bluuebunny/crossref_metadata_2025 huggingface dataset:
Grooming and Anxiety in Barbary Macaques
Authors: Semple Stuart , Harrison Christy , Lehmann Julia
Published: July 2013

Grooming is a fundamental component of sociality in many gregarious animal species, and elucidating the costs and benefits of this behaviour is crucial for understanding its function. There is evidence that animals giving grooming pay a cost in terms of the time and energy they invest, while recipients benefit not just from the removal of dirt and parasites, but also from the relaxing effects of being groomed. Recently, however, studies of primates have indicated that giving grooming may also provide such hedonic benefits, reducing levels of stress or anxiety in the groomer. In this study of free‐ranging adult female Barbary macaques at Trentham Monkey Forest (Stoke‐on‐Trent, UK), we tested the hypothesis that grooming reduces anxiety in the donor and/or the recipient. During focal follows, we quantified females' rates of self‐scratching as a behavioural index of their anxiety levels. Self‐scratching rates in the 2‐min periods after bouts of grooming (given, received and reciprocated) were compared to overall mean self‐scratching rates; we predicted that if grooming reduces anxiety, self‐scratching rates would be significantly lower after grooming bouts than mean levels. We first analysed all grooming bouts and then analysed separately grooming bouts with adult males, with all adult females, with subordinate adult females and with dominant adult females. Contrary to our prediction, self‐scratching rates were never seen to be lower after grooming than mean levels. In fact, for the majority of grooming partner–direction combinations, we found significantly higher rates of self‐scratching after grooming compared to mean levels. The hypothesis that grooming reduces anxiety was therefore not supported. Grooming seems in some cases to increase, not alleviate, anxiety. We explore possible explanations for these unexpected results.
Exploring the boundary of a specialist service for adults with intellectual disabilities using a Delphi study: a quantification of stakeholder participation
Authors: Hempe Eva‐Maria , Morrison Cecily , Holland Anthony
Published: July 2013

Background

There are arguments that a specialist service for adults with intellectual disabilities is needed to address the health inequalities that this group experiences. The boundary of such a specialist service however is unclear, and definition is difficult, given the varying experiences of the multiple stakeholder groups.

Objectives

The study reported here quantitatively investigates divergence in stakeholders’ views of what constitutes a good specialist service for people with intellectual disabilities. It is the first step of a larger project that aims to investigate the purpose, function and design of such a specialist service. The results are intended to support policy and service development.

Study design

A Delphi study was carried out to elicit the requirements of this new specialist service from stakeholder groups. It consisted of three panels (carers, frontline health professionals, researchers and policymakers) and had three rounds. The quantification of stakeholder participation covers the number of unique ideas per panel, the value of these ideas as determined by the other panels and the level of agreement within and between panels.

Findings

There is some overlap of ideas about of what should constitute this specialist service, but both carers and frontline health professionals contributed unique ideas. Many of these were valued by the researchers and policymakers. Interestingly, carers generated more ideas regarding how to deliver services than what services to deliver. Regarding whether ideas are considered appropriate, the variation both within and between groups is small. On the other hand, the feasibility of solutions is much more contested, with large variations among carers.

Conclusions

This study provides a quantified representation of the diversity of ideas among stakeholder groups regarding where the boundary of a specialist service for adults with learning disabilities should sit. The results can be used as a starting point for the design process. The study also offers one way to measure the impact of participation for those interested in participation as a mechanism for service improvement.
The circadian clock is functional in eosinophils and mast cells
Authors: Baumann Anja , Gönnenwein Simone , Bischoff Stephan C. , Sherman Hadas , Chapnik Nava , Froy Oren , Lorentz Axel
Published: July 2013

Allergic diseases are frequently exacerbated between midnight and early morning, suggesting a role for the biological clock. Mast cells (MC) and eosinophils are the main effector cells of allergic diseases and some MC‐specific or eosinophil‐specific markers, such as tryptase or eosinophil cationic protein, exhibit circadian variation. Here, we analysed whether the circadian clock is functional in mouse and human eosinophils and MC. Mouse jejunal MC and polymorphonuclear cells from peripheral blood (PMNC) were isolated around the circadian cycle. Human eosinophils were purified from peripheral blood of non‐allergic and allergic subjects. Human MC were purified from intestinal tissue. We found a rhythmic expression of the clock genes mPer1, mPer2, mClock and mBmal1 and eosinophil‐specific genes mEcp, mEpo and mMbp in murine PMNC. We also found circadian variations for hPer1, hPer2, hBmal1, hClock, hEdn and hEcp mRNA and eosinophil cationic protein (ECP) in human eosinophils of both healthy and allergic people. Clock genes mPer1, mPer2, mClock and mBmal1 and MC‐specific genes mMcpt‐5, mMcpt‐7, mc‐kit and mFcεRI α‐chain and protein levels of mMCPT5 and mc‐Kit showed robust oscillation in mouse jejunum. Human intestinal MC expressed hPer1, hPer2 and hBmal1 as well as hTryptase and hFcεRI α‐chain, in a circadian manner. We found that pre‐stored histamine and de novo synthesized cysteinyl leukotrienes, were released in a circadian manner by MC following IgE‐mediated activation. In summary, the biological clock controls MC and eosinophils leading to circadian expression and release of their mediators and, hence it might be involved in the pathophysiology of allergy.
Quantification and comparison of psychiatric distress in African patients with albinism and vitiligo: a 5‐year prospective study
Authors: Ajose F.O.A. , Parker R.A. , Merrall E.L.C. , Adewuya A.O. , Zachariah M.P.
Published: July 2013

Background

Vitiligo and Albinism are two disorders of pigmentation that make the affected African highly visible and strikingly different from their peers. Both pose considerable management challenges, attract significant stigma and profound impairment of quality of life.

Objective and Methods

To determine and compare psychiatric distress in vitiligo and albinism using the Hospital Anxiety and Depression Scale (HADS). Participants were 87 albinos and 102 vitiligo adult patients seen at an urban tertiary hospital in Nigeria between 2004 and 2009.

Results

Prevalence of psycho morbidity was 59% (60/102) in vitiligo compared with 26% (23/87) in the albinos. The mean anxiety score was estimated to be 2.55 points lower for albino patients (95% CI: 1.47 to 3.64), and the mean depression score 2.76 points lower (95% CI: 1.84 to 3.68), after adjustment for age, sex and marital status. However, significant differences were not observed when comparing the vitiligo patients with the subset of albino patients with skin cancer. Older patients had significantly higher anxiety and depression scores. Females had significantly higher anxiety scores (but not depression scores) compared to males. Genital involvement in vitiligo was significantly associated with anxiety but not depression.

Conclusions

We found that the African with vitiligo suffers significantly higher psychiatric distress than the African albino on average. Clinical evaluation of these patients would be incomplete without assessment of their psycho morbidity. There is need for increased focus on cancer prevention strategies in the African albino.
Phase equilibria for graphitic metapelite including solution of CO2 in melt and cordierite: implications for dehydration, partial melting and graphite precipitation
Authors: Chu X. , Ague J. J.
Published: July 2013

When graphite is present, carbon‐bearing species dissolve in the C‐O‐H fluid and lower the activity of water (). Accordingly, metamorphic reactions that involve water, namely dehydration and partial melting reactions, adjust their P–T positions to accommodate the change of . In this modelling study, pseudosections are calculated for graphite‐bearing systems that are either closed or that progressively lose fluid and/or melt. The diagrams incorporate a new model of CO2 solubility in felsic melts that we derived to be compatible with a recently published melt model. As the result of the lowered in the carbon‐bearing systems, the temperature displacements of the solidus can be as large as 50 °C at low pressures in cordierite‐bearing zones (<4 kbar), but are smaller than 15 °C at mid‐pressure P–T conditions (4–9 kbar). In the supersolidus region, the phase relations among silicate minerals + melt are very close to those in carbon‐free systems. The fluid CO2 content increases as temperature increases in the supersolidus assemblages. The CO2‐rich fluid can be stable in granulite facies conditions in an oxidized system. In graphitic systems, melt and/or cordierite dominate the CO2 budget of high‐grade rocks. During cooling, the fluid that exsolves from such crystalizing melt is CO2‐rich. In addition to the phase relations, the pseudosections presented in this study enable researchers to quantitatively investigate the evolution of phase modes, including graphite, along specific metamorphic P–T paths. At low pressures in the cordierite stability field, graphite is predicted to precipitate as the pressure increases or temperature decreases in the subsolidus assemblages, or temperature increases in the region of melt + fluid coexistence. On the other hand, the graphite abundance remains nearly constant along the mid‐pressure P–T series, but the graphite mode in the supersolidus region may increase due to residual enrichment if the melt is extracted. The modelling results show that metamorphic processes in closed systems lead to only small changes in graphite mode (a few tenths of a per cent). This strongly suggests that open‐system behaviours are required for large amounts of graphite deposition, including fluid infiltration and mixing or residual enrichment processes in high‐grade rocks. In addition to P–T pseudosections, P/T–XO diagrams (XO = O/(H + O) in the fluid) illustrate the thermodynamic features of internal buffering from another perspective, and explore the dependence of phase relations on the externally imposed redox state. If the system is equilibrated with CO2 or CH4‐rich infiltrating fluid, the temperature displacements of metamorphic reactions can be larger than 50 °C, compared with carbon‐free systems.
Rapid Oestrogenic Regulation of Social and Nonsocial Learning
Authors: Ervin K. S. J. , Phan A. , Gabor C. S. , Choleris E.
Published: July 2013

Much research on oestrogens has focused on their long‐term action, exerting behavioural effects within hours to days through gene transcription. Oestrogens also affect behaviour on a much shorter time scale. These rapid effects are assumed to occur through cell signalling and can elicit a behavioural effect as early as 15 min after treatment. These effects on behaviour have primarily been explored through the action of oestradiol at three well‐known oestrogen receptors (ERs): ERα, ERβ and the more recently described G protein‐coupled ER1 (GPER1). The rapid effects of oestradiol and ER agonists have been tested on both social and nonsocial learning paradigms. Social learning refers to a paradigm in which an animal acquires information and modifies its behaviour based on observation of another animal, commonly studied using the social transmission of food preferences paradigm. When administered shortly before testing, oestradiol rapidly improves social learning on this task, although no ER agonist has definitive, comparable improving effects. Some evidence points to GPER1, whereas ERα impairs, and ERβ activation has no effect on social learning. Conversely, ERα and GPER1 play a larger role than ERβ in the rapid improving effect of oestrogens on nonsocial learning, including social and object recognition. In addition, when administered immediately post‐acquisition, oestrogens also rapidly improve memory consolidation in a variety of learning paradigms: object recognition, object placement, inhibitory avoidance and the Morris water maze, indicating that oestradiol affects the consolidation of multiple types of memory. Evidence suggests that these improvements are the result of oestrogens acting in the dorsal hippocampus where selective activation of all three ERs shows rapid improving effects on spatial learning comparable to oestradiol. However, the hippocampus is not necessary for rapid oestradiol improvements on social recognition. Although acute treatment with oestradiol enhances learning and memory on various social and nonsocial learning paradigms, the specific ERs play different roles in each type of learning. Future research should aim to further determine the roles of ERs with respect to the enhancing effects of oestradiol on learning and memory, and also determine where in the brain oestradiol acts to affect social and nonsocial learning.
Spinal muscular atrophy: a motor neuron disorder or a multi‐organ disease?
Authors: Shababi Monir , Lorson Christian L. , Rudnik‐Schöneborn Sabine S.
Published: July 2013

Spinal muscular atrophy (SMA) is an autosomal recessive disorder that is the leading genetic cause of infantile death. SMA is characterized by loss of motor neurons in the ventral horn of the spinal cord, leading to weakness and muscle atrophy. SMA occurs as a result of homozygous deletion or mutations in Survival Motor Neuron‐1 (SMN1). Loss of SMN1 leads to a dramatic reduction in SMN protein, which is essential for motor neuron survival. SMA disease severity ranges from extremely severe to a relatively mild adult onset form of proximal muscle atrophy. Severe SMA patients typically die mostly within months or a few years as a consequence of respiratory insufficiency and bulbar paralysis. SMA is widely known as a motor neuron disease; however, there are numerous clinical reports indicating the involvement of additional peripheral organs contributing to the complete picture of the disease in severe cases. In this review, we have compiled clinical and experimental reports that demonstrate the association between the loss of SMN and peripheral organ deficiency and malfunction. Whether defective peripheral organs are a consequence of neuronal damage/muscle atrophy or a direct result of SMN loss will be discussed.
Role of osteopontin in differential diagnosis of ovarian tumors
Authors: Moszynski Rafal , Szubert Sebastian , Szpurek Dariusz , Michalak Slawomir , Sajdak Stefan
Published: July 2013

Aim

The aim of this study was to evaluate the role of the serum osteopontin (OPN) level as a biomarker for discriminating between malignant and benign ovarian tumors. Furthermore, comparisons with the diagnostic usefulness of the other tests were performed.

Methods

The study included 114 consecutive women with ovarian tumors (82 benign and 32 malignant) who were referred to our division.

Results

A cut‐off level of 28.0 ng/mL for OPN showed a sensitivity of 71.87% and a specificity of 89.02%. The area under the receiver–operator curve (ROC) was 0.812. There were no differences in diagnostic utility between OPN and the other studied tests. OPN levels were lower in patients with endometriotic ovarian cysts than in those with other benign ovarian tumors (14.00 vs 19.50 ng/mL; P = 0.018). The difference between the median OPN level in patients with endometriotic cysts (14.0 ng/mL) and those with malignant tumors (40.85 ng/mL) was also statistically significant (P < 0.0001). The calculated OPN/CA‐125 ratio was significantly different between patients with endometriotic cysts (median, 0.36; range, 0.05–2.89) and those with other benign tumors (median, 1.25; range, 0.05–5.70) (P = 0.0002). There was also a statistically significant difference in the median OPN/CA‐125 ratio between patients with endometrial cysts (median, 0.36; range, 0.05–2.89) and those with malignant tumors (median, 0.12; range, 0.01–3.39) (P = 0.004).

Conclusion

The diagnostic utility of OPN is similar to that of ultrasonographic evaluation and CA‐125 level assessment. Thus, OPN may be useful in differential diagnosis for less experienced ultrasonographers and is especially valuable for differential diagnosis of endometriotic cysts.
Postpartum smoking relapse among women who quit during pregnancy: Cross‐sectional study in Japan
Authors: Yasuda Takako , Ojima Toshiyuki , Nakamura Mieko , Nagai Akiko , Tanaka Taichiro , Kondo Naoki , Suzuki Kohta , Yamagata Zentaro
Published: July 2013

Aim

To determine the postpartum smoking relapse rate among women in Japan who quit smoking during pregnancy and to clarify factors related to smoking relapse.

Methods

A self‐administered questionnaire survey was conducted as a cross‐sectional study of all mothers of children who underwent health checkups after birth in randomly selected municipalities in Japan from May to July 2009. Using valid data of 20 601 mothers, smoking rate was calculated. In addition, χ2‐test and multiple logistic regression analysis were used to clarify related factors to the smoking relapse.

Results

The smoking rates among women were 15.8% at the time when they became pregnant, 5.1% during pregnancy and 11.3% after giving birth. Among women who smoked at the time they became pregnant, the smoking rate during pregnancy was 31.1%. Among women who quit smoking during pregnancy, the postpartum smoking relapse rate was 41.0%. The odds ratios (95% confidence interval) for factors in smoking relapse were 0.72 (0.60–0.88) for women spending time with their child in a relaxed mood, 0.67 (0.47–0.94) for women having someone to talk to on the Internet about childrearing, 1.94 (1.60–2.35) for women who worked and 3.37 (2.61–4.35) for women whose partner smoked after they gave birth.

Conclusion

It is hoped that future research will establish methods to further support smoking cessation and the continuation of smoking cessation after childbirth, and develop mechanisms to spread knowledge about the harm of smoking in society and encourage women not to start.
Facility‐based review of 296 maternal deaths at a tertiary centre in India: Could they be prevented?
Authors: Goswami Deepti , Rathore Asmita Muthal , Batra Swaraj , Dubey Chandan , Tyagi Shakun , Wadhwa Leena
Published: July 2013

Aims

The aim of this study was to identify causes of maternal mortality at the facility and to assess the standard of care, deficiencies in health services and preventability of these deaths using facility‐based maternal death reviews.

Material and Methods

This was a prospective study at a tertiary care hospital that included all women who died during pregnancy or within 42 days of being pregnant during 2005–2010.

Results

A review of 296 maternal deaths revealed that 59% of these occurred in medical wards. Indirect maternal deaths (54%) outnumbered the direct deaths (46%). Main causes were hepatitis (18%), hemorrhage (10%) and puerperal sepsis (10%). Only 5% of the women had received antenatal care at the facility. One‐third (34%) were referred from other centers. The majority (74%) were critically sick at admission. Most of the women (62%) died postpartum. Substandard care and deficient health services were identified in 8% and 20% of the cases, respectively. Sixteen (5%) maternal deaths were deemed preventable and another 36 (12%) possibly preventable. Since most of the preventable deaths (12/16) were due to hemorrhage, measures to control postpartum hemorrhage were promoted at the facility. Findings of the maternal death reviews were regularly conveyed to the State Health Department for prioritization and resource allocation to prevent maternal mortality.

Conclusion

More maternal deaths occurred in the medical than in the obstetrics wards at the facility. The leading causes were hepatitis, hemorrhage and puerperal sepsis. Most of the deaths were non‐preventable as the women were critically sick at admission; however, substandard care and health service deficiency were contributory in some of the cases.
Optimal timing of prophylactic antibiotic for cesarean delivery: A randomized comparative study
Authors: Bhattacharjee Nabendu , Saha Shyama Prasad , Patra Kajal Kumar , Mitra Udayan , Ghoshroy Samir Chandra
Published: July 2013

Aim

Cesarean delivery is associated with a significantly higher postoperative infection rate than that following vaginal birth and other surgical procedures. This study compared whether antibiotic prophylaxis administered preoperatively was more effective in preventing infectious morbidity following cesarean delivery than administration at cord clamping.

Material and Methods

In a randomized comparative trial, 953 women with a period of gestation of more than 34 weeks, scheduled to have cesarean section, were randomly assigned to the prophylactic single‐dose antibiotic administration either preoperatively (study group) or at cord clamping (control group). Primary outcome measure was postoperative maternal infectious morbidity and secondary outcome measures were neonatal complications, and postoperative maternal hospital stay and stay of neonates in the neonatal intensive care unit.

Results

Wound complications in the form of indurations, erythema and discharge, were significantly fewer in the study group as compared to the control group (10/476 vs 25/477, P = 0.010, conditional maximum likelihood estimate of odds ratio = 0.388 and 95% confidence interval = 0.175–0.805). Women in the study group also had fewer incidents of endomyometritis when compared to the control group (1.47% vs 3.56%; P = 0.041; conditional maximum likelihood estimate of odds ratio = 0.404). There was no significant difference in neonatal outcomes between the two groups. Mean postoperative stay of mothers in hospital was significantly shorter in the study group (P = 0.009, 95% confidence interval = −0.368 to −0.052) but neonatal intensive care unit stay of neonates was similar in both groups.

Conclusion

Administration of prophylactic antibiotic at 30–60 min before skin incision resulted in better maternal outcome when infectious morbidity and postoperative hospital stay were concerned, without influencing the neonatal outcome.
Laparoscopic ovarian‐sparing surgery for a young woman with an exophytic ovarian fibroma
Authors: Hasegawa Akiko , Koga Kaori , Asada Kayo , Wada‐Hiraike Osamu , Osuga Yutaka , Kozuma Shiro
Published: July 2013

Ovarian fibroma can occur in young women of reproductive age. Despite its benign feature, most surgical removals are done in open surgery with oophorectomy. However, an ovarian‐sparing tumor resection can be an option, especially for an exophytic type of fibroma, which accounts for more than half of ovarian fibromas. Here we report a case of exophytic ovarian fibroma in a young woman treated by laparoscopic ovarian‐sparing surgery. A 27‐year‐old woman presented with a pelvic mass. Magnetic resonance imaging revealed an 11 cm × 8 cm solid mass connected to the normal‐appearing left ovary by a pedicle‐like structure. A clinical diagnosis of an exophytic ovarian fibroma was made, and laparoscopic ovarian‐sparing surgery with an intraoperative pathological examination was planned. The tumor was resected by cutting the pedicle, morcellated in a pouch and removed. All procedures were performed laparoscopically and the affected ovary was completely preserved. Having confirmation of its benign characteristics by the intraoperative examination, no further excision was performed. The patient conceived 3 months after the surgery and no recurrence was reported. We propose that gynecologists should consider laparoscopic ovarian‐sparing surgery for exophytic ovarian fibroma in women of reproductive age.
Diagnostic significance of total creatine kinase and its isoform in tubal ectopic pregnancy
Authors: Soundravally Rajendiran , Krishna Latha Thammineni , Soundara Raghavan Subrahmanian , Ananthanarayanan Palghat Hariharan , Srilatha Krishnamoorthy
Published: July 2013

Aim

Tubal ectopic pregnancy (tEP) must be diagnosed as early as possible because it is one of the leading causes of pregnancy‐related death in the first trimester. The aim of this study was to evaluate the diagnostic value of serum total creatine kinase (CK) and its isoforms in diagnosis of tEP.

Methods

The study included 32 tEP cases, and gestational age‐matched intrauterine (IU) abortion and normal pregnancy cases (n = 31 each). Serum total CK and CK‐MB fraction were measured by the principle of spectrophotometry and CK‐MM fraction was calculated from the above parameters. Serum β‐hCG was measured using chemiluminescent immunoassay. All study parameters were measured at the time of presentation.

Results

Serum β‐hCG levels were significantly low in patients with both tEP and IU abortion than normal pregnancy. Women with tEP had higher concentrations of total CK, CK‐MM and lower concentrations of CK‐MB% compared to both gestational age‐matched IU pregnancy controls and IU abortion. Receiver–operator characteristic analysis revealed that the optimal cut‐off for total CK, CK‐MM and CPK‐MB% as predictors of ruptured EP were 147 IU/L, 135 IU/L and 10%, respectively, with the former two having higher specificity, and latter high sensitivity.

Conclusion

Estimation of CK and its CK isoenzyme fractions can aid in quick and accurate diagnosis of tEP.
Molecular mechanism of poor embryo development in postovulatory aged oocytes: Mini review
Authors: Takahashi Toshifumi , Igarashi Hideki , Amita Mitsuyoshi , Hara Shuichiro , Matsuo Koki , Kurachi Hirohisa
Published: July 2013

Oocyte quality is a key factor in determining embryo development; however, we have a poor understanding of what constitutes oocyte quality or the mechanisms governing it. Postovulatory aging of oocytes that have not been fertilized for a prolonged time after ovulation is known to significantly impair oocyte quality and subsequent embryo development after fertilization. Embryos derived from postovulatory‐aged oocytes are prone to undergo apoptosis due to the decreased Bcl‐2 expression. Postovulatory aging of oocytes changes the patterns of Ca2+ oscillations at fertilization as a result of impaired Ca2+ regulation in the endoplasmic reticulum. Moreover, postovulatory aging of oocytes impairs mitochondrial adenosine triphosphate production as a result of increasing oxidative stresses. Oxidative stresses also affect intracellular Ca2+ regulation and impair embryo development after fertilization. Collectively, the mechanism of postovulatory oocyte aging might be involved in reactive oxygen species‐induced mitochondrial injury followed by abnormal intracellular Ca2+ regulation in the endoplasmic reticulum.
Comparisons of the morbidity outcomes in repeated cesarean sections using midline and Pfannenstiel incisions
Authors: Puttanavijarn Lunthaporn , Phupong Vorapong
Published: July 2013

Aim

The aim of this study was to evaluate operative complications, operative time, postpartum complications and neonatal outcome in repeated cesarean section between previous low midline and previous Pfannenstiel cesarean section.

Material and Methods

This was a prospective comparative study conducted at the King Chulalongkorn Memorial Hospital in pregnant women with indication of repeated cesarean section for either low midline or Pfannenstiel incisions.

Results

A total of 320 pregnant women with previous cesarean section were enrolled into two groups: low midline (n = 160) and Pfannenstiel (n = 160) groups. Operative complications, postpartum complications and neonatal outcomes were not statistically different between the groups (P > 0.05). Median times for total operative time (50 vs 50 min, P = 0.833), time from skin incision to the uterus (4 vs 4 min, P = 0.877), and time from uterine incision to fetal delivery (3 vs 2 min, P = 0.871) were comparable between the groups.

Conclusions

Operative complications, operative time, postpartum complications and neonatal outcomes were comparable between low midline and Pfannenstiel groups in repeated cesarean sections irrespective of the previous technique used.
Acute peripartum twin–twin transfusion syndrome: Incidence, risk factors, placental characteristics and neonatal outcome
Authors: Lopriore Enrico , Holtkamp Nanneke , Sueters Marieke , Middeldorp Johanna M. , Walther Frans J. , Oepkes Dick
Published: July 2013

Aim

The aim of this study was to examine the incidence, placental characteristics and outcome in acute peripartum twin–twin transfusion syndrome (TTTS).

Material and Methods

All consecutive cases of monochorionic (MC) twins admitted to our center were included in the study. We excluded cases with chronic TTTS or twin anemia polycythemia sequence. Acute peripartum TTTS was defined when the inter‐twin hemoglobin difference at birth was >8 g/dL.

Results

A total of 241 MC twin pregnancies were included in the study. Acute peripartum TTTS was detected in six cases (2.5%, 6/241). Vaginal delivery occurred more often in the acute peripartum TTTS group compared to the control group of uncomplicated MC pregnancies, 100% (6/6) versus 57% (135/235) (P = 0.002), respectively. Acute anemia was detected only in firstborn twins. Placental angioarchitecture in acute peripartum TTTS was similar to the placentas in the control group.

Conclusions

The incidence of acute peripartum TTTS is low (2.5%). Birth order and mode of delivery appear to be associated with increased risk of acute peripartum TTTS.
Cross‐sectional study of gestational weight gain and perinatal outcomes in pregnant women at a tertiary care center in southern India
Authors: Radhakrishnan Usha , Kolar Geeta , Nirmalan Praveen K.
Published: July 2013

Aim

The aim of this study was to determine maternal and neonatal outcomes of less than recommended or excess gestational weight gain (GWG) based on the recommended Institute of Medicine (IOM) guidelines.

Material and Methods

Using a cross‐sectional study design, GWG was assessed for 1462 pregnant women presenting to a tertiary care perinatal institute in India. Body mass index at baseline, co‐existing morbidities, fetal growth, details of delivery, and maternal and fetal outcomes were determined and documented. Appropriate GWG for each woman was determined based on the revised IOM guidelines. Outcome measures included the proportion of pregnant women compliant with IOM guidelines for GWG and associations of less than recommended or excess GWG with maternal and neonatal outcomes.

Results

A total of 547 (37.41%, 95% confidence interval [CI]: 34.96–39.92) pregnant women gained less than recommended and 313 (21.41%, 95%CI: 19.36–23.57) pregnant women gained more than the recommended weight. Preterm deliveries were associated with less than optimal weight gain (adjusted odds ratio 3.58, 95%CI: 1.75–7.32) after adjusting for gestational age at delivery. GWG was not associated with neonatal outcomes in this population.

Conclusions

The lack of associations with perinatal outcomes indicates that the IOM guidelines may not be the appropriate standard for monitoring GWG in this population.
Role of Insulin and Adenosine in the Human Placenta Microvascular and Macrovascular Endothelial Cell Dysfunction in Gestational Diabetes Mellitus
Authors: Guzmán‐Gutiérrez Enrique , Arroyo Pablo , Salsoso Rocío , Fuenzalida Bárbara , Sáez Tamara , Leiva Andrea , Pardo Fabián , Sobrevia Luis
Published: July 2013

Microvascular and macrovascular endothelial function maintains vascular reactivity. Several diseases alter endothelial function, including hypertension, obesity, and diabetes mellitus. In addition, micro‐ and macrovascular endothelial dysfunction is documented in GDM with serious consequences for the growing fetus. Increased l‐arginine uptake via hCAT‐1 and NO synthesis by eNOS is associated with GDM. These alterations are paralleled by activation of purinergic receptors and increased umbilical vein, but not arteries blood adenosine accumulation. GDM associates with NO‐reduced adenosine uptake in placental endothelium, suggested to maintain and/or facilitate insulin vasodilation likely increasing hCAT‐1 and eNOS expression and activity. It is proposed that increased umbilical vein blood adenosine concentration in GDM reflects a defective metabolic state of human placenta. In addition, insulin recovers GDM‐alterations in hCAT‐1 and eNOS in human micro‐ and macrovascular endothelium, and its biological actions depend on preferential activation of insulin receptors A and B restoring a normal‐like from a GDM‐like phenotype. We summarized existing evidence for a potential role of insulin/adenosine/micro‐ and macrovascular endothelial dysfunction in GDM. These mechanisms could be crucial for a better management of the mother, fetus and newborn in GDM pregnancies.
(un) Disciplining thenursewriter: doctoral nursing students' perspective on writing capacity
Authors: Ryan Maureen M , Walker Madeline , Scaia Margaret , Smith Vivian
Published: July 2013

In this article, we offer a perspective into howCanadian doctoral nursing students’ writing capacity is mentored and, as a result, we argue is disciplined. We do this by sharing our own disciplinary and interdisciplinary experiences of writing with, for and about nurses. We locate our experiences within a broader discourse that suggests doctoral (nursing) students be prepared as stewards of the (nursing) discipline. We draw attention to tensions and effects of writing within (nursing) disciplinary boundaries. We argue that traditional approaches to developing nurses’ writing capacity in doctoral programs both shepherds and excludes emerging scholarly voices, and we present some examples to illustrate this dual role. We ask our nurse colleagues to consider for whom nurses write, offering an argument that nurses’ writing must ultimately improve patient care and thus would benefit from multiple voices in writing.
Intersectional perspectives on family involvement in nursing home care: rethinking relatives' position as a betweenship
Authors: Holmgren Jessica , Emami Azita , Eriksson Lars E , Eriksson Henrik
Published: July 2013

This study seeks to understand, in the context of intersectional theory, the roles of family members in nursing home care. The unique social locus at which each person sits is the result of the intersection of gender, status, ethnicity and class; it is situational, shifting with the context of every encounter. A content analysis of 15 qualitative interviews with relatives of nursing home residents in Sweden was used to gain a perspective on the relationships between relatives and residents, relatives and the nursing home as an institution, and relatives and the nursing home staff. We sought to understand these relationships in terms of gendered notions of the family and the residents, which are handed down from generation to generation and thus condition who and how relatives should be involved in care, and the ways in which relationships change as care moves from home to nursing home. It requires knowledge and awareness that the nursing home culture is based on intersectional power structures in order for relatives to be involved in nursing home care in alternative and individual ways.
Surgical ciliated cyst of the maxilla following maxillary osteotomy: a case report
Authors: Koo Min Chee C.A. , Brierley D.J. , Hunter K.D. , Pace C. , McKechnie A.J.
Published: July 2013

A healthy 42‐year‐old male presented with a 1‐week history of pain associated with a swelling localised to the upper right quadrant of his mouth. The patient had undergone a bimaxillary osteotomy 20 years previously. An initial clinical diagnosis included an inflammatory or developmental odontogenic cyst leading to enucleation of the lesion. Post‐operative histopathology revealed a diagnosis of surgical ciliated cyst of the maxilla. This case highlights the need for awareness of this cyst to ensure appropriate patient management.
Acquired Microcystic Lymphatic Malformation of the Distal Upper Extremity Mimicking Verrucae Vulgaris
Authors: Wang Stephanie , Krulig Eliana , Hernandez Claudia
Published: July 2013

An 18‐year‐old African American male with a history of congenital lymphedema of the right upper extremity presented for evaluation of multiple verrucous lesions on his right hand. Clusters of 2 to 4‐mm dome‐shaped vesicles were intermixed with scattered verrucous papules on the right forearm and the dorsal and palmar aspects of the hand. Histopathology of one the verrucous lesions showed well‐circumscribed areas of dilated lymphatic vascular channels with lymph in the lumen. The patient was diagnosed with microcystic lymphatic malformation, verrucous type. This article reviews the literature regarding reports of this variant of microcystic lymphatic malformation in the pediatric population.
Chevron Nails: A Normal Variant in the Pediatric Population
Authors: Delano Sofia , Belazarian Leah
Published: July 2013

A 7‐month‐old girl was evaluated for V‐shaped ridging of the fingernails consistent with chevron nails. Chevron nails are a normal variant in the pediatric population that is frequently outgrown. This case nicely demonstrates this normal finding that has so rarely been reported in the literature.
Treatment of Preadolescent Acne in the United States: An Analysis of Nationally Representative Data
Authors: Davis Scott A. , Sandoval Laura F. , Gustafson Cheryl J. , Feldman Steven R. , Cordoro Kelly M.
Published: July 2013

The prevalence of acne in younger children is increasing. Of the acne treatments that the U.S. Food and Drug Administration (FDA) has approved for ages 12 years and older, it is unclear which medications are being prescribed off‐label for this younger patient population. The purpose of this study is to compare the therapies being prescribed to preadolescent patients with acne (defined in this study as ages 7 to 11 years) with those being prescribed to adolescent patients (ages 12 to 18 years) and to determine whether prescribing patterns differ between dermatologists and pediatricians. Leading therapies for the treatment of children with a diagnosis of acne were collected from the National Ambulatory Medical Care Survey (NAMCS) from 1993 to 2009. Data were stratified according to age group and physician specialty. Physicians prescribed a wide variety of FDA‐approved and off‐label medications to preadolescent patients with acne. The leading medications were topical treatments, including adapalene (14.4%), benzoyl peroxide (12.8%), and tretinoin (12.5%). Treatment of this age group differed substantially between specialties, with dermatologists frequently prescribing topical retinoids and primary care physicians preferring antibiotics, particularly oral antibiotics. Limitations included a lack of data on acne severity and morphology through NAMCS, as well as the absence of longitudinal data. With the limited number of FDA‐approved treatment options, off‐label prescribing for acne in preadolescent patients is common. Furthermore, this study identified a potential knowledge gap between pediatricians based on their prescribing patterns in this patient population.
Time Courses and Time‐Resolved Spectra of Firefly Bioluminescence Initiated by Two Methods of ATP Injection and Photolysis of Caged ATP
Authors: Yanagisawa Yuki , Kageyama Takeshi , Wada Naohisa , Tanaka Masatoshi , Ohno Shin‐ya
Published: July 2013

The time‐dependent characteristics of firefly bioluminescence initiated by manual injection of adenosine triphosphate (ATP) into buffer solution containing luciferin (Ln), luciferase (Luc) and Mg2+ were measured with a resolution of 10 ms, and compared with those obtained by photolysis of caged ATP. The time course depends on pH; both rise and decay rates decrease when pH is lowered from 7.8 to 6.8. In contrast, the parameter λ in the kinetic formula related to diffusion of ATP is almost independent of pH. The pH dependence of the time course of bioluminescence can be explained by the same pH tendency as the rate of ATP binding at the active site of Luc. The time‐resolved spectra can be decomposed into two Gaussian components with maxima at 2.2 and 2.0 eV. At pH 7.8, the band at 2.2 eV is more intense than that at 2.0 eV for all three concentration conditions. At lower pH, the band at 2.2 eV becomes weaker than that at 2.0 eV. The intensity ratio of the 2.0 and 2.2 eV bands is constant for duration time of 600 s for both injection and photolysis experiments, and the above conclusions are unaffected by the concentration ratio [Ln]/[Luc].
Improvised Causativization
Authors: Kwon Kyongjoon
Published: July 2013

In this paper, I argue a special kind of causative alternation that arises from a speaker's immediate need to express the ‘forced control’ semantics of an imposed causer. This type of causativization, termed improvised causativization, is not limited by the argument structure of an intransitive base verb, whether it is unergative or unaccusative. Based on this observation, I propose that causativization be syntactically represented through acausephrase that is added after avP is completed; specifically, at the step of derivation when an intransitive profile is completed (cf. Levin & Rappaport Hovav 1995). Along with a claim in lexical semantics (Pylkkänen 2002, cf. Neeleman & van de Koot 2010) thatcauserelates a caused to a causing event, I argue that the mediating role of thecauseis based on a set of felicity conditions. Under this analysis, variations at different levels, i.e., individual, dialectal, diachronic, or language acquisitional, can be accounted for without further stipulation.
Does epithelial sodium channel hyperactivity contribute to cystic fibrosis lung disease?
Authors: Hobbs Carey A. , Da Tan Chong , Tarran Robert
Published: July 2013

Key points

Lung hydration and mucus clearance rates are set by a balance between CFTR‐mediated Cl− secretion and ENaC‐led Na+ absorption. In CF airways, CFTR is diminished, and ENaC is upregulated, leading to mucus dehydration and increased chance of infection.

Evidence for ENaC upregulation in CF airways includes electrophysiological evidence, increased ASL absorption rates, increased cleavage of CF ENaC and increased basolateral Na+/K+ ATPase activity in CF airways.

The mechanism of Na+ hyperabsorption in CF airways is unknown and it may be due to altered protein‐protein interactions and/or increased proteolysis of ENaC in CF airways. However, inhibition of ENaC is predicted to increase CF mucus hydration/clearance and thus, ENaC remains an important therapeutic target for the treatment of CF lung disease.

Abstract  Airway epithelia absorb Na+ through the epithelial Na+ channel (ENaC) and secrete Cl− through the cystic fibrosis transmembrane conductance regulator (CFTR) anion channel. This balance maintains sufficient airway surface liquid hydration to permit efficient mucus clearance, which is needed to maintain sterility of the lung. Cystic fibrosis (CF) is a common autosomal recessive inherited disease caused by mutations in the CFTR gene that lead to the reduction or elimination of the CFTR protein. CF is a multi‐organ disease that affects epithelia lining the intestines, lungs, pancreas, sweat ducts and vas deferens, among others. CF lungs are characterized by viscous, dehydrated mucus, persistent neutrophilia and chronic infections. ENaC is negatively regulated by CFTR and, in patients with CF, the absence of CFTR results in a double hit of reduced Cl−/HCO3− and H2O secretion as well as ENaC hyperactivity and increased Na+ and H2O absorption. Together, these effects are hypothesized to trigger mucus dehydration, resulting in a failure to clear mucus. Rehydrating CF mucus has become a recent clinical focus and yields important end‐points for clinical trials. However, while ENaC hyperactivity in CF airways has been detected in vivo and in vitro, recent data have brought the role of ENaC in CF lung disease pathogenesis into question. This review will focus on our current understanding of the contribution of ENaC to CF pathogenesis.
Neuronal major histocompatibility complex class I molecules are implicated in the generation of asymmetries in hippocampal circuitry
Authors: Kawahara Aiko , Kurauchi Shotaro , Fukata Yuko , Martínez‐Hernández José , Yagihashi Terumi , Itadani Yuya , Sho Rui , Kajiyama Taiichi , Shinzato Nao , Narusuye Kenji , Fukata Masaki , Luján Rafael , Shigemoto Ryuichi , Ito Isao
Published: July 2013

Key points

The molecular basis of left–right asymmetries in brain structure and function is a central question in neuroscience.

We have previously demonstrated that the neuronal circuitry composed of hippocampal pyramidal neurones is asymmetrical depending on the hemispheric origin of presynaptic inputs and cell polarity of the postsynaptic neurone.

In this study, we analysed the hippocampus of β2‐microglobulin (β2m)‐deficient mice lacking stable cell surface expression of major histocompatibility complex class I (MHCI), which is known to be important in cellular immunity.

We found that β2m‐deficient mice lacked structural and functional asymmetries in hippocampal circuitry, suggesting that MHCI is critical for the generation of hippocampal asymmetry.

Our results provide a first step in elucidating the cellular process that generates brain asymmetries.

Abstract  Left–right asymmetry is a fundamental feature of higher‐order brain function; however, the molecular basis of brain asymmetry has remained unclear. We have recently demonstrated asymmetries in hippocampal circuitry resulting from the asymmetrical allocation of NMDA receptor (NMDAR) subunit GluRɛ2 (NR2B) in pyramidal cell synapses. This asymmetrical allocation of ɛ2 subunits affects the properties of NMDARs and generates two populations of synapses, ‘ɛ2‐dominant’ and ‘ɛ2‐non‐dominant’ synapses, according to the hemispheric origin of presynaptic inputs and cell polarity of the postsynaptic neurone. To identify key regulators for generating asymmetries, we analysed the hippocampus of β2‐microglobulin (β2m)‐deficient mice lacking cell surface expression of major histocompatibility complex class I (MHCI). Although MHCI proteins are well known in the immune system, accumulating evidence indicates that MHCI proteins are expressed in the brain and are required for activity‐dependent refinement of neuronal connections and normal synaptic plasticity. We found that β2m proteins were localised in hippocampal synapses in wild‐type mice. NMDA EPSCs in β2m‐deficient hippocampal synapses receiving inputs from both hemispheres showed similar sensitivity to Ro 25‐6981, an ɛ2 subunit‐selective antagonist, with those in ‘ɛ2‐dominant’ synapses for both the apical and basal synapses of pyramidal neurones. The structural features of the β2m‐deficient synapse in addition to the relationship between the stimulation frequency and synaptic plasticity were also comparable to those of ‘ɛ2‐dominant’ synapses. These observations indicate that the β2m‐deficient hippocampus lacks ‘ɛ2‐non‐dominant’ synapses and circuit asymmetries. Our findings provide evidence supporting a critical role of MHCI molecules for generating asymmetries in hippocampal circuitry.