bluuebunny/crossref_metadata_2025 huggingface dataset:
Voriconazole Serum Concentrations in Obese and Overweight Immunocompromised Patients: A Retrospective Review
Authors: Davies‐Vorbrodt Samantha , Ito James I. , Tegtmeier Bernard R. , Dadwal Sanjeet S. , Kriengkauykiat Jane
Published: January 2013

Study Objective

To evaluate the relationship between voriconazole dose and corresponding serum concentrations in obese and overweight immunocompromised patients.

Design

Retrospective medical record review.

Setting

National Cancer Institute–designated comprehensive cancer center.

Patients

A total of 92 patients with hematologic malignancies and/or hematopoietic stem cell transplants who received voriconazole and had reported steady‐state serum concentrations (peak, random, or trough) during 2005–2010; 124 serum concentrations were available for analysis.

Measurements and Main Results

Data on patient demographics, voriconazole concentrations, and other clinical and safety data were collected. Patients were stratified based on body mass index (BMI). Patients with higher BMIs tended to have significantly higher median random voriconazole concentrations with intravenous administration (6.4 mg/L for BMI ≥ 25 kg/m2 vs 2.8 mg/L for BMI < 25 kg/m2, p=0.04). This trend was more notable with the intravenous than the oral formulations. With the oral formulation, patients with a BMI of 25 kg/m2 or greater had a median random concentration of 2.8 mg/L compared with 2.0 mg/L in patients with a BMI less than 25 kg/m2 (p=0.18). Patients with a BMI of  25 kg/m2 or greater also had a higher median daily voriconazole dose (640 vs 400 mg, p<0.001). No significant differences were noted in factors that would affect oral absorption of voriconazole (e.g., graft‐versus‐host disease) among BMI groups. When comparing all voriconazole concentrations, higher concentrations were associated with a greater percentage of patients who had alanine aminotransferase levels of more than 3 times the upper limit of normal. Patients with voriconazole random concentrations of 2 mg/L or greater had higher response rates (50%) than patients with concentrations lower than 2 mg/L (33%).

Conclusion

Standard voriconazole dosing using actual body weight in obese and overweight patients resulted in higher associated serum concentrations. Dosing using adjusted body weight may be necessary in this population in order to achieve optimal concentrations while preventing the potential for increased toxicity.
Acceptance of Recommendations by Inpatient Pharmacy Case Managers: Unintended Consequences of Hospitalist and Specialist Care
Authors: Anderegg Sammuel V. , DeMik David E. , Carter Barry L. , Dawson Jeffrey D. , Farris Karen , Shelsky Constance , Kaboli Peter
Published: January 2013

Study Objective

To determine whether recommendations made by pharmacists and accepted by hospital physicians resulted in fewer postdischarge readmissions and urgent care visits compared with recommendations that were not implemented.

Design

Prospective substudy of pharmacist recommendations.

Setting

Tertiary care academic medical center and private community‐based physician practices and community pharmacies.

Patients

A total of 192 patients aged 18 years or older who were a subsample of a randomized, prospective study, who were admitted with a previous diagnosis of one of nine cardiovascular or pulmonary diseases or diabetes mellitus or had received oral anticoagulation therapy and who were discharged to community‐based care provided by private physicians and community pharmacists.

Measurements and Main Results

Pharmacy case managers performed evaluations for patients and made recommendations to inpatient physicians. Patients received drug therapy counseling, a drug therapy list, and a wallet card at discharge. Data were collected from patients and private physicians for 90 days after discharge. Pharmacy case managers made 546 recommendations to inpatient physicians for 187 patients (97%). Overall, 260 (48%) of the 546 recommendations were accepted. The acceptance rate was lower for patients who had an urgent care visit compared with the other patients (33.6% vs 52.2%, p=0.033). High acceptance rates were noted for updating the record after medication reconciliation (36 patients [78%]) and when there was an actual allergy (2 [100%] of 2 patients) or medication error (2 [100%] of 2 patients). Physicians were less likely to accept recommendations related to drug indications (p<0.001), drug efficacy (p=0.041), and therapeutic drug and disease state monitoring (p=0.011). Recommendations made for patients with a relatively greater number of drugs were also less likely to be accepted (p=0.003).

Conclusion

Recommendations to reconcile medications or address actual drug allergies or medication errors were frequently accepted. However, only 48% of all recommendations were accepted by inpatient physicians, and there was no impact on health care use 90 days after discharge. This study suggests that recommendations by pharmacy case managers were underused, and the low acceptance rate may have reduced the potential to avoid readmissions.
Unexpected efficiency of cyclic amidine catalysts in depolymerizing poly(ethylene terephthalate)
Authors: Fukushima Kazuki , Coady Daniel J. , Jones Gavin O. , Almegren Hamid A. , Alabdulrahman Abdullah M. , Alsewailem Fares D. , Horn Hans W. , Rice Julia E. , Hedrick James L.
Published: January 2013

This article describes studies on the catalytic activity of several nitrogen‐based organic catalysts for the depolymerization of poly(ethylene terephthalate) (PET), in which a few cyclic amidines work more effectively than a potent, bifunctional guanidine‐based catalyst 1,5,7‐triazabicyclo‐[4,4,0]‐dec‐5‐ene (TBD) in the presence of short chain diols that play a role in activation of carbonyl groups through hydrogen bonding. Further studies prove that the catalytic efficiency at the above specific conditions depends only on the extent of activation of a hydroxyl group rather than simply the pKa of the bases. For glycolysis with excess short‐chain alkanediols, 1,8‐diazabicyclo[5.4.0]undec‐7‐ene is the best catalyst. In contrast, TBD shows outstanding catalytic activity in depolymerizations of PET with mono‐alcohols and longer‐chain diols. © 2013 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem, 2013
Combustion Characteristics of Ammonium Nitrate and Carbon Mixtures Based on a Thermal Decomposition Mechanism
Authors: Izato Yu‐ichiro , Miyake Atsumi , Date Shingo
Published: January 2013

In order to obtain a better understanding of the combustion characteristics of ammonium nitrate (AN) and carbon (C) mixtures (AN/C), burning tests and differential scanning calorimetry (DSC) were performed. AN mixed with carbon that is oxidized by nitric acid (HNO3), such as activated carbon (AC), burned at 1 MPa. However, AN mixed with carbon that is not oxidized by HNO3, such as graphite, did not burn under 7 MPa. Compositions with more than stoichiometric amounts of activated carbon had higher burning rates. Heat characteristic examinations found a similar trend. The burning rate of AN/AC mixed with CuO as a combustion catalyst deteriorated faster than an additive‐free one. From the DSC result, AN/AC/CuO had a higher onset temperature and a lower heat of reaction than AN/AC. These results suggested that, in the combustion wave of AN/C, a thermal decomposition zone is formed on the burning surface, and combustion performance was affected by the thermal decomposition of AN/C.
Impulse Plug Measurements of Blast Reflected Impulse at Close Range
Authors: Nansteel Mark W. , Veldman Roger L. , Chen Charles Chih‐Tsai , Lawrence William
Published: January 2013

A series of blast tests is described in which blast impulse is measured by an impulse plug technique for spherical explosive charges. In this approach the reflected blast impulse delivered to a hardened bullet‐shaped steel plug is determined from a measurement of the plug terminal momentum. Plug velocity is measured by a high‐speed, high‐resolution video camera operating at 20,000 frames per second. Spherical C4 charges are studied for varying charge weight and charge‐to‐plug standoff distance. Tested standoffs include the demanding near‐field blast zone within which pressure measurement by transducer is extremely difficult or impossible. Results are compared with previous studies made using transducer and impulse plug methods for both C4 and Pentolite charges. The present data for half‐pound C4 charges are in good agreement with much earlier impulse plug data for spherical Pentolite in the near‐field region, however, differences of up to 26 % are noted with more recent transducer measurements for C4 just beyond the near‐field zone. Test results are also compared with hydro‐code simulations of the plug response.
Interactions of vasopressin and oxytocin receptors with vasopressin analogues substituted in position 2 with 3,3′‐diphenylalanine – a molecular docking study
Authors: Ślusarz Magdalena J. , Sikorska Emilia , Ślusarz Rafał
Published: January 2013

Vasopressin and oxytocin receptors belong to the superfamily of G protein‐coupled receptors and play an important role in many physiological functions. They are also involved in a number of pathological conditions being important drug targets. In this work, four vasopressin analogues substituted at position 2 with 3,3′‐diphenylalanine have been docked into partially flexible vasopressin and oxytocin receptors. The bulky residue at position 2 acts as a structural restraint much stronger in the oxytocin receptor (OTR) than in the vasopressin V2 receptor (V2R), resulting in a different location of the analogues in these receptors. This explains the different, either agonistic or antagonistic, activities of the analogues in V2R and OTR, respectively. In all complexes, the conserved polar residues serve as anchor points for the ligand both in OTR and V2R. Strong interactions of the C‐terminus of analogue II ([Mpa1,d‐Dpa2,Val4,d‐Arg8]VP) with extracellular loop 3 may be responsible for its highest activity at V2R. It also appears that V2R adapts more readily to the docking analogues by conformational changes in the aromatic side chains triggering receptor activation. A weak activity at V1a vasopressin receptor appears to be caused by weak receptor–ligand interactions. Results of this study may facilitate a rational design of new analogues with the highest activity/selectivity at vasopressin and OTRs. Copyright © 2013 European Peptide Society and John Wiley & Sons, Ltd.
Constituting Identities That Challenge the Contemporary Discourse: Power, Discourse, Experience, and Emotion
Authors: MELVILLE WAYNE , BARTLEY ANTHONY
Published: January 2013

In this article, we use a narrative methodology to understand the work of three teachers who have constituted identities that have allowed them to challenge the contemporary discourse of science education. We describe how teachers’ evolving identities have been constituted through their responses to the discourses and situations of their work and their emotional response to these experiences. A Foucauldian analysis of the data indicates three important conclusions. The first is the need for, or development of, an environment that immerses teachers in discourse that allows, and actively supports, classroom practices that challenge the contemporary discourse. A key component of such discourse is an awareness of the emotional aspects of teaching. The second conclusion is the potential power of the mandated curriculum to legitimize, for teachers, discourses that challenge the contemporary discourse. Third, individual teachers may lack the power necessary to establish discourse environments that fully capitalize on their potential influence within the infrastructure of pedagogical science. © 2013 Wiley Periodicals, Inc. Sci Ed 97:171–190, 2013
In‐situ characterization of aqueous‐based hafnium oxide hydroxide sulfate thin films
Authors: Flynn Brendan , Kim Daeho , Clark Benjamin L. , Telecky Alan , Arnadottir Liney , Szanyi Janos , Keszler Douglas A. , Herman Gregory S.
Published: January 2013

The dehydration of hafnium oxide hydroxide sulfate thin films was studied using temperature programmed desorption (TPD) and X‐ray photoelectron spectroscopy. Films were found to desorb water up to 750 K with a maximum desorption rate at ~480 K. Carbon dioxide desorption was also observed in TPD measurements, which was related to contamination of precursor solutions and/or films by CO2 from the atmosphere. The O 1s spectra obtained for in‐situ annealed samples were fit with three components corresponding to Hf‐O, hydroxyl groups, and sulfate groups. Water TPD measurements from the dehydrated surface indicate the presence of two desorption states corresponding to molecularly and dissociatively adsorbed water. Copyright © 2013 John Wiley & Sons, Ltd.
Observation of self‐assembled layers of alkyl phosphonic acid on aluminum using low‐voltage scanning electron microscopy and AFM
Authors: Sato H. , Fujii T. , Tsuji E. , Aoki Y. , Shimizu K. , Skeldon P. , Thompson G.E. , Habazaki H.
Published: January 2013

Self‐assembled alkyl phosphate layers have been formed on a flat, anodized aluminum substrate in dilute ethanol solution containing 2 wt% n‐tetradecylphosphonic acid (TDP) and examined by low‐voltage scanning electron microscopy as well as atomic force microscopy and X‐ray photoelectron spectroscopy. Locally, multi‐layered alkyl phosphate films have been formed on aluminum, being clearly observed by a low‐voltage scanning electron microscope operated at less than 1 kV. Atomic force microscopy observations disclosed that bilayers of tetradecylphosphonic acid are stacked on the substrate to form multilayers. The present study revealed that the uniform self‐organized monolayer is not always formed readily on an oxidized aluminum surface. Copyright © 2013 John Wiley & Sons, Ltd.
Uncovering selection bias in case–control studies using Bayesian post‐stratification
Authors: Geneletti S. , Best N. , Toledano M. B. , Elliott P. , Richardson S.
Published: January 2013

Case–control studies are particularly prone to selection bias, which can affect odds ratio estimation. Approaches to discovering and adjusting for selection bias have been proposed in the literature using graphical and heuristic tools as well as more complex statistical methods. The approach we propose is based on a survey‐weighting method termed Bayesian post‐stratification and follows from the conditional independences that characterise selection bias. We use our approach to perform a selection bias sensitivity analysis by using ancillary data sources that describe the target case–control population to re‐weight the odds ratio estimates obtained from the study. The method is applied to two case–control studies, the first investigating the association between exposure to electromagnetic fields and acute lymphoblastic leukaemia in children and the second investigating the association between maternal occupational exposure to hairspray and a congenital anomaly in male babies called hypospadias. In both case–control studies, our method showed that the odds ratios were only moderately sensitive to selection bias. Copyright © 2013 John Wiley & Sons, Ltd.
A scan statistic for identifying optimal risk windows in vaccine safety studies using self‐controlled case series design
Authors: Xu Stanley , Hambidge Simon J. , McClure David L. , Daley Matthew F. , Glanz Jason M.
Published: January 2013

In the examination of the association between vaccines and rare adverse events after vaccination in postlicensure observational studies, it is challenging to define appropriate risk windows because prelicensure RCTs provide little insight on the timing of specific adverse events. Past vaccine safety studies have often used prespecified risk windows based on prior publications, biological understanding of the vaccine, and expert opinion. Recently, a data‐driven approach was developed to identify appropriate risk windows for vaccine safety studies that use the self‐controlled case series design. This approach employs both the maximum incidence rate ratio and the linear relation between the estimated incidence rate ratio and the inverse of average person time at risk, given a specified risk window. In this paper, we present a scan statistic that can identify appropriate risk windows in vaccine safety studies using the self‐controlled case series design while taking into account the dependence of time intervals within an individual and while adjusting for time‐varying covariates such as age and seasonality. This approach uses the maximum likelihood ratio test based on fixed‐effects models, which has been used for analyzing data from self‐controlled case series design in addition to conditional Poisson models. Copyright © 2013 John Wiley & Sons, Ltd.
Discovering, comparing, and combining moderators of treatment on outcome after randomized clinical trials: a parametric approach
Authors: Kraemer Helena Chmura
Published: January 2013

No one treatment is likely to affect all patients with a disorder in the same way. A treatment highly effective for some may be ineffective or even harmful for others. Statistically significant or not, the effect sizes of many treatments tend to be small. Consequently, emphasis in clinical research is gradually shifting (1) to increased focus on effect sizes and (2) to discovery and documentation of moderators of treatment effect on outcome in randomized clinical trials, that is, personalized medicine, in which individual differences between patients are explicitly acknowledged. How to test a null hypothesis of moderation of treatment outcome is reasonably well known. The focus here is on how, under parametric assumptions, to define the strength of moderation, that is, a moderator effect size, either for scientific purposes or for assessment of clinical significance, in order to compare moderators and choose among them and to develop a composite moderator, which might more strongly moderate the effect of a treatment on outcome than any single moderator that might ultimately provide guidance for clinicians as to whom to prescribe what treatment. Copyright © 2013 John Wiley & Sons, Ltd.
Changes in human placental oxygenation during maternal hyperoxia estimated by blood oxygen level‐dependent magnetic resonance imaging (BOLD MRI)
Authors: Sørensen A. , Peters D. , Fründ E. , Lingman G. , Christiansen O. , Uldbjerg N.
Published: January 2013

Objectives

To investigate changes in human placental oxygenation during maternal hyperoxia using non‐invasive blood oxygen level‐dependent (BOLD) magnetic resonance imaging (MRI).

Methods

Eight healthy pregnant women with uncomplicated singleton pregnancies at gestational weeks 28–36 were examined with BOLD MRI, over two consecutive 5‐min periods of different oxygenation: first normoxia (21% O2) and then hyperoxia (12 L O2/min), achieved by controlling the maternal oxygen supply with a non‐rebreather facial mask. Selecting three slices showing cross‐sections of the central part of the placenta, we investigated total placental oxygenation by drawing regions of interest (ROIs) covering the entire placenta, and regional placental oxygenation by drawing smaller ROIs in the darker and brighter areas of the placenta. For each ROI, the difference in BOLD signal between the two episodes was determined and the percentage increase in BOLD signal during hyperoxia (ΔBOLD) was calculated.

Results

In the BOLD image, the normoxic placenta appeared heterogeneous, with darker areas located to the fetal side and brighter areas to the maternal side. During hyperoxia, the placenta became brighter and the structure more homogeneous, and the BOLD signal of the total placenta increased (ΔBOLDtot, 15.2 ± 3.2% (mean ± SD), P < 0.0001). The increase was seen predominantly in the dark areas in the fetal part of the placenta (ΔBOLDfet, 32.1 ± 9.3%) compared with in the bright areas in the maternal part of the placenta (ΔBOLDmat, 5.4 ± 3.5%).

Conclusion

During hyperoxia, placental oxygenation was increased predominantly in the darker placental areas, which, given their anatomical location, represent the fetal circulation of the placenta. To our knowledge, this is the first study to successfully visualize changes in placental oxygenation using BOLD MRI. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.
Uterine artery Doppler and sFlt‐1/PlGF ratio: usefulness in diagnosis of pre‐eclampsia
Authors: Gómez‐Arriaga P. I. , Herraiz I. , López‐Jiménez E. A. , Gómez‐Montes E. , Denk B. , Galindo A.
Published: January 2013

Objective

To evaluate the usefulness of the mean pulsatility index of the uterine arteries (mPI‐UtA) and automated measurement of the soluble fms‐like tyrosine kinase 1 (sFlt‐1)/placental growth factor (PlGF) ratio on suspicion or at diagnosis of pre‐eclampsia (PE).

Methods

Patients with singleton pregnancies with PE (n = 60) diagnosed according to current recommendations, or with suspected PE (n = 32) defined by (1) blood pressure (BP) ≥ 160/100 mmHg, (2) BP ≥ 140/90 mmHg or proteinuria, together with suggestive clinical symptoms or (3) intrauterine growth restriction (IUGR) at < 34 + 0 weeks, were enrolled and mPI‐UtA and the sFlt‐1/PlGF ratio were measured. Values > 95th centile were considered abnormal. All cases were classified according to occurrence of PE and/or IUGR and subclassified, depending on gestational age at delivery, as early (< 34 + 0 weeks) or late (≥ 34 + 0 weeks).

Results

PE was confirmed in 72 cases, in which 32 early deliveries occurred. Isolated IUGR was diagnosed in nine early cases and one late case, while the remaining 10 cases were late deliveries without PE or IUGR. In pregnancies in which PE and IUGR were excluded, mPI‐UtA was abnormal in 40% but the sFlt‐1/PlGF ratio was normal in 100%. In early PE, mPI‐UtA at diagnosis was abnormal in 100% of cases with IUGR and in 91% without IUGR, while sFlt‐1/PlGF was abnormal in 100% and 96%, respectively. In late PE, mPI‐UtA was abnormal in 50% and 37% of cases with and without IUGR while the sFlt‐1/PlGF ratio was abnormal in 50% and 26%, respectively.

Conclusion

Abnormal mPI‐UtA and sFlt‐1/PlGF ratio are common in early PE. In late PE, mPI‐UtA is normal in most cases and thus not diagnostically useful. The sFlt‐1/PlGF ratio shows high specificity but low sensitivity to confirm PE when suspected. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.
Solid‐phase preconcentration and determination of mercury(II) using activated carbon in drinking water by X‐ray fluorescence spectrometry
Authors: Aranda Pedro R. , Colombo Leandro , Perino Ernesto , De Vito Irma E. , Raba Julio
Published: January 2013

A novel and simple method was developed for the preconcentration and determination of mercury(II) from hydrochloric acid solutions through their adsorption on Aliquat 336 (tri‐octylmethylammonium chloride)‐activated carbon. The determinations were made directly on the solid by X‐ray fluorescence spectrometry, which had the advantage of eliminating the step of elution of the mercury retained.

This preconcentration system enabled the determination of Hg(II) in drinking water samples at µg l−1 levels. A 1700‐fold enrichment factor was obtained. The described methodology showed excellent reproducibility, accuracy, and detection limits improvement by eliminating the step of elution of the analyte, replacing those methods based on cold vapor generation, reducing reagent consumption, and handling of samples. Copyright © 2013 John Wiley & Sons, Ltd.
Higgs bosons at 98 and 125 GeV at LEP and the LHC
Authors: Bélanger Geneviève , Ellwanger Ulrich , Gunion John F. , Jiang Yun , Kraml Sabine , Schwarz John H.
Published: January 2013

Abstract

We discuss NMSSM scenarios in which the lightest Higgs boson h
1 is consistent with the small LEP excess at ~ 98 GeV in e
+
e
− → Zh with
$ h\to b\overline{b} $
and the heavier Higgs boson h
2 has the primary features of the LHC Higgs-like signals at 125 GeV, including an enhanced γγ rate. Verification or falsification of the 98 GeV h
1 may be possible at the LHC during the 14 TeV run. The detection of the other NMSSM Higgs bosons at the LHC and future colliders is also discussed, as well as dark matter properties of the scenario under consideration.
TG13 flowchart for the management of acute cholangitis and cholecystitis
Authors: Miura Fumihiko , Takada Tadahiro , Strasberg Steven M. , Solomkin Joseph S. , Pitt Henry A. , Gouma Dirk J. , Garden O. James , Büchler Markus W. , Yoshida Masahiro , Mayumi Toshihiko , Okamoto Kohji , Gomi Harumi , Kusachi Shinya , Kiriyama Seiki , Yokoe Masamichi , Kimura Yasutoshi , Higuchi Ryota , Yamashita Yuichi , Windsor John A. , Tsuyuguchi Toshio , Gabata Toshifumi , Itoi Takao , Hata Jiro , Liau Kui‐Hin
Published: January 2013

We propose a management strategy for acute cholangitis and cholecystitis according to the severity assessment. For Grade I (mild) acute cholangitis, initial medical treatment including the use of antimicrobial agents may be sufficient for most cases. For non‐responders to initial medical treatment, biliary drainage should be considered. For Grade II (moderate) acute cholangitis, early biliary drainage should be performed along with the administration of antibiotics. For Grade III (severe) acute cholangitis, appropriate organ support is required. After hemodynamic stabilization has been achieved, urgent endoscopic or percutaneous transhepatic biliary drainage should be performed. In patients with Grade II (moderate) and Grade III (severe) acute cholangitis, treatment for the underlying etiology including endoscopic, percutaneous, or surgical treatment should be performed after the patient's general condition has been improved. In patients with Grade I (mild) acute cholangitis, treatment for etiology such as endoscopic sphincterotomy for choledocholithiasis might be performed simultaneously, if possible, with biliary drainage. Early laparoscopic cholecystectomy is the first‐line treatment in patients with Grade I (mild) acute cholecystitis while in patients with Grade II (moderate) acute cholecystitis, delayed/elective laparoscopic cholecystectomy after initial medical treatment with antimicrobial agent is the first‐line treatment. In non‐responders to initial medical treatment, gallbladder drainage should be considered. In patients with Grade III (severe) acute cholecystitis, appropriate organ support in addition to initial medical treatment is necessary. Urgent or early gallbladder drainage is recommended. Elective cholecystectomy can be performed after the improvement of the acute inflammatory process.
TG13 miscellaneous etiology of cholangitis and cholecystitis
Authors: Higuchi Ryota , Takada Tadahiro , Strasberg Steven M. , Pitt Henry A. , Gouma Dirk J. , Garden O. James , Büchler Markus W. , Windsor John A. , Mayumi Toshihiko , Yoshida Masahiro , Miura Fumihiko , Kimura Yasutoshi , Okamoto Kohji , Gabata Toshifumi , Hata Jiro , Gomi Harumi , Supe Avinash N. , Jagannath Palepu , Singh Harijt , Kim Myung‐Hwan , Hilvano Serafin C. , Ker Chen‐Guo , Kim Sun‐Whe
Published: January 2013

This paper describes typical diseases and morbidities classified in the category of miscellaneous etiology of cholangitis and cholecystitis. The paper also comments on the evidence presented in the Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG 07) published in 2007 and the evidence reported subsequently, as well as miscellaneous etiology that has not so far been touched on. (1) Oriental cholangitis is the type of cholangitis that occurs following intrahepatic stones and is frequently referred to as an endemic disease in Southeast Asian regions. The characteristics and diagnosis of oriental cholangitis are also commented on. (2) TG 07 recommended percutaneous transhepatic biliary drainage in patients with cholestasis (many of the patients have obstructive jaundice or acute cholangitis and present clinical signs due to hilar biliary stenosis or obstruction). However, the usefulness of endoscopic naso‐biliary drainage has increased along with the spread of endoscopic biliary drainage procedures. (3) As for biliary tract infections in patients who underwent biliary tract surgery, the incidence rate of cholangitis after reconstruction of the biliary tract and liver transplantation is presented. (4) As for primary sclerosing cholangitis, the frequency, age of predilection and the rate of combination of inflammatory enteropathy and biliary tract cancer are presented. (5) In the case of acalculous cholecystitis, the frequency of occurrence, causative factors and complications as well as the frequency of gangrenous cholecystitis, gallbladder perforation and diagnostic accuracy are included in the updated Tokyo Guidelines 2013 (TG13).
TG13: Updated Tokyo Guidelines for the management of acute cholangitis and cholecystitis
Authors: Takada Tadahiro , Strasberg Steven M. , Solomkin Joseph S. , Pitt Henry A. , Gomi Harumi , Yoshida Masahiro , Mayumi Toshihiko , Miura Fumihiko , Gouma Dirk J. , Garden O. James , Büchler Markus W. , Kiriyama Seiki , Yokoe Masamichi , Kimura Yasutoshi , Tsuyuguchi Toshio , Itoi Takao , Gabata Toshifumi , Higuchi Ryota , Okamoto Kohji , Hata Jiro , Murata Atsuhiko , Kusachi Shinya , Windsor John A. , Supe Avinash N. , Lee Sung Gyu , Chen Xiao‐Ping , Yamashita Yuichi , Hirata Koichi , Inui Kazuo , Sumiyama Yoshinobu
Published: January 2013

In 2007, the Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07) were first published in the Journal of Hepato‐Biliary‐Pancreatic Surgery. The fundamental policy of TG07 was to achieve the objectives of TG07 through the development of consensus among specialists in this field throughout the world. Considering such a situation, validation and feedback from the clinicians' viewpoints were indispensable. What had been pointed out from clinical practice was the low diagnostic sensitivity of TG07 for acute cholangitis and the presence of divergence between severity assessment and clinical judgment for acute cholangitis. In June 2010, we set up the Tokyo Guidelines Revision Committee for the revision of TG07 (TGRC) and started the validation of TG07. We also set up new diagnostic criteria and severity assessment criteria by retrospectively analyzing cases of acute cholangitis and cholecystitis, including cases of non‐inflammatory biliary disease, collected from multiple institutions. TGRC held meetings a total of 35 times as well as international email exchanges with co‐authors abroad. On June 9 and September 6, 2011, and on April 11, 2012, we held three International Meetings for the Clinical Assessment and Revision of Tokyo Guidelines. Through these meetings, the final draft of the updated Tokyo Guidelines (TG13) was prepared on the basis of the evidence from retrospective multi‐center analyses. To be specific, discussion took place involving the revised new diagnostic criteria, and the new severity assessment criteria, new flowcharts of the management of acute cholangitis and cholecystitis, recommended medical care for which new evidence had been added, new recommendations for gallbladder drainage and antimicrobial therapy, and the role of surgical intervention. Management bundles for acute cholangitis and cholecystitis were introduced for effective dissemination with the level of evidence and the grade of recommendations. GRADE systems were utilized to provide the level of evidence and the grade of recommendations. TG13 improved the diagnostic sensitivity for acute cholangitis and cholecystitis, and presented criteria with extremely low false positive rates adapted for clinical practice. Furthermore, severity assessment criteria adapted for clinical use, flowcharts, and many new diagnostic and therapeutic modalities were presented. The bundles for the management of acute cholangitis and cholecystitis are presented in a separate section in TG13.
Epizoochory in a hedgerow habitat: seasonal variation and selective diaspore adhesion
Authors: Hernández Ángel , Zaldívar Pilar
Published: January 2013

Epizoochory has been less studied than other seed dispersal mechanisms, such as endozoochory, and generally only a small percentage of plant species show adaptations to this strategy. Nevertheless, epizoochorous seed dispersal can affect an appreciable number of herb species in forests and man‐made habitats. Also, few studies have dealt with temporal variation in epizoochory. In this paper, medium‐long distance epizoochory is analyzed in a hedgerow habitat for the first time, using a domestic dog in an area in northwest Spain. Special attention is paid to seasonal variation and differential traits of plant taxa involved. Approximately 30 % of available herb taxa were found attached to hair. The intermonthly difference in the frequency of the taxa involved in epizoochory was significant, and the overall peak was reached in June–October linked with diaspore ripening phenology. Ninety‐three percent of the plant taxa adhered to hair had diaspores with traits facilitating epizoochory (hooks, spines, awns, rigid hairs), in comparison with 17 % for available plant taxa not adhered to hair. The taxa involved in epizoochory had larger diaspores than the rest of the available taxa, but ranged considerably in size. Numerous hooks covered the largest, heaviest diaspores, and allowed them to attach to hair. There was no significant difference in mean plant height between taxa involved in epizoochory and the rest of the available taxa. The difference in life span between taxa involved in epizoochory and the rest of available taxa was not significant, most of them being perennials in both cases. Seventy‐three percent of all the available plant taxa were potential forest plants typically found in edges and gaps, and 64 % of the plant taxa involved in epizoochory were these kinds of potential forest plants. High or medium involuntary positive selection by the dog of diaspores of Taraxacum gr. officinale, Galium aparine, Geum urbanum, and Agrimonia eupatoria was observed. In conclusion, epizoochorous dispersal can be quantitatively and functionally important in hedgerow habitats during summer‐autumn, affecting mainly herb taxa with specialized diaspores.
Application of Lipase from Marine BacteriaBacillus sonorensisas an Additive in Detergent Formulation
Authors: Nerurkar Madhura , Joshi Manasi , Pariti Sujata , Adivarekar Ravindra
Published: January 2013

The efficacy of lipase (triacylglycerol acylhydrolases EC 3.1.1.3) as a detergent additive from a newly isolated marine halophilic bacteriaBacillus sonorensisfrom marine clamsPaphia malabaricacollected in the Kalbadevi Estuary, Mumbai, has been assessed and reported. In terms of activity and stability, the lipase exhibited maximum activity in alkaline conditions and was observed to be stable over a temperature range from room temperature to 60 °C. The activity of the lipase increased in the presence of surfactants and detergents. Due to these properties of the lipase from marine bacteria, it was used as an additive in detergents to study its efficiency at corn oil removal from fabrics. The washing studies indicated that the efficiency of corn oil removal from the cotton fabrics increased by 20 % when lipase was incorporated in the detergent as compared to the treatment with detergent alone. The lipase was also capable of removing corn oil from natural as well as synthetic fabrics dyed with a respective, preferred class of dyes.
Reliability of Ultrasound Measures of the Transversus Abdominis: Effect of Task and Transducer Position
Authors: Larivière Christian , Gagnon Dany , De Oliveira Eros , Henry Sharon M. , Mecheri Hakim , Dumas Jean‐Pierre
Published: January 2013

Objective

To assess the reliability of ultrasound (US) measures of the transversus abdominis (TrA) muscle in a sample of subjects with and without specific chronic low back pain and to test whether reliability is enhanced by using different abdominal muscle activation tasks, with use of a foam cube for US transducer stabilization or by averaging 3 measures on the same image.

Design

Cross‐sectional repeated‐measures design.

Setting

Laboratory setting.

Patients

Fifteen subjects with chronic low back pain and 15 control subjects.

Methods

Subjects (n = 30) performed 3 tasks in the supine position: (1) contralateral straight leg raise (SLR), (2) bilateral hook‐lying leg raising (HLR), and (3) abdominal drawing‐in maneuver (ADIM) (control subjects only). Two 7‐second videos of the right and left abdominal wall (from rest to contraction) were collected, with and without use of the foam cube. One of the 2 raters repeated the testing 7 to 14 days later to assess intrarater reliability.

Main outcome measurements

US imaging of abdominal muscles thickness.

Results

The TrA muscle was recruited preferentially in the ADIM task compared with the automatic tasks (SLR and HLR). The reliability was comparable among the 3 tasks, with intrarater reliability results being better than interrater reliability results. The use of the foam cube or averaging measures on the same image was generally not effective to increase reliability.

Conclusions

Although they are not as preferential in TrA recruitment as the ADIM, the SLR and HLR tasks showed comparable reliability results. The foam cube used to control transducer orientation and pressure and averaging measures on the same image had limited effect on reliability.
Evaluation of the analgesic efficacy of AZD1940, a novel cannabinoid agonist, on post-operative pain after lower third molar surgical removal
Authors: Kalliomäki Jarkko , Segerdahl Märta , Webster Lynn , Reimfelt Annika , Huizar Karin , Annas Peter , Karlsten Rolf , Quiding Hans
Published: January 2013

Aim

To evaluate the analgesic efficacy of AZD1940, a novel peripherally acting cannabinoid CB1/CB2 receptor agonist, in patients undergoing third molar surgical removal.

Methods

This was a randomized, double-blind, placebo-controlled study in patients scheduled for surgical removal of an impacted lower third molar. Patients received a single oral dose of 800 μg AZD1940, 500 mg naproxen or placebo 1.5 h before surgery. The dose of 800 μg AZD1940 was selected based on earlier data from a single dose study in man, in which it was identified as the highest well tolerated dose. Ongoing post-operative pain (primary variable) and pain on jaw movement were assessed on a visual analog scale (VAS, 0-100 mm) from 0 to 8h postoperatively, deriving the area under the curve of ongoing pain (VAS AUC0–8h), and of pain on jaw movement (VASJM AUC0–8h). The time to requesting rescue medication (acetaminophen) was recorded. Subjective cannabinoid effects were assessed by the visual analog mood scale (VAMS).

Results

In total, 151 patients were randomized to AZD1940 (n = 61), placebo (n = 59) or naproxen (n = 31). There was no statistically significant difference in pain VAS AUC0–8h or in VASJM AUC0–8h between AZD1940 and placebo. Naproxen significantly reduced both pain VAS AUC0–8h and VASJM AUC0–8h as compared with placebo (p < 0.0001 for both). Significantly fewer patients on naproxen requested rescue medication and the duration of time to rescue was greater, as compared with placebo, whereas there were no significant differences between AZD1940 and placebo in these outcome variables. Statistically significant increases in VAMS items “sedated” and “high” were observed after AZD1940 compared with placebo. The increases in VAMS were numerically small compared with previous findings with a centrally acting cannabinoid. The most commonly observed adverse events (AE) on treatment with AZD1940 were postural dizziness (80% of subjects), nausea (26%), hypotension (21%) and headache (13%), most AE being mild to moderate.

Conclusion

The CB1/CB2 receptor agonist AZD1940 did not reduce post-operative pain after lower third molar surgical removal at doses exerting subjective cannabinoid effects.

Implications

Activation of peripheral CB1/CB2 receptors per se is probably of less clinical relevance for the treatment of acute nociceptive pain in man.
Activation of TRPM8 cold receptor triggers allodynia-like behavior in spinally injured rats
Authors: Gao Tianle , Hao Jingxia , Wiesenfeld-Hallin Zsuzsanna , Xu Xiao-Jun
Published: January 2013

Aims

Pain in response to innocuous cold stimulation (cold allodynia) is a common symptom in patients with neuropathic pain. Cold allodynia is difficult to treat and its mechanisms are poorly understood. Several transient receptor potential (TRP) channels have been shown to be the molecular sensors for cold stimulation in a temperature-dependent manner, but the contribution of various TRP channels in mediating cold allodynia in neuropathic pain is unclear. We have previously shown that spinally injured rats developed neuropathic pain-like behaviors, including marked cold allodynia. We now assessed the role of TRP channels in mediating cold allodynia in rats after ischemic spinal cord injury.

Methods

Methods: Spinal cord injury was produced using a photochemical method. The mechanical allodynia was assessed by examining the vocalization thresholds to graded mechanical touch/pressure applied with von Frey hairs. Temperature controlled cold stimulation was produced by a Peltier thermode (active surface 25 mm × 50 mm) connected to a MSA Thermal Simulator (Somedic, Sweden) with baseline temperature of 32 °C. The rate of temperature change was 0.5 °C/s. The temperature required to elicit cold allodynia was examined. The responses of the rats to topical application of icilin or menthol, agonists of transient receptor potential melastain 8 (TRPM8), were also studied.

Results

Normal rats did not exhibit nociceptive responses to cooling stimulation to the trunk and back area (minimal temperature +6°C) and they also did not react aversively to topical application of icilin or menthol. After spinal cord injury, the rats developed mechanical allodynia at the trunk and back just rostral to the dermatome of the injured spinal segments. In the same area, rats exhibited significant nociceptive responses to cooling from day 1 after injury, lasting for at least 70 days which is the longest time of observation. For the first two weeks after injury, the majority of spinally injured rats had a nociceptive response to cooling above 17°C. At day 70, about 50% of rats responded to cooling above 17 °C. Topical application of 400 μM icilin or 4mM menthol also elicited pain-like responses in spinally injured rats and these two cold mimetics also significantly exacerbated existing mechanical allodynia.

Conclusion

Our results showed that activation of the TRPM8 channel by menthol or icilin triggers allodynia in spinally injured rats and increases, rather than decreases, mechanical allodynia. TRPM8 channels which respond to cooling above 17 ° C may be involved at least in part in mediating cold allodynia in the rat model of neuropathic spinal cord injury pain.

Implications

The work introduced a method of quantitative testings of responses of rats to cold stimulation and may contribute to the understanding of mechanisms of cold allodynia after injury to the nervous system.
Feed allowance and maternal backfat levels during gestation influence maternal cortisol levels, milk fat composition and offspring growth
Authors: Amdi Charlotte , Giblin Linda , Hennessy Alan A. , Ryan Tomás , Stanton Catherine , Stickland Neil C. , Lawlor Peadar G.
Published: January 2013

The fetal and early postnatal environment can have a long-term influence on offspring growth. Using a pig model, we investigated the effects of maternal body condition (thin or fat) and maternal gestation feeding level (restricted, control or high) on maternal stress, milk composition, litter size, piglet birth weight and pre-weaning growth. A total of sixty-eight thin (backfat depth about 8 mm) and seventy-two fat (backfat depth about 12 mm) gilts were selected at about 22 weeks. This backfat difference was then accentuated nutritionally up to service at about 32 weeks. During gestation, individual gilts from within each group were randomly allocated to a gestation diet at the following feed allowances: 1·8 kg/d (restricted); 2·5 kg/d (control) and 3·5 kg/d (high) until day 90 of gestation. During gestation restricted gilts had higher levels of cortisol than high and control fed animals. Piglets born to fat gilts had higher average daily gain during the lactation period and higher weaning weights at day 28 than piglets born to thin gilts. Gilts on a high feed level had heavier piglets than those provided with restricted and control allocations. Fat gilts had less saturated fat in their milk at day 21 of lactation and higher unsaturated fat levels. No differences were found in the n-6:n-3 PUFA ratio in the milk between thin and fat gilts. In conclusion, maternal body condition influenced the daily weight gain of offspring up to weaning (day 28) and milk fat composition. Furthermore, maternal feed level during gestation alters maternal cortisol levels and milk fat composition.
Drynaria fortunei-derived total flavonoid fraction and isolated compounds exert oestrogen-like protective effects in bone
Authors: Wong Ka-Chun , Pang Wai-Yin , Wang Xin-Lun , Mok Sao-Keng , Lai Wan-Ping , Chow Hung-Kay , Leung Ping-Chung , Yao Xin-Sheng , Wong Man-Sau
Published: January 2013

Drynaria fortunei (Kunze) J. Sm. (DF), a Chinese herb commonly used for the treatment of bone fracture, was previously shown to exert anabolic effects on bone. However, its active ingredients as well as the mechanisms of action are far from clear. The present study aimed to characterise the bone anabolic effects of DF flavonoid fraction (DFTF) in ovariectomised (OVX) mice and to determine if DFTF and its isolated compounds exert oestrogen-like effects in rat osteoblast-like UMR-106 cells. Young OVX C57/BL6J mice were treated orally with DFTF (0·087, 0·173 or 0·346 mg/g per d), 17β-oestradiol (2 μg/g per d) or its vehicle for 6 weeks. Serum and urine samples were collected for biochemical marker analysis. Bones were collected for computed tomography analysis. UMR-106 cells were treated with DFTF and isolated compounds naringin, (2S)-5,7,3′,5′-tetrahydroxy-flavonone 7-O-neohesperidoside (compound 1) and 5,7-dihydroxychromone 7-O-neohesperidoside (compound 2). DFTF exerted dose-dependent effects in improving bone mineral densities as well as bone strength at the femur, tibia and lumbar spine L1 in OVX mice. DFTF and the three isolated compounds stimulated osteoblastic cell proliferation and alkaline phosphatase activities in a dose-dependent manner. In addition, they stimulated the ratio of osteoprotegrin and receptor-activator NF-κB ligand mRNA expression, suggesting their involvement in inhibiting osteoclastogenesis. These stimulatory effects on osteoblastic functions were abolished in the presence of oestrogen receptor (ER) antagonist, ICI 182780. The present results suggested that DFTF is effective in protecting against OVX-induced bone loss in mice, and its actions in regulating osteoblastic activities appear to be mediated by ER.