bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations of glycated haemoglobin A1c and glycated albumin with subclinical atherosclerosis in middle‐aged and elderly Chinese population with impaired glucose regulation
Authors: Ma Xiaojing , Shen Yun , Hu Xiang , Hao Yaping , Luo Yuqi , Tang Junling , Zhou Jian , Bao Yuqian , Jia Weiping
Published: April 2015

The aim of this study was to investigate the correlations of glycated haemoglobin A1c (HbA1c) and glycated albumin (GA) with subclinical atherosclerosis in middle‐aged and elderly Chinese populations with impaired glucose regulation (IGR). In total, 640 subjects with IGR and no history of cardiovascular disease or carotid artery plaque were recruited for this study (256 men, 384 women; age range, 40–70 years). The carotid intima‐media thickness (C‐IMT) measured by carotid ultrasonography was used as an indicator of subclinical atherosclerosis. Increased C‐IMT was defined as ≥ 0.70 mm (upper quartile). HbA1c and GA were measured with high‐performance liquid chromatography and enzymatic method, respectively. The average HbA1c and GA among all 640 subjects were 5.7 ± 0.3% and 14.0 ± 1.1%, respectively. HbA1c and GA were higher in subjects with increased C‐IMT than in subjects with normal C‐IMT (5.8 ± 0.3% vs 5.7 ± 0.3% and 14.2 ± 1.0% vs 13.9 ± 1.1%, respectively; both P < 0.01). Correlation analysis showed that both HbA1c and GA were positively correlated with C‐IMT (r = 0.135 and 0.112, respectively; both P < 0.01). Logistic regression analysis revealed that both HbA1c (odds ratio (OR), 2.630; 95% confidence interval (95% CI), 1.401–4.935; P = 0.003) and GA OR, 1.215; 95% CI, 1.008–1.466; P = 0.041) were independent risk factors for increased C‐IMT. Both HbA1c and GA reflect the risk of subclinical atherosclerosis in middle‐aged and elderly Chinese populations with IGR.
Health Information Technology Adoption in the Emergency Department
Authors: Selck Frederic W. , Decker Sandra L.
Published: April 2015

Objective

To describe the trend in health information technology (IT) systems adoption in hospital emergency departments (EDs) and its effect on ED efficiency and resource use.

Data Sources

2007–2010 National Hospital Ambulatory Medical Care Survey – ED Component.

Study Design

We assessed changes in the percent of visits to EDs with health IT capability and the estimated effect on waiting time to see a provider, visit length, and resource use.

Principal Findings

The percent of ED visits that took place in an ED with at least a basic health IT or an advanced IT system increased from 25.2 and 3.1 percent in 2007 to 69.1 and 30.6 percent in 2010, respectively (p < .05). Controlling for ED fixed effects, waiting times were reduced by 6.0 minutes in advanced IT‐equipped EDs (p < .05), and the number of tests ordered increased by 9 percent (p < .01). In models using a 1‐year lag, advanced systems also showed an increase in the number of medications and images ordered per visit.

Conclusions

Almost a third of visits now occur in EDs with advanced IT capability. While advanced IT adoption may decrease wait times, resource use during ED visits may also increase depending on how long the system has been in place. We were not able to determine if these changes indicated more appropriate care.
Effects of Germination on the Nutritional Properties, Phenolic Profiles, and Antioxidant Activities of Buckwheat
Authors: Zhang Ge , Xu Zhicun , Gao Yuanyuan , Huang Xianxiao , Zou Yanping , Yang Tiankui
Published: April 2015

Germination is considered to be an effective process for improving the nutritional quality and functionality of cereals. In this study, changes of nutritional ingredients, antinutritional components, chemical composition, and antioxidant activities of buckwheat seeds over 72 h of germination were investigated, and the reasons for these changes are discussed. With the prolonged germination time, the contents of crude protein, reducing sugar, total phenolics, total flavonoids, and condensed tannins increased significantly, while the levels of crude fat, phytic acid, and the activity of trypsin inhibitor decreased. Phenolic compounds, such as rutin, vitexin, isovitexin, orientin, isoorientin, chlorogenic acid, trans‐3‐hydroxycinnamic acid, and p‐hydroxybenzoic acid increased significantly during the germination process, which may be due to the activation of phenylalanine ammonialyase. The improvement of flavonoids led to significant enhancement of the antioxidant activities of germinated buckwheat. Germinated buckwheat had better nutritional value and antioxidant activities than ungerminated buckwheat, and it represented an excellent natural source of flavonoids and phenolic compounds, especially rutin and C‐glycosylflavones. Therefore, germinated buckwheat could be used as a promising functional food for health promotion.
Malignant melanoma showing a rapid response to nivolumab
Authors: Tsutsumi Miho , Asai Jun , Wada Makoto , Takenaka Hideya , Katoh Norito
Published: April 2015

Malignant melanoma is a highly aggressive skin tumour, with a recent rise in incidence. Nivolumab is a recently developed anti‐programmed cell death‐1 immune checkpoint inhibitor and its usage has resulted in a significant improvement in the overall survival of patients with metastatic melanomas. We report a case of advanced melanoma that showed a significant and rapid response to nivolumab treatment. The patient displayed multiple melanoma‐associated vitiligo prior to treatment; this symptom was theorised to indicate potentially immunoreactive melanoma and the need for nivolumab. In addition, interferon‐β was injected prior to nivolumab treatment. The significant rapid response to nivolumab suggested the induction of a marked immune response against melanoma by interferon‐β. Therefore, interferon‐β could be a useful and effective adjuvant for nivolumab therapy.
Th2 cytokines impair innate immune responses to rhinovirus in respiratory epithelial cells
Authors: Contoli M. , Ito K. , Padovani A. , Poletti D. , Marku B. , Edwards M. R. , Stanciu L. A. , Gnesini G. , Pastore A. , Spanevello A. , Morelli P. , Johnston S. L. , Caramori G. , Papi A.
Published: April 2015

Background

Asthma and other Th2 inflammatory conditions have been associated with increased susceptibility to viral infections. The mechanisms by which Th2 cytokines can influence immune responses to infections are largely unknown.

Methods

We measured the effects of Th2 cytokines (IL‐4 and IL‐13) on bronchial epithelial cell innate immune antiviral responses by assessing interferon (IFN‐β and IFN‐λ1) induction following rhinovirus (RV)‐16 infection. We also investigated the modulatory effects of Th2 cytokines on Toll‐like receptor 3 (TLR3), interferon‐responsive factor 3 (IRF3) and nuclear factor (NF)‐kB, that is key molecules and transcription factors involved in the rhinovirus‐induced interferon production and inflammatory cascade. Pharmacological and redox modulation of these pathways was also assessed.

Results

Th2 cytokines impaired RV‐16‐induced interferon production, increased rhinovirus replication and impaired TLR3 expression in bronchial epithelial cells. These results were replicated in vivo: we found increased IL‐4 mRNA levels in nasal epithelial cells from nasal brushing of atopic rhinitis patients and a parallel reduction in TLR3 expression and increased RV‐16 replication compared to nonatopic subjects. Mechanistically, Th2 cytokines impaired RV‐16‐induced activation of IRF3, but had no effects on RV‐16‐induced NF‐kB activation in bronchial epithelial cell cultures. N‐acetylcysteine and phosphoinositide 3‐kinase (PI3K) inhibitor restored the inhibitory effects of Th2 cytokines over RV‐16‐induced activation of IRF3.

Conclusions

IL‐4 and IL‐13, through inhibition of TLR3 expression and signalling (IRF3), impair immune response to RV‐16 infection. These data suggest that Th2 conditions increase susceptibility to infections and identify pharmacological approaches with potential to restore impaired immune response in these conditions.
NSAID‐exacerbated respiratory disease: a meta‐analysis evaluating prevalence, mean provocative dose of aspirin and increased asthma morbidity
Authors: Morales D. R. , Guthrie B. , Lipworth B. J. , Jackson C. , Donnan P. T. , Santiago V. H.
Published: April 2015

Background

The prevalence and mean provocative dose of oral aspirin (MPDA) triggering respiratory reactions in people with asthma have been inconsistently reported, and the relationship between NSAID‐exacerbated respiratory disease (NERD) and asthma morbidity was less well quantified.

Methods

A systematic review was performed by identifying studies diagnosing NERD using blinded, placebo‐controlled oral provocation challenge tests (OPCTs) or by self‐reported history in people with asthma. Data were extracted, and effect estimates for changes in respiratory function, MPDA and asthma morbidity were pooled using random‐effects meta‐analysis.

Results

The prevalence of NERD in adults with asthma was 9.0% (95% CI 6–12%) using OPCTs and 9.9% (95% CI 9.4–10.5%) using self‐reported history from questionnaires. The MPDA in adults with NERD was 85.8 mg (95% CI 73.9–97.6). In people with NERD, the risk of: uncontrolled asthma was increased twofold (RR 1.96 (95% CI 1.25–3.07)); severe asthma and asthma attacks was increased by 60% (RR 1.58 (95% CI 1.15–2.16) and RR 1.59 (95% CI 1.21–2.09), respectively); emergency room visits was increased by 80% (RR 1.79 (95% CI 1.29–2.49)); and asthma hospitalization was increased by 40% (RR 1.37 (95% CI 1.12–1.67)) compared to people with NSAID‐tolerant asthma.

Conclusions

Respiratory reactions triggered by oral aspirin in people with asthma are relatively common. At the population level, the prevalence of NERD was similar when measured using appropriately conducted OPCTs or by self‐reported history. On average, respiratory reactions were triggered by clinically relevant doses of oral aspirin. Asthma morbidity was significantly increased in people with NERD who potentially require more intensive monitoring and follow‐up.
Loneliness and the social monitoring system: Emotion recognition and eye gaze in a real‐life conversation
Authors: Lodder Gerine M. A. , Scholte Ron H. J. , Goossens Luc , Engels Rutger C. M. E. , Verhagen Maaike
Published: April 2015

Based on the belongingness regulation theory (Gardner et al., 2005, Pers. Soc. Psychol. Bull., 31, 1549), this study focuses on the relationship between loneliness and social monitoring. Specifically, we examined whether loneliness relates to performance on three emotion recognition tasks and whether lonely individuals show increased gazing towards their conversation partner's faces in a real‐life conversation. Study 1 examined 170 college students (Mage = 19.26; SD = 1.21) who completed an emotion recognition task with dynamic stimuli (morph task) and a micro(‐emotion) expression recognition task. Study 2 examined 130 college students (Mage = 19.33; SD = 2.00) who completed the Reading the Mind in the Eyes Test and who had a conversation with an unfamiliar peer while their gaze direction was videotaped. In both studies, loneliness was measured using the UCLA Loneliness Scale version 3 (Russell, 1996, J. Pers. Assess., 66, 20). The results showed that loneliness was unrelated to emotion recognition on all emotion recognition tasks, but that it was related to increased gaze towards their conversation partner's faces. Implications for the belongingness regulation system of lonely individuals are discussed.
Effects of Climate History and Environmental Grain on Species’ Distributions in Africa and South America
Authors: Nakazawa Yoshinori , Peterson Andrew Townsend
Published: April 2015

Climate changes during the Pleistocene produced shifts, reductions, and expansions of biomes that, in turn, have been hypothesized to have driven speciation and extinction and shaped patterns of biodiversity. Here, we explore effects of Late Pleistocene climatic changes on environmentally and geographically cohesive areas mimicking species’ distributions. We analyzed persistence of these ‘species’ over the transition from the warm Last Interglacial period to the cool Last Glacial Maximum period to warm present‐day conditions, for four levels of environmental restriction (5, 10, 15 and 20% of overall variation; akin to niche breadths). African environments were overall much less conserved over these periods than those of South America, matching diversity contrasts between the two continents. Results thus indicate that biodiversity patterns relate closely to historical patterns of environmental grain and their stability through time; this view is a step toward an integral understanding of the role of environmental and geographic factors in the process of biological diversification.
Clinical features and prognosis of eyeball rupture: eye injury vitrectomy study
Authors: Feng Kang , Wang Chang‐guan , Hu Yun‐tao , Yao Yi , Jiang Yan‐rong , Shen Li‐jun , Pang Xiu‐qin , Nie Hong‐ping , Ma Zhi‐zhong
Published: April 2015

Background

The objective of the study was to delineate clinical characteristics, surgical interventions, anatomic and visual outcomes of ruptured eye balls after trauma, and establish the prognostic indicators, which can assist clinicians in making correct surgical decisions during globe exploration for ruptured eyes.

Design

The study design used was a multicentre prospective cohort study, including six university‐affiliated tertiary hospitals.

Participants

We selected 242 cases of ruptured globe from the Eye Injury Vitrectomy Study database, until 31 December 2012.

Methods

All selected cases underwent vitreoretinal surgery, enucleation or evisceration, and were followed up for at least 6 months. Age, visual acuity (VA) after injury, ocular trauma zone, time to surgery, corneal laceration, scleral wound, extrusion of iris or lens, ciliary body damage, intraocular haemorrhage, retinal detachment or defect, proliferative vitreoretinopathy (PVR) and choroidal damage were the predisposing factors evaluated by logistic regression models.

Main Outcome Measures

We compared the pre‐surgical indicators between cases of anatomically restored eyes with VA of 4/200 or better, or eyes with initial no light perception restored light perception or better, and cases of VA worse than 4/200, silicone oil‐sustained eyes, phthisis or enucleation.

Results

Nearly 40% of cases with ruptured globe were anatomically restored through vitreoretinal surgery. The closed‐funnel retinal detachment or extensive retinal loss (odds ratio [OR] = 3.38, P = 0.026), PVR‐C (OR = 3.45, P = 0.008), and choroidal damage (OR = 4.20, P = 0.004) were correlated with poor outcomes.

Conclusion

The closed‐funnel retinal detachment or extensive retinal loss, PVR‐C, and choroidal damage are the risk factors for unfavourable outcomes in globe ruptures.
A prospective, multicenter study assessing the DENTSPLY Implants, OsseoSpeed™TX, length 6 mm in the posterior maxilla and mandible: a 1‐year follow‐up study
Authors: Han Jie , Zhang Xiao , Tang Zhihui , Zhang Li , Shi Dong , Meng Huanxin
Published: April 2015

Objective

The aim of this multicenter study was to prospectively assess clinical and radiographic outcomes of short implants (length 6 mm) in the posterior region and early‐loading with splinted‐fixed dental prostheses.

Materials and methods

A total of 45 subjects (77.8% with chronic periodontitis) were enrolled at three study sites. In total, 95 implants (diameter 4 mm, length 6 mm; OsseoSpeed™ 4.0 S; DENTSPLY Implants; Mölndal, Sweden) were placed, two or three implants per subject, using one‐stage surgery and loaded with a screw‐retained splinted ceramic‐fixed prosthesis 6 weeks later. Clinical and radiographic examinations were performed preoperatively, post‐surgery, at loading, and 6 and 12 months after prosthesis placement.

Results

Four implants failed before loading; all other implants showed favorable clinical and radiographic findings throughout the observation period (1‐year survival and success rate: 95.8%). Postoperative pain and swelling were negligible. Mean changes in marginal bone levels measured from loading were minimal (0.01 ± 0.37 and −0.13 ± 0.46 mm after 6 months and 1 year, respectively). Bone loss less than 1.00 mm was found in 77.5% implants, and bone gain was found in 15.5% implants. Probing depth change less than 2 mm was found in 98.7% of the implants between loading and 1‐year follow‐up. Prosthetic complications included one ceramic veneer chipping.

Conclusion

One‐year data indicate that the use of 6‐mm‐long implants is a predictable treatment. This provides a good treatment option in situations with limited bone height in posterior regions.
Normalized activation in the somatosensory cortex 30 years following nerve repair in children: an fMRI study
Authors: Chemnitz Anette , Weibull Andreas , Rosén Birgitta , Andersson Gert , Dahlin Lars B. , Björkman Anders
Published: April 2015

The clinical outcome following a peripheral nerve injury in the upper extremity is generally better in young children than in teenagers and in adults, but the mechanism behind this difference is unknown. In 28 patients with a complete median nerve injury sustained at the ages of 1–13 years (n = 13) and 14–20 years (n = 15), the cortical activation during tactile finger stimulation of the injured and healthy hands was monitored at a median time since injury of 28 years using functional magnetic resonance imaging (fMRI) at 3 Tesla. The results from the fMRI were compared with the clinical outcome and electroneurography. The cortical activation pattern following sensory stimulation of the median nerve‐innervated fingers was dependent on the patient's age at injury. Those injured at a young age (1–13 years) had an activation pattern similar to that of healthy controls. Furthermore, they showed a clinical outcome significantly superior (P = 0.001) to the outcome in subjects injured at a later age; however, electroneurographical parameters did not differ between the groups. In subjects injured at age 14–20 years, a more extended activation of the contralateral hemisphere was seen in general. Interestingly, these patients also displayed changes in the ipsilateral hemisphere where a reduced inhibition of somatosensory areas was seen. This loss of ipsilateral inhibition correlated to increasing age at injury as well as to poor recovery of sensory functions in the hand. In conclusion, cerebral changes in both brain hemispheres may explain differences in clinical outcome following a median nerve injury in childhood or adolescence.
Joint bleeds in von Willebrand disease patients have significant impact on quality of life and joint integrity: a cross‐sectional study
Authors: van Galen K. P. M. , Sanders Y. V. , Vojinovic U. , Eikenboom J. , Cnossen M. H. , Schutgens R. E. G. , van der Bom J. G. , Fijnvandraat K. , Laros‐Van Gorkom B. A. P. , Meijer K. , Leebeek F. W. G. , Mauser‐Bunschoten E. P. ,   the WiN Study Group
Published: April 2015

Background:

Joint bleeds (JB) are reported in a minority of patients with von Willebrand disease (VWD) but may lead to structural joint damage. Prevalence, severity and impact of JB in VWD are largely unknown.

Objectives:

The aim of this study was to assess JB prevalence, onset, treatment and impact on health‐related quality of life (HR‐QoL) and joint integrity in moderate and severe VWD.

Methods:

In the Willebrand in the Netherlands study 804 moderate and severe VWD patients [von Willebrand factor (VWF) activity ≤30U dL−1] completed a questionnaire on occurrence, sites and consequences of JB. To analyse JB number, onset, treatment and impact on joint integrity we additionally performed a patient–control study on medical file data comparing patients with JB to age, gender, factor VIII (FVIII)‐ and VWF activity matched VWD patients without JB.

Results:

Of all VWD patients 23% (184/804) self‐reported JB. These 184 patients reported joint damage more often (54% vs. 18%, P < 0.001) and had lower HR‐QoL (SF36, P < 0.05) compared to VWD patients not reporting JB. Of 55 patients with available JB data, 65% had the first JB before age 16. These 55 patients used more clotting factor concentrate (CFC; median dose 43 vs. 0 IE FVIII kg−1 year−1, P < 0.001), more often had X‐ray joint damage (44% vs. 11%, P = 0.001] and chronic joint pain (44% vs. 18%, P = 0.008) compared to 55 control VWD patients without JB.

Conclusion:

In conclusion, joint bleeds are reported by 23% of moderate and severe VWD patients, mostly start in childhood, are associated with more CFC use, joint pain, lower HR‐QoL and significantly more radiological and self‐reported joint damage.
Ongoing risk of thrombosis with factor XI concentrate: 5 years experience in two centres
Authors: Batty P. , Honke A. , Bowles L. , Hart D. P. , Pasi K. J. , Uprichard J. , Austin S. K.
Published: April 2015

Introduction

Factor XI (FXI) deficiency is the commonest of the rare bleeding disorders, affecting 2079 individuals in the United Kingdom. Treatment options for bleeding or surgery include antifibrinolytics, fresh frozen plasma or plasma‐derived (pd) FXI concentrates. There were a number of reports of thrombosis following treatment with FXI concentrates prior to changes in their manufacturing processes made in the mid‐1990's. Aims: The aim of the study was to determine the occurrence of adverse events (haemorrhagic and thrombotic) following usage of pd‐FXI concentrates at two large UK haemophilia centres. Retrospective chart review of all consecutively treated patients with BPL Factor XI® or Hemoleven® over a 5‐year period (11/06–11/11) was performed.

Results

Twenty‐nine patients (median age = 57.1 years) received treatment over 64 treatment episodes (surgery = 56, bleeding = 5, other = 3), using 126 000 U of concentrate. Median baseline FXI:C was 9 U dL−1 (range = <1–51), with 21 having severe and eight partial deficiency. BPL Factor XI® was used in 39 episodes (79 110 U) and Hemoleven® 25 episodes (46 890 U). There were six clinically significant bleeding events, managed either with a single additional dose of FXI concentrate (n = 4) or requiring no further intervention (n = 2). One patient required blood transfusion and one oral iron replacement. Two thrombotic events (transient ischaemic attack and pulmonary emboli), occurred in two patients with severe FXI deficiency, despite cautious FXI concentrate usage in the perioperative period.

Conclusions

FXI concentrate use is efficacious and safe in the majority of cases although physicians should remain mindful of the possibility of thrombotic complications.
Prevalence of uremic itching in patients undergoing hemodialysis
Authors: Kavurmacı Mehtap
Published: April 2015

Uremic itching is a common problem with multifactorial etiology seen in hemodialysis patients. This study was carried out to determine the factors affecting and incidence of itching in patients undergoing hemodialysis treatment. The descriptive study was carried out in 130 patients who underwent hemodialysis treatment because of end‐stage renal disease in Eastern Turkey between October 2014 and December 2014. A questionnaire prepared by the researcher based on the literature and the Visual Analog Scale were used for data collection. The data were collected by the researcher through face‐to‐face interviews in the hemodialysis unit. The evaluation of data obtained in the research has been performed using SPSS 16.0 software using percentages, chi‐square analysis, and t‐test. As a result of the study, 85.4% of the patients were found to have itching, the severity of itching was 4.86 ± 3.01 according to Visual Analog Scale, and itching of the patients was found to be affected by serum phosphorus and parathyroid hormone levels. Uremic itching continues to be seen as a problem in hemodialysis patients.
MED12 somatic mutations in fibroadenomas and phyllodes tumours of the breast
Authors: Piscuoglio Salvatore , Murray Melissa , Fusco Nicola , Marchiò Caterina , Loo Florence L , Martelotto Luciano G , Schultheis Anne M , Akram Muzaffar , Weigelt Britta , Brogi Edi , Reis‐Filho Jorge S
Published: April 2015

Aims

Somatic mutations in exon 2 of the mediator complex subunit 12 (MED12) gene have been identified in 60% of breast fibroadenomas (FAs). The aim of this study was to define whether phyllodes tumours (PTs) would harbour MED12 somatic mutations in a way akin to FAs.

Methods and results

A collection of 73 fibroepithelial tumours (including 26 FAs, 25 benign PTs, nine borderline PTs and 13 malignant PTs) from 64 patients was retrieved from the authors' institution. Sections from formalin‐fixed paraffin‐embedded (FFPE) blocks were microdissected to ensure an enrichment in neoplastic stromal elements of >70%. DNA samples extracted from tumour and matched normal tissues were subjected to Sanger sequencing of exon 2 of the MED12 gene. MED12 exon 2 somatic mutations, including 28 somatic single nucleotide variants and 19 insertions and deletions, were found in 65%, 88%, 78% and 8% of FAs, benign PTs, borderline PTs and malignant PTs, respectively. Malignant PTs harboured MED12 exon 2 somatic mutations significantly less frequently than FAs, benign and borderline PTs.

Conclusions

Although MED12 exon 2 somatic mutations probably constitute the driver genetic event of most FAs, benign and borderline PTs, our results suggest that the majority of malignant PTs may be driven by other genetic/epigenetic alterations.
Trends in nontuberculous mycobacterial disease in hospitalized subjects in Spain (1997–2010) according to HIV infection
Authors: Álvaro‐Meca A , Rodríguez‐Gijón L , Díaz A , Gil Á , Resino S
Published: April 2015

Objectives

The aim of the study was to estimate the incidence of nontuberculous mycobacterial (NTM) disease and the rate of NTM disease‐related mortality and to analyse trends in these variables according to HIV infection.

Methods

We performed a retrospective study for the period 1997–2010 using data from the Minimum Basic Data Set (MBDS) provided by the Spanish Ministry of Health. The exposure variables were: (i) HIV infection (HIV positive versus HIV negative); (ii) calendar period in relation to widespread use of combination antiretroviral therapy (cART) [1997–1999 (early cART period), 2000–2003 (middle cART period) and 2004–2010 (late cART period)]. The outcome variables were (i) new NTM disease diagnosis and (ii) mortality.

Results

A total of 3729 cases of incident NTM disease were collected in MBDS, 1795 in the HIV‐negative group and 1934 in the HIV‐positive group, among whom 602 deaths occurred, 223 in the HIV‐negative group and 379 in the HIV‐positive group. The incidence of NTM disease and the rate of NTM disease‐related mortality were 1000‐fold higher in the HIV‐positive group than in the HIV‐negative group. Regarding the incidence of NTM disease, in the HIV‐negative group the incidence increased from 2.91 to 3.97 events per 1 000 000 patient‐years from 1997–1999 to 2004–2010 (P < 0.001), while in the HIV‐positive group the incidence decreased from 2.29 to 0.71 events per 1000 patient‐years from 1997–1999 to 2004–2010 (P < 0.001). Regarding mortality, in the HIV‐negative group mortality increased from 2.63 to 4.26 events per 10 000 000 patient‐years from 1997–1999 to 2000–2003 (P = 0.059), and then the rate stabilized at around 3.87 events per 10 000 000 patient‐years in 2004–2010 (P = 0.128), while in the HIV‐positive group mortality decreased from 4.28 to 1.39 events per 10 000 patient‐years from 1997–1999 to 2004–2010 (P < 0.001).

Conclusions

HIV infection was associated with a higher NTM disease incidence and higher NTM disease‐related mortality than in the general population, but these rates decreased in the HIV‐positive group from 1997–1999 to 2004–2010, whereas the NTM disease incidence increased in the HIV‐negative group.
Barriers to antiretroviral treatment initiation in rural KwaZulu‐Natal, South Africa
Authors: Plazy M , Newell M‐L , Orne‐Gliemann J , Naidu K , Dabis F , Dray‐Spira R
Published: April 2015

Objectives

Although antiretroviral therapy (ART) has been freely available since 2004 in South Africa, not all those who are eligible initiate ART. We aimed to investigate individual and household characteristics as barriers to ART initiation in men and women in rural KwaZulu‐Natal.

Methods

Adults ≥ 16 years old living within a sociodemographic surveillance area (DSA) who accessed the local HIV programme between 2007 and 2011 were included in the study. Individual and household factors associated with ART initiation within 3 months of becoming eligible for ART were investigated using multivariable logistic regression stratified by sex and after exclusion of individuals who died before initiating ART.

Results

Of the 797 men and 1598 women initially included, 8% and 5.5%, respectively, died before ART initiation and were excluded from further analysis. Of the remaining 733 men and 1510 women, 68.2% and 60.2%, respectively, initiated ART ≤ 3 months after becoming eligible (P = 0.34 after adjustment for CD4 cell count). In men, factors associated with a higher ART initiation rate were being a member of a household located < 2 km from the nearest HIV clinic and being resident in the DSA at the time of ART eligibility. In women, ART initiation was more likely in those who were not pregnant, in members of a household where at least one person was on ART and in those with a high wealth index.

Conclusions

In this rural South African setting, barriers to ART initiation differed for men and women. Supportive individual‐ and household‐level interventions should be developed to guarantee rapid ART initiation taking account gender specificities.
New approach for a reliable in vitro sun protection factor method Part I: Principle and mathematical aspects
Authors: Miksa S. , Lutz D. , Guy C.
Published: April 2015

Synopsis

Objective

Development of an international harmonized in vitro method for sun protection factor (SPF) assessment is currently in progress because of the lack of both reproducibility and accuracy in the current methodology. The aim of this article was to focus on the principle and mathematical aspects (Part I) of a new approach for a reproducible and correlated in vitro test method to obtain results similar to the in vivo SPF for labelling purposes.

Methods

The currently used in vitro test is based on the spectroradiometric measurement of the residual ultraviolet (UV) transmitted through a thin layer of sunscreen spread on a substrate. To reach the goals of reproducibility and accuracy, the specifications of the key parameters and different steps of the procedure are clearly described in this study.

Results

Once reproducibility is obtained with an ad hoc procedure, the accuracy of the SPF values for a large number of products can be demonstrated with the prerequisite of a single UV irradiation dose and a multisubstrate solution. Using a total of 27 samples, the mean coefficient of variation was found to be <10% and the coefficient of correlation with the SPF clinical value reached approximately 0.81.

Conclusion

The first part of the article revealed a relevant tool for the in vitro SPF assessment that can be closely correlated to the in vivo SPF for labelling purposes. The second part study will focus on the practical aspects and implementation (Part II) achieved using the present method, will validate the robustness of the models and demonstrate the need to have different product categories to reach a reliable in vitro SPF method adaptable for all products available in the market.
Analyzing Chinese older people's quality of life through their use of the internet
Authors: Fowler Jie G. , Gentry James W. , Reisenwitz Timothy H.
Published: April 2015

The purpose of the research is to explore the well‐being/QOL of the ageing population in China. Specifically, the study investigates the experience/meaning of ageing and the strategies that consumers deploy to cope with ageing issues through internet communication. The results show that older people have found creative ways to cope with ageing by recalling the frugal experiences in the past, and purchasing small items as emotion enhancers. The findings also indicate that older Chinese bloggers have limited acquisition desire, do not wish to be a burden on their children, and worry greatly about their future financial status, especially given concerns about the healthcare system.
Intention to use physical and psychological community care services: a comparison between young‐old and older consumers in Korea
Authors: Hwang Hyesun
Published: April 2015

The purpose of this study is to examine older peoples' intention to use community care services, based on official data from Statistics Korea. This study attempted to compare the intention to use community care services by young‐old consumers (60–64 years) and older consumers (65 years and over) according to three factors of a behavioral model for health services: predisposing, enabling and need. The older consumer group had more need for overall community care services and experienced more health problems. A reverse pattern appeared in the mean difference of intention score for physical and psychological services. The groups that have a greater need for physical services are regarded as vulnerable groups: they are older with a lower education level, lower income, lower social status and more health problems. They have no other choice for meeting their physical health needs than to depend on the social care system. The vulnerable groups may also have mental health problems, but it seems that they do not have enough resources and cannot afford the care. The intention to use physical community care services was much higher for older consumers who have physical health problems. Conversely, the intention to use psychological community care services was much lower for the older consumer group if they have physical problems.
Burden of Stroke in Italy: An Economic Model Highlights Savings Arising from Reduced Disability following Thrombolysis
Authors: Chiumente M. , Gianino M. M. , Minniti D. , Mattei T. J. , Spass B. , Kamal K. M. , Zimmerman D. E. , Muca A. , Luda E.
Published: April 2015

Background

The consequences of stroke must be assessed not only in terms of incidence and mortality rates, but also in terms of disability, which may persist long after the acute phase. Thrombolysis, if timely administered, can effectively reduce post-stroke disability.

Aims

The economic model presented herein aims to evaluate, in eligible patients, the effects of alteplase on post-stroke disability and related costs over three-years.

Methods

The economic analysis was developed on the basis of four key components: clinical outcomes from international trials, economic consequences extracted from cost of illness studies, regulatory data from national and international agencies, and national epidemiological data. A population-level model estimated the difference in disability costs between patients treated with standard care versus those receiving thrombolytic therapy within 4×5 h of acute ischemic stroke. The analysis covered 36 months from discharge.

Results

Reduced costs related to post-stroke disability were observed in treated patients compared with those receiving standard care (control). The overall savings were ¢2330×15 per average patient: ¢1445×81 during the first 18 months, ¢362×25 between 18 and 24 months, and ¢522×09 in the 24–36 months period. The overall savings on 3174 Italian treated patients in 2013 were ¢7 395 907 over three-years.

Conclusion

Our study reveals that performing thrombolytic therapy in eligible patients improves economic outcomes compared with patients receiving standard care. This model is useful for decision makers, both within and outside of the Italian national context, as a tool to assess the cost-effectiveness of thrombolysis in both short- and long-term period.
TALOS: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial to Test the Effects of Citalopram in Patients with Acute Stroke
Authors: Kraglund Kristian Lundsgaard , Mortensen Janne Kaergaard , Grove Erik Lerkevang , Johnsen Søren Paaske , Andersen Grethe
Published: April 2015

Rationale

Selective Serotonin Reuptake Inhibitors (SSRI) are effective in the treatment of post-stroke depression and may have potential neuroprotective and vascular effects. Data from registry studies have further indicated a protective effect against recurrent ischemic events, but also an increased risk of bleeding in patients with ischemic stroke. Therefore, prospective studies are needed to determine the effects of SSRI treatment after acute ischemic stroke.

Aims and design

TALOS is an investigator-initiated, national multicenter randomized- and placebo-controlled, double-blind trial testing citalopram in acute ischemic stroke. We hypothesize that citalopram treatment initiated in the acute phase after ischemic stroke will improve outcome assessed by the modified Rankin Score (mRS) and reduce the risk of death from vascular causes, transient ischemic attack (TIA)/stroke and myocardial infarction.

Study outcomes

There are two co-primary effect variables: (i) Functional status at six-months, measured by the modified Rankin Scale, and (ii) Vascular death, TIA/stroke and myocardial infarction. Secondary effect variables include: (i) Single primary outcomes; (ii) The Barthel Index; (iii) Mini Mental State Examination at six-months; (iv) Final infarct size (Magnetic Resonance Imaging).

Discussion

SSRI treatment is well tolerated and overall beneficial in the wake of stroke; it may also be neuroprotective and prevent new vascular events.
Reliability of Oscillometric Blood Pressure Monitoring in Atrial Fibrillation Patients Admitted for Electric Cardioversion
Authors: Maselli Monica , Giantin Valter , Corrado Domenico , Franchin Alessandro , Attanasio Francesca , Pengo Valentina , Tramontano Alessandra , De Toni Pietro , Perissinotto Egle , Manzato Enzo
Published: April 2015

The reliability of automated oscillometric blood pressure (BP) monitors in atrial fibrillation (AF) has been poorly investigated, only comparing different patients with AF and sinus rhythm (SR), and is a method influenced by individual characteristics. This study compared the reliability of the oscillometric device A&D TM‐2430 (A&D Company, Tokyo, Japan) with that of a mercury sphygmomanometer in AF patients whose SR was restored after electric cardioversion (ECV). Three consecutive BP measurements were obtained on the day before and about 30 days after ECV in stable treatment conditions. Of the 100 patients studied, 63 reported an SR at follow‐up, with a significant increase in systolic BP and a significant decrease in diastolic BP according to both devices. There were no significant differences between the systolic and diastolic biases before and after ECV using Bland Altman analysis (P > .05 each). The oscillometric device analyzed, using three repeated measurements, is reliable in measuring BP in AF patients.
Multiscale tomographic analysis of heterogeneous cast Al‐Si‐X alloys
Authors: ASGHAR Z. , REQUENA G. , SKET F.
Published: April 2015

The three‐dimensional microstructure of cast AlSi12Ni and AlSi10Cu5Ni2 alloys is investigated by laboratory X‐ray computed tomography, synchrotron X‐ray computed microtomography, light optical tomography and synchrotron X‐ray computed microtomography with submicrometre resolution. The results obtained with each technique are correlated with the size of the scanned volumes and resolved microstructural features. Laboratory X‐ray computed tomography is sufficient to resolve highly absorbing aluminides but eutectic and primary Si remain unrevealed. Synchrotron X‐ray computed microtomography at ID15/ESRF gives better spatial resolution and reveals primary Si in addition to aluminides. Synchrotron X‐ray computed microtomography at ID19/ESRF reveals all the phases ≥ ∼1 μm in volumes about 80 times smaller than laboratory X‐ray computed tomography. The volumes investigated by light optical tomography and submicrometre synchrotron X‐ray computed microtomography are much smaller than laboratory X‐ray computed tomography but both techniques provide local chemical information on the types of aluminides. The complementary techniques applied enable a full three‐dimensional characterization of the microstructure of the alloys at length scales ranging over six orders of magnitude.
Clustered nuclei splitting via curvature information and gray‐scale distance transform
Authors: ZHANG CHAO , SUN CHANGMING , SU RAN , PHAM TUAN D.
Published: April 2015

Clusters or clumps of cells or nuclei are frequently observed in two dimensional images of thick tissue sections. Correct and accurate segmentation of overlapping cells and nuclei is important for many biological and biomedical applications. Many existing algorithms split clumps through the binarization of the input images; therefore, the intensity information of the original image is lost during this process. In this paper, we present a curvature information, gray scale distance transform, and shortest path splitting line‐based algorithm which can make full use of the concavity and image intensity information to find out markers, each of which represents an individual object, and detect accurate splitting lines between objects using shortest path and junction adjustment. The proposed algorithm is tested on both synthetic and real nuclei images. Experiment results show that the performance of the proposed method is better than that of marker‐controlled watershed method and ellipse fitting method.
Understanding the Effects of Establishing Various Cutoff Criteria in the Definition of Men with Premature Ejaculation
Authors: Rowland David L. , Kolba Tiffany N.
Published: April 2015

Introduction

Over the past decade, professional organizations and consensus groups have offered a variety of definitions for premature ejaculation (PE), all generally including a set of common concepts but all varying in specific language and operationalization. Clearly articulated definitions of such conditions are important because they not only affect prevalence rates but also diagnostic inclusion—who is deemed to have the condition and therefore who might be eligible for treatment.

Aim

The current study had two goals: (i) to examine the effects on prevalence rates of moving the cutoff points from more stringent to less stringent for each of three PE criteria—ejaculatory latency, distress, and ejaculating before desired; and (ii) to explore in detail the relationships among the three criteria.

Methods

Using an Internet-based sample of 1,183 men, we examined the responses of 374 with PE-type symptoms based on consensus definitions, and determined the effect of decreasing restrictions on the cutoff criteria. In addition, we calculated both correlations and concordance rates among criteria.

Results

Numeric and graphic depiction of the effects of moving the cutoff point for each of the three criteria is provided in the URL “PE Prevalence©,” a dynamic tool developed specifically for this study (https://sites.google.com/a/valpo.edu/PEprevalence/). In addition, statistical relationships among the PE criteria suggest sufficient independence to warrant inclusion of all three in a diagnostic procedure as well as to consider a 2-minute ejaculatory latency as the threshold for a PE diagnosis.

Conclusions

Based on our data, clinicians should approach the 1-minute ejaculatory latency time (ELT) criterion with flexibility, considering ELTs up to 2 minutes for a PE diagnosis. At the same time, frequency of occurrence of either ejaculating before desired or of distress about the condition, as long as they reach at least 50% of the time, had only minor impact on PE diagnostic inclusion.
Free Thyroxine Concentrations by Equilibrium Dialysis and Chemiluminescent Immunoassays in 13 Hypothyroid Dogs Positive for Thyroglobulin Antibody
Authors: Randolph J.F. , Lamb S.V. , Cheraskin J.L. , Schanbacher B.J. , Salerno V.J. , Mack K.M. , Scarlett J.M. , Place N.J.
Published: April 2015

Objective

To determine if concentrations of free thyroxine (FT4) measured by semi‐automated chemiluminescent immunoassay (CLIA) correspond toFT4 determined by equilibrium dialysis (ED) in hypothyroid dogs positive for thyroglobulin antibody (TGA).

Animals

ThirteenTGA‐positive dogs classified as hypothyroid based on subnormalFT4 concentrations byED.

Methods

Qualitative assessment of canineTGAwas performed using an enzyme‐linked immunosorbent assay. Serum total thyroxine and total triiodothyronine concentrations were measured by radioimmunoassay. SerumFT4 concentration was determined byED, and also by semi‐automatedCLIAfor humanFT4 (FT4h) and veterinaryFT4 (FT4v). Canine thyroid stimulating hormone concentration was measured by semi‐automatedCLIA.

Results

Each dog's comprehensive thyroid profile supported a diagnosis of hypothyroidism. For detection of hypothyroidism, sensitivities ofCLIAforFT4h andFT4v were 62% (95%CI, 32–85%) and 75% (95%CI, 36–96%), respectively, compared toFT4 byED. Five of 13 (38%) dogs hadFT4h and 2 of 8 (25%) dogs hadFT4v concentrations byCLIAthat were increased or within the reference range. Percentage of false‐negative test results forFT4 byCLIAcompared toEDwas significantly (P < .0001 forFT4h andP < .001forFT4v) higher than the hypothesized false‐negative rate of 0%.

Conclusions and Clinical Importance

Caution should be exercised in screening dogs for hypothyroidism usingFT4 measured byCLIAalone. Some (25–38%)TGA‐positive hypothyroid dogs hadFT4 concentrations determined byCLIAthat did not support a diagnosis of hypothyroidism.
Genomic studies on the nature of species: adaptation and speciation in Mimulus
Authors: Twyford Alex D. , Streisfeld Matthew A. , Lowry David B. , Friedman Jannice
Published: April 2015

Evolutionary biology is in an exciting era, in which powerful genomic tools make the answers accessible to long‐standing questions about variation, adaptation and speciation. The availability of a suite of genomic resources, a shared knowledge base and a long history of study have made the phenotypically diverse plant genus Mimulus an important system for understanding ecological and evolutionary processes. An international Mimulus Research Meeting was held at Duke University in June 2014 to discuss developments in ecological and evolutionary genetic studies in Mimulus. Here, we report major recent discoveries presented at the meeting that use genomic approaches to advance our understanding of three major themes: the parallel genetic basis of adaptation; the ecological genomics of speciation; and the evolutionary significance of structural genetic variation. We also suggest future research directions for studies of Mimulus and highlight challenges faced when developing new ecological and evolutionary model systems.
Critical roles of arginine in growth and biofilm development by Streptococcus gordonii
Authors: Jakubovics Nicholas S. , Robinson Jill C. , Samarian Derek S. , Kolderman Ethan , Yassin Sufian A. , Bettampadi Deepti , Bashton Matthew , Rickard Alexander H.
Published: April 2015

Streptococcus gordonii is an oral commensal and an early coloniser of dental plaque. In vitro, S. gordonii is conditionally auxotrophic for arginine in monoculture but biosynthesises arginine when coaggregated with Actinomyces oris. Here, we investigated the arginine‐responsive regulatory network of S. gordonii and the basis for conditional arginine auxotrophy. ArcB, the catabolic ornithine carbamoyltransferase involved in arginine degradation, was also essential for arginine biosynthesis. However, arcB was poorly expressed following arginine depletion, indicating that arcB levels may limit S. gordonii arginine biosynthesis. Arginine metabolism gene expression was tightly co‐ordinated by three ArgR/AhrC family regulators, encoded by argR, ahrC and arcR genes. Microarray analysis revealed that > 450 genes were regulated in response to rapid shifts in arginine concentration, including many genes involved in adhesion and biofilm formation. In a microfluidic salivary biofilm model, low concentrations of arginine promoted S. gordonii growth, whereas high concentrations (> 5 mM arginine) resulted in dramatic reductions in biofilm biomass and changes to biofilm architecture. Collectively, these data indicate that arginine metabolism is tightly regulated in S. gordonii and that arginine is critical for gene regulation, cellular growth and biofilm formation. Manipulating exogenous arginine concentrations may be an attractive approach for oral biofilm control.