bluuebunny/crossref_metadata_2025 huggingface dataset:
Can a Multimodal Mind–Body Program Enhance the Treatment Effects of Physical Activity in Breast Cancer Survivors With Chronic Tumor-Associated Fatigue? A Randomized Controlled Trial
Authors: Spahn Günther , Choi Kyung-Eun , Kennemann Charlotte , Lüdtke Rainer , Franken Ulla , Langhorst Jost , Paul Anna , Dobos Gustav J.
Published: June 2013

Background. Chronic fatigue is one of the most restricting symptoms following primary breast cancer treatment, but clinical studies on symptom management are rare. The objective was to evaluate the impact of a multimodal mind–body program (MMMT), including moderate physical activity as compared with a walking intervention alone, on chronic fatigue symptoms of women with stage I to IIIA breast cancer. Patients and Methods. Sixty-four women (mean age = 56.7 years) suffering from chronic fatigue after active tumor treatment were randomly assigned to either an experimental or a control (n = 32 each) intervention (10 weeks). Fatigue, quality of life (QoL), functional well-being, anxiety, and depression were measured with standard questionnaires at baseline, after 10 weeks, and after 3 months. Results. Compared with baseline, both groups had reduced fatigue scores after treatment without any significant difference between groups (posttreatment, Δ = −0.3, confidence interval = −1.6 to 1.0, P = .678; follow-up, Δ = −0.4, confidence interval = −1.8 to 0.9, P = .510). All patients also improved regarding QoL and general functional well-being. Conclusion. Since both interventions reduced fatigue symptoms and enhanced QoL to a similar extent, we observed no verifiable add-on effect of the MMMT regarding fatigue symptoms. Considering the higher costs with additional expenditure related to MMMT, home-based walking intervention is recommended.
Report of 2 Cases of Primary Epithelioid Hemangioendothelioma of the External Iliac Vein
Authors: Muñoz Alberto , Diaz-Perez Julio A. , Romero-Rojas Alfredo E. , Hernandez Elizabeth , Martin-Berdazco Francisco
Published: June 2013

The epithelioid hemangioendothelioma (EHE) is a rare type of endothelial neoplasm found mainly in soft tissues and visceral organs and in extraordinary cases in large veins like the iliac veins. Currently, there is an active discussion in which EHE behavior, classification, new diagnostic tools, and treatment procedures are proposed. Here, we present 2 cases of EHE and discuss our experience in diagnosis and treatment of this neoplasm.
Stool DNA testing for cancer surveillance in inflammatory bowel disease: an early view
Authors: Kisiel John B. , Ahlquist David A.
Published: June 2013

Patients with inflammatory bowel disease (IBD) are at increased risk for colorectal cancer (CRC). Despite weak supporting evidence, important logistic barriers and high cost, colonoscopy is currently the only recommended approach to CRC surveillance in patients with IBD. As such, there is imperative to explore alternative or complementary strategies with potential to improve the efficiency and effectiveness of surveillance in IBD. Given our increasing understanding of tumorigenesis in IBD and the accompanying cascade of molecular alterations, there is a strong rationale to pursue biomarker assays for this application. Stool-based DNA testing with advanced technology has been shown to be highly discriminatory for detection of sporadic colorectal cancer and advanced precancers. In early observations, stool DNA testing also shows promise for the accurate detection of IBD-associated colorectal neoplasms. These findings raise important clinical and translational questions about how to best evaluate and develop this technology, and devise clinical algorithms that will complement colonoscopy to improve patient outcomes.
Moving Forward With a Focus on NASN Priorities
Authors: Duff Carolyn L. , Mazyck Donna
Published: June 2013

For the 3rd consecutive year, the July issue of NASN School Nurse has published this NASN Annual Highlights Report. This 2013 report emphasizes current NASN priorities, discussing the updated strategic plan and providing insight into the accomplishments and strengths of our organization. Carolyn Duff, the newly installed NASN president, and Donna Mazyck, NASN executive director, collaborated to provide information of significance to NASN membership and stakeholders through the use of an interview format. As always, we encourage members to connect with NASN through a variety of formats outlined in the member center on our website ( www.nasn.org ).
French HIV Experts on Early Antiretroviral Treatment for Prevention
Authors: Lebouché Bertrand , Engler Kim , Lévy Joseph J. , Gilmore Norbert , Spire Bruno , Rozenbaum Willy , Lacene Tinhinane , Routy Jean-Pierre
Published: June 2013

Early use of highly active antiretroviral treatment (ART) in people living with HIV for HIV prevention has gained legitimacy but remains controversial. Nineteen French HIV experts with diverse specializations (over half of whom were clinicians) were qualitatively interviewed on their views about ART irrespective of CD4 count of more than 500 cells/mm3 for purposes of HIV prevention, which is not systematically recommended in France. Content analysis identified 2 broad categories: individual considerations (subcategories: patient health and well-being; patient preparedness and choice) and collective considerations (subcategories: HIV transmission risk; impact on the epidemic; cost). Uncertainty surrounded many experts’ considerations, and unity was lacking on key issues (eg, candidacy for early preventive treatment, expected clinical- and population-level effects). An umbrella theme labeled “Weighing the merits of early ART in the face of uncertainties” was identified. Our analyses raise doubts about the current acceptability of widespread implementation of early ART for HIV prevention in France.
Impact of Poor Retention in HIV Medical Care on Time to Viral Load Suppression
Authors: Crawford Timothy N. , Sanderson Wayne T. , Thornton Alice
Published: June 2013

Objective:

The purpose of this study was to evaluate how poor retention in HIV care impacts time to viral suppression after initiating highly active antiretroviral therapy.

Methods:

A retrospective cohort study design, employing a medical chart review, was conducted at an academic infectious disease clinic at the University of Kentucky. Patients seeking care between 2003 and 2011 were included in the study. A log-normal model was employed to determine the factors associated with time to viral suppression.

Results:

Of the 532 patients in the study, 426 (80.1%) patients were virally suppressed. Controlling for insurance status, race, baseline CD4 counts, and viral loads, the expected time to viral suppression for nonoptimal retainers was longer compared to optimal retainers (100% retained in care; time ratio: 2.04; 95% confidence interval: 1.40-2.90).

Conclusion:

Researchers should continue to study the impact of retention on clinical outcomes and strategies to improve retention and reengage those lost to follow-up back into care.
Risk Factors for Lower Extremity Tendinopathies in Military Personnel
Authors: Owens Brett D. , Wolf Jennifer Moriatis , Seelig Amber D. , Jacobson Isabel G. , Boyko Edward J. , Smith Besa , Ryan Margaret A.K. , Gackstetter Gary D. , Smith Tyler C. ,   for the Millennium Cohort Study Team, Bagnell Melissa , Creaven Gina , Crum-Cianflone Nancy , Davies James , Granado Nisara , Hernando Dennis , Horton Jaime , Jones Kelly , LeardMann Cynthia , Lee William , Linfesty Michelle , Lynch Gordon , McMaster Hope , Medina-Torne Sheila , Pietrucha Amanda , Powell Teresa , Sausedo Kari , Sheppard Beverly , Snell Katherine , Speigle Steven , White Martin , Whitmer James , Wong Charlene
Published: June 2013

Background:

Overuse injuries have a significant impact on United States military service members, but research to date has been limited in its ability to assess occupational and behavioral risk factors.

Hypothesis/Purpose:

To prospectively identify risk factors for the development of lower extremity tendinopathy and plantar fasciitis in United States military personnel.

Study Design:

Descriptive epidemiology study.

Methods:

Baseline data from the Millennium Cohort Study, a long-term observational cohort of military personnel, were utilized. Service members were enrolled in the cohort in 2001, 2004, and 2007. A total of 80,106 active-duty personnel were followed over 1 year for the development of patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis. Regression analyses were used to estimate significant associations between each tendinopathy, plantar fasciitis, and demographic, behavioral, and occupational characteristics.

Results:

Using medical records, 450 cases of Achilles tendinitis, 584 cases of patellar tendinopathy, and 1228 cases of plantar fasciitis were identified. Recent deployment was associated with an increased risk for developing plantar fasciitis (adjusted odds ratio [AOR], 1.27; 95% confidence interval [CI], 1.04-1.56). Moderate weekly alcohol consumption was marginally associated with an increased risk for Achilles tendinopathy (AOR, 1.33; 95% CI, 1.00-1.76). Overweight or obese individuals were more likely to develop Achilles tendinopathy and plantar fasciitis.

Conclusion:

Lower extremity tendinopathies and plantar fasciitis are common among military service members, and this study identified several modifiable risk factors for their occurrence. These potential risk factors could serve as the focus for future preventive and intervention studies.
Low Paneth cell numbers at onset of gastrointestinal graft-versus-host disease identify patients at high risk for nonrelapse mortality
Authors: Levine John E. , Huber Elisabeth , Hammer Suntrea T. G. , Harris Andrew C. , Greenson Joel K. , Braun Thomas M. , Ferrara James L. M. , Holler Ernst
Published: June 2013

Key Points

Paneth cell numbers in the duodenum at onset of GVHD correlate with outcomes. Paneth cells are easy to identify and quantify with light microscopy and may supplement histopathological grading of GI GVHD.
A genome-wide integrative study of microRNAs in human liver
Authors: Gamazon Eric R , Innocenti Federico , Wei Rongrong , Wang Libo , Zhang Min , Mirkov Snezana , Ramírez Jacqueline , Huang R Stephanie , Cox Nancy J , Ratain Mark J , Liu Wanqing
Published: June 2013

Background

Recent studies have illuminated the diversity of roles for microRNAs in cellular, developmental, and pathophysiological processes. The study of microRNAs in human liver tissue promises to clarify the therapeutic and diagnostic value of this important regulatory mechanism of gene expression.

Results

We conducted genome-wide profiling of microRNA expression in liver and performed an integrative analysis with previously collected genotype and transcriptome data. We report here that the Very Important Pharmacogenes (VIP Genes), comprising of genes of particular relevance for pharmacogenomics, are under substantial microRNA regulatory effect in the liver. We set out to elucidate the genetic basis of microRNA expression variation in liver and mapped microRNA expression to genomic loci as microRNA expression quantitative trait loci (miR-eQTLs). We identified common variants that attain genome-wide significant association (p < 10-10) with microRNA expression. We also found that the miR-eQTLs are significantly more likely to predict mRNA levels at a range of p-value thresholds than a random set of allele frequency matched SNPs, showing the functional effect of these loci on the transcriptome. Finally, we show that a large number of miR-eQTLs overlap with SNPs reproducibly associated with complex traits from the NHGRI repository of published genome-wide association studies as well as variants from a comprehensive catalog of manually curated pharmacogenetic associations.

Conclusion

Our study provides important insights into the genomic architecture of gene regulation in a vital human organ, with important implications for our understanding of disease pathogenesis, therapeutic outcome, and other complex human phenotypes.
Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study
Authors: Bagshaw Sean M , Sood Manish M , Long Jennifer , Fowler Robert A , Adhikari Neill KJ ,   Canadian Critical Care Trials Group H1N1 Collaborative
Published: June 2013

Background

Canada’s pandemic H1N1 influenza A (pH1N1) outbreak led to a high burden of critical illness. Our objective was to describe the incidence of AKI (acute kidney injury) in these patients and risk factors for AKI, renal replacement therapy (RRT), and mortality.

Methods

From a prospective cohort of critically ill adults with confirmed or probable pH1N1 (16 April 2009–12 April 2010), we abstracted data on demographics, co-morbidities, acute physiology, AKI (defined by RIFLE criteria for Injury or Failure), treatments in the intensive care unit, and clinical outcomes. Univariable and multivariable logistic regression analyses were used to evaluate the associations between clinical characteristics and the outcomes of AKI, RRT, and hospital mortality.

Results

We included 562 patients with pH1N1-related critical illness (479 [85.2%] confirmed, 83 [14.8%] probable]: mean age 48.0 years, 53.4% female, and 13.3% aboriginal. Common co-morbidities included obesity, diabetes, and chronic obstructive pulmonary disease. AKI occurred in 60.9%, with RIFLE categories of Injury (23.0%) and Failure (37.9%). Independent predictors of AKI included obesity (OR 2.94; 95%CI, 1.75-4.91), chronic kidney disease (OR 4.50; 95%CI, 1.46-13.82), APACHE II score (OR per 1-unit increase 1.06; 95%CI, 1.03-1.09), and PaO2/FiO2 ratio (OR per 10-unit increase 0.98; 95%CI, 0.95-1.00). Of patients with AKI, 24.9% (85/342) received RRT and 25.8% (85/329) died. Independent predictors of RRT were obesity (OR 2.25; 95% CI, 1.14-4.44), day 1 mechanical ventilation (OR 4.09; 95% CI, 1.21-13.84), APACHE II score (OR per 1-unit increase 1.07; 95% CI, 1.03-1.12), and day 1 creatinine (OR per 10 μmol/L increase, 1.06; 95%CI, 1.03-1.10). Development of AKI was not independently associated with hospital mortality.

Conclusion

The incidence of AKI and RRT utilization were high among Canadian patients with critical illness due to pH1N1.
The effectiveness of neuroendoscopic versus non-neuroendoscopic procedures in the treatment of lateral ventricular cysts: a retrospective medical record review study
Authors: Zhao Peng , Wang Xinsheng , Li Chuzhong , Gui Songbai , Zong Xuyi , Zhang Yazhuo
Published: June 2013

Background

The aim of this study was to assess the effectiveness of neuroendoscopy compared with non-neuroendoscopic procedures for treating patients with arachnoid membrane cysts in the lateral ventricles.

Methods

The medical records of 28 patients with arachnoid membrane cysts in the lateral ventricles who were treated with neuroendoscopy and 39 such patients treated with non-neuroendoscopic techniques using classic treatment procedures were reviewed. The neuroendoscopic approach combined craniotomy, corticectomy, lesion resection and cyst ventriculostomy or cyst cisternostomy to restore normal cerebrospinal fluid circulation. The non-neuroendoscopic techniques included craniotomy, corticectomy, and lesion resection performed under a microscope. Clinical outcomes of symptoms and cyst size change on imaging were compared between the two treatment groups during follow-up (range: 1–5 years).

Results

Patients in the neuroendoscopy group had significantly less blood loss (P < 0.001) and shorter operative time (P < 0.001), better marked improvement in symptoms (64.3% vs. 5.1%, respectively), and a higher total resection rate (92.9% vs. 66.7%; P = 0.011) compared with the patients in the non-neuroendoscopy group. In the neuroendoscopy group there was no cyst recurrence whereas in the non-neuroendoscopy group 8 (20.5%) patients had cyst recurrence. However, all patients in the neuroendoscopy group had postoperative transient fever and 8 (28.6%) patients had subdural fluid accumulation which was treated and subsequently resolved during follow-up. These symptoms did not occur in the non-neuroendoscopy group.

Conclusion

We found that neuroendoscopic therapy for arachnoid cysts in the lateral ventricles was more efficacious than non-neuroendoscopic methods. Our results indicate that neuroendoscopy may produce better clinical outcomes than non-neuroendoscopic procedures in treating patients with arachnoid cysts in the lateral ventricles.
Detection of cancer before distant metastasis
Authors: Coumans Frank AW , Siesling Sabine , Terstappen Leon WMM
Published: June 2013

Background

To establish a distant metastasis (DM) cells must disseminate from the primary tumor and overcome a series of obstacles, the metastatic cascade. In this study we develop a mathematical model for this cascade to estimate the tumor size and the circulating tumor cell (CTC) load before the first metastasis has formed from a primary breast cancer tumor.

Methods

The metastatic cascade is described in discrete steps: 1. local tumor growth; 2. dissemination into circulation; 3. survival in circulation; 4. extravasation into tissue; and 5. growth into a metastasis. The model was built using data and relationships described in the literature to predict the relationship between tumor size and probability of distant metastasis for 38715 patients with surgically removed TXNXM0 primary breast cancer from the Netherlands Cancer Registry. The model was calibrated using primary tumor size, probability of distant metastasis and time to distant metastasis for 1489 patients with stage T1BNXM0 (25% of total patients with T1BNXM0). Validation of the model was done with data for all patients.

Results

From the time to distant metastasis of these 38715 breast cancer patients, we determined a tumor doubling time of 1.7 ± 0.9 months. Fitting the data for 25% of T1B patients estimates a metastatic efficiency of 1 metastasis formed per 60 million disseminated tumor cells. Validation of the model to data of patients in all T-stages shows good agreement between model and epidemiological data. To reduce the 5-year risk of distant metastasis for TXNXM0 from 9.2% to 1.0%, the primary tumor needs to be detected and removed before it reaches a diameter of 2.7 ± 1.6 mm. At this size, the model predicts that there will be 9 ± 6 CTC/L blood.

Conclusions

To reduce the rate of distant metastasis in surgically treated TXNXM0 breast cancer to 1%, imaging technology will need to be able to detect lesions of 2.7 mm in diameter or smaller. Before CTC detection can be applied in the early disease setting, sensitivity will need to be improved by at least 15-fold and combined with technology that minimizes false positives.
A cross-sectional observational study of unmet health needs among homeless and vulnerably housed adults in three Canadian cities
Authors: Argintaru Niran , Chambers Catharine , Gogosis Evie , Farrell Susan , Palepu Anita , Klodawsky Fran , Hwang Stephen W
Published: June 2013

Background

Homeless persons experience a high burden of health problems; yet, they face significant barriers in accessing health care. Less is known about unmet needs for care among vulnerably housed persons who live in poor-quality or temporary housing and are at high risk of becoming homeless. The objectives of this study were to examine the prevalence of and factors associated with unmet needs for health care in a population-based sample of homeless and vulnerably housed adults in three major cities within a universal health insurance system.

Methods

Participants were recruited at shelters, meal programs, community health centers, drop-in centers, rooming houses, and single room occupancy hotels in Vancouver, Toronto, and Ottawa, Canada, throughout 2009. Baseline interviews elicited demographic characteristics, health status, and barriers to health care. Logistic regression was used to identify factors associated with self-reported unmet needs for health care in the past 12 months.

Results

Of the 1,181 participants included in the analysis, 445 (37%) reported unmet needs. In adjusted analyses, factors associated with a greater odds of reporting unmet needs were having employment in the past 12 months (AOR = 1.40, 95% CI = 1.03–1.91) and having ≥3 chronic health conditions (AOR = 2.17, 95% CI = 1.24–3.79). Having higher health-related quality of life (AOR = 0.21, 95% CI = 0.09–0.53), improved mental (AOR = 0.97, 95% CI = 0.96–0.98) or physical health (AOR = 0.98, 95% CI = 0.96–0.99), and having a primary care provider (AOR = 0.63, 95% CI = 0.46–0.85) decreased the odds of reporting unmet needs.

Conclusions

Homeless and vulnerably housed adults have a similar likelihood of experiencing unmet health care needs. Strategies to improve access to primary care and reduce barriers to accessing care in these populations are needed.
Changes in health expenditures in China in 2000s: has the health system reform improved affordability
Authors: Long Qian , Xu Ling , Bekedam Henk , Tang Shenglan
Published: June 2013

Background

China's health system reform launched in early 2000s has achieved better coverage of health insurance and significantly increased the use of healthcare for vast majority of Chinese population. This study was to examine changes in the structure of total health expenditures in China in 2000–2011, and to investigate the financial burden of healthcare placed on its population, particularly between urban and rural areas and across different socio-economic development regions.

Methods

Health expenditures data came from the China National Health Accounts study in 1990–2011, and other data used to calculate the financial burden of healthcare were from China Statistical Yearbook and China Population Statistical Yearbook. Total health expenditures were divided into government and social expenditure, and out-of-pocket payment. The financial burden of healthcare was estimated as out-of-pocket payment per capita as a percentage of annual household living consumption expenditure per capita.

Results

Between 2000 and 2011, total health expenditures in China increased from Chinese yuan 319 to 1888 (United States dollars 51 to 305), with average annual increase of 17.4%. Government and social health expenditure increased rapidly being 22.9% and 18.8% of average annual growth rate, respectively. The share of out-of-pocket payment in total health expenditure for the urban population declined from 53% in 2005 to 36% in 2011, but had only a slight decrease for the rural population from 53% to 50%. Out-of-pocket payment, as a percentage of annual household living consumption, has continued to rise, particularly in the rural population from the less developed region (6.1% in 2000 to 8.8% in 2011).

Conclusions

The rapid increase of public funding to subsidize health insurance in China, as part of the reform strategy, did not mitigate the out-of-pocket payment for healthcare over the past decade. Financial burden of healthcare on the rural population increased. Affordability among the rural households with sick members, particularly in the less developed region, is getting worse. It needs effective measures on cost control including healthcare provider payment reform and well developed health insurance schemes to offer better financial protection for the vulnerable Chinese seeking essential healthcare.
Disproportionate utilization of healthcare resources among veterans with COPD: a retrospective analysis of factors associated with COPD healthcare cost
Authors: Darnell Kyle , Dwivedi Alok Kumar , Weng Zhouyang , Panos Ralph J
Published: June 2013

Background

COPD is a significant cause of morbidity and mortality in the Veterans Health Administration (VHA). To determine the clinical factors associated with the cost of COPD management, we analyzed the relationship between clinical characteristics and COPD healthcare costs at the Cincinnati VAMC.

Methods

We queried the VHA Decision Support System for patients diagnosed with COPD at the Cincinnati VAMC and calculated their VHA COPD-related encounters and costs in FY2008. Patients were ranked by COPD-related cost. We determined the detailed clinical characteristics of patients selected by modified systematic sampling and performed univariate and multivariable ordinary linear regression analysis to determine factors associated with cost.

Results

3263 Veterans had 11,869 encounters with a primary or secondary diagnosis of COPD: 10,032 clinic visits, 505 emergency department (ED) visits, and 1,332 hospitalizations and incurred a total COPD-related healthcare cost of $21.4 M: $2.4 M clinic visits, $0.21 M ED visits, and $18.7 M hospitalizations and $0.89 M for COPD-related prescription costs. When the patients were ranked by VHA healthcare costs, the top 20% of patients accounted for 86% of the total costs and 57% of the total encounters with a primary or secondary diagnosis code of COPD and 90% of the total costs and 75% of the total encounters with a primary diagnosis code of COPD. The clinical characteristics and VHA healthcare costs of 840 of the 3263 unique individuals with COPD were analyzed to determine those characteristics associated with increased COPD-related costs. Univariate analysis showed significant associations with 24 clinical variables; the 4 most highly associated factors were nursing home residence, total hospital admissions, use of oral corticosteroids, and supplemental oxygen (p < 0.001 for all). In multivariate analysis, total number of admissions (p < 0.001), management by a pulmonologist (p < 0.001), number of clinic visits (p < 0.001), use of short acting anticholinergic (p = 0.001), forced expiratory volume in 1 second (FEV1) (p = 0.011), number of prescriptions (p = 0.011), body mass index (BMI) (p = 0.025), and use of inhaled corticosteroid (p = 0.043) were associated with COPD management cost.

Conclusion

The total number of admissions, clinic visits, physiologic impairment, BMI, number of medications, and type of provider are strongly associated with the total cost of COPD management. These factors may be used to focus COPD management toward patients with the potential for high utilization of healthcare resources.
Rheological and volumetric properties of TiO2-ethylene glycol nanofluids
Authors: Cabaleiro David , Pastoriza-Gallego María J , Gracia-Fernández Carlos , Piñeiro Manuel M , Lugo Luis
Published: June 2013

Homogeneous stable suspensions obtained by dispersing dry TiO2 nanoparticles in pure ethylene glycol were prepared and studied. Two types of nanocrystalline structure were analyzed, namely anatase and rutile phases, which have been characterized by scanning electron microscopy. The rheological behavior was determined for both nanofluids at nanoparticle mass concentrations up to 25%, including flow curves and frequency-dependent storage and loss moduli, using a cone-plate rotational rheometer. The effect of temperature over these flow curve tests at the highest concentration was also analyzed from 283.15 to 323.15 K. Furthermore, the influence of temperature, pressure, nanocrystalline structure, and concentration on the volumetric properties, including densities and isobaric thermal expansivities, were also analyzed.
Ingestion of milk containing the Dp2 peptide, a dust mite allergen, protects mice from allergic airway inflammation and hyper-responsiveness
Authors: Liu Hsu-Chung , Pai Shun-Yuan , Cheng Winston TK , Chen Hsiao-Ling , Tsai Tung-Chou , Yang Shang-Hsun , Chen Chuan-Mu
Published: June 2013

Background

Allergen-specific immunotherapy has been demonstrated to have potential for the treatment of allergic diseases. Transgenic animals are currently the best available bioreactors to produce recombinant proteins, which can be secreted in milk. It has not been clearly demonstrated whether milk from transgenic animals expressing recombinant allergens has immunomodulatory effects on allergic asthma.

Methods

We aimed to determine whether the oral administration of milk containing a mite allergen can down-regulate allergen-specific airway inflammation. Transgenic CD-1 mice that express a recombinant group 2 allergen from Dermatophagoides pteronyssinus (Dp2) in their milk were generated using an embryonic gene-microinjection technique. Mouse pups were fed transgenic Dp2-containing milk or wild-type milk. Subsequently, these mice were sensitized and challenged with Dp2 to induce allergic airway inflammation.

Results

Upon sensitization and challenge, mice fed transgenic Dp2 milk had decreased T-helper 2 (Th2) and increased T-helper 1 (Th1) responses in the airway compared with mice fed wild-type milk. Moreover, pre-treatment with transgenic Dp2 milk attenuated airway inflammation and decreased airway hyper-responsiveness.

Conclusions

This study provides new evidence that oral administration of transgenic milk containing the Dp2 allergen down-regulated and moderately protected against allergic airway inflammation. Milk from transgenic animals expressing allergens may have potential use in the prevention of allergic asthma.
High throughput quantitative phenotyping of plant resistance using chlorophyll fluorescence image analysis
Authors: Rousseau Céline , Belin Etienne , Bove Edouard , Rousseau David , Fabre Frédéric , Berruyer Romain , Guillaumès Jacky , Manceau Charles , Jacques Marie-Agnès , Boureau Tristan
Published: June 2013

Background

In order to select for quantitative plant resistance to pathogens, high throughput approaches that can precisely quantify disease severity are needed. Automation and use of calibrated image analysis should provide more accurate, objective and faster analyses than visual assessments. In contrast to conventional visible imaging, chlorophyll fluorescence imaging is not sensitive to environmental light variations and provides single-channel images prone to a segmentation analysis by simple thresholding approaches. Among the various parameters used in chlorophyll fluorescence imaging, the maximum quantum yield of photosystem II photochemistry (Fv/Fm) is well adapted to phenotyping disease severity. Fv/Fm is an indicator of plant stress that displays a robust contrast between infected and healthy tissues. In the present paper, we aimed at the segmentation of Fv/Fm images to quantify disease severity.

Results

Based on the Fv/Fm values of each pixel of the image, a thresholding approach was developed to delimit diseased areas. A first step consisted in setting up thresholds to reproduce visual observations by trained raters of symptoms caused by Xanthomonas fuscans subsp. fuscans (Xff) CFBP4834-R on Phaseolus vulgaris cv. Flavert. In order to develop a thresholding approach valuable on any cultivars or species, a second step was based on modeling pixel-wise Fv/Fm-distributions as mixtures of Gaussian distributions. Such a modeling may discriminate various stages of the symptom development but over-weights artifacts that can occur on mock-inoculated samples. Therefore, we developed a thresholding approach based on the probability of misclassification of a healthy pixel. Then, a clustering step is performed on the diseased areas to discriminate between various stages of alteration of plant tissues. Notably, the use of chlorophyll fluorescence imaging could detect pre-symptomatic area. The interest of this image analysis procedure for assessing the levels of quantitative resistance is illustrated with the quantitation of disease severity on five commercial varieties of bean inoculated with Xff CFBP4834-R.

Conclusions

In this paper, we describe an image analysis procedure for quantifying the leaf area impacted by the pathogen. In a perspective of high throughput phenotyping, the procedure was automated with the software R downloadable at http://www.r-project.org/. The R script is available at http://lisa.univ-angers.fr/PHENOTIC/telechargements.html.
Accuracy of methionine-PET in predicting the efficacy of heavy-particle therapy on primary adenoid cystic carcinomas of the head and neck
Authors: Toubaru Sachiko , Yoshikawa Kyosan , Ohashi Seiya , Tanimoto Katsuyuki , Hasegawa Azusa , Kawaguchi Koji , Saga Tsuneo , Kamada Tadashi
Published: June 2013

Background

We evaluated whether or not PET or PET/CT using L-methyl-[11C]-methionine (MET) can allow for the early prediction of local recurrence and metastasis, as well as the prognosis (disease-specific survival), in patients with adenoid cystic carcinoma of the head and neck treated by carbon ion beam radiotherapy.

Methods

This was a retrospective cohort study of sixty-seven patients who underwent a MET-PET or PET/CT study prior to and one month after the completion of carbon ion radiotherapy (CIRT). The minimum follow-up period for survivors was 12 months. The MET accumulation of the tumor was evaluated using the semiquantitative tumor to normal tissue ratio (TNR). A univariate analysis was conducted using the log-rank method, and the Cox model was used in a multivariate survival regression analysis.

Results

The average TNR prior to and following treatment was 4.8 (±1.5) and 3.0 (±1.3), respectively, showing a significant decrease following treatment. In the univariate analysis, a high TNR prior to treatment (TNRpre) was a significant factor for predicting the occurrence of metastasis and the disease-specific survival. A high TNR following treatment (TNRpost) was a significant factor for predicting the development of local recurrence. The residual ratio of TNR changes (TNRratio) seemed to be less useful than the TNRpre. In the multivariate analysis, the TNRpost and tumor size were the factors found to significantly influence the risk of local recurrence. The TNRpre, TNRratio and tumor size were all significant factors influencing the occurrence of metastasis. Regarding the disease-specific survival, the TNRpre and age were the only factors with a significant influence on the outcome.

Conclusions

The TNRpre was a factor that was significantly related to the occurrence of metastasis and the disease-specific survival after CIRT for adenoid cystic carcinoma of the head and neck. The TNRpost was a factor that was significantly related to the development of local recurrence. Thus, MET-PET or PET/CT can be useful for predicting or determining the therapeutic efficacy of CIRT.
Delayed rupture of a pseudoaneurysm in the brachial artery of a burn reconstruction patient
Authors: Lee Jun Yong , Kim Hyeri , Kwon Ho , Jung Sung-No
Published: June 2013

A brachial artery pseudoaneurysm is a rare but serious condition that can be limb threatening. A number of reports have found that it may be the result of damage to the blood vessels around the brachial artery, either directly or indirectly, due to trauma or systemic diseases. We present our experience of delayed pseudoaneurysm rupture of the brachial artery in a rehabilitation patient with burns of the upper extremity who underwent fasciotomy and musculocutaneous flap coverage. We also provide a review of the brachial artery pseudoaneurysm.
Contributions of VLDLR and LRP8 in the establishment of retinogeniculate projections
Authors: Su Jianmin , Klemm Michael A , Josephson Anne M , Fox Michael A
Published: June 2013

Background

Retinal ganglion cells (RGCs), the output neurons of the retina, project to over 20 distinct brain nuclei, including the lateral geniculate nucleus (LGN), a thalamic region comprised of three functionally distinct subnuclei: the ventral LGN (vLGN), the dorsal LGN (dLGN) and the intergeniculate leaflet (IGL). We previously identified reelin, an extracellular glycoprotein, as a critical factor that directs class-specific targeting of these subnuclei. Reelin is known to bind to two receptors: very-low-density lipoprotein receptor (VLDLR) and low-density lipoprotein receptor-related protein 8 (LRP8), also known as apolipoprotein E receptor 2 (ApoER2). Here we examined the roles of these canonical reelin receptors in retinogeniculate targeting.

Results

To assess the roles of VLDLR and LRP8 in retinogeniculate targeting, we used intraocular injections of fluorescently conjugated cholera toxin B subunit (CTB) to label all RGC axons in vivo. Retinogeniculate projections in mutant mice lacking either VLDLR or LRP8 appeared similar to controls; however, deletion of both receptors resulted in dramatic defects in the pattern of retinal innervation in LGN. Surprisingly, defects in vldlr

−/−
;lrp8

−/−
double mutant mice were remarkably different than those observed in mice lacking reelin. First, we failed to observe retinal axons exiting the medial border of the vLGN and IGL to invade distant regions of non-retino-recipient thalamus. Second, an ectopic region of binocular innervation emerged in the dorsomedial pole of vldlr

−/−
;lrp8

−/−
mutant dLGN. Analysis of retinal projection development, retinal terminal sizes and LGN cytoarchitecture in vldlr

−/−
;lrp8

−/−
mutants, all suggest that a subset of retinal axons destined for the IGL are misrouted to the dorsomedial pole of dLGN in the absence of VLDLR and LRP8. Such mistargeting is likely the result of abnormal migration of IGL neurons into the dorsomedial pole of dLGN in vldlr

−/−
;lrp8

−/−
mutants.

Conclusions

In contrast to our expectations, the development of both the LGN and retinogeniculate projections appeared dramatically different in mutants lacking either reelin or both canonical reelin receptors. These results suggest that there are reelin-independent functions of VLDLR and LRP8 in LGN development, and VLDLR- and LRP8-independent functions of reelin in class-specific axonal targeting.
Biological rhythm disturbance in remitted bipolar patients
Authors: Rosa Adriane R , Comes Mercè , Torrent Carla , Solè Brisa , Reinares Maria , Pachiarotti Isabella , Salamero Manel , Kapczinski Flávio , Colom Francesc , Vieta Eduard
Published: June 2013

Background

Biological rhythm disturbance is common in bipolar patients and seems to affect the course and prognosis of the illness negatively. The main aim of the current study was to assess biological rhythms in remitted bipolar patients. We also assessed whether there was an association between clinical variables or functioning and biological rhythms in remitted bipolar participants.

Methods

The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) was used to assess biological rhythm disturbance. It is an 18-item interviewer-administered instrument which allows us to investigate the main areas related to circadian rhythm disturbance (sleep/social, activities, and eating pattern) in bipolar disorder.

Results and discussion

Bipolar patients (n = 107) experienced greater biological rhythm alterations than the control group (n = 100) (BRIAN total scores 35.36 ± 7.11 vs. 32.48 ± 6.10, t = 6.912, p = 0.002, Cohen's d = 0.43, r = 0.21). In particular, patients were more impaired than the control group with regard to sleep/social (14.67 ± 4.14 vs. 13.49 ± 2.91, t = 10.61, p = 0.018, Cohen's d = 0.33, r = 0.16) and activity (8.49 ± 2.51 vs. 7.07 ± 2.13, t = 3.90, p = 0.001, Cohen's d = 0.61, r = 0.29) domains. Furthermore, a significant correlation was found between biological rhythms with residual depressive symptoms (r = 0.459, p < 0.001) and functioning (r = 0.432, p < 0.001). These findings suggest a potential link between biological rhythms and the pathophysiology of bipolar disorder. It highlights the importance of novel instruments (e.g., BRIAN) which allow us to assess biological rhythm disturbance in psychiatry. Finally, specific psychosocial interventions focused on lifestyle regularity may be considered as a supplemental treatment of bipolar illness episodes.
Analysis of Site Response and Building Damage Distribution Induced by the 31 October 2002 Earthquake at San Giuliano di Puglia (Italy)
Authors: Puglia Rodolfo , Vona Marco , Klin Peter , Ladina Chiara , Masi Angelo , Priolo Enrico , Silvestri Francesco
Published: June 2013

This paper concerns the analysis of the site amplification that significantly influenced the non-uniform damage distribution observed at San Giuliano di Puglia (Italy) after the 2002 Molise earthquake (MW = 5.7). In fact, the historical core of the town, settled on outcropping rock, received less damage than the more recent buildings, founded on a clayey subsoil. Comprehensive geotechnical and geophysical investigations allowed a detailed definition of the subsoil model. The seismic response of the subsoil was analyzed through 2-D finite-element and 3-D spectral-element methods. The accuracy of such models was verified by comparing the numerical predictions to the aftershocks recorded by a temporary seismic network. After calibration, the seismic response to a synthetic input motion reproducing the main shock was simulated. The influence of site amplification on the damage distribution observed was finally interpreted by combining the predicted variation of ground motion parameters with the structural vulnerability of the buildings.
Moment-Rotation Behavior of Force-Based Plastic Hinge Elements
Authors: Scott Michael H. , Ryan Keri L.
Published: June 2013

The moment-rotation behavior of force-based frame elements is expressed as a function of plastic hinge length and moment-curvature parameters for two types of plastic hinge integration under the representative loading condition of antisymmetric bending. For modified Gauss-Radau hinge integration, there is a unique relationship between the resulting moment-rotation hardening ratio and parameters defining the plastic hinge length and moment-curvature hardening ratio. For two-point Gauss-Radau hinge integration, the spread of yielding across the hinge regions leads to a multilinear moment-rotation response, for which a secant approximation of the hardening stiffness is directed to a target plastic rotation. An example application demonstrates that significantly unconservative assessments of lateral load-carrying capacity can be attained if modeling parameters for plastic hinge length and moment-curvature strain hardening are not calibrated to account for the discrepancy between moment-curvature and moment-rotation behavior of an element.
Social Representations of Earthquakes: A Study of People Living in Three Highly Seismic Areas
Authors: Joffe Helene , Rossetto Tiziana , Solberg Christian , O'Connor Cliodhna
Published: June 2013

Much research on people's seismic adjustment activity in highly seismic areas has assumed that low levels of adjustment are attributable to insufficient awareness of seismic risk. Empirical evidence for this assumption is weak, and there is growing appreciation of the role played by sociocultural and emotional variables in risk perception and behavior. This study explored these socio-cultural and emotional dimensions via 144 interviews and questionnaires, with matched samples of locals in Seattle (United States), Osaka (Japan), and Izmir (Turkey). The data showed that high awareness of possible seismic adjustment measures was not translated into behavior, with all sites demonstrating low adjustment uptake, though the North Americans adopted significantly more adjustments than the other cultures. Thematic analysis of the interview data suggested that adjustment behavior was undermined by anxiety, distrust, distancing self from earthquake risk and fatalistic beliefs. The paper concludes by recommending how culture-specific disaster mitigation plans may be developed to address these factors.
Detection of Building Damage Areas of the 2006 Central Java, Indonesia, Earthquake through Digital Analysis of Optical Satellite Images
Authors: Miura Hiroyuki , Midorikawa Saburoh , Kerle Norman
Published: June 2013

In order to evaluate the capability of building damage detection from optical satellite images, a procedure for digital image analysis is examined and applied to images captured before and after the 2006 Central Java, Indonesia, earthquake. In the image analysis, the pixels of the images are classified into vegetation, bare ground, and built-up areas. The damage areas are detected by the differential of the digital numbers in the built-up areas. The estimated damage distribution is validated by comparing it with the GIS data on building damage obtained from a field survey. The results show that the severely damaged areas were well detected by the analysis. In the densely vegetated areas, however, the damage was underestimated because many of the buildings were obscured by trees. For assessing quantitative damage information, the relationship between the number of collapsed buildings and the areas detected by the image analysis is evaluated.
Nonlinear Dynamic Analysis and Seismic Coefficient for Abutments and Retaining Walls
Authors: Kolay Chinmoy , Prashant Amit , Jain Sudhir K.
Published: June 2013

Two-dimensional computational models of bridge abutment-soil systems are developed using the OpenSees framework. Nonlinear hysteretic behavior of backfill and foundation soil is simulated through a pressure-dependent nested yield surface plasticity model. Sliding and debonding at the soil-structure interfaces are simulated using node-to-node contact elements. Cantilever abutments and retaining walls of 6 m and 12 m height are analyzed using two recorded free-field accelerograms scaled for peak ground acceleration values of 0.12 g, 0.24 g, 0.36 g, 0.48 g, 0.60 g, and 0.72 g. Further, pseudo-static analysis using Mononobe-Okabe theory is carried out with varying seismic coefficients, and the results are compared with those of the dynamic analyses. Based on this comparison, recommendations are made for the value of seismic coefficient to be used in pseudo-static analysis so as to obtain results that are comparable to those obtained through a sophisticated nonlinear analysis.
On the Relation between Rigorous and Simplified Models for the Dynamic Response Analysis of Multicomponent and Multisupport Excitations
Authors: Roudsari Mehrzad Tahamouli , Hosseini Mahmood
Published: June 2013

In analysis of structures subjected to multisupport excitations, generally in addition to the support acceleration time histories as inputs, the velocity and displacement time histories are also required. To identify the cases in which it is sufficient to use just the acceleration histories of supports, this paper attempts to show that there is a relation between multieomponent and multisupport excitation analyses. By considering the ordinary equations of motion as a special case of a more general case in which the motions of all degrees of freedom are taken into account, a matrix transformation is introduced, by which the governing equations of the multisupport excitation case are changed into ordinary equations of the dynamic response analysis of multi-degree-of-freedom (MDOF) systems. It has been shown that the “matrix of earthquake influence factors” cannot be defined for all structures in general state of multisupport excitation.
Implications of Masonry Infill and Partition Damage in Performance Perception in Residential Buildings after a Moderate Earthquake
Authors: Sucuoğlu HalÛk
Published: June 2013

Engineers usually focus on the performance of structural members, whereas the occupants of a residential building are affected mostly by the performance of infill and partition walls in buildings after a moderate earthquake. This often creates controversy and discussion regarding the post-earthquake use of buildings. Seismic rehabilitation codes for existing buildings offer sophisticated measures in rating the seismic performances of structural components, whereas performance measures suggested for infill and other partition walls are crude by comparison. Furthermore, seismic design codes for new buildings totally disregard such disparity, since their force-based approaches are built on single-level performance targets specified implicitly for the entire building under a design level, that is, a rare earthquake. In this paper, performance levels of buildings after an earthquake of moderate intensity are discussed from the viewpoints of engineers and building occupants. Suggestions are made for achieving uniform performance in structures where the seismic forces are resisted by structural members as well as the infills and partition walls coupling with the structural system although the contribution of such walls to seismic resistance and their performance is not usually considered in design.