bluuebunny/crossref_metadata_2025 huggingface dataset:
Cell autonomous and microenvironmental regulation of tumor progression in precursor states of multiple myeloma
Authors: Manier Salomon , Kawano Yawara , Bianchi Giada , Roccaro Aldo M. , Ghobrial Irene M.
Published: April 2016

Purpose of review

Multiple myeloma is a plasma cell malignancy evolving in the bone marrow and leading to end organ damage such as bone lesions, cytopenias, and kidney failure. This review delineates recent advances in the molecular mechanisms leading to tumor progression in multiple myeloma. Two different aspects enable tumor expansion: cell autonomous through genomic alterations in the tumor clone and noncell autonomous deregulations in the bone marrow tumor microenvironment. These alterations provide the framework for the continuous progression of multiple myeloma from early precursor conditions such as monoclonal gammopathy of undetermined significance and smoldering multiple myeloma to overt multiple myeloma.

Recent findings

In this review, we discuss recent findings in the genomic alterations that occur in the tumor clone such as somatic genomic mutations, copy number variation and chromosomal translocation, and delineate noncell autonomous deregulations in which tumor cells take advantage of a permissive microenvironment to further proliferate. The latter compartment includes interaction with bone marrow stromal cells, osteoblasts, osteoclasts, and immune escape.

Understanding the mechanisms that lead tumor progression from early stages to overt multiple myeloma could guide to more effective therapies and therefore prevent disease progression.
Knowledge and Attitudes About Attention-Deficit/Hyperactivity Disorder and Specific Learning Disorder in an Urban Indian Population
Authors: Mukherjee Sayantani , Shah Henal R. , Ramanathan Seethalakshmi , Dewan Mantosh
Published: April 2016

Attention-deficit/hyperactivity disorder (ADHD) and specific learning disorders (SLDs) are an important cause of scholastic backwardness among children and often go unrecognized. Few studies have examined knowledge and attitudes toward ADHD and SLD among school-aged children. To address this deficit, 120 school-aged children, attending a child guidance clinic in Mumbai, were interviewed using a questionnaire that examined children’s knowledge and attitudes about ADHD and SLD. The results were compared both qualitatively and quantitatively with a frequently occurring medical illness, common cold. Approximately 80% to 100% of children were aware of their illness; however, a large variation was noted in the proportion of children (15%–80%) who could describe their symptoms, provide accurate attributions for their illness, and identify treatment modalities. Children with ADHD reported greater control over their illness. The study identified a significant lack of knowledge about ADHD and SLD among school-aged children in India and discusses implications of this finding.
Hsp90β is involved in the development of high salt-diet-induced nephropathy via interaction with various signalling proteins
Authors: Yan Shi-hai , Zhao Ning-wei , Jiang Wei-min , Wang Xin-tong , Zhang Si-qi , Zhu Xuan-xuan , Zhang Chun-bing , Gao Yan-hong , Gao Feng , Liu Fu-ming , Fang Zhu-yuan
Published: April 2016

A high-salt diet often leads to a local intrarenal increase in renal hypoxia and oxidative stress, which are responsible for an excess production of pathogenic substances. Here, Wistar Kyoto/spontaneous hypertensive (WKY/SHR) rats fed a high-salt diet developed severe proteinuria, resulting from pronounced renal inflammation, fibrosis and tubular epithelial cell apoptosis. All these were mainly non-pressure-related effects. Hsp90β, TGF-β, HIF-1α, TNF-α, IL-6 and MCP-1 were shown to be highly expressed in response to salt loading. Next, we found that Hsp90β might play the key role in non-pressure-related effects of salt loading through a series of cellular signalling events, including the NF-κB, p38 activation and Bcl-2 inactivation. Hsp90β was previously proven to regulate the upstream mediators in multiple cellular signalling cascades through stabilizing and maintaining their activities. In our study, 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG) or Hsp90β knockdown dramatically alleviated the high-salt-diet-induced proteinuria and renal damage without altering blood pressure significantly, when it reversed activations of NF-κB, mTOR and p38 signalling cascades. Meanwhile, Co-IP results demonstrated that Hsp90β could interact with and stabilize TAK1, AMPKα, IKKα/β, HIF-1α and Raptor, whereas Hsp90β inhibition disrupted this process. In addition, Hsp90β inhibition-mediated renal improvements also accompanied the reduction of renal oxidative stress. In conclusion, salt loading indeed exhibited non-pressure-related impacts on proteinuria and renal dysfunction in WKY/SHR rats. Hsp90β inhibition caused the destabilization of upstream mediators in various pathogenic signalling events, thereby effectively ameliorating this nephropathy owing to renal hypoxia and oxidative stress.
Remotely-sensed tornado signatures indicate an ecological threshold for eagle nest destruction
Authors: Ross Jeremy D. , Cavert Cheryl L. , Larsson Lena C.
Published: April 2016

Bald Eagles (Haliaeetus leucocephalus) will reuse massive nests placed high in trees over multiple years, potentially exposing them to catastrophe loss during severe storms. The stochasticity of localized weather, however, has traditionally been viewed as impeding the quantitative study of such risks. In March 2015 a severe weather outbreak along the Arkansas River near Tulsa, Oklahoma caused widespread damage among a highly-concentrated and long-monitored population of nesting Bald Eagles. We conducted field surveys on the extent of nest loss and consulted weather and observer records to determine what characteristics of the storm (maximum azimuthal wind shear) or nests (years of use) might have been associated with nest destruction. We found 5 of 9 nests along a ~24km stretch of the river were destroyed during the storm, causing the death of at least 8 eaglets. Mean years of use was higher among destroyed nests (4.8) than surviving nests (4.0), though not significantly so within this limited sample. The degree of maximum azimuthal shear (i.e., wind rotation) during the storm within 800m of the nests, however, did significantly differ both in terms of maximums (15.8 vs 9.5 ms−1) and means (9.4 vs 6.6 ms−1) for destroyed versus persisting nests, respectively. Our findings suggest a threshold of tornadic wind shear beyond which Bald Eagle nests, irrespective of age, could be prone to catastrophe. Such insights are key to developing accurate models of population persistence, especially in light of potential shifts in severe weather patterns under various climate change scenarios.
CD44 Controls Endothelial Proliferation and Functions as Endogenous Inhibitor of Angiogenesis
Authors: Pink Anne , Školnaja Marianna , Päll Taavi , Valkna Andres
Published: April 2016

CD44 transmembrane glycoprotein is involved in angiogenesis, but it is not clear whether CD44 functions as a pro- or antiangiogenic molecule. Here, we assess the role of CD44 in angiogenesis and endothelial proliferation by usingCd44-null mice and CD44 silencing in human endothelial cells. We demonstrate that angiogenesis is increased inCd44-null mice compared to either wild-type or heterozygous animals. Silencing of CD44 expression in cultured endothelial cells results in their augmented proliferation and viability. The growth-suppressive effect of CD44 is mediated by its extracellular domain and is independent of its hyaluronan binding function. CD44-mediated effect on cell proliferation is independent of specific angiogenic growth factor stimulation. These results show that CD44 expression on endothelial cells constrains endothelial cell proliferation and angiogenesis. Thus, endothelial CD44 might serve as a therapeutic target both in the treatment of cardiovascular diseases, where endothelial protection is desired, as well as in cancer treatment, due to its antiangiogenic properties.
FGMP: assessing fungal genome completeness and gene content
Authors: Cissé Ousmane H. , Stajich Jason E.
Published: April 2016

Background

Inexpensive high-throughput DNA sequencing has democratized access to genetic information for most organisms so that research utilizing a genome or transcriptome of an organism is not limited to model systems. However, the quality of the assemblies of sampled genomes can vary greatly which hampers utility for comparisons and meaningful interpretation. The uncertainty of the completeness of a given genome sequence can limit feasibility of asserting patterns of high rates of gene loss reported in many lineages.

Results

We propose a computational framework and sequence resource for assessing completeness of fungal genomes called FGMP (Fungal Genome Mapping Project). Our approach is based on evolutionary conserved sets of proteins and DNA elements and is applicable to various types of genomic data. We present a comparison of FGMP and state-of-the-art methods for genome completeness assessment utilizing 246 genome assemblies of fungi. We discuss genome assembly improvements/degradations in 57 cases where assemblies have been updated, as recorded by NCBI assembly archive.

Conclusion

FGMP is an accurate tool for quantifying level of completion from fungal genomic data. It is particularly useful for non-model organisms without reference genomes and can be used directly on unassembled reads, which can help reducing genome sequencing costs.
Synthesis, structure and characterization of five new organically templated metal sulfates with 2-aminopyridinium
Authors: Bednarchuk Tamara J. , Kinzhybalo Vasyl , Pietraszko Adam
Published: April 2016

The chemistry of organically templated metal sulfates has attracted interest from the materials science community and the development of synthetic strategies for the preparation of organic–inorganic hybrid materials with novel structures and special properties is of current interest. Sulfur–oxygen–metal linkages provide the possibility of using sulfate tetrahedra as building units to form new solid-state materials. A series of novel organically templated metal sulfates of 2-aminopyridinium (2ap) with aluminium(III), cobalt(II), magnesium(II), nickel(II) and zinc(II) were obtained from the respective aqueous solutions and studied by single-crystal X-ray diffraction. The compounds crystallize in centrosymmetric triclinic unit cells in three structure types: type 1 for 2-aminopyridinium hexaaquaaluminium(III) bis(sulfate) tetrahydrate, (C5H7N2)[Al(H2O)6](SO4)2·4H2O, (I); type 2 for bis(2-aminopyridinium) tris[hexaaquacobalt(II)] tetrakis(sulfate) dihydrate, (C5H7N2)2[Co(H2O)6]3(SO4)4·2H2O, (II), and bis(2-aminopyridinium) tris[hexaaquamagnesium(II)] tetrakis(sulfate) dihydrate, (C5H7N2)2[Mg(H2O)6]3(SO4)4·2H2O, (III); and type 3 for bis(2-aminopyridinium) hexaaquanickel(II) bis(sulfate), (C5H7N2)2[Ni(H2O)6](SO4)2, (IV), and bis(2-aminopyridinium) hexaaquazinc(II) bis(sulfate), (C5H7N2)2[Zn(H2O)6](SO4)2, (V). The templating role of the 2ap cation in all of the reported crystalline substances is governed by the formation of characteristic charge-assisted hydrogen-bonded pairs with sulfate anions and the presence of π–π interactions between the cations. Additionally, both coordinated and uncoordinated water molecules are involved in hydrogen-bond formation. As a consequence, extensive three-dimensional hydrogen-bonding patterns are formed in the reported crystal structures.
Dynamics of external fit and internal fit: case of electronics industry
Authors: Lin Chin-Shien , Peng Tzu-Ju Ann , Chang Ruei-Yuan , Dang Van Thac
Published: April 2016

Purpose

The purpose of this paper is to reveal the strategic change-related issues by examining the dynamics between external fit and internal fit, as the success of strategic change is involved in the consideration of both internal and external fit.

Design/methodology/approach

This paper uses regression analysis to analyze the panel data from the electronics companies in Taiwan’s stock market between 2004 and 2011.

Findings

The empirical results show that there is a relationship between internal fit and external fit, and the momentum of internal fit was found as well. Moreover, the impact of the interaction effect of external and internal fit on performance is moderated by external fit.

Originality/value

This research contributes to and extends the current research in both theoretical and practical ways. From a theoretical aspect, this paper considers internal fit and external fit simultaneously and has adopted the profile deviation approach to test their impacts on performance. From a practical aspect, the empirical results have derived implications for managers as to understand the dynamics such as trade-off, momentum and synergy between the two types of strategic fit, which may be helpful for making decision on strategy change.
The incremental information content of audit opinion
Authors: Tahinakis Panayiotis , Samarinas Michalis
Published: April 2016

Purpose

– The purpose of this paper is to examine the incremental information content of audit opinion while considering opinion determinants, such as auditor and auditee size, or a firm’s financial state.

Design/methodology/approach

– A market valuation model is employed using US firm data collected over 30 years. The model relates stock returns to earnings and incorporates as additional variables auditors’ opinion types, opinion determinants and their interactions with audit expression.

Findings

– The findings suggest that audit opinion has a significant market impact. The estimated positive or negative information content of the audit opinion types is associated with certain opinion determinants, such as auditor and auditee size and a firm’s financial state.

Research limitations/implications

– Additional firm-year observations regarding certain opinion qualifications could benefit future research.

Practical implications

– This study offers useful insights by demonstrating the importance of auditing profession to the users of financial statements. It examines investors’ perception of each audit opinion type and the conditions under which this expression has the most serious effects. The results demonstrate the role of audit opinion and its cause-effect relationship with various economic events, allowing regulators not only to track the efficiency of various audit policy changes but also act preventively and amend the regulatory framework.

Originality/value

– This paper empirically supports the significance of the auditing process and audit opinions by examining investor perceptions. It employs a value relevance model, in contrast to market-based research that adopts an event study methodology.
Discussion of “articulating accounting principles
Authors: Singleton-Green Brian
Published: April 2016

Purpose

– The purpose of this paper is to provide a discussion of Brian Rutherford’s paper “Articulating accounting principles: classical accounting theory as the pursuit of ‘explanation by embodiment’”.

Design/methodology/approach

– The paper draws on the author’s experience of 13-years working at ICAEW trying to improve relations between the worlds of accounting practice and accounting research.

Findings

– The paper argues that classical accounting theory became discredited because it was too detached from the world of practice and in fact seriously misunderstood it, and that accounting research using the methods of the social sciences is not incompatible with normative accounting theory. However, if Brian Rutherford’s paper encourages even more accounting researchers to engage in accounting policy debates, and to do so in ways that reflect a sympathetic understanding of existing practices, that would be a welcome development.

Originality/value

– The paper contributes to the continuing debate on how accounting research can contribute to improvements in accounting practice.
BJOG Editor's Choice
Authors: Thorp John
Published: April 2016

Deputy Editor‐in‐Chief, Dr John Thorp, discusses his top articles from this issue in an audio podcast available https://soundcloud.com/bjog/may-editors-choice-2016
Antimicrobial Activities of Nisin, Tea Polyphenols, and Chitosan and their Combinations in Chilled Mutton
Authors: He Li , Zou Likou , Yang Qianru , Xia Jinghua , Zhou Kang , Zhu Yuanting , Han Xinfeng , Pu Biao , Hu Bin , Deng Wenwen , Liu Shuliang
Published: April 2016

Antimicrobial activities of nisin, tea polyphenols (TPs), and chitosan, and their combinations were evaluated against both Gram‐positive bacteria (GPB) and Gram‐negative bacteria (GNB) by the agar dilution method. Results showed that the MIC of nisin was 2.44 to 1250 mg/L for GPB and reached 5000 mg/L for GNB. The MICs of TPs and chitosan were 313 to 625 mg/L and 469 mg/L for GNB, and 156 to 5000 mg/L and 234 to 938 mg/L for GPB, respectively. These results indicated that TPs and chitosan exhibited inhibitory effects against both GPB and GNB, whereas nisin inhibited the growth of GPB only. Based on the orthogonal test of their MICs, and evaluation of preservative effect and sensory attributes in chilled mutton, the optimum combination was chosen as 0.625, 0.313, and 3.752 g/L for nisin, TPs, and chitosan, respectively. By using the optimum treatment, the shelf life of chilled mutton was extended from 6 to 18 d at 4 °C in the preservative film packages. These results indicate that the combination of nisin, TPs, and chitosan could be used as preservatives to efficiently inhibit the growth of spoilage microorganisms and pathogens in meat, thus improving the safety and shelf life of chilled mutton.
Tectonic Imprints of the Hazara Kashmir Syntaxis on the Mesozoic Rocks Exposed in Munda, Mohmand Agency, Northwest Pakistan
Authors: Asghar ALI , Umer HABIB , Atta Ur REHMAN , Noor ZADA , Zain Ul ABIDIN , Muhammad ISMAIL
Published: April 2016

Two well‐developed mesoscopic folds, D2 and D3, which postdate the middle amphibolite metamorphism, were recognized in the western hinterland zone of Pakistan. NW–SE trending D2 folds developed during NE–SW horizontal bulk shortening followed by NE–SW trending D3 folds, which developed during SE–NW shortening. Micro‐ to mesoscopically the NW–SE trending S2 crenulation cleavage, boudins and mineral stretching lineations are overprinted by D3. The newly established NW–SE trending micro‐ to mesoscopic structures in Munda termed D2, which postdated F1/F2, is synchronously developed with F3 structures in the western hinterland zone of Pakistan. We interpret that D2 and D3 folds are counterclockwise rotated in the tectonic event that has evolved the Hazara Kashmir Syntaxis after the main phase Indian plate and Kohistan Island Arc collision. Chlorite replacement by biotite in the main matrix crenulation cleavages indicates prograde metamorphism related with D2. The inclusion of muscovite and biotite in garnet porphyroblasts and the presence of staurolite in these rocks indicate that the Barrovian metamorphic conditions predate D2 and D3. We interpret that garnet, staurolite and calcite porphyroblasts grew before D2 because the well developed S2 crenulation cleavage wraps around these porphyroblasts.
A Hazard Assessment Method for Potential Earthquake‐Induced Landslides – A Case Study in Huaxian County, Shaanxi Province
Authors: Jiamei LIU , Mengtan GAO , Shuren WU , Tao WANG , Jian WU
Published: April 2016

The hazard assessment of potential earthquake‐induced landslides is an important aspect of the study of earthquake‐induced landslides. In this study, we assessed the hazard of potential earthquake‐induced landslides in Huaxian County with a new hazard assessment method. This method is based on probabilistic seismic hazard analysis and the Newmark cumulative displacement assessment model. The model considers a comprehensive suite of information, including the seismic activities and engineering geological conditions in the study area, and simulates the uncertainty of the intensity parameters of the engineering geological rock groups using the Monte Carlo method. Unlike previous assessment studies on ground motions with a given exceedance probability level, the hazard of earthquake‐induced landslides obtained by the method presented in this study allows for the possibility of earthquake‐induced landslides in different parts of the study area in the future. The assessment of the hazard of earthquake‐induced landslides in this study showed good agreement with the historical distribution of earthquake‐induced landslides. This indicates that the assessment properly reflects the macroscopic rules for the development of earthquake‐induced landslides in the study area, and can provide a reference framework for the management of the risk of earthquake‐induced landslides and land planning.
Evaluation of40Ar/39Ar Geochronology of Authigenic Illites in Determining Hydrocarbon Charge Timing: A Case Study from the Silurian Bituminous Sandstone Reservoirs, Tarim Basin, China
Authors: Youyu ZHANG , Keyu LIU , Xiuquan LUO
Published: April 2016

The Silurian bituminous sandstones (SBS) in the Tarim Basin, China are important basin‐wide reservoirs with an estimated area of approximately 249000 km2. We investigated the ages of authigenic illites in the SBS reservoirs and constrained their formation timing by using the40Ar/39Ar step wise heating method. The age spectra,39Ar recoil loss and their controlling factors were investigated systematically. The40Ar/39Ar ages were compared with the conventional K/Ar ages of identical clay fractions. The clay in the SBS reservoirs is dominated by orderly mixed‐layer illite/smectite (I/S) with 5%–30% smectite layers. The I/S minerals morphology comprises primarily honeycomb, short filamentous and curved‐lath particles, characteristic of authigenic illites. The unencapsulated40Ar/39Ar total gas ages (UTGA) of the authigenic illites range from 188.56 ± 6.20 Ma to 491.86 ± 27.68 Ma, which are 7% to 103% older than the corresponding K/Ar ages of 124.87 ± 1.11 Ma to 383.45 ± 2.80 Ma, respectively. The K‐Ar ages indicate multistage accumulations with distinct distribution patterns in the Tarim Basin: older (late Caledonian‐early Hercynian) around the basin margin, younger (late Hercynian) in the basin centre, and the youngest (middle to late Yanshanian) in the Ha‐6 well‐block, central area of the North Uplift The age difference is believed to have been caused by the39Ar recoil loss during the irradiation process. Compared with the K/Ar ages, the estimated39Ar recoil losses in this study are in the range from 7% to 51%. The39Ar recoil loss appears to increase not only with the decreasing particle sizes of the I/S, but also with increasing percentage of smectite layers (IR) of the I/S, and smectite layer content (SLC) of the samples. We conclude that due to significant39Ar recoil losses, UTGA may not offer any meaningful geological ages of the authigenic illite formation in the SBS and thus can not be used to represent the hydrocarbon charge timing.39Ar recoil losses during40Ar/39Ar dating can not be neglected when dating fine authigenic illite, especially when the ordered mixed‐layer I/S containing small amount of smectite layers (IR<30%) in the reservoir formations. Compared with the unencapsulated Ar‐Ar method, the conventional K‐Ar method is less complicated, more accurate and reliable in dating authigenic illites in petroleum reservoirs.
Edmondson grade predicts survival of patients with primary clear cell carcinoma of liver after curative resection: A retrospective study with long‐term follow‐up
Authors: Xu Wei , Ge Penglei , Liao Wenjun , Ren Jinjun , Yang Huayu , Xu Haifeng , Sang Xinting , Lu Xin , Zhong Shouxian , Mao Yilei
Published: April 2016

Aim

Primary clear cell carcinoma of liver (PCCCL) is a specific and rare subtype of primary hepatocellular carcinoma (HCC). We performed a retrospective study with long‐term follow‐up to investigate predictive factors and prognosis of intrahepatic recurrences of PCCCL after radical resection.

Methods

We retrospectively analyzed records of 38 patients with PCCCL who were diagnosed at Peking Union Medical College Hospital between January 1989 and September 2010, with a long‐term follow up to January 2015, to determine their clinical characteristics and postoperative survival. The data were compared with 400 patients received radical hepatectomy for common type hepatocellular carcinoma (CHCC) during the study period.

Results

PCCCL tumors were smaller than those of CHCC (P < 0.001) and the incidence of vascular invasion of tumors in PCCCL group was significantly lower than that in CHCC (P = 0.029). The 1‐, 3‐, and 5‐year overall survival (OS) for PCCCL patients were 94.6%, 67.3%, and 58.5%, respectively; 1‐, 3‐, and 5‐year disease‐free survival (DFS) were 89.2%, 54.1%, and 48.6%, respectively. Both OS and DFS were significantly better for PCCCL patients than for CHCC (P = 0.039 and 0.044). Cox modeling showed high Edmondson grade to be the only independent predictive factor for survival of PCCCL patients, which were different from those of CHCC.

Conclusions

PCCCL is a less malignant subtype of HCC than CHCC, patients with PCCCL likely have later intrahepatic recurrences and a better prognosis. Edmondson grade predicts survival of patients with PCCCL after curative resection; those with higher Edmondson grades may require more careful follow‐up and aggressive post‐hepatectomy therapy.
Prick test: evolution towards automated reading
Authors: Justo X. , Díaz I. , Gil J. J. , Gastaminza G.
Published: April 2016

The prick test is one of the most common medical methods for diagnosing allergies, and it has been carried out in a similar and laborious manner over many decades. In an attempt to standardize the reading of the test, many researchers have tried to automate the process of measuring the allergic reactions found by developing systems and algorithms based on multiple technologies. This work reviews the techniques for automatic wheal measurement with the aim of pointing out their advantages and disadvantages and the progress in the field. Furthermore, it provides a classification scheme for the different technologies applied. The works discussed herein provide evidence that significant challenges still exist for the development of an automatic wheal measurement system that not only helps allergists in their medical practice but also allows for the standardization of the reading and data exchange. As such, the aim of the work was to serve as guideline for the development of a proper and feasible system.
What is the role of catheter antibiotic prophylaxis for patients undergoing joint arthroplasty?
Authors: Scarlato Rose‐Marie , Dowsey Michelle M. , Buising Kirsty L. , Choong Peter F. M. , Peel Trisha N.
Published: April 2016

Background

Antimicrobial prophylaxis at the time of urinary catheter insertion and removal is commonly administered in patients undergoing joint arthroplasty, despite the lack of evidence to support this practice. The rationale is the theoretical risk of prosthetic joint infection arising from bacterial seeding from the urinary tract at the time of catheterization. In an era of antimicrobial stewardship, further assessment is warranted.

Methods

This study aimed to investigate the incidence of catheter‐associated (CA) bacteriuria and bacteraemia in patients undergoing total joint arthroplasty and to assess the antimicrobial susceptibility of any isolated microorganisms. This prospective observational study undertaken over a 6‐month period (May to October 2014) included 99 patients undergoing elective primary hip and knee arthroplasty at St Vincent's Hospital, Melbourne. Urine specimens were collected at insertion and removal of urinary catheters along with blood cultures upon urinary catheter removal.

Results

Overall 98% of the cohort received catheter antimicrobial prophylaxis for urinary catheter insertion and removal; the majority of patients received gentamicin (94%). Bacteriuria on catheter insertion had an incidence of 4.4%. The incidence of CA bacteriuria was 1.3%. All cultured organisms were sensitive to commonly used antibiotics including cephazolin. There were no cases of bacteraemia with urinary catheter removal. Increasing age, American Society of Anesthesiologists status and female gender were associated with the development of bacteriuria.

Conclusion

The incidence of CA bacteriuria and bacteraemia with antimicrobial prophylaxis is low. This study provokes discussion about the requirement of catheter prophylaxis in this surgical context and the utility of preoperative urine screening.
Evaluation of additive effect of quantitative fetal fibronectin to cervical length for prediction of spontaneous preterm birth among asymptomatic low‐risk women
Authors: Jwala Sushma , Tran Tino L. , Terenna Courtney , McGregor Ali , Andrel Jocelyn , Leiby Benjamin E. , Baxter Jason K. , Berghella Vincenzo
Published: April 2016

Introduction

Our objective was to evaluate the possible additive effect of quantitative fetal fibronectin to transvaginal ultrasound cervical length measurement between 180/7 and 236/7 weeks for prediction of spontaneous preterm birth at <370/7 weeks among asymptomatic low‐risk women.

Material and methods

A prospective observational study was performed of asymptomatic women with singleton gestations between 180/7 and 236/7 weeks and no prior spontaneous preterm birth. Women with multiple gestations, rupture of membranes, vaginal bleeding, intercourse or vaginal exam within 48 h of enrollment were excluded. Physicians were blinded to the quantitative fetal fibronectin levels, but the cervical length measurements were made available. The primary outcome was spontaneous preterm birth at <370/7 weeks.

Results

Of the 528 asymptomatic low‐risk women who were prospectively enrolled, 36 (6.82%) had spontaneous preterm birth at <370/7 weeks. Using the receiver‐operating characteristic curve, fetal fibronectin value of ≥5 ng/mL was identified as the optimal cut‐off for predicting spontaneous preterm birth at <370/7 weeks. As compared with cervical length ≥20 mm alone, with the use of cervical length ≤20 mm or quantitative fetal fibronectin ≥5 ng/mL as screening criteria for prediction of spontaneous preterm birth at <370/7 weeks; sensitivity improved from 11.11 to 61.11%, specificity decreased from 99.59 to 55.08%, positive predictive value decreased from 66.67 to 9.05%, negative predictive value marginally improved from 93.87 to 95.09% and predictive accuracy decreased from 93.56 to 55.49%.

Conclusions

Although the sensitivity improved, other predictive statistics and predictive accuracy did not improve by the addition of mid‐trimester quantitative fetal fibronectin to cervical length measurement. Therefore, addition of mid‐trimester quantitative fetal fibronectin to cervical length measurement cannot be recommended at this time for prediction of spontaneous preterm birth at <370/7 weeks in asymptomatic low‐risk women.
Use of conditional centiles of middle cerebral artery pulsatility index and cerebroplacental ratio in the prediction of adverse perinatal outcomes
Authors: Karlsen Henriette O. , Ebbing Cathrine , Rasmussen Svein , Kiserud Torvid , Johnsen Synnøve L.
Published: April 2016

Introduction

Centiles of middle cerebral artery pulsatility index and cerebroplacental ratio are useful for predicting adverse perinatal outcomes. A ‘conditional centile’ is conditioned by a previous measurement reflecting degree of individual change over time. Here we test whether such centiles are independent predictors and whether their combination improves prediction.

Material and methods

This prospective longitudinal study included 220 pregnant women diagnosed with or at risk of having a small‐for‐gestational‐age fetus. Serial Doppler measurements of the umbilical artery and middle cerebral artery pulsatility indexs were used to calculate cerebroplacental ratio. Preterm birth, operative delivery due to fetal distress, admission to neonatal intensive care unit, 5‐min Apgar score <7, newborn hypoglycemia, and perinatal mortality were considered adverse outcomes. Possible associations were analyzed by log‐binomial regression analysis.

Results

Serial Doppler measurements of the middle cerebral artery were available in 207 participants and cerebroplacental ratio in 205. Conditional centiles ≤5 and ≤10 for both middle cerebral artery pulsatility index and cerebroplacental ratio were associated with increased risk for adverse perinatal outcomes. However, only the combination of cerebroplacental ratio centile and conditional centile ≤10 showed a better performance in the prediction of operative delivery due to fetal distress (p = 0.032), admission to neonatal intensive care unit (p = 0.048), and the combined variable “any adverse outcomes” (p = 0.034) compared with the use of centile ≤10 alone.

Conclusions

Conditional centile for middle cerebral artery pulsatility index and cerebroplacental ratio ≤5 and ≤10 are associated with adverse perinatal outcomes. When adding conditional centile to conventional centile for cerebroplacental ratio, the prediction improved compared with the use of conventional centile alone.
Human umbilical and fetal cerebral blood flow velocity waveforms following maternal glucose loading: a cross‐sectional observational study
Authors: Haugen Guttorm , Bollerslev Jens , Henriksen Tore
Published: April 2016

Introduction

Our aim was to study umbilical and fetal cerebral arterial blood flow velocity waveforms related to fetal biometric measures and maternal body mass index, glucose levels and parity following maternal oral glucose loading.

Material and methods

The study had an experimental design in a cross‐sectional observational study including 105 low‐risk pregnancies (30–32 weeks of gestation). Ultrasound Doppler measurements of umbilical and middle cerebral arterial (UA and MCA) velocity waveforms were performed before and at 2 h after completed 75‐g oral glucose tolerance tests (OGTT). We assessed changes in UA and MCA pulsatility indices (PI).

Results

MCA PI was significantly reduced following OGTT (p < 0.001); these changes were not related to changes in fetal heart rate (r = −0.11, p = 0.278). UA PI was also significantly reduced following OGTT (p = 0.033); these changes were related to fetal heart rate (r = −0.47, p < 0.001). This reduction was not significant (p = 0.230) when the PI values were adjusted for fetal heart rate. The ratio MCA PI to UA PI was reduced (p = 0.001). The effect of OGTT on MCA PI was not related to fetal abdominal circumference whereas the effect on the adjusted UA PI values was correlated to abdominal circumference (r = −0.20, p = 0.045) but not to abdominal circumference Z‐score (r = −0.16, p = 0.115). The influence of OGTT on the Doppler parameters as well as heart rates was not related to prepregnant body mass index, glucose levels before or after OGTT, parity, fetal sex or gestational age.

Conclusions

Maternal glucose loading seems to decrease fetal cerebral blood flow impedance independent of fetal size.
Intestinal Conditioning After Cardiac Arrest: The Use of Normothermic Extracorporeal Membrane Oxygenation in the Non‐Heart‐Beating Animal Model
Authors: Guo Mingxiao , Yao Danhua , Li Linlin , Lu Chunlei , Li Yousheng , Li Jieshou
Published: April 2016

The effect of normothermic extracorporeal membrane oxygenation (NECMO) on small bowel preservation in a clinically relevant large animal model of expected donation after cardiac death (eDCD) was evaluated. Thirty domestic crossbred donor pigs were divided into five groups. The first group served as the live donation (LD) group, the second group served as the donation after cardiac death (DCD) group, and the remaining were further assigned into three subgroups: E1 group (1 h NECMO support), E3 group (3 h NECMO support), and E5 group (5 h NECMO support). Pathology, electron microscopy, energy metabolism, cell apoptosis, and tight junction (TJ) protein expression level of intestinal mucosa and the level of plasma d‐lactic acid were evaluated in normal, cardiac death and at the end of extracorporeal support, respectively. The mean arterial pressure and PaO2 were maintained over 60 and 267 mm Hg during NECMO support, respectively. One hour of extracorporeal support could improve the energy status in intestines of the DCD group. Although the histologic damage and apoptosis of the E1 group had no significant difference with those of the LD and DCD groups (P > 0.05), the levels of intestinal mucosa TJ protein decreased (P < 0.05), and plasma d‐lactic acid increased progressively (P < 0.05). With the extension of extracorporeal support, the degree of intestinal mucosa damage and intestinal permeability gradually increased, as well as the content of adenosine triphosphate in intestinal mucosa. The normothermic extracorporeal support for 1 h in DCD is beneficial for improving the energy status and viability of the bowel. However, the integrity of intestinal mucosa was destroyed gradually as extracorporeal support time went by. And the activation of intestinal epithelial apoptosis and hyperoxia might be the factors that lead to intestinal mucosa injury.
Treatment of severe recurrent hepatitis C after liver transplantation in HIV infected patients using sofosbuvir‐based therapy
Authors: Campos‐Varela I. , Moreno A. , Morbey A. , Guaraldi G. , Hasson H. , Bhamidimarri K. R. , Castells L. , Grewal P. , Baños I. , Bellot P. , Brainard D. M. , McHutchison J. G. , Terrault N. A.
Published: April 2016

Background

For liver transplant recipients with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co‐infection, recurrence after LT is associated with a higher risk of graft loss than for HCV mono‐infected patients. Prior HCV treatment options were limited by side effects and drug–drug interactions.

Aim

To evaluate treatment outcomes with sofosbuvir (SOF)‐based therapy among HIV/HCV coinfected liver transplant recipients.

Methods

Access to SOF and ribavirin (RBV) prior to regulatory approval was attained via an international compassionate access program for transplant recipients with a life expectancy of 1 year or less in the absence of HCV treatment. This report focuses on the short and longer term outcomes in HCV‐HIV co‐infected liver transplant recipients.

Results

Twenty patients were treated, nine with early severe recurrence and 11 with cirrhosis. Eleven patients received SOF and RBV, one SOF, RBV and Peg‐interferon, three SOF, RBV and simeprevir and five SOF, RBV and daclatasvir. Of the 18 patients who completed treatment, 16 (89%) achieved sustained virological response 12 weeks after the end of treatment (SVR12). Liver function tests (including bilirubin and albumin) improved significantly over time. Nineteen serious adverse events occurred in eight (40%) patients, none of them related to SOF. Two patients died during treatment and another, 1 year after the end of therapy, due to progressive end‐stage liver disease. Importantly, HIV suppression was not compromised. No significant drug‐drug interactions were reported.

Conclusions

Sofosbuvir‐based regimens are safe, well‐tolerated and provide high rates of SVR in HCV‐HIV co‐infected patients with severe recurrence after‐liver transplant.
Imaging the Layered Fabric Of Paints From Nomansland Rock Art (South Africa)
Authors: Hœrlé S. , Pearce D. G. , Bertrand L. , Sandt CH. , Menu M.
Published: April 2016

South African rock art provides a window into the Bushman worldview. For a better understanding of Bushman history and beliefs and the conservation of rock art sites, a better knowledge of the materials making up the paints, the mineral accretions and their alterations is required. A conjunction of imaging techniques (optical microscopy, SEM–EDX, Raman spectromicroscopy and synchrotron FT–IR) allowed us to describe the complex layered fabric that evidences a history of accretion, painting and alteration in eight samples of painted rock. Two types of paints are identified and the distribution of calcium oxalates is discussed in terms of conservation and dating potential.
Effects of Osteoporosis‐Inducing Drugs on Vitamin D‐Related Gene Transcription and Mineralization in MG‐63 and Saos‐2 Cells
Authors: Wegler Christine , Wikvall Kjell , Norlin Maria
Published: April 2016

Vitamin D3 is important for calcium and phosphate homeostasis. To exert its effects, vitamin D3 has to be enzymatically activated into 1,25D3 (1,25‐dihydroxyvitamin D3). Regulation by endogenous vitamin D metabolites of the activation and inactivation of 1,25D3 is important to maintain adequate amounts of active vitamin D3. Vitamin D deficiency and low bone mineral density have been linked to treatments with antiretroviral drugs and glucocorticoids. However, the causes of drug‐induced osteoporosis remain unclear. The antiretroviral drugs efavirenz and ritonavir as well as the glucocorticoid dexamethasone were included in this study. Their effects on transcription of vitamin D‐regulating enzymes in MG‐63 cells were investigated. Ritonavir and dexamethasone both induced transcription of CYP27B1, the enzyme responsible for the formation of 1,25D3. Efavirenz, however, suppressed CYP27B1 expression. When administered together with endogenous vitamin D metabolites, dexamethasone and efavirenz counteracted the 1,25D3‐mediated up‐regulation of CYP24A1, which inactivates 1,25D3. This suggests that the drugs may interfere with local regulation of the vitamin D metabolizing system in osteoblasts. Studies on mineralization were performed in MG‐63 cells and Saos‐2 cells by measuring calcium concentrations accumulated over time. The effects of efavirenz, ritonavir and dexamethasone and/or vitamin D metabolites were examined. 1,25D3 induced mineralization in both cell lines. Efavirenz administered alone did not affect mineralization but suppressed the inducing effects of 1,25D3 on mineralization in both MG‐63 cells and Saos‐2 cells. In summary, the results suggest that antiretroviral drugs and glucocorticoids may adversely affect bone by interference with the vitamin D system in osteoblasts.
Adherence to prophylaxis and bleeding outcome in haemophilia: a multicentre study
Authors: Schrijvers LieSbeth H. , Beijlevelt ‐ van der Zande Marlene , Peters Marjolein , Lock Janske , Cnossen Marjon H. , Schuurmans Marieke J. , Fischer Kathelijn
Published: April 2016

Prevention of bleeding and joint damage in severe haemophilia is dependent on adherence to prophylactic replacement therapy. The aim of this study was to assess adherence to prophylaxis, including associations with age, bleeding and clotting factor consumption (CFC). In three Dutch haemophilia centres, semi‐structured interviews about adherence to prophylaxis in the previous 2 weeks were conducted with patients or parents of a child with haemophilia. Patients were classified, according to pre‐specified definitions, as adherent, sub‐optimally adherent or non‐adherent based on missing, timing, and dose of infusions. Association of annual bleeding rates, mean CFC, person performing the infusion (parents verus patients) with adherence categories were analysed. Overall, 241 patients with haemophilia using prophylaxis were studied. Parents were more adherent (66%; n = 48/73) than patients (43%; n = 72/168). Sub‐optimal adherence occurred in 29% of parents and 37% of patients and was characterized by changes in timing of infusion (mostly from morning to evening), while missing <6% of infusions. Non‐adherence occurred less often: in 5% of parents and 20% of patients. Reduced adherence was associated with lower CFC, but not with joint bleeding. In conclusion, non‐adherence in haemophilia was relatively rare, yet 1/3 of patients struggled to administer prophylaxis at the appropriate time of day.
Specific cytotoxic T‐cell immune responses against autoantigens recognized by chronic lymphocytic leukaemia cells
Authors: Zaleska Joanna , Skorka Katarzyna , Zajac Malgorzata , Karczmarczyk Agnieszka , Karp Marta , Tomczak Waldemar , Hus Marek , Wlasiuk Paulina , Giannopoulos Krzysztof
Published: April 2016

Mounting evidence suggests that autoreactivity and inflammatory processes are involved in the pathogenesis of chronic lymphocytic leukaemia (CLL). Cytoskeletal proteins, including non‐muscle myosin heavy chain IIA (MYHIIA), vimentin (VIM) and cofilin‐1 (CFL1), exposed on the surface of apoptotic cells have been identified as autoantigens that are recognized by the specific B‐cell receptors of the CLL cells. In 212 CLL patients analysed with quantitative reverse transcriptase‐polymerase chain reaction

we found CFL1 overexpression and low expression of MYH9 in comparison with healthy volunteers. We detected specific cytotoxic immune responses for peptides derived from MYHIIA in 66·7%, VIM in 87·5% and CFL1 in 62·5% CLL patients in an Enzyme‐Linked ImmunoSpot assay. Low frequencies of autoreactive peptide‐specific T cells were detected against MYHIIA, VIM and CFL1 in CLL patients ex vivo; most of the detected cells had an effector‐memory phenotype. Our findings support the existence of cytotoxic immune responses against three autoantigens that have been identified as targets of CLL clonotypic B‐cell receptors. The presence of autoreactive CD8+ T cells against MYHIIA, VIM and CFL1 in CLL patients indicates the involvement of antigen‐specific autoreactive T cells in the pathogenesis of CLL.
Bingeing on Sobriety: White Holes, Black Holes and Time's Arrow in the Intra‐Psychic Worlds of Addicted and Substance Abusing Patients
Authors: Sweet Alistair D. , Miller Ian S.
Published: April 2016

Every psychotherapist working in the challenging field of the addictions is familiar with patients who yo‐yo between extended periods of abstinence from substances, or other compulsive and non‐substance‐based addictive behaviours, and who then lapse or relapse to compressed periods of excessive substance misuse, the so‐called binge episode. In this paper we reverse the lens of theoretical focus somewhat, from its more traditional position within the clinical field of addiction. We suggest that periods of abstinence from substance misuse, or other compulsive behaviours, may also represent a type of binge‐like behaviour which satisfies, for a time, core needs though which may also invariably be non‐sustainable if the underlying psychodynamic processes underscoring such repetitive abstinence binges are not explored and translated, in work with the patient. Linkage will also be made between poles of experience that addicted and substance abusing patients evince, which are here termed black holes (Sweet, ) and white holes (Miller, personal communication, 2015). These proposed intra‐psychic structures are, it is asserted, intimately related to the ability, or not, of the individual to bear psychological pain and distress, tolerate separation from objects at both an inter‐personal and intra‐psychic level and to delay gratification of instinctually grounded desires and wishes. The authors reference Hopper's () previous description of both black holes and white holes in the addictions, and Glasser's () conception of the black hole in relation to perversion and his description of the ‘core complex’, drawing out both similarities and differences in the viewpoints presented. Key ideas in the paper are illuminated and contextualized through the presentation of a number of illustrative clinical examples.