bluuebunny/crossref_metadata_2025 huggingface dataset:
Refinements and restoring contour in head and neck reconstruction
Authors: Sofiadellis Foti , Grinsell Damien
Published: April 2015

Background

To date head and neck reconstructions of oncological defects have concentrated on primarily filling the defect to achieve primary wound healing, secondly restore function and lastly cosmesis. This paper describes a refinement of existing free tissue transfer techniques for improvement of contour, function and aesthetics.

Methods

A retrospective review of 38 patients operated on by one surgeon at St Vincent's, Royal Melbourne and Western Hospitals over a 3‐year period was conducted. Data were collected on patient demographics, tumour details, nature of the defect, type of reconstructive procedure, nature of additional tissue used, radiotherapy, complications and outcome.

Results

We present refinements in using de‐epithelialized skin paddles, flexor hallucis longus, and rectus and vastus lateralis muscle in order to achieve optimal reconstruction. Free tissue transfer refinements are discussed in anterolateral thigh, fibula, rectus and anteromedial thigh free flaps. The average defect size and volume of neck dissection prior to reconstruction is presented. A variation of radical, modified radical and selective neck dissections were required for oncological staging and clearance. Rare and minor associated complications are discussed. Post‐operative radiotherapy treatment was used in the majority of patients with preoperative adjuvant therapy required in some salvage cases. All patients achieved primary wound healing post‐operatively with no salivary leaks, flap failures or exposure of neck vessels.

Conclusions

Supplementary microsurgical tissue transfer of de‐epithelialized skin, vastus lateralis, flexor hallucis longus and rectus muscles is a valuable option for restoring contour, aesthetics and vessel protection post‐radiotherapy.
Role of general surgeons in acute urinary obstruction
Authors: Rizvi Syed Ali Abbas , Leung Amy , Pretorius Casper Francois
Published: April 2015

Background

An emergency JJ stent is occasionally required to manage a patient with obstructive uropathy. In regional centres where there is no emergency urology service available, general surgeons are required to perform ureteric stent insertions. The aim of our study is to assess the efficacy of general surgeons in ureteric stent insertion.

Methods

We retrospectively analysed the ureteric stent registry data from 1 January 2010 to 31 July 2014.

Results

A total of 185 ureteric stents were inserted between 1 January 2010 and 31 July 2014. Of these, 132 were for emergency cases. General surgeons performed 65 of the emergency stents. There were no complications associated with ureteric stent insertion.

Conclusion

Ureteric stent insertion can be safely performed by general surgeons if adequately trained. Surgical trainees intending to work at the regional centres should be trained in ureteric stent insertions to prevent unnecessary hospital transfers.
Operative intervention rates for acute diverticulitis: a multicentre state‐wide study
Authors: Hong Michael K.‐Y. , Tomlin Andrew M. , Hayes Ian P. , Skandarajah Anita R.
Published: April 2015

Background

Acute colonic diverticulitis is placing an increasing strain on our health care resources. Measurement of the problem is difficult at a regional level, yet essential to improve and optimize treatment of this condition. Therefore, we aimed to use Australian state‐level administrative data to determine the current practice and outcomes in major metropolitan hospitals.

Methods

Coding algorithms designed to increase the yield and accuracy of administrative data were used to find emergency admissions from the Victorian Admitted Episodes Dataset. Eight tertiary referral centres with specialist colorectal services from 2009 to 2013 were studied. Key metrics including the operative intervention rate were measured.

Results

There were 2829 emergency admissions for acute diverticulitis across 4 years in eight hospitals, with 724 being complicated. The emergency operative intervention rate was 10.4%, with a third of admissions for complicated diverticulitis having an operation. Hartmann's procedure was the most commonly performed emergency operation, accounting for 72% of resections. Patient characteristics were consistent across the hospitals, including a median length of stay of 3 and 6 days for uncomplicated and complicated diverticulitis, respectively.

Conclusion

Hartmann's procedure is currently the most common emergency operation for acute complicated diverticulitis in Victorian metropolitan hospitals. Our practice and outcomes can be measured meaningfully using administrative data.
Four Ways Life Extension will Change Our Relationship with Death
Authors: Davis John K.
Published: April 2015

Discussions of life extension ethics have focused mainly on whether an extended life would be desirable to have, and on the social consequences of widely available life extension. I want to explore a different range of issues: four ways in which the advent of life extension will change our relationship with death, not only for those who live extended lives, but also for those who cannot or choose not to. Although I believe that, on balance, the reasons in favor of developing life extension outweigh the reasons against doing so (something I won't argue for here), most of these changes probably count as reasons against doing so.

First, the advent of life extension will alter the human condition for those who live extended lives, and not merely by postponing death. Second, it will make death worse for those who lack access to life extension, even if those people live just as long as they do now. Third, for those who have access to life extension but prefer to live a normal lifespan because they think that has advantages, the advent of life extension will somewhat reduce some of those advantages, even if they never use life extension. Fourth, refusing life extension turns out to be a form of suicide, and this will force those who have access to life extension but turn it down to choose between an extended life they don't want and a form of suicide they may (probably mistakenly) consider immoral.
In Favour of Medical Dissensus: Why We Should Agree to Disagree About End‐of‐Life Decisions
Authors: Wilkinson Dominic , Truog Robert , Savulescu Julian
Published: April 2015

End‐of‐life decision‐making is controversial. There are different views about when it is appropriate to limit life‐sustaining treatment, and about what palliative options are permissible. One approach to decisions of this nature sees consensus as crucial. Decisions to limit treatment are made only if all or a majority of caregivers agree. We argue, however, that it is a mistake to require professional consensus in end‐of‐life decisions.

In the first part of the article we explore practical, ethical, and legal factors that support agreement. We analyse subjective and objective accounts of moral reasoning: accord is neither necessary nor sufficient for decisions. We propose an alternative norm for decisions – that of ‘professional dissensus’.

In the final part of the article we address the role of agreement in end‐of‐life policy. Such guidelines can ethically be based on dissensus rather than consensus.

Disagreement is not always a bad thing.
Prescribing Posttraumatic Growth
Authors: Harbin Ami
Published: April 2015

This article introduces questions in psychiatric ethics regarding the substantial field of qualitative and quantitative research into ‘posttraumatic growth’, which investigates how, after devastating experiences, individuals can come to feel that they have developed warmer relationships, increased spirituality, or a clearer vision of their priorities. In one area of this research, researchers of posttraumatic growth outline strategies for clinicians interested in assisting their patients in achieving such growth. In this article, I articulate two ethical concerns about this account of posttraumatic growth and the practice of growth‐oriented therapy. The first is a concern about the status and effects of the ideal of posttraumatic health implicit in their account, and the second a concern about the ethical implications of the clinical recommendations for the post‐trauma patient. I argue for the need for more attention to the hazardous implications of relating to patients as though they are on their way to, and themselves largely in control of, their own posttraumatic growth.
The p.R1819_C1948delinsS mutation makes von Willebrand factor ADAMTS13‐resistant and reduces its collagen‐binding capacity
Authors: Daidone Viviana , Saga Giorgia , Barbon Giovanni , Pontara Elena , Cattini Maria G. , Morpurgo Margherita , Zanotti Giuseppe , Casonato Alessandra
Published: April 2015

This report concerns abnormal ADAMTS13 (a disintegrin and metalloprotease with a thrombospondin type 1 motif, member 13) and collagen interactions coinciding with the p.R1819_C1948delinsS von Willebrand factor (VWF) mutation associated with the deletion of the C‐terminus of the A3 domain (amino acids 1819–1947) in a patient with a history of bleeding. The von Willebrand disease (VWD) phenotype of the patient featured low plasma and platelet VWF, multimers with smears extending over the highest normal oligomers in plasma, but not platelets, and an impaired collagen‐binding capacity. In vitro full‐length p.R1819_C1948delinsS VWF expression showed impaired VWF release, increased cellular content with normally‐multimerized VWF and impaired collagen binding. The recombinant p.R1819_C1948delinsS VWF fragment, extending from domains A2 to B3 (p.R1819_C1948delinsS A2‐B3 VWF), was completely resistant to proteolysis by ADAMTS13 in the presence of 1·5 mol/l urea, unlike its normal counterpart. The defect stems from impaired ADAMTS13 binding to p.R1819_C1948delinsS A2‐B3, analysed under static conditions. Partial deletion of the C‐terminus of the A3 domain thus makes VWF resistant to ADAMTS13, interfering with ADAMTS13 binding to VWF, and impairing the collagen‐binding capacity of VWF. The p.R1819_C1948delinsS mutation has both haemorrhagic features (defective collagen binding, reduced VWF levels) and prothrombotic (ADAMTS13 resistance) features, and the latter probably mitigate the patient's bleeding symptoms.
INFORMATION AGGREGATION, GROWTH, AND FRANCHISE EXTENSION WITH APPLICATIONS TO FEMALE ENFRANCHISEMENT AND INEQUALITY
Authors: Ellis Christopher , Fender John
Published: April 2015

We develop a model of voluntary gradual franchise extension and growth based on the idea that voting is an information aggregation mechanism. A larger number of voters means that more correct decisions are made, hence increasing output, but also implies that any incremental output must be shared among more individuals. These conflicting incentives lead to a dynamic model of franchise extensions that is consistent with several real world episodes, including female enfranchisement. The model also predicts that in certain circumstances growth and enfranchisement will be accompanied by Kuznets curve type behaviour in inequality. Contrary to the preceding literature these conclusions do not rest on incentives for strategic delegation.
The Neuropathology of Chronic Traumatic Encephalopathy
Authors: McKee Ann C. , Stein Thor D. , Kiernan Patrick T. , Alvarez Victor E.
Published: April 2015

Repetitive brain trauma is associated with a progressive neurological deterioration, now termed as chronic traumatic encephalopathy (CTE). Most instances of CTE occur in association with the play of sports, but CTE has also been reported in association with blast injuries and other neurotrauma. Symptoms of CTE include behavioral and mood changes, memory loss, cognitive impairment and dementia. Like many other neurodegenerative diseases, CTE is diagnosed with certainty only by neuropathological examination of brain tissue. CTE is a tauopathy characterized by the deposition of hyperphosphorylated tau (p‐tau) protein as neurofibrillary tangles, astrocytic tangles and neurites in striking clusters around small blood vessels of the cortex, typically at the sulcal depths. Severely affected cases show p‐tau pathology throughout the brain. Abnormalities in phosphorylated 43 kDa TAR DNA‐binding protein are found in most cases of CTE; beta‐amyloid is identified in 43%, associated with age. Given the importance of sports participation and physical exercise to physical and psychological health as well as disease resilience, it is critical to identify the genetic risk factors for CTE as well as to understand how other variables, such as stress, age at exposure, gender, substance abuse and other exposures, contribute to the development of CTE.
A Review of Neuroimaging Findings in Repetitive Brain Trauma
Authors: Koerte Inga K. , Lin Alexander P. , Willems Anna , Muehlmann Marc , Hufschmidt Jakob , Coleman Michael J. , Green Isobel , Liao Huijun , Tate David F. , Wilde Elisabeth A. , Pasternak Ofer , Bouix Sylvain , Rathi Yogesh , Bigler Erin D. , Stern Robert A. , Shenton Martha E.
Published: April 2015

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease confirmed at postmortem. Those at highest risk are professional athletes who participate in contact sports and military personnel who are exposed to repetitive blast events. All neuropathologically confirmed CTE cases, to date, have had a history of repetitive head impacts. This suggests that repetitive head impacts may be necessary for the initiation of the pathogenetic cascade that, in some cases, leads to CTE. Importantly, while all CTE appears to result from repetitive brain trauma, not all repetitive brain trauma results in CTE. Magnetic resonance imaging has great potential for understanding better the underlying mechanisms of repetitive brain trauma. In this review, we provide an overview of advanced imaging techniques currently used to investigate brain anomalies. We also provide an overview of neuroimaging findings in those exposed to repetitive head impacts in the acute/subacute and chronic phase of injury and in more neurodegenerative phases of injury, as well as in military personnel exposed to repetitive head impacts. Finally, we discuss future directions for research that will likely lead to a better understanding of the underlying mechanisms separating those who recover from repetitive brain trauma vs. those who go on to develop CTE.
Clinical Features of Repetitive Traumatic Brain Injury and Chronic Traumatic Encephalopathy
Authors: Montenigro Philip H. , Bernick Charles , Cantu Robert C.
Published: April 2015

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease characterized by a distinct pattern of hyperphosphorylated tau (p‐tau). Thought to be caused by repetitive concussive and subconcussive injuries, CTE is considered largely preventable. The majority of neuropathologically confirmed cases have occurred in professional contact sport athletes (eg, boxing, football). A recent post‐mortem case series has magnified concerns for the public's health following its identification in six high school level athletes. CTE is diagnosed with certainty only following a post‐mortem autopsy. Efforts to define the etiology and clinical progression during life are ongoing. The goal of this article is to characterize the clinical concepts associated with short‐ and long‐term effects of repetitive traumatic brain injury, with a special emphasis on new clinical diagnostic criteria for CTE. Utilizing these new diagnostic criteria, two cases of neuropathologically confirmed CTE, one in a professional football player and one in a professional boxer, are reported. Differences in cerebellar pathology in CTE confirmed cases in boxing and football are discussed.
Dental fear‐related cognitive vulnerability perceptions, dental prevention beliefs, dental visiting, and caries: a cross‐sectional study in Madrid (Spain)
Authors: Carrillo‐Diaz Maria , Crego Antonio , Armfield Jason M. , Romero Martin
Published: April 2015

Objective

This study aimed to analyze the role that psychosocial elements may play concerning dental attendance and oral health in children. In particular, we explored the associations among dental fear‐related cognitive vulnerability perceptions, dental prevention beliefs, the pattern of dental visits, and the number of decayed teeth.

Methods

A cross‐sectional design was used to collect data from 250 Spanish schoolchildren who completed a questionnaire. Oral health status was evaluated by pediatric dentists. Statistical analyses were mainly based on binary logistic regression and multiple linear regression, which allowed us to test possible associations among variables as well as interaction and mediation effects.

Results

Children with more vulnerability‐related cognitions (Adj. OR = 0.74 P < 0.05) and more unfavorable dental prevention beliefs (Adj. OR = 1.47 P < 0.01) were less likely to attend the dentist regularly. Moreover, the interaction between dental prevention beliefs and cognitive vulnerability perceptions was associated with more decayed teeth (β = −0.13 P < 0.05). The irregular pattern of dental visit, associated with fearful and unfavorable dental prevention cognitions, accounted for 20% of the effects of these variables on dental caries.

Conclusion

The combination of greater cognitive vulnerability‐related perceptions and low awareness of the benefits of dental prevention increased the risk of dental caries. Children with this profile also tended to demonstrate a more inadequate pattern of dental attendance. Preventive oral health programs would benefit from considering the role of children's cognitions on their oral health habits and dental health.
A Bayesian Theory of Sequential Causal Learning and Abstract Transfer
Authors: Lu Hongjing , Rojas Randall R. , Beckers Tom , Yuille Alan L.
Published: April 2015

Two key research issues in the field of causal learning are how people acquire causal knowledge when observing data that are presented sequentially, and the level of abstraction at which learning takes place. Does sequential causal learning solely involve the acquisition of specific cause‐effect links, or do learners also acquire knowledge about abstract causal constraints? Recent empirical studies have revealed that experience with one set of causal cues can dramatically alter subsequent learning and performance with entirely different cues, suggesting that learning involves abstract transfer, and such transfer effects involve sequential presentation of distinct sets of causal cues. It has been demonstrated that pre‐training (or even post‐training) can modulate classic causal learning phenomena such as forward and backward blocking. To account for these effects, we propose a Bayesian theory of sequential causal learning. The theory assumes that humans are able to consider and use several alternative causal generative models, each instantiating a different causal integration rule. Model selection is used to decide which integration rule to use in a given learning environment in order to infer causal knowledge from sequential data. Detailed computer simulations demonstrate that humans rely on the abstract characteristics of outcome variables (e.g., binary vs. continuous) to select a causal integration rule, which in turn alters causal learning in a variety of blocking and overshadowing paradigms. When the nature of the outcome variable is ambiguous, humans select the model that yields the best fit with the recent environment, and then apply it to subsequent learning tasks. Based on sequential patterns of cue‐outcome co‐occurrence, the theory can account for a range of phenomena in sequential causal learning, including various blocking effects, primacy effects in some experimental conditions, and apparently abstract transfer of causal knowledge.
Muscle weakness in children with neurofibromatosis type 1
Authors: Cornett Kayla M D , North Kathryn N , Rose Kristy J , Burns Joshua
Published: April 2015

Aim

To investigate if children with neurofibromatosis type 1 (NF1) have reduced muscle strength compared with children with typical development.

Method

Maximal isometric strength of 15 upper and lower limb muscle groups was evaluated in 30 children with NF1 (16 males, 14 females; aged 4–16y) and 30 age‐, sex‐, height‐, and weight‐matched controls using hand‐held dynamometry by a single evaluator. Both the left and right sides were assessed.

Results

Children with NF1 were significantly weaker than children with typical development across all 15 muscle groups assessed (p<0.05). Apart from elbow flexion, there were no differences between the left and right sides (p>0.05). Magnitude of differences between the children with NF1 compared with the controls ranged from 3% to 43%. Males and females were equally affected.

Interpretation

This study shows that children with NF1 have reduced muscle strength compared with children with typical development. This muscle weakness is present from the earliest stages of the disease assessed and persists throughout childhood with no sex difference. These results support recent evidence from mouse studies that NF1 is associated with a primary myopathy.
Efficacy of a long‐acting C‐peptide analogue against peripheral neuropathy in streptozotocin‐diabetic mice
Authors: Jolivalt C. G. , Rodriguez M. , Wahren J. , Calcutt N. A.
Published: April 2015

Aims

To investigate the efficacy of a pegylated C‐peptide (Peg‐C‐peptide) against indices of peripheral neuropathy in a mouse model of type 1 diabetes and to compare efficacy of this C‐peptide analogue against that of the native molecule.

Methods

C57Bl/6 mice were injected with two consecutive doses of streptozotocin (STZ) to induce type 1 diabetes. Mice were treated twice daily with native C‐peptide [0.4–1.3 mg/kg subcutaneously (s.c.)] or twice weekly with Peg‐C‐peptide (0.1–1.3 mg/kg s.c.) for 20 weeks. Motor and sensory nerve conduction velocities, thermal and tactile responses and rate dependent H‐wave depression were assessed after 20 weeks of diabetes. Foot skin intraepidermal fibres and corneal nerves were counted, and sciatic nerve substance P and plasma C‐peptide levels were also determined.

Results

After 5 months of STZ‐induced diabetes, mice exhibited significant motor and sensory nerve conduction slowing, thermal hypoalgesia, tactile allodynia and attenuation of rate‐dependent depression of the H reflex. These functional disorders were accompanied by nerve substance P depletion but not loss of small sensory fibres in the hind paw epidermis or the cornea. The efficacy of twice‐daily treatment with native C‐peptide in preventing these disorders was matched or exceeded by twice‐weekly treatment with Peg‐C‐peptide. Both native and Peg‐C‐peptide also increased corneal nerve occupancy in the sub‐basal nerve plexus of control rats.

Conclusions

These data identify actions of C‐peptide against novel and clinically pertinent aspects of diabetic neuropathy in mice and also establish Peg‐C‐peptide as a long‐acting therapeutic method of potential clinical value.
Transpulmonary Echocardiography to Guide Stent Implantation into Coarctation of the Aorta
Authors: Teramachi Yozo , Suda Kenji , Yoshimoto Hironaga , Kishimoto Shintaro , Kudo Yoshiyuki , Iemura Motofumi
Published: April 2015

Although stent implantation into aortic coarctation has been performed solely under fluoroscopy, we successfully applied intracardiac echocardiography (ICE) to guide this procedure in a 13‐year‐old patient. Placing an intracardiac echocardiographic catheter in the left pulmonary artery facing upward, we readily visualized the precise anatomy of coarctation, measured the pressure gradient, and monitored the stent inflation process. This report suggests a new application of ICE for intervention with structural and vascular diseases other than interatrial septum.
WITHIN‐MOTHER ESTIMATES OF THE EFFECTS OF WIC ON BIRTH OUTCOMES IN NEW YORK CITY
Authors: Currie Janet , Rajani Ishita
Published: April 2015

There is a large literature suggesting that “WIC works” to improve birth outcomes. However, methodological limitations related to selection into the Women, Infants, and Children (WIC) program have left room for doubt about this conclusion. This article uses birth records from New York City to address some limitations of the previous literature. We estimate models with mother fixed effects to control for fixed characteristics of mothers and we directly investigate the way that time‐varying characteristics of mothers affect selection into the WIC program. We find that WIC is associated with reductions in low birth weight, even among full‐term infants, and with reductions in the probability that a child is “small for dates.” These improvements are associated with a reduction in the probability that the mother gained too little weight during pregnancy. Improvements tend to be largest for first born children. We also find that women on WIC are more likely to be diagnosed with chronic conditions, and receive more intensive medical services, a finding that may reflect improved access to medical care. (JEL I12, H42)
Survival, fecundity, and body mass of Amplicephalus curtulus influenced by ‘Candidatus Phytoplasma ulmi’ (16SrV‐A) infection
Authors: Arismendi Nolberto L. , Carrillo Roberto
Published: April 2015

The leafhopper Amplicephalus curtulus Linnavuori & DeLong (Hemiptera: Cicadellidae) can transmit ‘Candidatus Phytoplasma ulmi’ (16SrV‐A) from a native Chilean shrub, Ugni molinae Turcz. (Myrtaceae), to ryegrasses. A recent study showed that this phytoplasma reduced the total protein content and the activity of detoxifying enzymes in A. curtulus, which could also affect its vector fitness. This study evaluated the effect of ‘Ca. Phytoplasma ulmi’ on the longevity, fecundity, and body mass of A. curtulus. Both females and males were exposed to ‘Ca. Phytoplasma ulmi’‐infected plants for 96 h, whereas a control group remained unexposed. Quartiles from adult emergence to 75% (t75), 50% (t50), and 25% (t25) survival rates were determined for each leafhopper survival distribution. The dry weight was also established at the end of the experiment. The adult lifespan of phytoplasma‐infected males and females was significantly lower than that of the uninfected leafhoppers in quartile survival distributions t50 and t25. The phytoplasma‐infected males and females lived 3 and 4 weeks less than uninfected ones in the last quartile, respectively. Fecundity was established by number of nymphs per female (in four periods) in phytoplasma‐infected and uninfected assays. In general, the weekly pattern of the number of nymphs per phytoplasma‐infected female was lower than that of uninfected leafhoppers; it was 37% lower at the end of the experiment. Phytoplasma‐infected females weighed significantly less (11%) than uninfected individuals. Phytoplasma‐infected males weighed 8% less than uninfected ones, but this difference was not significant. Our data indicated that ‘Ca. Phytoplasma ulmi’ negatively affected the fitness of A. curtulus, and nymphs produced by phytoplasma‐infected females varied over time, which may influence the disease dynamics in nature or in field crops.
Fat and sassy: factors underlying male mating success in a butterfly
Authors: Kehl Tobias , Bensch Julia , Böhm Friederike , Kniepkamp Björn Ole , Leonhardt Vivien , Schwieger Sarah , Fischer Klaus
Published: April 2015

Theory predicts that male mating success depends on resource holding potential (RHP), which is reflected by proxies of condition, such as body mass, fat content, strength, or weaponry. In species lacking any physical means to inflict injuries upon combatants, such as butterflies, the factors determining mating success are less clear. Against this background, we explored the determinants of male mating success in the tropical butterfly Bicyclus anynana Butler (Lepidoptera: Nymphalidae: Satyrinae), by comparing physiological, immunological, and morphological traits between winning and losing males. Our results showed that successful males are characterized by a better flight performance, evidenced by having longer wings, a heavier thorax, a lighter abdomen, a higher fat content, and higher phenoloxidase expression levels than their unsuccessful counterparts, when being compared after their first mating. Males that won three consecutive trials against the same combatant were also characterized by a better flight performance, having larger forewings, a higher body mass, and a higher fat content. Thus, successful males were larger and in better condition than unsuccessful ones. Strikingly, many differences found indicated an enhanced flight performance for the former, which we suggest ultimately plays the key role for male mating success in B. anynana. As fat is the main energy source for flying insects, being crucial to flight endurance and in turn presumably to male mating success, it may represent a key determinant at the proximate level.
Short‐term plasticity regulates the excitation/inhibition ratio and the temporal window for spike integration in CA1 pyramidal cells
Authors: Bartley Aundrea F. , Dobrunz Lynn E.
Published: April 2015

Many neurodevelopmental and neuropsychiatric disorders involve an imbalance between excitation and inhibition caused by synaptic alterations. The proper excitation/inhibition (E/I) balance is especially critical in CA1 pyramidal cells, because they control hippocampal output. Activation of Schaffer collateral axons causes direct excitation of CA1 pyramidal cells, quickly followed by disynaptic feedforward inhibition, stemming from synaptically induced firing of GABAergic interneurons. Both excitatory and inhibitory synapses are modulated by short‐term plasticity, potentially causing dynamic tuning of the E/I ratio. However, the effects of short‐term plasticity on the E/I ratio in CA1 pyramidal cells are not yet known. To determine this, we recorded disynaptic inhibitory postsynaptic currents and the E/I ratio in CA1 pyramidal cells in acute hippocampal slices from juvenile mice. We found that, whereas inhibitory synapses had paired‐pulse depression, disynaptic inhibition instead had paired‐pulse facilitation (≤ 200‐ms intervals), caused by increased recruitment of feedforward interneurons. Although enhanced disynaptic inhibition helped to constrain paired‐pulse facilitation of excitation, the E/I ratio was still larger on the second pulse, increasing pyramidal cell spiking. Surprisingly, this occurred without compromising the precision of spike timing. The E/I balance regulates the temporal spike integration window from multiple inputs; here, we showed that paired‐pulse stimulation can broaden the spike integration window. Together, our findings show that the combined effects of short‐term plasticity of disynaptic inhibition and monosynaptic excitation alter the E/I balance in CA1 pyramidal cells, leading to dynamic modulation of spike probability and the spike integration window. Short‐term plasticity is therefore an important mechanism for modulating signal processing of hippocampal output.
Expression of the postsynaptic scaffold PSD‐95 and development of synaptic physiology during giant terminal formation in the auditory brainstem of the chicken
Authors: Goyer David , Fensky Luisa , Hilverling Anna Maria , Kurth Stefanie , Kuenzel Thomas
Published: April 2015

In the avian nucleus magnocellularis (NM) endbulb of Held giant synapses develop from temporary bouton terminals. The molecular regulation of this process is not well understood. Furthermore, it is unknown how the postsynaptic specialization of the endbulb synapses develops. We therefore analysed expression of the postsynaptic scaffold protein PSD‐95 during the transition from bouton‐to‐endbulb synapses. PSD‐95 has been implicated in the regulation of the strength of glutamatergic synapses and could accordingly be of functional relevance for giant synapse formation. PSD‐95 protein was expressed at synaptic sites in embryonic chicken auditory brainstem and upregulated between embryonic days (E)12 and E16. We applied immunofluorescence staining and confocal microscopy to quantify pre‐and postsynaptic protein signals during bouton‐to‐endbulb transition. Giant terminal formation progressed along the tonotopic axis in NM, but was absent in low‐frequency NM. We found a tonotopic gradient of postsynaptic PSD‐95 signals in NM. Furthermore, PSD‐95 immunosignals showed the greatest increase between E12 and E15, temporally preceding the bouton‐to‐endbulb transition. We then applied whole‐cell electrophysiology to measure synaptic currents elicited by synaptic terminals during bouton‐to‐endbulb transition. With progressing endbulb formation postsynaptic currents rose more rapidly and synapses were less susceptible to short‐term depression, but currents were not different in amplitude or decay‐time constant. We conclude that development of presynaptic specializations follows postsynaptic development and speculate that the early PSD‐95 increase could play a functional role in endbulb formation.
Variance Distribution in Sibling Relationships: Advantages of Multilevel Modeling Using Full Sibling Groups
Authors: Marciniak Karyn
Published: April 2015

The majority of research on sibling relationships has investigated only one or two siblings in a family, but there are many theoretical and methodological limitations to this single dyadic perspective. This study uses multiple siblings (541 adults) in 184 families, where 96 of these families had all siblings complete the study, to demonstrate the value in including full sibling groups when conducting research on sibling relationships. Two scales, positivity and willingness to sacrifice, are evaluated with a multilevel model to account for the nested nature of family relationships. The distribution of variance across three levels: relationship, individual, and family are computed, and results indicate that the relationship level explains the most variance in positivity, whereas the individual level explains the majority of variance in willingness to sacrifice. These distributions are affected by gender composition and family size. The results of this study highlight an important and often overlooked element of family research: The meaning of a scale changes based on its distribution of variance at these three levels. Researchers are encouraged to be cognizant of the variance distribution of their scales when studying sibling relationships and to incorporate more full sibling groups into their research methods and study design.
Cyanobacterial dynamics in shallow Lake Apopka (Florida, U.S.A.) before and after the shift from a macrophyte‐dominated to a phytoplankton‐dominated state
Authors: Waters Matthew N. , Schelske Claire L. , Brenner Mark
Published: April 2015

Paleolimnological data were used to reconstruct the primary producer history of shallow, hyper‐eutrophic Lake Apopka, Florida, U.S.A. Lake Apopka changed from a macrophyte‐dominated state to a phytoplankton‐dominated state in 1947. It has remained phytoplankton‐dominated despite efforts to re‐establish clear‐water conditions and submersed aquatic plants.

Photosynthetic pigments, organic matter and nutrients (C, N, P) were analysed in a 4.28‐m sediment core that spans the past c. 8000 years. Our objectives were to: (i) reconstruct the primary producer history of Lake Apopka throughout its c. 8000‐year existence, (ii) determine whether the cyanobacterial dominance established in 1947 in Lake Apopka is the only period of cyanobacterial dominance in the lake's history and (iii) relate changes in the cyanobacterial community to known human impacts and recent management efforts.

Lake Apopka possessed a macrophyte‐dominated primary producer community throughout most of its Holocene history, with diatoms, green algae and some cyanobacteria characterising the non‐macrophyte, primary producer component of the community.

Since 1947, however, higher plants have been virtually absent in the lake and cyanobacteria have dominated the primary producer community, marking the first time that cyanobacteria have played such an important role in the lake. The cyanobacterial community itself has undergone multiple changes since 1947, confounding management efforts that have focused on a single driver of the primary producer community, that is phosphorus.
The EPIC study: a lesson to learn
Authors: Auerswald G. , Kurnik K. , Aledort L. M. , Chehadeh H. , Loew‐Baselli A. , Steinitz K. , Reininger A. J. ,   the EPIC clinical study group
Published: April 2015

Introduction

Inhibitory antibodies to factor VIII occur in about 30% of previously untreated patients (PUPs) and are the most serious complication of haemophilia A. It is unclear why some patients develop inhibitors and others do not.

Aims

The Early Prophylaxis Immunologic Challenge (EPIC) study was designed to test the hypothesis that inhibitor incidence in PUPs with severe or moderately severe haemophilia A could be reduced when a once‐weekly FVIII prophylaxis starts with 25 IU kg−1 rAHF‐PFM before 1 year of age and immunological danger signals are minimized.

Methods

These signals were minimized by avoiding: surgery; the first FVIII infusion during severe bleeding or an infection; central venous access devices and administering vaccinations intramuscularly 3–4 days before or after FVIII.

Results

Eight of the 19 treated subjects (42.1%) developed confirmed inhibitors. Eleven of the 19 treated subjects were PUPs without any prior exposure to FVIII. Three of them (27.3%) developed a confirmed inhibitor together with FVIII‐binding antibodies. The study was stopped because the likelihood to reach the primary objective was minimal, a decision endorsed by the data safety monitoring board.

Conclusion

Because of early termination, the EPIC study hypothesis could not be corroborated. Nonetheless, our data analyses indicate that the current definition of an inhibitor only based on plasma inhibitor activity ≥0.6 BU mL−1 may not always reflect the presence of FVIII‐neutralizing antibodies. The findings of this study teach us that low‐level inhibitor activity results need in addition a confirmatory test and/or the assessment of the therapeutic response.
The Modern Woman as Global Exemplar, Part II: Florence Nightingale and a Transnational Gendered Modernity
Authors: Reeves Caroline
Published: April 2015

This essay examines the late 19th‐century/early 20th‐century global process of cooptation and incorporation of foreign moral exemplars into local compendia of “Women Worthies.” Presenting a case study of the early 20th‐century adoption of Florence Nightingale (1820–1910) as a new Woman Worthy in China, Egypt, and the Anglo‐American sphere, I investigate the introduction of previously unknown female figures into local collections of biographies of eminent women. My work suggests new lines of research into global processes of continuity and change, and posits socio‐cultural commonplaces of the early “global modern” revealed by these transnational stories and their ubiquity. In investigating the oft‐told story of Florence Nightingale, this paper uncovers the intersection between transnational processes of gender definition and the local constitution of a global, gendered modernity and calls for similar studies in other world areas.
The Modern Woman as Global Exemplar, Part I: Biographies of Women Worthies
Authors: Reeves Caroline
Published: April 2015

The literary genre of “Biographies of Women Worthies” exists across the globe, historically and analytically important. This essay examines the potential this genre of writing holds for scholars of world and transnational history, particularly those who wish to incorporate gender and cultural studies into their work. I focus on the late 19th‐/early 20th‐century global process of cooptation and incorporation of foreign moral exemplars into local compendia of eminent women and suggest avenues for cross‐area research to expand the field of World History.
The Crown and the Veil: Titles, Spiritual Kinship, and Diplomacy in Tenth‐Century Bulgaro–Byzantine Relations
Authors: Mladjov Ian
Published: April 2015

When it comes to diplomatic relations, the phrase “too close for comfort” perfectly describes the relationship between the medieval Byzantine and Bulgarian states in the Balkan peninsula. In the early 10th century, shortly after Bulgaria's conversion to the Eastern rite of Christianity, the two states engaged in a bloody and lengthy conflict over not just territory and wealth but also over the now exacerbated issues of diplomatic equality and prestige. Marching on Constantinople, the Bulgarian monarch Simeon I demanded the imperial title itself and was partly accommodated by the Ecumenical patriarch Nicholas I in an idiosyncratic ceremony that has caused much debate among Byzantinists and Slavicists. This study explores the main features of the historiographical debate and attempts to find the correct answers in the testimony of the relevant sources. And while the incident under investigation might appear self‐contained, it lies at the heart of a major preoccupation of Byzantine diplomacy: Byzantium's monopoly on the political heritage of Rome and the Roman imperial title. Correctly interpreted and compared to Byzantium's diplomatic relations with the Frankish ruler Charlemagne, Simeon's recognition as a non‐Roman emperor and peer of his Byzantine counterpart in 913 suggests a pattern of grudging and incomplete accommodation designed to guarantee both the safety and the identity of the Byzantine Empire.
Microcystic stromal tumour of the ovary: frequent mutations of β‐catenin (CTNNB1) in six cases
Authors: Bi Rui , Bai Qian‐Ming , Yang Fei , Wu Li‐Jing , Cheng Yu‐Fan , Shen Xu‐Xia , Cai Xu , Zhou Xiao‐Yan , Yang Wen‐Tao
Published: April 2015

Aims

To analyse the clinicopathological, immunohistochemical and β‐catenin (CTNNB1) mutation characteristics of six cases of microcystic stromal tumour of the ovary (MCST).

Methods and results

Six Chinese patients with MCST who ranged in age from 29 to 69 years (mean 50 years) were included in the study. Five patients were detected with a pelvic mass during routine health examinations and one patient presented initially with opsomenorrhoea. All tumours involved the left ovary, with solid‐cystic cut surface in five cases and cystic cut surface in one case. Microscopically, microcysts, solid nests and hyaline degenerated fibrous stroma were variably mixed. Immunohistochemically, the tumour cells in all cases were diffusely positive for CD10, vimentin and WT‐1 and negative for α‐inhibin and calretinin. β‐catenin expression was observed in both the nucleus and the cytoplasm in five cases and only in the cytoplasm in one case. The results of CTNNB1 mutation analysis revealed four missense point mutations in four cases, which were c.97T>C, c.101G>A, c.110C>G and c.122C>T.

Conclusions

MCST shows a unique morphology with characteristic immunophenotype. β‐catenin expression in the nucleus and β‐catenin mutations were identified in the majority of cases, which suggests that the Wnt/β‐catenin pathway may play a crucial role in the tumorigenesis of MCST.
Causes of the latitudinal gradient in birdsong complexity assessed from geographical variation within two Himalayan warbler species
Authors: Singh Pratap , Price Trevor D.
Published: April 2015

Aspects of birdsong complexity, such as the number of distinct notes in a song, commonly increase along latitudinal gradients, a pattern for which at least 10 explanations have been suggested. In two Himalayan warblers, songs are more complex in the northwest than in the southeast. In Grey‐hooded Warbler Phylloscopus xanthoschistos, high complexity results from increased note diversity within song types, sung across a higher bandwidth. In Blyth's Leaf Warbler Phylloscopus reguloides, high complexity is a consequence of increased variation between song types. The hypothesis with strongest support is that songs evolved to be more complex in species‐poor, demonstrably less noisy environments. We consider geographical variation to be an outcome of sexual selection favouring complexity across environments, where detection of the signal varies. Sexual selection favouring complexity may be resolved in different ways, because complexity has multiple features (repertoire size, song switching, etc.). We argue this has led to the great diversity in song that we have documented among five Phylloscopus species.
Effect of biodegradable film (lyophilised alga Fucus spiralis and sorbic acid) on quality properties of refrigerated megrim (Lepidorhombus whiffiagonis)
Authors: García‐Soto Bibiana , Miranda José M. , Rodríguez‐Bernaldo de Quirós Ana , Sendón Raquel , Rodríguez‐Martínez Ana V. , Barros‐Velázquez Jorge , Aubourg Santiago P.
Published: April 2015

The effect of replacing the on‐board currently employed polyethylene film by a novel type of environmentally friendly packaging was studied. For it, a polylactic acid (PLA) biodegradable film including lyophilised alga Fucus spiralis and sorbic acid was applied during megrim (Lepidorhombus whiffiagonis) refrigeration and its effect on fish quality loss was evaluated. Thus, sensory assessment showed that samples wrapped up with PLA film including 8% alga and 1% sorbic acid were still acceptable on day 11, while control fish specimens (kept under polyethylene film) were rejected at that time. Under such biodegradable film condition, a preservative effect was also implied according to chemical indices assessment related to microbial activity (trimethylamine–N) and lipid oxidation development (peroxide and fluorescent compounds formation); additionally, lower mean numbers for different microbiological groups (aerobes, Enterobacteriaceae and psychrotrophs) were detected. This result provides a promising replacement strategy to enhance refrigerated fish quality and reduce the waste material content.
Crystal Structure and Thermodynamic Stability of Ba/Ti‐Substituted Pollucites for Radioactive Cs/Ba Immobilization
Authors: Xu Hongwu , Chavez Manuel E. , Mitchell Jeremy N. , Garino Terry J. , Schwarz Haiqing L. , Rodriguez Mark A. , Rademacher David X. , Nenoff Tina M.
Published: April 2015

As an analogue of the mineral pollucite (CsAlSi2O6), CsTiSi2O6.5 is a potential host phase for radioactive Cs. However, as 137Cs and 135Cs transmute to 137Ba and 135Ba, respectively, through the beta decay, it is essential to study the structure and stability of this phase upon Cs → Ba substitution. In this work, two series of Ba/Ti‐substituted samples, CsxBa(1−x)/2TiSi2O6.5 and CsxBa1−xTiSi2O7−0.5x, (x = 0.9 and 0.7), were synthesized by high‐temperature crystallization from their respective precursors. Synchrotron X‐ray diffraction and Rietveld analysis reveal that while CsxBa(1−x)/2TiSi2O6.5 samples are phase‐pure, CsxBa1−xTiSi2O7−0.5x samples contain Cs3x/(2+x)Ba(1−x)/(2+x)TiSi2O6.5 pollucites (i.e., also two‐Cs‐to‐one‐Ba substitution) and a secondary phase, fresnoite (Ba2TiSi2O8). Thus, the CsxBa1−xTiSi2O7−0.5x series is energetically less favorable than CsxBa(1−x)/2TiSi2O6.5. To study the stability systematics of CsxBa(1−x)/2TiSi2O6.5 pollucites, high‐temperature calorimetric experiments were performed at 973 K with or without the lead borate solvent. Enthalpies of formation from the constituent oxides (and elements) have thus been derived. The results show that with increasing Ba/(Cs + Ba) ratio, the thermodynamic stability of these phases decreases with respect to their component oxides. Hence, from the energetic viewpoint, continued Cs → Ba transmutation tends to destabilize the parent silicotitanate pollucite structure. However, the Ba‐substituted pollucite co‐forms with fresnoite (which incorporates the excess Ba), thereby providing viable ceramic waste forms for all the Ba decay products.