 42.8 using eCRFs, vs. 39.8 months Q1 = 31.7; Q3 = 52.2 with pCRFs (p = 0.11). Electronic CRFs were globally preferred by all (31/72 vs. 15/72 for paper) for easier monitoring and improved data quality.

Conclusions

This study found that eCRFs and pCRFs are used in studies with different patient numbers, center numbers and risk. The first ones are more advantageous in large, low–risk studies and gain support from a majority of stakeholders.
Effects of demand-side financing on utilisation, experiences and outcomes of maternity care in low- and middle-income countries: a systematic review
Authors: Murray Susan F , Hunter Benjamin M , Bisht Ramila , Ensor Tim , Bick Debra
Published: January 2014

Background

Demand-side financing, where funds for specific services are channelled through, or to, prospective users, is now employed in health and education sectors in many low- and middle-income countries. This systematic review aimed to critically examine the evidence on application of this approach to promote maternal health in these settings. Five modes were considered: unconditional cash transfers, conditional cash transfers, short-term payments to offset costs of accessing maternity services, vouchers for maternity services, and vouchers for merit goods. We sought to assess the effects of these interventions on utilisation of maternity services and on maternal health outcomes and infant health, the situation of underprivileged women and the healthcare system.

Methods

The protocol aimed for collection and synthesis of a broad range of evidence from quantitative, qualitative and economic studies. Nineteen health and social policy databases, seven unpublished research databases and 27 websites were searched; with additional searches of Indian journals and websites. Studies were included if they examined demand-side financing interventions to increase consumption of services or goods intended to impact on maternal health, and met relevant quality criteria. Quality assessment, data extraction and analysis used Joanna Briggs Institute standardised tools and software. Outcomes of interest included maternal and infant mortality and morbidity, service utilisation, factors required for successful implementation, recipient and provider experiences, ethical issues, and cost-effectiveness. Findings on Effectiveness, Feasibility, Appropriateness and Meaningfulness were presented by narrative synthesis.

Results

Thirty-three quantitative studies, 46 qualitative studies, and four economic studies from 17 countries met the inclusion criteria. Evidence on unconditional cash transfers was scanty. Other demand-side financing modes were found to increase utilisation of maternal healthcare in the index pregnancy or uptake of related merit goods. Evidence of effects on maternal and infant mortality and morbidity outcomes was insufficient. Important implementation aspects include targeting and eligibility criteria, monitoring, respectful treatment of beneficiaries, suitable incentives for providers, quality of care and affordable referral systems.

Conclusions

Demand-side financing schemes can increase utilisation of maternity services, but attention must be paid to supply-side conditions, the fine-grain of implementation and sustainability. Comparative studies and research on health impact and cost-effectiveness are required.
Effect of calcium phosphate and vitamin D3supplementation on bone remodelling and metabolism of calcium, phosphorus, magnesium and iron
Authors: Trautvetter Ulrike , Neef Nadja , Leiterer Matthias , Kiehntopf Michael , Kratzsch Jürgen , Jahreis Gerhard
Published: January 2014

Background

The aim of the present study was to determine the effect of calcium phosphate and/or vitamin D3on bone and mineral metabolism.

Methods

Sixty omnivorous healthy subjects participated in the double-blind, placebo-controlled parallel designed study. Supplements were tricalcium phosphate (CaP) and cholecalciferol (vitamin D3). At the beginning of the study (baseline), all subjects documented their normal nutritional habits in a dietary record for three successive days. After baseline, subjects were allocated to three intervention groups: CaP (additional 1 g calcium/d), vitamin D3(additional 10 μg/d) and CaP + vitamin D3. In the first two weeks, all groups consumed placebo bread, and afterwards, for eight weeks, the test bread according to the intervention group. In the last week of each study period (baseline, placebo, after four and eight weeks of intervention), a faecal (three days) and a urine (24 h) collection and a fasting blood sampling took place. Calcium, phosphorus, magnesium and iron were determined in faeces, urine and blood. Bone formation and resorption markers were analysed in blood and urine.

Results

After four and eight weeks, CaP and CaP + vitamin D3supplementations increased faecal excretion of calcium and phosphorus significantly compared to placebo. Due to the vitamin D3supplementations (vitamin D3, CaP + vitamin D3), the plasma 25-(OH)D concentration significantly increased after eight weeks compared to placebo. The additional application of CaP led to a significant increase of the 25-(OH)D concentration already after four weeks. Bone resorption and bone formation markers were not influenced by any intervention.

Conclusions

Supplementation with daily 10 μg vitamin D3significantly increases plasma 25-(OH)D concentration. The combination with daily 1 g calcium (as CaP) has a further increasing effect on the 25-(OH)D concentration. Both CaP alone and in combination with vitamin D3have no beneficial effect on bone remodelling markers and on the metabolism of calcium, phosphorus, magnesium and iron.

Trial registration

NCT01297023
Plasma protein profiling of Mild Cognitive Impairment and Alzheimer’s disease using iTRAQ quantitative proteomics
Authors: Song Fei , Poljak Anne , Kochan Nicole A , Raftery Mark , Brodaty Henry , Smythe George A , Sachdev Perminder S
Published: January 2014

Background

With the promise of disease modifying treatments, there is a need for more specific diagnosis and prognosis of Alzheimer’s disease (AD) and mild cognitive impairment (MCI). Plasma biomarkers are likely to be utilised to increase diagnostic accuracy and specificity of AD and cognitive decline.

Methods

Isobaric tags (iTRAQ) and proteomic methods were used to identify potential plasma biomarkers of MCI and AD. Relative protein expression level changes were quantified in plasma of 411 cognitively normal subjects, 19 AD patients and 261 MCI patients. Plasma was pooled into 4 groups including normal control, AD, amnestic single and multiple domain MCI (aMCI), and nonamnestic single and multiple domain MCI (nMCI). Western-blotting was used to validate iTRAQ data. Integrated function and protein interactions were explored using WEB based bioinformatics tools (DAVID v6.7 and STRING v9.0).

Results

In at least two iTRAQ replicate experiments, 30 proteins were significantly dysregulated in MCI and AD plasma, relative to controls. These proteins included ApoA1, ApoB100, complement C3, C4b-binding protein, afamin, vitamin D-binding protein precursor, isoform 1 of Gelsolin actin regulator, Ig mμ chain C region (IGHM), histidine-rich glycoprotein and fibrinogen β and γ chains. Western-blotting confirmed that afamin was decreased and IGHM was increased in MCI and AD groups. Bioinformatics results indicated that these dysregulated proteins represented a diversity of biological processes, including acute inflammatory response, cholesterol transport and blood coagulation.

Conclusion

These findings demonstrate that expression level changes in multiple proteins are observed in MCI and AD plasma. Some of these, such as afamin and IGHM, may be candidate biomarkers for AD and the predementia condition of MCI.