bluuebunny/crossref_metadata_2025 huggingface dataset:
Image‐guided biopsy of small renal masses in the era of ablative therapies
Authors: Salem Sepehr , Ponsky Lee E , Abouassaly Robert , Cherullo Edward E , Isariyawongse Justin P , MacLennan Gregory T , Nakamoto Dean , Haaga John R
Published: November 2012

Objective

To further evaluate the accuracy, safety, and impact of image‐guided renal biopsies on clinical decision making and management of the indeterminate small renal masses.

Methods

A total of 145 patients (males 99, females 46) with small renal masses suspicious for malignancy were evaluated during the study period. The patients' mean age was 67.2 (± 11.6) years. Computed tomography guided biopsies were carried out in all cases by an experienced interventional radiologist. An experienced genitourinary pathologist reviewed all pathological specimens. Patients' demographic characteristics, tumor histology and subsequent intervention, as well as periprocedural morbidities were recorded and analyzed.

Results

A total of 145 renal biopsy procedures were carried out. The small renal masses mean size was 2.4 ± 1.1 cm. Biopsy was diagnostic in 126 (86.9%) cases and non‐diagnostic in 19 (13.1%) cases. Of diagnostic biopsies, 107 (84.9%) were malignant, 84.1% of which were primary renal cell carcinoma. Histological subtyping and grading of tumor was possible in 100% and 52.2% of renal cell carcinomas, respectively. The major renal cell carcinoma subtype was clear cell (63.3%) followed by papillary (24.4%) and chromophobe (8.8%). Repeat biopsy was carried out in nine of 19 non‐diagnostic cases, and diagnosis was possible in 66.7%. Sensitivity of percutaneous renal biopsy was 91%, and its accuracy was 85.5%. Overall, patients' age, sex, tumor size, and location were not related to non‐diagnostic biopsy results and/or tumor pathology. No cases of hemorrhage, seeding of biopsy tract, infection or mortalities were observed.

Conclusions

Our findings showed that image‐guided biopsy of indeterminate small renal masses is safe and can provide the correct diagnosis with a high degree of accuracy. Thus, this procedure can play an important role in establishing a histopathological diagnosis before treatment of enhancing small renal masses with ablative technologies. Furthermore, repeat biopsy can alter the clinical management of non‐diagnostic biopsies.
“Oh, you've got such a strong accent”: Language Identity Intersecting with Professional Identity in the Human Services in Australia
Authors: Harrison Gai
Published: November 2012

Language operates as a form of differentially valued cultural capital that is an influential factor in educational and employment outcomes. English in particular represents a valuable form of linguistic capital in both the broader world market and many regional and local contexts. This article, focusing on one group of professionals, draws on an exploratory study carried out with overseas‐born bilingual social workers residing in Australia, who reflect on how their language identities intersect with their professional identities in the human services workplace. Although most informants identified tangible benefits associated with being bilingual, especially in terms of working with a diverse clientele, they were equally aware of how being categorized as a ‘non‐native’ speaker of English could diminish their professional credibility and thwart their chances of upward mobility in the workplace. In this regard, this article highlights inconsistencies in how difference is valued in the human services workplace, implicating a more covert process of linguistic othering.
Salvadoran Migrants in Australia: An Analysis of Transnational Families’ Capability to Care across Borders
Authors: Merla Laura
Published: November 2012

In this paper, I focus on the transnational care practices of Salvadoran refugees living in Perth (Western Australia) and who care for their ageing parents who have remained in their home country. The analysis is based on a conceptualization of transnational care as a set of capabilities that include, but are not limited to, mobility, social relations, time allocation, education and knowledge, paid work and communication (Merla and Baldassar, 2011). I focus in particular on the impact of Salvadoran refugees’ difficult access to, and use of, these capabilities on their capacity to fulfil their culturally defined sense of obligation to care for their ageing parents. Results show that extended transnational kinship networks play a major role in helping migrants overcome obstacles to transnational caregiving.
Sources of variation in larval parasitism of two sympatrically outbreaking birch forest defoliators
Authors: SCHOTT TINO , IMS ROLF A. , HAGEN SNORRE B. , YOCCOZ NIGEL G.
Published: November 2012

1. Studies of insect communities rarely support the parasitoid–host regulation hypothesis. Spatio‐temporal variation in parasitoid prevalence due to complex food web interactions or abiotic factors may prevent parasitoids from regulating hosts.

2. We examined the relative contribution of spatial (altitude) and temporal (years) sources to total variation in parasitoid prevalence rates in outbreaks of Epirrita autumnata Borkhausen and Operophtera brumata Linnaeus populations. We tested whether prevalence rates of generalist parasitoids were correlated between sympatric host populations and to what extent any of the parasitoids were host density dependent.

3. Four larval parasitoids (two specialists and two generalists) exhibited significantly structured spatio‐temporal dynamics over years and altitudes. The prevalence rates of one of the generalists were spatio‐temporally correlated between the two host species, while for the other they were not.

4. Three parasitoids showed tendencies for direct or delayed positive density dependence as expected from numerical and functional responses to their hosts. However, the effects were weak and minute compared to the variation attributed to year and altitude.

5. We conclude that unknown aspects of the larval parasitoid ecology that co‐vary with altitude and year in the study system dominate their prevalence dynamics and thus act to hinder density‐dependent responses that could potentially regulate host populations.
Lipoprotein Lp(a) as predictor of myocardial infarction in comparison to fibrinogen, LDL cholesterol and other risk factors: results from the prospective Göttingen Risk Incidence and Prevalence Study (GRIPS)
Authors: CREMER P. , NAGEL D. , LABROT B. , MANN H. , MUCHE R. , ELSTER H. , SEIDEL D.
Published: November 2012

Abstract. Based on pathophysiological findings Lp(a) is considered to be a cardiovascular risk factor. The Göttingen Risk Incidence and Prevalence Study (GRIPS) provides the possibility to evaluate this impact of Lp(a) on the basis of a large prospective cohort study. GRIPS included 6002 men, aged 40–59·9 years at baseline. Data of a 5 year follow‐up period is now available for > 95% of the study participants. Multivariate logistic regression models for the estimation of MI risk confirm Lp(a) as an important risk factor, ranking fifth behind LDL cholesterol, family history of MI, plasma fibrinogen and HDL cholesterol (inversely related). The GRIPS data strongly support strategies for the identification and treatment of persons at increased MI risk which focus on LDL cholesterol. However, Lp(a) and fibrinogen have to be seriously considered as additional risk factors and should be included in diagnostic panels for the estimation of MI risk.
Post‐prandial triglyceride‐rich lipoprotein metabolism: possible role of sialilated apolipoprotein E isoproteins
Authors: ITO H. , NAITO C. , SUZUKI Y. , NAKAMURA K. , NAGASE M.
Published: November 2012

Abstract. While serum concentrations of triglyceride (TG) and apolipoprotein (apo) E decreased significantly after 75 g glucose load, serum triglyceride concentration increased markedly and apoB concentration decreased significantly after 100 g fat load in 10 healthy men. Chylomicrons and very low density lipoproteins (VLDL) increased after the fat load but decreased after the glucose load. ApoB‐100/B‐48 ratio in VLDL fraction decreased slightly at 30 min and increased markedly at 60 min after the glucose load. On the other hand, the ratio decreased definitely at 30 min and then increased until 90 min after the fat load. Isoelectric focusing (IEF) and two‐dimensional gel electrophoresis revealed that the relative concentration of sialilated apoE in VLDL fraction decreased after the glucose load and increased after the fat load. In hypertriglyceridaemic patients, apoE3S1/E3 ratio in VLDL fraction was significantly higher than that in normal and hypercholesterolaemic patients. The results suggest that some structural changes in apoE, due probably to sialilation, may exert an influence on the hepatic uptake of the lipoproteins.
Influence of digoxin‐like immunoreactive factor on late complications in patients with diabetes mellitus
Authors: STRAUB R. H. , ELBRACHT R. , KRÄMER B. K. , ROTH M. , PALITZSCH K.‐D. , SCHÖLMERICH J.
Published: November 2012

Abstract. The aim of this study was to compare the intensity of typical late complications in diabetic patients (n = 65, 28 type I, 37 type II) who were not on glycoside drugs with low vs. high serum levels of digoxin‐like immunoreactive factor (DLIF: group I, n = 42, DLIF ≤ the detection limit of 0·2 ng ml−1; and group II, n = 23, mean ± SEM: 1·17 ± 0·31 [0·25–4·96] ng ml−1). For detection of nephropathy, urinary albumin excretion (24 h) and creatinine clearance tests were used. For coronary heart disease a questionnaire and standard ECG; for peripheral occlusive vascular disease a questionnaire; for eye disease a fundoscopy; for neuropathy a neurological score system; and for autonomic neuropathy a standardized test battery was employed. Patients with high DLIF levels showed better test results in vibratory perception (95·7 ± 1·5 vs. 82·8 ± 3·8%, normal finding = 100%, 2p = 0·016), had better percentile localizations concerning maximal pupillary area in darkness (28·4 ± 6·6 vs. 8·1 ± 1·8%, 2p = 0·0004), contraction velocity at 1 s (21·5 ± 5·8 vs. 8·0 ± 2·2%, 2p = 0·012), and dilation velocity at 6 s (23·0 ± 6·8 vs. 10·5 ± 2·5%, 2p = 0·041), had less retinopathy (with retinopathy: 26·1% vs. 64·3%, 2p = 0·0028), and better percentile localizations in the respiratory sinus arrhythmia test (68·4 ± 7·3 vs. 44·1 ± 4·9%, 2p = 0·0064). There was no difference concerning nephropathy, blood pressure, coronary heart disease and peripheral vascular disease. Separate analysis according to the type of diabetes confirmed the results in each group. This would indicate that DLIF is a possible protective endogenous substance for eye disease, and peripheral (large sensory fibres) and autonomic neuropathy in diabetic subjects independent of the type of diabetes.
Effects of selective LDL‐apheresis and pravastatin therapy on platelet function in familial hypercholesterolaemia
Authors: BRÖIJERSÉN A. , ERIKSSON M. , LARSSON P. T. , BECK O. , BERGLUND L. , ANGELIN B. , HJEMDAHL P.
Published: November 2012

Abstract. Platelet function was studied in 10 patients with familial hypercholesterolaemia, following lipid‐lowering treatment with selective LDL‐apheresis and with the HMG‐CoA reductase inhibitor pravastatin. Platelet function was assessed before, and 2, 5 and 14 days after LDL‐apheresis, and before and after 4 weeks of pravastatin therapy. Both treatments significantly reduced total‐ and LDL‐cholesterol, whereas LDL‐apheresis also reduced VLDL‐cholesterol. Lp(a)‐levels were reduced by LDL‐apheresis and elevated by pravastatin treatment. Pravastatin therapy significantly enhanced platelet aggregability in vivo, as measured by ex vivo filtragometry. Plasma serotonin levels also increased. Other markers of in vivo activation of platelets, i.e. β‐thromboglobulin in plasma and urine, and 11‐dehydro‐thromboxane B2 in urine were unaltered. Adenosine diphosphate‐induced platelet aggregation in vitro remained unchanged during pravastatin therapy, and the platelet volume distribution was not affected. LDL‐apheresis reduced the mean platelet volume, as well as the percentage of large platelets, whereas the percentage of small platelets increased. Other measures of platelet function in vivo or in vitro were, however, unaltered following LDL‐apheresis.

Thus, pravastatin therapy enhances certain aspects of platelet aggregability in vivo, whereas a single treatment with selective LDL‐apheresis does not consistently affect platelet aggregability during resting conditions. These results do not support the concept that reduction of LDL‐cholesterol improves platelet function in hypercholesterolaemic patients, at least not in the short‐term. However, the reduction of platelet volume after LDL‐apheresis may be beneficial for patients receiving this therapy regularly.
The D3cpv Cameleon reports Ca2+ dynamics in plant mitochondria with similar kinetics of the YC3.6 Cameleon, but with a lower sensitivity
Authors: LORO G. , RUBERTI C. , ZOTTINI M. , COSTA A.
Published: November 2012

Mitochondria are key organelles involved in many aspects of plant physiology and, their ability to generate specific Ca2+ signatures in response to abiotic and biotic stimuli has been reported as one of their roles. The recent identification of the mammalian mitochondrial Ca2+ uniporter opens a new research area in plant biology. To study the mitochondrial Ca2+ handling, it is essential to have a reliable probe. Here we have reported the generation of an Arabidopsis transgenic line expressing the genetically encoded probe Cameleon D3cpv targeted to mitochondria, and compared its properties with the already known Cameleon YC3.6.
A review of the human activities impacting cetaceans in the eastern tropical Atlantic
Authors: Weir Caroline R. , Pierce Graham J.
Published: November 2012

The eastern tropical Atlantic (ETA), extending from Mauritania south to Angola, is inhabited by at least 34 cetacean species. Knowledge of cetaceans and the human activities affecting them in the ETA is scant.

Available literature was reviewed over three eras of ETA cetacean research: the whaling era (1700s–1950s); the stranding and specimen era (1950s–70s); and the modern field research era (1980s–present). Eight human activities were documented to impact ETA cetacean species: directed takes (whaling and small cetaceans); by‐catch or entanglement in fishing gear; the ETA tuna purse seine fishery; overfishing; habitat loss and degradation; vessel strikes; marine ecotourism; and live captures for display. Climate change may represent a future threat.

Directed takes of small cetaceans were documented in 12 ETA countries, and incidental by‐catch (especially in gillnets) in at least nine countries. Additionally, unknown levels of cetacean mortality occur in ETA tuna purse seine fisheries. The use of cetaceans as ‘bushmeat’ was documented in 15 countries and involved at least 23 species. Little information could be found on cetacean mortality in Liberia, Benin, Cameroon, Equatorial Guinea, São Tomé and Príncipe or the Democratic Republic of the Congo.

Human activities were most frequently and widely reported to impact on common bottlenose dolphins Tursiops truncatus and Atlantic humpback dolphins Sousa teuszii, which are particularly vulnerable to anthropogenic interactions due to their nearshore occurrence.

The lack of information on the scale of impacts and on cetacean abundance and population structure in the ETA currently hinders assessments of the sustainability of mortality levels.
Relationships between frailty, neighborhood security, social cohesion and sense of belonging among community‐dwelling older people
Authors: Cramm Jane M , Nieboer Anna P
Published: November 2012

Aim

The relationships between frailty and neighborhood social resources and neighborhood quality among community‐dwelling older people are poorly understood. We therefore enquired into these associations while controlling for important individual characteristics.

Methods

Our cross‐sectional study included 945 out of 1440 (66% response rate) community‐dwelling older people (aged ≥70 years) in Rotterdam. The sample included approximately 430 older adults per district and was proportional with respect to neighborhood and age. Potential participants were mailed questionnaires, non‐respondents were first sent a reminder, then asked by telephone and finally visited at home to complete the questionnaire.

Results

Age, sex, marital status and level of education varied between the frail and non‐frail. A significantly larger proportion of the frail was female (64.4% vs 48.0%; P ≤ 0.001), fewer were married (22.1% vs 48.4%; P ≤ 0.001) and the frail were, on average, older than the non‐frail (78.8 vs 76.0 years; P ≤ 0.001). A significantly larger proportion of the frail were poorly educated (25.9% vs 18.6%; P ≤ 0.01). Multilevel regression analyses showed that older age (P < 0.001) was associated with higher likelihood of frailty and marital status (P < 0.001) with lower likelihood of frailty. Feeling more secure (P < 0.001) and having a stronger sense of social cohesion and neighborhood belonging (P < 0.05) seemed to protect against frailty.

Conclusion

The results of this study support the importance of feeling safe, social cohesion and a sense of belonging within the neighborhood. These findings could have important implications for efforts to reduce frailty of older people within communities. Geriatr Gerontol Int 2013; 13: 759–763.
Comparison of long‐term survival outcome of operative vs nonoperative management of recurrent rectal cancer
Authors: Bhangu A. , Ali S. M. , Cunningham D. , Brown G. , Tekkis P.
Published: November 2012

Aim  Complete surgical resection is considered the best treatment for recurrent rectal cancer (RRC). The aim of the study was to compare survival outcomes from operative and nonoperative patients presenting with RRC.

Method  Patients with RRC whose management was discussed by a tertiary referral specialist multidisciplinary team between January 2007 and August 2011 were identified from a prospectively maintained database. The primary end‐point was 3‐year overall survival.

Results  Of 127 patients with RRC, it was isolated to the pelvis in 105 and associated with distant disease at presentation in 22. From the time of primary surgery to first recurrence, 1‐, 3‐, 5‐ and 10‐year local recurrence rates were 22%, 72%, 85% and 96%, respectively. The number of operated patients available at 1, 2 and 3 years’ follow‐up was 53, 34 and 23, respectively. Of 70 patients who underwent pelvic resection for recurrence, 64% received R0, 20% received R1 and 16% received R2 resections. Corresponding 3‐year overall survival rates were 69%, 56% and 20% (P = 0.011). There was no significant difference in survival between R2 resection and those managed nonoperatively (hazard ratio = 1.258; P = 0.579). Those undergoing surgery for pelvic recurrence affecting one or more compartments had a worse prognosis than those with single‐compartment involvement (hazard ratio = 2.640; P = 0.027). Three‐year local recurrence‐free survival was 80% with R0 resection vs 60% with R1 resection.

Conclusion  Most recurrences occur within 5 years of primary surgery, although some occur up to 10 years later. R0 resection is the treatment of choice. There was no survival benefit of R2 resection over nonresected recurrences.
HAPPINESS, GROWTH, AND PUBLIC POLICY†
Authors: EASTERLIN RICHARD A.
Published: November 2012

If society's goal is to increase people's feelings of well‐being, economic growth in itself will not do the job. Full employment and a generous and comprehensive social safety net do increase happiness. Such policies are arguably affordable not only in higher income nations but also in countries that account for most of the population of the less‐developed world. These conclusions are suggested by an analysis of a wide range of evidence on happiness in countries throughout the world. (JEL I31, I38, O21, F20, D60, E60)
Mass Media and Party Divergence in Multiparty Systems
Authors: Bækgaard Martin , Jensen Carsten
Published: November 2012

Does the mass media affect the dispersion of the policy positions of political parties? In this article it is argued that the mass media polarize parties' policy positions because vote‐seeking strategies are more viable if party policy positions are clearly communicated to the electorate and because a vote‐seeking strategy corresponds with parties taking a distinct policy position away from the median. Hence, the main hypothesis is that party policy position dispersion is larger with more mass media penetration. In order to test this argument, a novel dataset on party positions and mass media penetration in 267Danish municipalities in 2004 is utilized and a new measure of the dispersion of policy positions in multiparty systems is constructed. The analysis corroborates the article's main hypothesis.
Zum Versagen der Marktdisziplinierung in der Finanzkrise
Authors: Tichy Gunther
Published: November 2012

Economic policy design frequently assumes that markets, reacting instantaneously to news, rapidly discipline countries’ unsustainable policies. Interest rates would rise immediately. The recent financial crisis calls this assumption seriously into question. The countries at the European periphery accumulated competition problems and enormous current-account deficits for one and a half decades before the spreads reacted. As the rating-agencies’ did no better job and their assessments are strongly correlated with the spreads, the paper uses their published reasons for downgrading countries to explain the changes of spreads. It appears that limited information in a complex situation forces financial-market participants as well as observers to reduce complexity to simple plausible ‘stories’ which can be easily communicated. These ‘stories’ concentrate on financial aspects and are highly persistent, but over-react if they are forced to shift to a new ‘story’.
Der volkswirtschaftliche Verlust durch Stromausfälle: Eine empirische Analyse für Haushalte, Unternehmen und den öffentlichen Sektor
Authors: Schmidthaler Michael , Reichl Johannes , Schneider Friedrich
Published: November 2012

This work discusses different methodological approaches for the economic evaluation of electricity supply security, quantifies the expected economic costs of power outages in Austria, and provides an interpretation of the results regarding the future challenges of sustaining the currently high levels of electricity supply security.

By applying a macroeconomic simulation tool, which assesses the damages of power outages which can be defined for the period between one to 48 hours taking into account the day of the week and time of day, the value of supply security can be estimated precisely with high spatial and sectoral resolution. This is demonstrated exemplarily for a power outage scenario which is similar in scope, timing and duration to a historic even in Italy in 2003 affecting over 50 million people. Decision-makers in politics and businesses can use the analysis tool APOSTEL to conduct precise evaluations of the value of supply security, for cost-benefit analyses of supply security enhancing investments, of regulatory descions which affect the level of supply securty and for many more applications with regards to energy policy. Precise knowledge of the social and economic value of a secure supply of electricity becomes even more crucial considering that the average value of lost load for a one-hour power cut in Austria on a weekday morning in the summer is calculated at 17.1 € per kWh of electricity not supplied.
Religionsökonomie: eine Übersicht
Authors: Höhener Janine , Schaltegger Christoph A.
Published: November 2012

For a long time, religion has been viewed as a topic outside the range of economics. In the last few decades however, economists increasingly started to extend their methods to non-market-based behavior, including religion. One main research area in the economics of religion concerns the economic consequences of religion both for the individual and for the society at large. The second field of research uses economic reasoning to explain religious behavior of individuals as well as the existence of religious groups. This article provides an overview on this literature and summarizes the main conclusions drawn so far.
Aldosterone affects blood flow and vascular tone regulated by endothelium‐derived NO: therapeutic implications
Authors: Toda Noboru , Nakanishi Sadanobu , Tanabe Shinichi
Published: November 2012

Aldosterone, in doses inappropriate to the salt status, plays an important role in the development of cardiovascular injury, including endothelial dysfunction, independent of its hypertensive effects. Acute non‐genomic effects of aldosterone acting on mineralocorticoid receptors are inconsistent in healthy humans: vasoconstriction or forearm blood flow decrease via endothelial dysfunction, vasodilatation mediated by increased NO actions, or no effects. However, in studies with experimental animals, aldosterone mostly enhances vasodilatation mediated by endothelium‐derived NO. Chronic exposure to aldosterone, which induces genomic responses, results in impairments of endothelial function through decreased NO synthesis and action in healthy individuals, experimental animals and isolated endothelial cells. Chronic aldosterone reduces NO release from isolated human endothelial cells only when extracellular sodium is raised. Oxidative stress is involved in the impairment of endothelial function by promoting NO degradation. Aldosterone liberates endothelin‐1 (ET‐1) from endothelial cells, which elicits ETA receptor–mediated vasoconstriction by inhibiting endothelial NO synthesis and action and through its own direct vasoconstrictor action. Ca2+ flux through T‐type Ca2+ channels activates aldosterone synthesis and thus enhances unwanted effects of aldosterone on the endothelium. Mineralocorticoid receptor inhibitors, ETA receptor antagonists and T‐type Ca2+ channel blockers appear to diminish the pathophysiological participation of aldosterone in cardiovascular disease and exert beneficial actions on bioavailability of endothelium‐derived NO, particularly in resistant hypertension and aldosteronism.
A New Method for Identifying the Effects of Foreign Exchange Interventions
Authors: CHEN CHIH‐NAN , WATANABE TSUTOMU , YABU TOMOYOSHI
Published: November 2012

Central banks react even to intraday changes in the exchange rate; however, in most cases, intervention data are available only at a daily frequency. This temporal aggregation makes it difficult to identify the effects of interventions on the exchange rate. We apply the Bayesian Markov‐chain Monte Carlo (MCMC) approach to this endogeneity problem. We use “data augmentation” to obtain intraday intervention amounts and estimate the efficacy of interventions using the augmented data. Applying this new method to Japanese data, we find that an intervention of 1 trillion yen moves the yen/dollar rate by 1.8%, which is more than twice as much as the magnitude reported in previous studies applying ordinary least squares to daily observations. This shows the quantitative importance of the endogeneity problem due to temporal aggregation.
On the Effects of Deposit Insurance and Observability on Bank Runs: An Experimental Study
Authors: KISS HUBERT JANOS , RODRIGUEZ‐LARA ISMAEL , ROSA‐GARCÍA ALFONSO
Published: November 2012

We study the effects of deposit insurance and observability of previous actions on the emergence of bank runs by means of a controlled laboratory experiment. We consider three depositors in the line of a bank, who decide between withdrawing or keeping their money deposited. We have three treatments with different levels of deposit insurance which reflect the losses a depositor may incur in the case of a bank run. We find that different levels of deposit insurance and the possibility of observing other depositors’ actions affect the likelihood of bank runs. When decisions are not observable, higher levels of deposit insurance decrease the probability of bank runs. When decisions are observable, this need not to be the case. These results suggest that (i) observability might be considered as a partial substitute of deposit insurance and (ii) the optimal deposit insurance should take into account the degree of observability.
Selective Endovascular Aneurysm Neck Ligation to Treat Compressive Cranial Neuropathy
Authors: Edgell Randall C. , Kaila Junaid , Haghighi Afshin Borhani
Published: November 2012

OBJECTIVE

To report a novel endovascular coiling technique for ligation of aneurysms presenting with cranial neuropathy.

METHODS

We describe three patients (all female, median age: 57) presenting with unruptured, mass effect producing, aneurysms. All three were treated with coiling of the aneurysm inflow zone without deploying coils in the dome or fundus. Their clinical manifestations, the radiologic features of the aneurysms, and details of endovascular inflow zone ligation are presented.

RESULTS

Clinical and radiological improvement was seen in all three patients after 6‐12 months follow‐up.

CONCLUSION

This technique may be considered in patients presenting with compressive cranial neuropathy and an aneurysm configuration that allows selective coiling of the inflow zone.
Photodynamic therapy for skin rejuvenation: review and summary of the literature – results of a consensus conference of an expert group for aesthetic photodynamic therapy
Authors: Karrer Sigrid , Kohl Elisabeth , Feise Konstantin , Hiepe‐Wegener Dagmar , Lischner Stephan , Philipp‐Dormston Wolfgang , Podda Maurizio , Prager Welf , Walker Torsten , Szeimies Rolf‐Markus
Published: November 2012

Skin rejuvenating effects of photodynamic therapy (PDT) for photoaged skin has been well‐documented in several clinical trials. Different photosensitizers (5‐aminolevulinic acid, methyl aminolevulinate) and diverse light sources (light‐emitting diodes, lasers, intense pulsed light) have been used with promising results. An improvement of lentigines, skin roughness, fine lines and sallow complexion has been achieved with PDT. These clinically evident effects are at least in part due to histologically proven increase of collagen and decrease of elastotic material in the dermis. Effective improvement of photoaged skin, simultaneous treatment and possibly also prevention of actinic keratoses, the possibility of repeated treatments and, in contrast to other procedures, limited and calculable side effects make PDT a promising procedure for skin rejuvenation.
β‐Lactam antimicrobials: what have you done for me lately?
Authors: Talbot George H.
Published: November 2012

The “perpetual challenge of infectious diseases” is no better exemplified than by the phenomena of rapid emergence and spread of bacterial resistance. Although β‐lactam antimicrobials have thus far been a mainstay of the therapeutic armamentarium for treatment of severe infections, their preeminent position has been challenged by an onslaught of resistance mechanisms in major nosocomial and community‐acquired pathogens, including modification of penicillin‐binding proteins, production of β‐lactamases, overexpression of efflux pumps, and loss of porins. Given this formidable array of resistance mechanisms facing patients and their physicians, one can reasonably ask if there is hope for the future of β‐lactams.
A Case Study of Spectral and Non‐Spectral Interferences on Copper Isotope Measurements by Multi‐Collector ICP‐MS (Wet Plasma)
Authors: Petit Jérôme C. J. , Taillez Aurélien , Mattielli Nadine
Published: November 2012

Mathematical modelling was combined with experimental Cu isotope measurements to demonstrate the effect of the sample matrix in changing the absolute and relative abundances of spectral interferences from Ti and Cr species. This unforeseen non‐spectral effect, evidenced by variable inaccuracies of the different Zn‐normalised Cu isotope ratios, was investigated by comparing real sedimentary samples and artificial solutions intended to match the Cu:Ti:Cr ratios of the real samples after (one or two step) chromatographic processing. Artificial solutions showed positive bias in δ65CuX/Y with the magnitude depending on (a) the 6XZn/6YZn ratio used for normalisation, (b) the Ti/Cu ratio and (c) the transmission coefficient of the TiO species. In contrast, real samples showed different δ65CuX/Y patterns and displayed a more complex population of Ti and Cr oxides and hydroxides, giving rise to positive and negative inaccuracies that were two to six times higher compared with the artificial samples. The results evidence contrasting behaviour of Ti and Cr when forming polyatomic species in the plasma and stress that artificial solutions may fail to predict how residual elements interact with the analyte/dopant pair during MC‐ICP‐MS analyses. More importantly, the study shows that all Zn isotope ratios do not have the same merit in correcting for mass bias in the presence of matrix elements and should all be monitored to verify the absence of spectral interferences for Cu isotope measurements. In this respect, accurate Cu data could be generally obtained by a two‐step chromatographic purification providing a minimum reduction of ~ 21000 and ~ 3000 times the initial amounts of Ti and Cr, respectively.
Diagnostic Accuracy of Cardiac Magnetic Resonance Imaging in the Detection and Characterization of Left Atrial Catheter Ablation Lesions: A Multicenter Experience
Authors: HUNTER ROSS J. , JONES DANIEL A. , BOUBERTAKH REDHA , MALCOLME‐LAWES LOUISA C. , KANAGARATNAM PRAPA , JULI CHRISTOPH F. , DAVIES D. WYN , PETERS NICHOLAS S. , BAKER VICTORIA , EARLEY MARK J. , SPORTON SIMON , DAVIES L. CERI , WESTWOOD MARK , PETERSEN STEFFEN E. , SCHILLING RICHARD J.
Published: November 2012

MRI Detection of Left Atrial Ablation Lesions. Introduction: We tested the hypothesis that cardiovascular magnetic resonance (CMR) imaging can reliably distinguish the presence or absence of left atrial (LA) ablation lesions by blinded analysis of pre‐ and postablation imaging.

Methods:
Consecutive patients at 2 centers undergoing pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation by either wide area circumferential radiofrequency ablation (WACA) or ostial ablation with a cryoballoon underwent CMR late gadolinium enhancement (LGE) imaging pre‐ and 3 months postablation. Imaging was anonymized for blinded analysis of (1) LGE images, and (2) a 3D fusion image with LGE projected onto a segmented LA surface. Scans were categorized using both assessment techniques separately as pre‐ or postablation, and if postablation, whether lesions were in an ostial or WACA distribution.

Results:
LGE imaging was performed in 50 patients (aged 60 ± 10 years, 68% male, 24 underwent WACA and 26 had cryoablation). Sensitivity and specificity for detection of ablation lesions was 60% and 96% on LGE imaging. Sensitivity was higher using 3D fusion imaging (88%; P = 0.003). The proportion in whom lesions were both detected and the distribution correctly assessed as WACA or ostial was higher with 3D fusion imaging compared to LGE imaging (54% vs 28%; P = 0.014). There was no difference in the detection of radiofrequency ablation lesions compared to cryoablation lesions (58% vs 62%; P = 1.000).

Conclusion:
LGE imaging of atrial scar is not yet sufficiently accurate to reliably identify ablation lesions or to determine lesion distribution. (J Cardiovasc Electrophysiol, Vol. 24, pp. 396‐403, April 2013)
Association Between Antihypertensive Medication Adherence and Visit‐to‐Visit Variability of Blood Pressure
Authors: Muntner Paul , Levitan Emily B. , Joyce Cara , Holt Elizabeth , Mann Devin , Oparil Suzanne , Krousel‐Wood Marie
Published: November 2012

It has been hypothesized that high visit‐to‐visit variability (VVV) of systolic blood pressure (SBP) may be the result of poor antihypertensive medication adherence. The authors studied this association using data from 1391 individuals taking antihypertensive medication selected from a large managed care organization. The 8‐item Morisky Medication Adherence Scale, administered during 3 annual surveys, captured self‐report adherence, with scores <6, 6 to <8, and 8 representing low, medium. and high adherence, respectively. The mean (standard deviation [SD]) for SD of SBP across study visits was 12.9 (4.4), 13.5 (4.8), and 14.1 (4.5) mm Hg in participants with high, medium, and low self‐reported adherence, respectively. After multivariable adjustment and compared with those with high self‐report adherence, SD of SBP was 0.60 (95% confidence interval, 0.13–1.07) and 1.08 (95% confidence interval, 0.29–1.87) mm Hg higher among participants with medium and low self‐report adherence, respectively. Results were consistent when pharmacy fill was used to define adherence. These data suggest that low antihypertensive medication adherence explains only a small proportion of VVV of SBP. J Clin Hypertens (Greenwich). 2012; 00:00–00. ©2012 Wiley Periodicals, Inc.
Polyandry‐fecundity relationship in insects: methodological and conceptual problems
Authors: Torres‐Vila L. M.
Published: November 2012

Polyandry is perhaps the most puzzling component of mating systems because the fitness benefits for females of mating with more than one male during lifetime are poorly understood. The occurrence and extent of polyandry varies considerably both among and within species, and a positive association between polyandry and fecundity is widespread but not universal. The scenario is further complicated because the scientific literature on this issue includes studies that are often inconclusive or contradictory even for the same target species. A previous meta‐analysis detected the crucial importance of two usually neglected aspects that potentially bias the interpretation of primary studies about the polyandry–fecundity relationship: the methodological approach – experimental or descriptive – and the polyandry concept itself – realized or potential. In this paper, we experimentally test the effect of these aspects with the moth Lobesia botrana. We used an innovative protocol in which the experimental and the descriptive methods were conducted simultaneously on the same target population and the results were then interpreted from the perspective of both concepts of polyandry. The results clearly showed that 1) the conclusions about the polyandry–fecundity relationship were strongly dependent on the methodological approach used and 2) the concept of polyandry invoked by the researcher was a confounding effect that potentially biases data interpretation. We suggest that greater attention must be paid to intraspecific variation among females in their propensity to remate. The differentiation in experimental studies between potentially polyandrous and monandrous phenotypes could greatly improve our knowledge about the maintenance of female mating polymorphism in most species and the adaptive significance of polyandry.
New Observations on the Ciliate Genus Vestibulongum (Pycnotrichidae): Vestibular Ultrastructure, Macronuclear Endosymbiotic Bacteria, Biogeography, and Evidence for Host Specificity
Authors: Grim J. Norman , Clements Kendall D.
Published: November 2012

Two isolates of the pycnotrichid ciliate genus, Vestibulongum, were collected from the host fish, Acanthurus xanthopterus, from two locations in the Southern Pacific Ocean. One was from the Great Barrier Reef (GBR), and a second from Papua New Guinea. These sites are thousands of km from the type locality, off the coast of South Africa. New data were collected from protargol‐stained samples to more fully characterize the general form and light microscopic structures of the ciliate. Specimens from all three sites had a long vestibule, characteristic of most members of the family. Data suggest that specimens from each site are the same genus. The kinetids of the Vestibulongum isolated from the GBR contained the typical components of postciliary, transverse, and nemodesmatal microtubules, and Kd fibrils. Also, two quite different forms of endomacronuclear bacteria were observed and are described. One of those has distinct endospores, which are similar to endospores in nuclear endosymbiotic bacteria in a species of Balantidium from the gut of another species of surgeonfish.
Factors affecting short‐ and long‐term effects of leukocyte removal therapy in active ulcerative colitis
Authors: Nakano Ryo , Iwakiri Ryuichi , Ikeda Yuji , Kishi Tomoya , Tsuruoka Nanae , Shimoda Ryo , Sakata Yasuhisa , Yamaguchi Kanako , Fujimoto Kazuma
Published: November 2012

Background and Aim

Leukocyte removal therapy (LRT) is recognized as an effective treatment for active ulcerative colitis (UC). In this study, factors associated with the efficacy and long‐term effects of LRT were evaluated.

Methods

From April 1998 to March 2010, 98 patients with moderate to severe UC were randomly assigned to granulocyte and monocyte/macrophage adsorptive apheresis (GMA) (n = 47) or leukocytapheresis (LCAP) (n = 51) treatment. Patients received two sessions of LRT in the first week, followed by three weekly administrations. All patients were treated with 5‐aminosalicylic acid and corticosteroid. Steroid doses were tapered if patients achieved clinical improvement. Clinical remission was defined as a decrease in clinical activity index to < 4 and endoscopic findings to Matts' grade 1 or 2. When clinical activity index decreased but still remained ≥ 5 and Matts' grading was 1 or 2, the patient was considered to have improved. Patients were observed for at least 1 year and diagnosed as relapsed when additional treatment was required.

Results

Seventy‐one (73%) patients achieved clinical remission or improvement. No significant difference was found between LCAP and GMA. Increased age, ≥ 3 attacks of UC, and ≥ 2 sessions of LRT were indicative of refractoriness to LRT. During 1 year observation, 28 patients were relapsed. Duration of UC, ≥ 3 attacks of UC, and ≥ 2 sessions of LRT were indicative of refractoriness to the long‐term effects of LRT.

Conclusion

Both GMA and LCAP were effective to treat active UC. However, long duration of UC, multiple UC attacks, and past history of LRT reduce the efficacy.
Characteristics of elderly hepatitis C virus‐associated hepatocellular carcinoma patients
Authors: Kumada Takashi , Toyoda Hidenori , Kiriyama Seiki , Tanikawa Makoto , Hisanaga Yasuhiro , Kanamori Akira , Tada Toshifumi , Tanaka Junko
Published: November 2012

Background and Aim

The average age of hepatitis C virus (HCV)‐related hepatocellular carcinoma (HCC) patients has been rising in Japan. We evaluate characteristics of HCV‐positive patients who develop HCC in older age to determine an optimal surveillance strategy.

Methods

A total of 323 patients with three or more years of follow‐up before HCC diagnosis and 323 propensity‐matched controls without HCC were studied. HCC patients were classified into four groups according to age at the time of HCC diagnosis: group A (≤ 60 years, n = 36), group B (61–70 years, n = 115), group C (71–80 years, n = 143), and group D (> 80 years, n = 29). Clinical and laboratory data were compared.

Results

Platelet counts were significantly higher in the older groups at HCC diagnosis (P < 0.0001). The rate of platelet counts decline was lower in older groups (P = 0.0107). The average integration value of serum alanine aminotransferase (ALT) in groups A, B, C, and D were 80.9 IU/L, 62.3 IU/L, 59.0 IU/L, and 44.9 IU/L, respectively (P < 0.0001). In older patients (≥ 65 years old), cirrhosis and average integration value of ALT were significantly associated with hepatocarcinogenesis, but platelet count was not.

Conclusion

Elderly HCV‐positive patients (≥ 65 years old) with low ALT values developed HCC regardless of their platelet counts. These findings should be taken into account when designing the most suitable HCC surveillance protocol for this population.
Acid‐suppressive therapy is associated with spontaneous bacterial peritonitis in cirrhotic patients: A meta‐analysis
Authors: Deshpande Abhishek , Pasupuleti Vinay , Thota Priyaleela , Pant Chaitanya , Mapara Sulaiman , Hassan Sohaib , Rolston David D K , Sferra Thomas J , Hernandez Adrian V
Published: November 2012

Background and Aim

Proton pump inhibitors (PPI) and H2‐receptor antagonists (H2RA) are frequently prescribed in hospitalized patients with cirrhosis. There are conflicting reports regarding the role of acid‐suppressive therapy in predisposing hospitalized patients with cirrhosis to spontaneous bacterial peritonitis (SBP). The aim of this meta‐analysis was to evaluate the association between acid‐suppressive therapy and the risk of SBP in hospitalized patients with cirrhosis.

Methods

We searched MEDLINE and four other databases for subject headings and text words related to SBP and acid‐suppressive therapy. All observational studies that investigated the risk of SBP associated with PPI/H2RA therapy and utilized SBP as an endpoint were considered eligible. Data from the identified studies were combined by means of a random‐effects model and odds ratios (ORs) were calculated.

Results

Eight studies (n = 3815 patients) met inclusion criteria. The risk of hospitalized cirrhotic patients developing SBP increased when using acid‐suppressive therapy. The risk was greater with PPI therapy (n = 3815; OR 3.15, 95% confidence interval 2.09–4.74) as compared to those on H2RA therapy (n = 562; OR 1.71, 95% confidence interval 0.97–3.01).

Conclusions

Pharmacologic acid suppression was associated with a greater risk of SBP in hospitalized patients with cirrhosis. Cirrhotic patients receiving a PPI have approximately three times the risk of developing SBP compared with those not receiving this medication. Prospective studies may help clarify this relationship and shed light on the mechanism(s) by which acid‐suppressive therapy increases the risk of SBP in hospitalized patients with cirrhosis.
Preoperative body size and composition, habitual diet, and post‐operative complications in elective colorectal cancer patients in Norway
Authors: Berstad P. , Haugum B. , Helgeland M. , Bukholm I. , Almendingen K.
Published: November 2012

Background

Both malnutrition and obesity are related to worsened post‐operative outcomes after colorectal surgery. Obese cancer patients may be malnourished as a result of short‐term weight loss. The present study aimed to evaluate preoperative nutritional status, body composition and dietary intake related to post‐operative complications (POC) and post‐operative hospital days (POHD) in elective colorectal cancer (CRC) patients.

Methods

Anthropometry, body composition measured by bioelectric spectroscopy and dietary habits assessed by a validated food‐frequency questionnaire were examined in 100 newly‐diagnosed CRC patients. Data from 30‐day POC and POHD were collected from medical records. Nonparametric and chi‐squared tests and logistic regression were used to analyse associations between body and dietary variables and post‐operative outcome.

Results

Twenty‐nine patients had at least one POC. The median POHD was six. Body size and composition measures and short‐term weight loss were no different between patients with and without POC, or between patients with POHD <7 and ≥7. Dietary variables were otherwise no different between patients with and without POC, although the median intake of marine n‐3 polyunsaturated fatty acids (PUFA, the sum of eicosapentaenoic and docosahexaenoic acids) was significantly lower in patients with versus without POC (0.7 versus 1.2 g day−1, P = 0.04).

Conclusions

We found that preoperative body size, body composition and short‐term weight loss were not related to 30‐day post‐operative outcomes in CRC patients. A high content of marine n‐3 PUFA in preoperative habitual diets may protect against POC after CRC surgery.