bluuebunny/crossref_metadata_2025 huggingface dataset:
Malignant pyoderma gangrenosum eroding the parotid gland successfully treated with dexamethasone pulse therapy
Authors: Ambooken Betsy , Khader Anza , Muhammed Kunnummel , Rajan Uma , Snigdha Ottakandathil
Published: October 2014

Background

Malignant pyoderma gangrenosum is a rare ulcerative variant of pyoderma gangrenosum (PG) involving the head and neck. Early intervention is crucial to prevent an aggressive outcome.

Objectives

We report a patient with malignant PG eroding into the parotid gland treated with dexamethasone pulse therapy.

Methods

A 47‐year‐old man presented with necrotic ulcers, predominantly over the face and neck, of one month's duration. Findings of a thorough systemic evaluation were within normal limits. A Mantoux test and pathergy test were negative. Tissue specimens for acid‐fast bacilli and fungal cultures were negative. A biopsy showed epidermal necrosis along with perivascular and periappendageal neutrophilic infiltrate without granuloma or vasculitis, consistent with PG. Over the next two weeks, the ulcers progressed in depth and width. The ulcer overlying the right parotid gland continuously discharged clear fluid. The invasive nature of the ulcers and histopathological findings confirmed the diagnosis of malignant PG. Dexamethasone pulse therapy was administered as 100 mg dexamethasone in 500 ml 5% dextrose infused over 3–4 hours on three consecutive days.

Results

This treatment resulted in complete healing of the ulcers within six weeks. The patient subsequently received nine similar pulses administered at 28‐day intervals and has shown no evidence of relapse over the past year.

Conclusions

In the present patient, parenteral antibiotics and daily steroids, colchicine, and oral minocycline had failed to halt the progression of ulcers. However, dexamethasone pulse therapy resulted in complete healing without sequelae and also proved cost‐effective.
Staphylococcal enterotoxin B induces specific IgG4 and IgE antibody serum levels in atopic dermatitis
Authors: Orfali Raquel L. , Sato Maria N. , Santos Vanessa G. , Titz Tiago O. , Brito Cyro A. , Duarte Alberto J. S. , Takaoka Roberto , Aoki Valéria
Published: October 2014

Background

Atopic dermatitis (AD) is a chronic recurrent inflammatory disease, with prevalence of about 10–20% in children and 1–3% in adults. Staphylococcus aureus is present in 80–100% of skin from atopic patients and is related to worsening of the disease by the action of enterotoxins. The aim of this study was to evaluate the profile of anti‐Staphylococcus aureus enterotoxin B (SEB) antibody isotypes and IgG subclass levels in adult AD.

Methods

We selected 38 patients with AD, diagnosed by Hanifin and Rajka's criteria, aged between 18 and 65, and 26 healthy controls (HC). The severity of the disease was established according to the Eczema Area and Severity Index and patients graded as mild (28%), moderate (58%), and severe (14%). Sera were assessed for IgG subclasses, IgA, IgM, and IgE against SEB by ELISA.

Results

Elevated circulating IgE and IgG4 anti‐SEB antibody levels associated with decreased IgA and IgM levels were detected in patients with AD, when compared to HC individuals. The severity of AD was related to low IgG1 and IgG3 levels and a high IgE antibody response to SEB. Interestingly, absence of IgG4 response to SEB was lower in patients with AD (2.63%), when compared to controls (34.6%), while a similar absence was detected for IgG1 and IgE antibodies (AD, 23.3 and 18.4% vs. HC, 38.5 and 19.2%).

Conclusion

Our findings evidenced a contributing role for IgG4 and IgE antibodies in AD pathogenesis, which are triggered by staphylococcal superantigens.
Bacteriostasis evaluation of the different soaking solutions in perineal skin preparation before the male urethral open operation: a randomized controlled trial
Authors: Ma Li , Liu Ling , Tian Ye , Peng Yinqiong , Wang Kunjie , Wu Tao , Liu Changqing
Published: October 2014

Perineal soaking is of crucial importance for skin preparation before the male urethral open operation; however, soaking solutions vary across the world. The aim of this research was to explore the bacteriostasis efficacy of the different soaking solutions in perineal skin preparation before the operation. Thirty‐six patients were randomly divided into three groups. In Group A, 0·1% povidone iodine was used to soak the 12 patients' perineum to reduce the bacterial load of the skin preparation before the operation. Similarly, combination of 0·1% povidone iodine and 1·6% saline for Group B and 1·6% saline for Group C was used. Bacteria samples were collected in four sites of the patients' perineum, before soaking, 1 d after soaking and 2 d after soaking, respectively. No serious adverse reactions were observed. There was a significant lower bacteria load in Group C after soaking (P = 0·032). For penoscrotal junction, there were significant lower bacteria loads after soaking in both Group A and Group B compared with Group C (P = 0·009), and there was significant lower bacteria load after soaking in Group A (P = 0·001) and Group B (P = 0·017). Similar with penoscrotal junction, bacteria load at the bottom of the scrotum decreased significantly in Group A (P = 0·001) and Group B (P = 0·002) and there were significant lower bacteria loads after soaking in both Group A and Group B compared with Group C (P = 0·041). In the middle of the penis, still, there were significant lower bacteria loads after soaking in both Group A and Group B compared with Group C (P = 0·019), and there was significant lower bacteria load after soaking in Group A (P = 0·012) and Group B (P = 0·006). In conclusion, combination of 0·1% povidone iodine and 1·6% saline solution for the preoperative skin preparation of male open urethral operation is safe and efficient.
Applications of Statistics in the Field of General Insurance: An Overview
Authors: Grize Yves L.
Published: October 2014

This is an expository paper on applications of statistics in the field of general insurance, also called non‐life insurance. Unlike life insurance where advanced statistical techniques have long been part of financial mathematics and actuarial applications, their use is only relatively recent in non‐life insurance. The business model of insurance companies, especially those active in non‐life insurance, has seen dramatic changes over the last 15 years. The aim of this paper is to convince the readers that especially today non‐life insurance is not only an exciting ground to apply existing modern statistical tools but also a fertile environment for new and challenging statistical developments. The activities of an insurance company can be viewed as an industrial process where data management and data analysis play a key role. That is why a fundamental understanding of data‐related issues (such as data quality, variability, analysis and correct interpretation) is so essential to the insurance business. These are exactly the tasks where professional statisticians excel. Also, a better understanding of the field of general insurance by statisticians will promote fruitful exchanges between actuaries and statisticians, thereby helping to bring actuarial and statistical professional societies closer to each other. Selected examples are used to cover the essential aspects of general insurance, and all of them are based on the author's experience. The paper concludes with some remarks on the role of statisticians working in general insurance.
A Conversation with Jean‐Louis Bodin
Authors: Saporta Gilbert
Published: October 2014

Jean‐Louis Bodin has had a distinguished career as an official statistician in the French and European statistical systems, where he has been working for 40 years.

Born in 1941 in Bordeaux, the capital city of one of the most famous vineyards in the world, he became graduate of two French prestigious schools, the Ecole Polytechnique in 1963, then the ENSAE (Ecole Nationale de la Statistique et de l'Administration Economique) in 1966. After having spent 20 years in different positions in the French Statistical System, he dedicated the last 20 years of his career to international relations in official statistics and cooperation for strengthening statistical capacities of transition and developing countries. In particular, he was one of the main drafters of the UN Resolution on Fundamental Principles for Official Statistics and of the African Statistical Charter. He is also known for having created AFRISTAT, the Economic and Statistical Observatory of Sub‐Saharan African countries. He was also during years one of the French representatives in the UN Statistical Commission, the UN Conference of European Statisticians and the Statistical Committee Programme of the European Union.

Jean‐Louis Bodin has played for 40 years a very active role in national and international statistical societies. He served on many disparate positions in the ISI family: executive director of the International Association of Survey Statisticians from 1981 to 1985 under the successive chairmanships of Gérard Théodore and Leslie Kish, founding member in 1985 with Vera Nyitrai of the International Association for Official Statistics and president of the Association from 1989 to 1991, secretary‐general of the National Organizing Committee of the 47th ISI Session held in Paris in August 1989, Chair of the Programme Coordinating Committee of the 50th ISI Session held in Beijing in August 1995, ISI president‐elect then president from 1997 to 2001, president of the Jury of the Mahalanobis Prize from 2002 to 2005. He was also president of theSociété de Statistique de Parisin 1994. He received the certificate of Fellow of the American Statistical Association in 1996 and was a member of the ASA Committee for International Relations in Statistics from 1993 to 1997.

He was bestowed in 2006 as aChevalier de la Légion d'Honneur(Knight of the Legion of Honour) in France and in 1997 as aKawaleski Orderu Zasługi(Knight of the Order of Merit) in Poland. He received the Medal of Statistical Merit in Vietnam in 2003 and the African Statistical Award bestowed by the UN Economic Conference for Africa in 2012.

This conversation was held in June 2013 with Gilbert Saporta in Paris.

Gilbert Saporta: Welcome to this interview, Jean‐Louis. I'm delighted that you could spend some time with me to discuss your career, your achievements and your views on some aspects of official statistics. It appears that your professional career as a French official statistician and your participation in ISI activities were tightly linked.

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Hydrogen sulphide decreases IL‐1β‐induced activation of fibroblast‐like synoviocytes from patients with osteoarthritis
Authors: Sieghart Daniela , Liszt Melissa , Wanivenhaus Axel , Bröll Hans , Kiener Hans , Klösch Burkhard , Steiner Günter
Published: October 2014

Balneotherapy employing sulphurous thermal water is still applied to patients suffering from diseases of musculoskeletal system like osteoarthritis (OA) but evidence for its clinical effectiveness is scarce. Since the gasotransmitter hydrogen sulphide (H2S) seems to affect cells involved in degenerative joint diseases, it was the objective of this study to investigate the effects of exogenous H2S on fibroblast‐like synoviocytes (FLS), which are key players in OA pathogenesis being capable of producing pro‐inflammatory cytokines and matrix degrading enzymes. To address this issue primary FLS derived from OA patients were stimulated with IL‐1β and treated with the H2S donor NaHS. Cellular responses were analysed by ELISA, quantitative real‐time PCR, phospho‐MAPkinase array and Western blotting. Treatment‐induced effects on cellular structure and synovial architecture were investigated in three‐dimensional extracellular matrix micromasses. NaHS treatment reduced both spontaneous and IL‐1β‐induced secretion of IL‐6, IL‐8 and RANTES in different experimental settings. In addition, NaHS treatment reduced the expression of matrix metallo‐proteinases MMP‐2 and MMP‐14. IL‐1β induced the phosphorylation of several MAPkinases. NaHS treatment partially reduced IL‐1β‐induced activation of several MAPK whereas it increased phosphorylation of pro‐survival factor Akt1/2. When cultured in spherical micromasses, FLS intentionally established a synovial lining layer‐like structure; stimulation with IL‐1β altered the architecture of micromasses leading to hyperplasia of the lining layer which was completely inhibited by concomitant exposure to NaHS. These data suggest that H2S partially antagonizes IL‐1β stimulation via selective manipulation of the MAPkinase and the PI3K/Akt pathways which may encourage development of novel drugs for treatment of OA.
PDGF beta targeting in cervical cancer cells suggest a fine‐tuning of compensatory signalling pathways to sustain tumourigenic stimulation
Authors: Tudoran Oana Mihaela , Soritau Olga , Balacescu Loredana , Pop Laura , Meurice Guillaume , Visan Simona , Lindberg Staffan , Eniu Alexandru , Langel Ulo , Balacescu Ovidiu , Berindan‐Neagoe Ioana
Published: October 2014

The platelet‐derived growth factor (PDGF) signalling pathway has been reported to play an important role in human cancers by modulating autocrine and paracrine processes such as tumour growth, metastasis and angiogenesis. Several clinical trials document the benefits of targeting this pathway; however, in cervical cancer the role of PDGF signalling in still unclear. In this study, we used siRNA against PDGF beta (PDGFBB) to investigate the cellular and molecular mechanisms of PDGFBB signalling in Ca Ski and HeLa cervical cancer cells. Our results show that PDGFBB inhibition in Ca Ski cells led to rapid alterations of the transcriptional pattern of 579 genes, genes that are known to have antagonistic roles in regulating tumour progression. Concomitantly, with the lack of significant effects on cervical cancer cells proliferation, apoptosis, migration or invasion, these findings suggests that cervical cancer cells shift between compensatory signalling pathways to maintain their behaviour. The observed autocrine effects were limited to cervical cancer cells ability to adhere to an endothelial cell (EC) monolayer. However, by inhibiting PDGFBB on cervical cells, we achieved reduced proliferation of ECs in co‐culture settings and cellular aggregation in conditioned media. Because of lack of PDGF receptor expression on ECs, we believe that these effects are a result of indirect PDGFBB paracrine signalling mechanisms. Our results shed some light into the understanding of PDGFBB signalling mechanism in cervical cancer cells, which could be further exploited for the development of synergistic anti‐tumour and anti‐angiogenic therapeutic strategies.
The impact of an operative note proforma at a paediatric surgical centre
Authors: Chan Benjamin K.Y. , Exarchou Klaire , Corbett Harriet J. , Turnock Rick R.
Published: October 2014

Rationale, aims and objectives

With expectations for standardization and evidence‐based practice, the Royal College of Surgeons (RCS) published the ‘Good Surgical Practice’ in 2008. The document sets standards for operative records anticipating improved documentation, audits, medico‐legal review and quality and safety of handover. We evaluated (1) documentation against RCS standards; (2) whether RCS standards are applicable to and adequate for paediatric surgery; and (3) the impact of a standardized operative proforma.

Methods

All general surgery and urology admissions during July 2011 and August 2012 were retrospectively reviewed using 23 set criteria. An operative note proforma was introduced in February 2012. Results were compared and statistically analysed using two‐tailed Fisher's exact test, with Bonferroni correction where appropriate (SPSS 20.0, IBM SPSS Statistics, Armonk, NY, USA).

Results

There were 345 children admitted; 63.2% underwent an operation (119 in 2011 versus 99 in 2012); 55% of operations were day cases. The initial audit noted poor documentation in 7 of 23 criteria. Following introduction of the operative note proforma, documentation improved significantly: patient identifiers by 12.3%, procedure time 43.3%, assistant's name 31.9%, procedure type 21.4%, closure 6.2%, anaesthetist's name 15.9%, anaesthetic type 56.8% and surgeons grade 65.8% (P < 0.05). Subgroup analysis in the latter cohort shows most of these effects to be related to the use of the proforma rather than education alone (P < 0.05). Quality of documentation was better by consultants versus trainees in 2 of 23 criteria (P < 0.05).

Conclusion

We have demonstrated a simple and cost‐effective way of improving the quality of operative documentation, in line with guidelines set out by the RCS, in a climate of increasing economic austerity.
Polyphenols from green tea prevent antineuritogenic action of Nogo‐A via 67‐kDa laminin receptor and hydrogen peroxide
Authors: Gundimeda Usha , McNeill Thomas H. , Barseghian Barsegh A. , Tzeng William S. , Rayudu David V. , Cadenas Enrique , Gopalakrishna Rayudu
Published: October 2014

Axonal regeneration after injury to the CNS is hampered by myelin‐derived inhibitors, such as Nogo‐A. Natural products, such as green tea, which are neuroprotective and safe for long‐term therapy, would complement ongoing various pharmacological approaches. In this study, using nerve growth factor‐differentiated neuronal‐like Neuroscreen‐1 cells, we show that extremely low concentrations of unfractionated green tea polyphenol mixture (GTPP) and its active ingredient, epigallocatechin‐3‐gallate (EGCG), prevent both the neurite outgrowth‐inhibiting activity and growth cone‐collapsing activity of Nogo‐66 (C‐terminal domain of Nogo‐A). Furthermore, a synergistic interaction was observed among GTPP constituents. This preventive effect was dependent on 67‐kDa laminin receptor (67LR) to which EGCG binds with high affinity. The antioxidants N‐acetylcysteine and cell‐permeable catalase abolished this preventive effect of GTPP and EGCG, suggesting the involvement of sublethal levels of H2O2in this process. Accordingly, exogenous sublethal concentrations of H2O2, added as a bolus dose (5 μM) or more effectively through a steady‐state generation (1–2 μM), mimicked GTPP in counteracting the action of Nogo‐66. Exogenous H2O2mediated this action by bypassing the requirement of 67LR. Taken together, these results show for the first time that GTPP and EGCG, acting through 67LR and elevating intracellular sublethal levels of H2O2, inhibit the antineuritogenic action of Nogo‐A.

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Currently, several agents are being evaluated for overcoming axonal growth inhibitors to promote functional recovery after stroke and spinal cord injury. Epigallocatechin‐3‐gallate (EGCG), present in green tea polyphenol mixture (GTPP), prevents antineuritogenic activity of Nogo‐A, a myelin‐derived axonal growth inhibitor. The preventive action of EGCG involves the cell‐surface‐associated 67‐kDa laminin receptor and H2O2. GTPP may complement ongoing efforts to treat neuronal injuries.>
Understanding the Antecedents, Contingencies, and Performance Implications of Process Innovation: A Dynamic Capabilities Perspective
Authors: Piening Erk P. , Salge Torsten Oliver
Published: October 2014

This paper examines one of the most important sources of competitiveness in dynamic industries—the capability of firms to introduce process innovations. While the management of product innovation has received considerable theoretical and empirical attention in the literature, our knowledge about how firms become process innovators—and why many firms fail to do so—remains underdeveloped. In order to provide novel insights into the configuration of firms' process innovation activities and their performance implications, this paper draws on the dynamic capabilities approach. More specifically, this study aims to shed light on the antecedents, contingencies, and performance consequences of interfirm differences in process innovation success, that is, firms' propensity and effectiveness of implementing new production, supply chain, or administrative processes. Particular emphasis is placed upon the analysis of potential complementarities or substitution effects between innovation activities such as internal and external research and development, prototyping, external knowledge acquisition, and employee training. Cross‐sectional data from a large‐scale survey of German manufacturing and service firms serves as the basis for testing the hypotheses advanced in this paper. Findings suggest that by engaging in a broad range of different innovation activities, firms can indeed increase the likelihood of achieving process innovation success, which is in turn positively related to firm financial performance. Yet decreasing marginal returns to innovation activities have to be considered as process innovation propensity was found to increase with the number of activities pursued simultaneously only up to a point, after which negative marginal returns set in (inverted U‐shaped relationship). Furthermore, while environmental turbulence was found to have surprisingly little influence when it comes to translating process innovation success into firms' subsequent financial performance, industry membership as well as the nature of the innovation process (i.e., internal generation, external adoption, or cocreation of an innovation) emerged as key contingency factors. These findings have important theoretical as well as practical implications for managing new process introductions.
Types of R&D Collaborations and Process Innovation: The Benefit of Collaborating Upstream in the Knowledge Chain
Authors: Un C. Annique , Asakawa Kazuhiro
Published: October 2014

This paper explains how research and development (R&D) collaborations impact process innovation; given the differences in innovation mechanisms, prior insights from studies of product innovation do not necessarily apply to process innovation. Extending the knowledge‐based view of the firm, this paper classifies four types of R&D collaborations—with universities, suppliers, competitors, and customers—in terms of two knowledge dimensions: position in the knowledge chain and contextual knowledge distance. Position in the knowledge chain is the position of the R&D collaboration partner in the knowledge chain of the industry—the input–output sequence of activities that result in the transformation of raw materials into products that are used by end customers. Based on this knowledge chain, this paper considers universities and suppliers as upstream R&D collaborators, and competitors and customers as downstream R&D collaborators. Contextual knowledge distance is the difference in industry‐related contexts of operation of the R&D collaboration partners and the firm. Based on this, this paper views R&D collaborators that are suppliers and competitors as having low contextual knowledge distance to the firm, and R&D collaborators that are customers and universities as having high contextual knowledge distance to the firm. Using this classification, this paper proposes a ranking of R&D collaborations in terms of their impact on process innovation: R&D collaborations with suppliers have the highest impact, followed by R&D collaborations with universities, then R&D collaborations with competitors, and finally R&D collaborations with customers. These arguments are tested on a four‐year panel of 781 manufacturing firms. The results of the analyses indicate that R&D collaborations with suppliers and universities appear to have a positive impact on process innovation, R&D collaborations with customers appear to have no impact, and R&D collaborations with competitors appear to have a negative impact. As a consequence, the main driver of the impact of R&D collaborations on process innovation appears to be position in the knowledge chain rather than contextual knowledge distance. These novel ideas and findings contribute to the literature on process innovation. Even though process innovation tends to be internal and tacit to the firm, it can still benefit from external R&D collaborations; this paper is the first to analyze this relationship and provide a theoretical framework for understanding why this would be the case. This study also has important managerial implications. It suggests that managers need to be careful in choosing the partners for their firms' R&D collaborations. Engaging in R&D collaborations with universities and suppliers appears to be helpful for process innovation, whereas conducting R&D collaborations with competitors may potentially harm process innovation.
User Involvement throughout the Innovation Process in High‐Tech Industries
Authors: Bosch‐Sijtsema Petra , Bosch Jan
Published: October 2014

The feedback and input of users have been an important part of product innovation in recent years. User input has been studied from different approaches and is applied through different methods in particular phases of the innovation process. However, these methods are not integrated into the whole innovation process and are used only in particular phases or on an ad hoc basis. New developments in technology, social media, and new ways of working closer with customers have opened up new possibilities for firms to gain user input throughout the whole innovation process. However, the impact that these new developments in technology offer for user input innovation in high‐tech firms is unclear. Therefore, we study how high‐tech firms collect and apply user feedback throughout the whole innovation process. The paper is based on a comparative case study of eight cases in the high‐tech industry, in which qualitative data collection was applied. The key contribution of the paper is a conceptual framework on user data‐driven innovation throughout the innovation cycle. This framework gives insight into user involvement types and approaches to collect and apply user feedback throughout the innovation process.
Resveratrol suppresses the inflammatory responses of human gingival epithelial cells in a SIRT1 independent manner
Authors: Minagawa T. , Okui T. , Takahashi N. , Nakajima T. , Tabeta K. , Murakami S. , Yamazaki K.
Published: October 2014

Background and Objective

In periodontitis, chronic infection by periodontopathic bacteria induces uncontrolled inflammation, which leads to periodontal tissue destruction. Human gingival epithelial cells (HGECs) constitute a critical first line of defense against periodontopathic bacteria, both as a physical barrier and as regulators of inflammation. Resveratrol, a polyphenol found in grapes and red wine, reportedly has anti‐inflammatory properties. Therefore, we investigated the effects of resveratrol on the Porphyromonas gingivalis‐induced inflammatory responses of HGECs and their mechanism.

Material and Methods

We stimulated the HGEC line, epi 4, with live or heat‐killed P. gingivalis in the presence of resveratrol, and analyzed expressions of the interleukin‐8, monocyte chemoattractant protein‐1 and interleukin‐1β genes. We determined the involvement of SIRT1 in the effect of resveratrol using sirtinol (a SIRT1 inhibitor) or SIRT1 knockdown. We also examined whether the effects were mediated by activation of AMP‐activated kinase, suppression of reactive oxygen species, or inhibition of nuclear factor‐κB (NF‐κB).

Results

Resveratrol treatment decreased the expression of inflammatory cytokines and slightly increased the expression of SIRT1. However, neither SIRT1 inhibition nor SIRT1 knockdown counteracted its anti‐inflammatory effects. Although resveratrol did not affect AMP‐activated kinase activation or reactive oxygen species production, it slightly suppressed NF‐κB translocation when cells were stimulated with heat‐killed P. gingivalis.

Conclusion

Resveratrol suppressed the inflammatory responses of P. gingivalis‐stimulated HGECs, probably by inhibiting NF‐κB signaling but independent of SIRT1.
Addressing Sexual Dysfunction After Risk-Reducing Salpingo-Oophorectomy: Effects of a Brief, Psychosexual Intervention
Authors: Bober Sharon L. , Recklitis Christopher J. , Bakan Jennifer , Garber Judy E. , Patenaude Andrea F.
Published: October 2014

Introduction

Women at high risk for ovarian cancer due to BRCA1 or BRCA 2 mutation or family history are recommended to undergo risk-reducing salpingo-oophorectomy (RRSO) after age 35 or completion of childbearing. This potentially life-saving surgery leads to premature menopause, frequently resulting in distressing and unaddressed sexual dysfunction.

Aim

To pilot a novel sexual health intervention for women with BRCA1/2 mutations who previously underwent RRSO a using a single-arm trial. Feasibility and primary outcomes including sexual dysfunction and psychological distress were assessed.

Methods

This single-arm trial included a one-time, half-day educational session comprised of targeted sexual health education, body awareness and relaxation training, and mindfulness-based cognitive therapy strategies, followed by two sessions of tailored telephone counseling. Assessments were completed at baseline and 2 months postintervention.

Main Outcome Measure

Study end points include feasibility and effectiveness as reported by the participant.

Results

Thirty-seven women completed baseline and postintervention assessments. At baseline, participants had a mean age of 44.4 (standard deviation [SD] = 3.9) years and mean duration of 3.8 (SD = 2.7) years since RRSO. Overall sexual functioning (P = 0.018), as well as desire (P = 0.003), arousal (P = 0.003), satisfaction (P = 0.028), and pain (P = 0.018), improved significantly. There were significant reductions in somatization (P = 0.029) and anxiety scores (P < 0.001), and, overall, for the Global Severity Index (P < 0.001) of the Brief Symptom Inventory. Sexual self-efficacy and sexual knowledge also improved significantly from baseline to postintervention (both P < 0.001). Women were highly satisfied with the intervention content and reported utilizing new skills to manage sexual dysfunction.

Conclusions

This intervention integrates elements of cognitive behavioral therapy with sexual health education to address a much-neglected problem after RRSO. Results from this promising single-arm study provide preliminary data to move toward conducting a randomized, controlled trial.
Communicating “Evidence”: Lifestyle, Cancer, and the Promise of a Disease‐free Future
Authors: Bell Kirsten , Ristovski‐Slijepcevic Svetlana
Published: October 2014

In the era of evidence‐based health care, conferences aimed at disseminating scientific knowledge perform an essential role in shaping policy and research agendas and transforming physician practice. Drawing on observations at two U.S. cancer prevention conferences aimed at knowledge translation, we examine the ways that evidence regarding the relationship between cancer and lifestyle is articulated and enacted. We show that characterizations of the evidence base at the conferences far outstripped what is presently known about the relationship between cancer and lifestyle. The messages presented to conference participants were also personalized and overtly moralistic, with attendees engaged not merely as practitioners but as members of the public at risk for cancer. We conclude that conferences seeking to bring together knowledge “makers” and knowledge “users” play a potentially important role in the production of scientific facts and are worthy of further study as distinct sites of knowledge production. [cancer, lifestyle, conferences, evidence‐based practice, knowledge translation]
A Study of valproic acid for patients with spinal muscular atrophy
Authors: Saito Toshio , Nurputra Dian K , Harahap Nur Imma F , Harahap Indra Sari K , Yamamoto Hiroshi , Muneshige Emi , Nishizono Hiroaki , Matsumura Tsuyoshi , Fujimura Harutoshi , Sakoda Saburo , Saito Kayoko , Nishio Hisahide
Published: October 2014

Background

Valproic acid (VPA) is expected to become an effective therapeutic agent for spinal muscular atrophy (SMA) because of its histone deacetylase inhibitor effect.

Aim

To evaluate the effectiveness of VPA for SMA.

Methods

Seven consecutive Japanese SMA patients (three males, four females) were recruited. Of those, six were type 2 (cases A–E, G) and one was type 3 (case F). One female patient (case E) was aged 2 years and 10 months, whereas the others ranged in age from 15 to 42 years. VPA was administered for 6 months with L‐carnitine. We carried out SMN transcript analysis of peripheral white blood cells, and evaluated using the Modified Hammersmith Functional Motor Scale for SMA (MHFMS), vital capacity (VC), maximum insufflation capacity (MIC), and cough peak flow (CPF) before and at 1, 3 and 6 months after starting treatment.

Results

Cases B–E and G completed the study. The final VPA dosage in cases B–D and G was 400 mg/day, whereas that in case E was 100 mg/day. The quantity of the FL‐SMN transcription product showed a tendency to increase. Case E showed a remarkable improvement in MHFMS, and gained motor function to turn from side to side during the study period. Although no significant changes were observed in MHFMS in the older cases, VC, MIC and CPF were improved in those.

Conclusion

Our findings suggest that VPA treatment is effective for improving MHFMS and respiratory function in some SMA patients. A placebo‐controlled randomized trial is warranted to confirm the efficacy of VPA for SMA.
Frequent hepatic steatosis in amyotrophic lateral sclerosis: Implication for systemic involvement
Authors: Nodera Hiroyuki , Takamatsu Naoko , Muguruma Naoki , Ukimoto Kazuhiro , Nishio Susumu , Oda Masaya , Izumi Yuishin , Kaji Ryuji
Published: October 2014

Background

Abnormal energy metabolism has been reported in amyotrophic lateral sclerosis (ALS) that broadens the concept of ALS as a systemic disease. Dyslipidemia is likely to reflect the clinical outcome in ALS.

Aim

To study whether evidence of dysmetabolism can be detected non‐invasively by imaging study, such as liver sonography.

Methods

Abdominal sonography, lipid profiles and liver enzymes were obtained in three groups of individuals: (i) the patients with ALS; (ii) other neurodegenerative diseases; and (iii) asymptomatic dyslipidemic persons. The sonographic steatosis grade was determined by a blinded technician. Statistical tests including one‐way anova with post‐hoc test, multiple linear regression were carried out.

Results

The lipid profiles and liver enzymes were similar between the ALS and dyslipidemic groups. The disease control group had lower low‐density lipoprotein, low‐density lipoprotein‐to‐high‐density lipoprotein ratio and triglyceride than other groups. Hepatic steatosis was present in 76% of ALS patients, 19% of the disease control and 38% of the dyslipidemic group (P < 0.001 vs ALS). Multivariate analysis showed that only the patient group was correlated to the sonographic score.

Conclusion

The present study showed that hepatic steatosis is frequent and a unique phenomenon in ALS among neurodegenerative diseases. Hepatic steatosis might be a sensitive marker for dysmetabolism in ALS.
Evaluation of bone marrow as a metastatic site of human neuroblastoma
Authors: Morandi Fabio , Corrias Maria Valeria , Pistoia Vito
Published: October 2014

Arising from neural crest cells, neuroblastoma (NB) is the most common extracranial pediatric solid tumor. The clinical presentation of NB is heterogeneous, ranging from patients with asymptomatic tumor masses, who require minimal treatment, to patients with metastatic disease who are treated with multimodal therapies. Clinical outcome is also variable, with overall survival ranging from 98% to 100% in infants with stage 1 NB, to less than 30% in patients with stage 4 MYCN‐amplified NB. More than 50% of patients show metastasis at diagnosis, with the involvement of different vascularized tissues, including the bone marrow (BM). In this paper, we focus on BM infiltration by NB cells, which is considered an adverse prognostic factor. In particular, we discuss the role of different biological factors that may favor the dissemination of NB cells in the BM, such as chromosomic abnormalities, gene amplification, transcription factors, cell‐surface receptors, products of oncogenes, and, more importantly, cytokines and chemokines. In addition, we analyze different techniques to evaluate BM infiltration by malignant cells (i.e., flow cytometry, immunocytochemistry, and quantitative reverse transcriptase polymerase chain reaction). Finally, we review recent data regarding phenotypic and genetic characterization of BM‐infiltrating malignant cells and characterization of the BM microenvironment in NB patients compared to healthy subjects.
Total intravenous anesthesia will supercede inhalational anesthesia in pediatric anesthetic practice
Authors: Lauder Gillian R.
Published: October 2014

Inhalational anesthesia has dominated the practice of pediatric anesthesia. However, as the introduction of agents such as propofol, short‐acting opioids, midazolam, and dexmedetomidine a monumental change has occurred. With increasing use, the overwhelming advantages of total intravenous anesthesia (TIVA) have emerged and driven change in practice. These advantages, outlined in this review, will justify why TIVA will supercede inhalational anesthesia in future pediatric anesthetic practice.
Ultrasound‐guided Pararadicular Injection in the Lumbar Spine: A Comparative Study of the Paramedian Sagittal and Paramedian Sagittal Oblique Approaches
Authors: Kim Young Hoon , Park Hue Jung , Moon Dong Eon
Published: October 2014

Background

Ultrasound‐guided nerve root blocks and transforaminal injections are well established, and several procedural feasibility studies have been reported. However, the contrast dispersion pattern during ultrasound‐guided pararadicular injection has not been reported. We hypothesized that the paramedian sagittal oblique approach provides a superior intraforaminal contrast‐spread pattern compared to the paramedian sagittal approach during ultrasound‐guided pararadicular injections in the lumbar spine.

Methods

Ninety injections were performed in 42 adult patients using pararadicular injections. Each injection was allocated to 1 of 2 groups. In the paramedian sagittal approach group, the transducer was positioned perpendicularly over the skin, and a bent needle was inserted using an in‐plane technique. In the paramedian sagittal oblique approach group, the needle was advanced with the transducer tilted ~20 to 25° toward the pararadicular aditus plane. In both groups, the needle was advanced until the intertransverse ligament was punctured. Nonionic contrast media was injected under fluoroscopic guidance.

Results

The contrast was injected in the targeted pararadicular compartment in 83 of 90 injections (92.2%). Among the successful pararadicular injections, the intraforaminal contrast pattern was detected in 17 cases (39.5%) in the paramedian sagittal approach group and in 35 cases (87.5%) in the paramedian sagittal oblique approach group (P < 0.001). Both groups showed significant pain reduction compared to the baseline (P < 0.001); however, the visual analog scale for pain showed significantly lower pain in the paramedian sagittal oblique approach group compared to the paramedian sagittal approach group (P = 0.036). Rates of ventral epidural flow, intra‐ and extraepineural pattern of contrast, and intravascular injections were similar between the two approaches.

Conclusion

The paramedian sagittal oblique approach delivered a superior intraforaminal contrast‐spread pattern and significantly greater pain relief than the paramedian sagittal approach during ultrasound‐guided pararadicular injections in the lumbar spine.
Basiliximab treatment for steroid‐resistant rejection in pediatric patients following liver transplantation for acute liver failure
Authors: Shigeta Takanobu , Sakamoto Seisuke , Uchida Hajime , Sasaki Kengo , Hamano Ikumi , Kanazawa Hiroyuki , Fukuda Akinari , Kawai Toshinao , Onodera Masafumi , Nakazawa Atsuko , Kasahara Mureo
Published: October 2014

An IL‐2 receptor antagonist, basiliximab, decreases the frequency of ACR in liver transplant (LT) recipients as induction therapy. The aim of this study was to evaluate the effectiveness of basiliximab against SRR as rescue therapy in pediatric LT patients with ALF. Forty pediatric ALF patients underwent LT between November 2005 and July 2013. Among them, seven patients suffering from SRR were enrolled in this study. The median age at LT was 10 months (6–12 months). SRR was defined as the occurrence of refractory rejection after more than two courses of steroid pulse therapy. Basiliximab was administered to all patients. The withdrawal of steroids without deterioration of the liver function was achieved in six patients treated with basiliximab therapy without patient mortality, although one patient developed graft loss and required retransplantation for veno‐occlusive disease. The pathological examinations of liver biopsies in the patients suffering from SRR revealed severe centrilobular injuries, particularly fibrosis within one month after LT. We demonstrated the effectiveness and safety of rescue therapy consisting of basiliximab for SRR in pediatric LT recipients with ALF.
Recent Advances in the Application of Chlorophyll a Fluorescence from Photosystem II
Authors: Guo Ya , Tan Jinglu
Published: October 2014

In the photosynthesis process, part of the absorbed photon energy in photosystem II (PSII) may be reemitted as chlorophyll a fluorescence (ChlF). Environmental and plant physiological changes affect the emission of ChlF, which makes ChlF a potentially useful tool to sense these changes. Volumes of research on ChlF are published each year and some published work has been controversial. To facilitate the application of ChlF, it is important to have a holistic picture of the field. This review summarizes ChlF applications published in the last 10 years.
Intuition Fail: Philosophical Activity and the Limits of Expertise
Authors: Buckwalter Wesley
Published: October 2014

Experimental philosophers have empirically challenged the connection between intuition and philosophical expertise. This paper reviews these challenges alongside other research findings in cognitive science on expert performance and argues for three claims. First, evidence taken to challenge philosophical expertise may also be explained by the well‐researched failures and limitations of genuine expertise. Second, studying the failures and limitations of experts across many fields provides a promising research program upon which to base a new model of philosophical expertise. Third, a model of philosophical expertise based on the limitations of genuine experts may suggest a series of constraints on the reliability of professional philosophical intuition.

Even when the experts all agree, they may well be mistaken. — Bertrand Russell, On the Value of Scepticism
Host resistance in cattle to infestation with the cattle tick Rhipicephalus microplus
Authors: Jonsson N. N. , Piper E. K. , Constantinoiu C. C.
Published: October 2014

Resistance to Rhipicephalus microplus infestation in cattle has many effector mechanisms, each of which is likely to be modulated by complex, interacting factors. Some of the mechanisms of host resistance and their modulating factors have been identified and quantified, although much remains to be explained. The variation in resistance to tick infestation is most marked between Bos taurus and Bos indicus cattle, taurine cattle given the same exposure carrying between five and 10 times as many ticks as indicine cattle. Tick resistance is mostly manifest against attaching larvae, which attempt to feed often and without success, death occurring mostly within 24 h of finding a host. There is evidence of innate and adaptive immune response to tick infestation, and it appears that the relative importance of each differs between indicine and taurine cattle. There is conflicting information regarding the role of humoral immunity in tick resistance, and recent studies indicate that strong IgG responses to tick antigens are not protective. A strong T‐cell‐mediated response directed against larval stages, as mounted by indicine cattle, seems to be protective. Variation in the extracellular matrix of skin (epidermal growth factors, collagens and other matrix components such as lumican) also contributes to variation in host resistance.
Campaign‐Style Enforcement and Regulatory Compliance
Authors: Liu Nicole Ning , Lo Carlos Wing‐Hung , Zhan Xueyong , Wang Wei
Published: October 2014

This article examines the recoupling mechanism of campaign‐style enforcement and its effects on environmental regulatory compliance. Drawing on the policy implementation literature and institutional theory, the authors develop a conceptual model of campaign‐style enforcement in which both resource mobilization and power redistribution are theorized to address decoupling problems in regulatory compliance. The two‐pathway recoupling mechanism is evidenced by an empirical investigation of the implementation of China's energy conservation and emission reduction policy as part of that country's 11th Five‐Year Plan. Findings suggest that campaign‐style enforcement can effectively improve regulatory compliance when it addresses the efficiency/legitimacy conflict by providing policy incentives and reorganizing a clear hierarchy of political authority. The article concludes with a discussion of the strengths and limitations of campaign‐style enforcement.
Nutritional requirements and use of macroalgae as ingredients in abalone feed
Authors: Bansemer Matthew S. , Qin Jian G. , Harris James O. , Howarth Gordon S. , Stone David A.J.
Published: October 2014

Temperate abalone species in aquaculture have a grow‐out period of approximately 3 years because of their slow and heterogeneous growth rate. Abalone aquaculture is still a developing industry, and at least two major issues, nutrition and health, impede its development. Abalone are fed macroalgae on‐farm in a number of countries, includingChina,Korea,SouthAfrica andChile. Formulated diets are crucial to the success of abalone aquaculture in countries where abalone do not grow readily when fed brown macroalgae or when access to macroalgae is insufficient for culture. Typically, the growth rate of abalone fed formulated diets is higher than abalone fed live macroalgae. However, due to a long production period, diets for abalone not only need to sustain high growth rates, but also maintain optimal health. Feeding live macroalgae improves the feeding activity, health and marketability of abalone. In this review, the nutritional requirements of abalone and dietary ingredients used in formulated diets will be discussed, together with the use of dried macroalgal meal as a dietary ingredient in formulated diets to improve the feeding activity, health and marketability of abalone in commercial production.
Firms' Export Dynamics: Experience Versus Size
Authors: Berthou Antoine , Vicard Vincent
Published: October 2014

This paper provides evidence about the impact that size and experience in exporting have on firms' dynamics, a critical input in models of firms dynamics. The analysis uses a census of French exports by firm‐destination‐product over the period 1994–2008 with a monthly frequency. We first uncover a large calendar year effect associated with the timing of entry: the fact new exporters may start exporting late during the year inflates the growth rate between the first and second years. When computed on a full year basis starting with the month of entry, first year exports of new exporters are on average 36 per cent larger than on a calendar year basis. We then show that, controlling for size, export experience is negatively related to net growth of exports for surviving exporters. Controlling for export experience, the relationship between average size and net growth of exports shows no systematic pattern. Finally, churning in foreign markets, that is the gross contributions of entry and exit to exporters net growth, is decreasing with export experience and (sharply) with size.