bluuebunny/crossref_metadata_2025 huggingface dataset:
The security dilemma evident in South Africa’s foreign policy towards Africa
Authors: Prinsloo Barend Louwrens
Published: June 2016

South Africa’s (SA) ruling party, the African National Congress (ANC), is looking to expand SA’s influence and power in the region and on the African continent in order to advance domestic socio-economic development. In the process, SA’s political identity is changing. Much of the article also focuses on the evolution or adaptation of the national political identity of SA. This discussion shows that there is a risk that the new political identity may not be accepted by the majority of South African citizens or by its allies in the region and on the continent. If the new political identity fails to take hold and domestic socio-economic problems are not addressed, the ANC could lose its future political support while anarchy and uncertainty, in the context of the ‘security dilemma’, may further perpetuate to the general public and partnering states. An exacerbating factor is the fact that SA’s domestic policies are linked to its foreign policies. Failures to successfully introduce domestic policies may also hold negative consequences for its foreign policy objectives and may well lead to unintended rivalry and conflict in the region and the continent.
Rule-based modeling with Virtual Cell
Authors: Schaff James C. , Vasilescu Dan , Moraru Ion I. , Loew Leslie M. , Blinov Michael L.
Published: June 2016

Summary: Rule-based modeling is invaluable when the number of possible species and reactions in a model become too large to allow convenient manual specification. The popular rule-based software tools BioNetGen and NFSim provide powerful modeling and simulation capabilities at the cost of learning a complex scripting language which is used to specify these models. Here, we introduce a modeling tool that combines new graphical rule-based model specification with existing simulation engines in a seamless way within the familiar Virtual Cell (VCell) modeling environment. A mathematical model can be built integrating explicit reaction networks with reaction rules. In addition to offering a large choice of ODE and stochastic solvers, a model can be simulated using a network free approach through the NFSim simulation engine.

Availability and implementation: Available as VCell (versions 6.0 and later) at the Virtual Cell web site (http://vcell.org/). The application installs and runs on all major platforms and does not require registration for use on the user’s computer. Tutorials are available at the Virtual Cell website and Help is provided within the software. Source code is available at Sourceforge.

Contact:  vcell_support@uchc.edu

Supplementary information:  Supplementary data are available at Bioinformatics online.
Chronic kidney disease-mineral and bone disorder
Authors: Moschella Carla
Published: June 2016

Chronic kidney disease affects 23 million Americans and is associated with many complications, one of the most complex of which is mineral and bone disorder. Pathophysiologic mechanisms begin to occur early in CKD but when the glomerular filtration rate declines to <50% of normal, biochemical and bone matrix abnormalities, which vary and are multifactorial, begin to be clinically apparent. Mainstays of treatment remain management of hyperphosphatemia and prevention or treatment of secondary hyperparathyroidism.
Single-Fiber Recordings of Nociceptive Fibers in Patients With HSAN Type V With Congenital Insensitivity to Pain
Authors: Sagafos Dagrun , Kleggetveit Inge P. , Helås Tormod , Schmidt Roland , Minde Jan , Namer Barbara , Schmelz Martin , Jørum Ellen
Published: June 2016

Objectives:

Nerve growth factor (NGF) is a protein important for growth and survival, but also for modulation of sensitivity of nociceptors and sympathetic neurons. The purpose of the present study was to investigate the effects of reduced NGF signaling in patients with hereditary sensory and autonomic neuropathies type V, congenital insensitivity to pain, caused by a mutation of the NGFβ gene, including a characterization of single nociceptive fibers using microneurography (MNG).

Materials and Methods:

One homozygote and 2 heterozygote patients with this mutation were examined with electromyography/neurography, thermal testing, quantitative sudomotor axon reflex test, and electrically induced axon reflex erythema in addition to MNG.

Results:

Low quantitative sudomotor axon reflex test measurements of 0.02 (left foot) and 0.03 (right foot) μL/cm2and elevated thermal thresholds for warmth and cold detection testing showed clear impairment of small nerve fibers, both sudomotor efferent and somatic afferent fibers, in the patient homozygote for the mutation. MNG from one of the heterozygote patients revealed changes in the small nociceptive fibers in skin, including abnormally low conduction velocity, spontaneous activity in A-δ fibers and C-nociceptors and abnormal or lacking response to heat.

Discussion:

The findings of grossly intact pain thresholds compared with anamnestic insensitivity of pain in deep somatic tissue such as bone suggest a gradient of impairment dependent on different NGF availability in various tissues. Even though these patients in some aspects report insensitivity to pain, they also report chronic spontaneous pain as their main symptom, strikingly highlighting differential mechanisms of insensitivity to evoked pain versus spontaneous pain.
Three-Dimensional Analysis of Hemimetameric Segmental Shift in Congenital Scoliosis
Authors: Saito Toshiki , Kawakami Noriaki , Tsuji Taichi , Ohara Tetsuya , Suzuki Yoshitaka , Nohara Ayato , Tauchi Ryoji , Kawakami Kazuki
Published: June 2016

Study Design:

This is a retrospective cohort study.

Background:

Hemimetameric segmental shift (HMMS) is defined as a hemivertebral deformation in which 2 or more hemivertebrae exist on both sides of the spine and are separated by at least 1 normal vertebra. Reports of HMMS are rare and based on simple anterior x-ray images. No reports have used 3-dimensional computed tomography (3D-CT) to analyze both the anterior and posterior elements. The objective of this study was to analyze the morphology and clinical features of HMMS 3 dimensionally.

Methods:

HMMS was confirmed in 32 (6.6%, 16 males and 16 females) of 483 patients diagnosed with congenital scoliosis at the study institution between 1998 and 2013. The average age at the first visit was 6 years and 3 months. 3D-CT imaging was performed for 30 patients older than 2 years (average age: 9 y and 8 mo) and used to classify cases according to posterior elements.

Results:

With regard to the number of hemivertebrae present, 21 patients had 2 hemivertebrae, 7 patients had 3 hemivertebrae, and 2 patients had 4 hemivertebrae. Patients with 2 hemivertebrae predominantly had hemivertebrae in the thoracolumbar spine. Patients were classified into 2 categories: malformation existing at an equal level in anterior and posterior sides (unison HMMS) and malformation existing at nonequal levels (discordant HMMS). Nine patients had unison HMMS and all of them had 2 hemivertebrae (average: 4.6 vertebrae). Twenty-one patients had discordant HMMS, with 12 having 2 hemivertebrae, 7 having 3 hemivertebrae, and 2 having 4 hemivertebrae.

Conclusions:

Through 3D-CT analysis, HMMS was categorized as unison or discordant. Discordant HMMS was observed in 21 of 30 (70%) patients and in all patients with >3 hemivertebrae. Diagnosing HMMS, whether unison or discordant, is clinically important and should be done with careful analysis of bone models and/or radiologic images to determine the correct spinal levels.

Level of Evidence:

Level IV—diagnostic study.
Macrophage Inhibition Factor–Mediated CD74 Signal Modulate Inflammation and Matrix Metabolism in the Degenerated Cartilage Endplate Chondrocytes by Activating Extracellular Signal Regulated Kinase 1/2
Authors: Xiong Chengjie , Huang Yong , Kang Hui , Zhang Tonghui , Xu Feng , Cai Xianhua
Published: June 2016

Study Design.

The macrophage inhibition factor (MIF)-mediated CD74 dependent extracellular signal–regulated kinase 1/2 (ERK1/2) phosphorylation were associated with inflammatory activity and matrix metabolism in human degenerated cartilage endplate (CEP). Anabolic/catabolic factors in pathogenesis of CEP degeneration were evaluated.

Objective.

To study the effect of MIF-mediated CD74 dependent ERK1/2 activation on the CEP degeneration.

Summary of Background Data.

MIF-CD74 signal is closely related to the CEP degeneration by inducing the secretion of inflammatory cytokines. ERK1/2-mediated inflammatory pathway also plays a crucial role in the intervertebral disc degeneration. The role of the ERK1/2 pathway in CEP chondrocytes response to MIF-CD74 signal has, however, not been fully elucidated.

Methods.

Chondrocytes were exposed to MIF, with or without ERK1/2 inhibition; CD74 interfered chondrocytes were also exposed to MIF, with or without ERK inhibition. mRNAs were isolated for real-time polymerase chain reaction measurement of gene expression. Western blotting was carried out to analyze the protein expression.

Results.

ERK1/2 expression was significantly increased by MIF. MIF modulates metabolism in CEP chondrocytes and decreased by its inhibitor PD98059. ERK1/2 expression was significantly decreased by CD74siRNA. Inflammatory cytokines expression was significantly increased by MIF-induced ERK1/2 activation and significantly suppressed by PD98059. On the contrary, matrix expression was significantly decreased by MIF-induced ERK1/2 activation and reversed by PD98059. CD74siRNA decreased the CD74 expression in chondrocytes. Inflammatory cytokines and matrix expression were not induced by MIF in CD74 interfered chondrocytes.

Conclusion.

These results show that MIF-CD74 signal elicits an imbalance between anabolic and catabolic metabolism in CEP chondrocytes via ERK signal pathway. ERK inhibition could exert therapeutic effect against the harmful effects of MIF-CD74 signal in CEP degeneration.

Level of Evidence: N/A
A CT-Based Simulation Study to Compare the Risk of Facet Joint Violation by the Cervical Pedicle Screw Between Degenerative and Nondegenerative Cervical Spines
Authors: Lee Dong-Ho , Noh Hyounmin , Hwang Chang Ju , Lee Choon Sung , Abumi Kuniyoshi , Cho Jae Hwan
Published: June 2016

Study Design.

A retrospective case-control study.

Objective.

This study aimed (A) to compare entry points and trajectories of the cervical pedicle screw (CPS) between degenerative and nondegenerative spines, and (B) to evaluate the risk of facet joint violation by the CPS according to the degree of facet degeneration.

Summary of Background Data.

Entry point, trajectories, and risk of misplacement of the CPS have been widely researched; however, its application to degenerative cervical spine has to be elucidated.

Methods.

Sixty patients who underwent cervical surgeries at our institution were classified into two groups according to cervical facet joint degeneration. A simulation program with 0.7-mm thickness axial computed tomographic images was used to evaluate facet joint violation by the CPS from C3 to C6. Horizontal and vertical offsets of entry points were measured from two different anatomical landmarks on lateral mass, namely the lateral notch and the center of the superior ridge. The transverse and sagittal angles of the screws were also measured. Facet joint violation was evaluated and classified into either “minor” (<50% of screw diameter) or “major” (≥50% of screw diameter).

Results.

The mean transverse and sagittal angles showed no difference between the two groups. However, a more superior vertical offset from the superior ridge in terms of entry point was observed in the degenerative cervical spine group at all levels (P = 0.001–0.026). In addition, facet joint violation was more frequently found in severely degenerated facet joints than in mild to moderately degenerated facet joints (P = 0.011).

Conclusion.

The entry point of CPS was moved more superiorly in the degenerative cervical spine in this study, which increased the risk of facet joint violation in our patients. Thus, surgeons need to modify the insertion technique of the CPS or to insert lateral mass screw instead of the CPS when it is considered to insert screws at the uppermost vertebra in the degenerative cervical spine.

Level of Evidence: 4
A Novel Surgical Approach to Coracoid-based Eosinophilic Granuloma and the Technical Trick
Authors: Gökkuş Kemal , Unal Mehmet B. , Aydin Ahmet T.
Published: June 2016

The coracoid base is a very rare location for tumors. It is difficult to diagnose and approach, but easy to dismiss. In this case, the tumor (eosinophilic granuloma of the scapula) was located at the base of the coracoid, and the posterior cortex was eroded by the tumor. Accessing this lesion through the deltopectoral approach with coracoid osteotomy without penetrating the supposed tumor extending posterior soft tissue will be discussed. This approach gives a wider and safer access to the surgeon than the posterior approach. This report presents a customized solution with the deltopectoral approach, and the chevron-type osteotomy to access the coracoid base and tension band wiring to fix the osteotomy side.
The Role of Lymphadenectomy Versus Sentinel Lymph Node Biopsy in Early-stage Endometrial Cancer
Authors: Tschernichovsky Roi , Diver Elisabeth J. , Schorge John O. , Goodman Annekathryn
Published: June 2016

Objective:

The objective of this study is to review existing data regarding the feasibility, diagnostic performance, and oncologic outcomes of sentinel lymph node biopsy (SLNB) versus lymphadenectomy (LND) in endometrial cancer.

Materials and Methods:

A PubMed search identified studies on different staging strategies in endometrial cancer, including routine LND, predictive models of selective nodal dissection, and SLNB.

Results:

There is ongoing controversy over the risk-benefit ratio of LND in assessing nodal involvement in presumed early-stage endometrial cancer. Current experience with sentinel node biopsy suggests high detection rates and low false-negative rates across most series, as well as the increased detection of occult metastatic disease overlooked by conventional pathology. Although data on the long-term oncologic outcomes of sentinel node biopsy in this setting are limited, short-term follow-up shows no immediate impairment of disease-free survival or overall survival rates when compared with LND.

Conclusions:

SLNB holds promise as a less-morbid and more accurate alternative to LND for determining nodal spread in early-stage endometrial cancer. Further studies are necessary to understand how lymph node status will guide postoperative management and impact survival of women with nodal metastases.
Malignant Peripheral Nerve Sheath Tumors
Authors: Bishop Andrew J. , Zagars Gunar K. , Torres Keila E. , Bird Justin E. , Feig Barry W. , Guadagnolo B. Ashleigh
Published: June 2016

Purpose:

The purpose of this study is to investigate local control (LC), survival outcomes, and associated prognostic factors for patients with malignant peripheral nerve sheath tumors (MPNSTs) treated with combined surgery and radiation therapy (RT).

Methods:

We reviewed the medical records of 71 consecutive patients treated with surgery and RT for localized MPNST between 1965 and 2012. Preoperative RT was used to treat 23 patients (32%) to a median dose of 50 Gy (range, 50 to 60 Gy), whereas 48 (68%) received postoperative RT to a median dose of 64 Gy (range, 45 to 70 Gy).

Results:

Median follow-up for living patients was 118 months (range, 21 to 512 mo). The 5-year LC, distant metastatic free survival, and disease-specific survival rates were 84%, 62%, and 66%, respectively. To identify predictors of outcome, several multivariate models were constructed: (1) positive/uncertain surgical margin status was the only factor adversely associated local relapse at 5 years (28% vs. 5% for negative margins; P=0.02; hazard ratios 5.92; 95% confidence interval, 1.3-27.4). (2) No factors were significantly associated with distant metastatic free survival. Of the 35 patients (49%) who sustained disease relapse, only 3 were ultimately salvaged. Only 2 patients had grade 2 late toxicities (necrosis, fibrosis) based on Common Terminology Criteria for Adverse Events version 4.03 criteria, and 1 patient had grade 1 edema.

Conclusions:

Combination therapy with surgery and RT provides favorable LC. Distant recurrences, however, continue to be challenging with limited salvage success at the time of relapse.
Operative Method for Transverse Colon Carcinoma: Transverse Colectomy Versus Extended Colectomy
Authors: Chong Choon Seng , Huh Jung Wook , Oh Bo Young , Park Yoon Ah , Cho Yong Beom , Yun Seong Hyeon , Kim Hee Cheol , Lee Woo Yong
Published: June 2016

BACKGROUND:

The type of surgery performed for primary transverse colon cancer varies based on tumor characteristics and surgeon perspective. The optimal oncological outcome following different surgical options has not been clearly established, and transverse colectomy has shown oncological equivalence only in small cohort studies.

OBJECTIVE:

Our aim was to compare long-term oncological outcomes after transverse colectomy versus extended resection for transverse colon cancer.

DESIGN:

This study is a retrospective review of prospectively collected data.

SETTING:

This study was conducted at a tertiary care hospital.

METHOD:

All patients treated for transverse colon cancer at the Samsung Medical Center between 1995 and 2013 were included.

MAIN OUTCOME MEASURES:

Oncological outcomes were compared between 2 groups of patients: a transverse colectomy group and an extended colectomy group (which included extended right hemicolectomy and left hemicolectomy).

RESULTS:

A total of 1066 patients were included, of whom 750 (70.4%) underwent extended right hemicolectomy, 127 (11.9%) underwent transverse colectomy, and 189 (17.7%) underwent left hemicolectomy. According to univariate analysis, surgical approach, histological type, tumor morphology, cancer T and N stage, cancer size, and lymphovascular invasion were significant factors contributing to disease-free survival (DFS). However, as seen in multivariate analysis, only node-positive disease (HR = 2.035 (1.188–3.484)), tumors with ulcerative morphology (HR = 3.643 (1.132–11.725)), and the presence of vascular invasion (HR = 2.569 (1.455–4.538)) were significant factors for DFS. Further analysis with a propensity-matched cohort between the transverse and extended colectomy groups demonstrated no significant differences in DFS and overall survival.

LIMITATIONS:

This study was limited because it was performed at a single institution and it was retrospective in nature.

CONCLUSION:

In terms of perioperative and oncological outcomes, transverse colectomy and extended colectomy did not differ despite a shorter specimen length and fewer lymph nodes harvested in the transverse colectomy group. Independent prognostic factors for DFS were node-positive disease, the presence of vascular invasion, and ulcerative morphology.
Guidelines on Hair Restoration for East Asian Patients
Authors: Lee In-Joon , Jung Jae Heon , Lee Young-Ran , Kim Jung Chul , Hwang Sungjoo Tommy
Published: June 2016

BACKGROUND

In East Asian countries, hair transplantation is a quite common procedure for treating pattern hair loss, cosmetically correcting the hairline, and correcting eyebrow and pubic hair defects. Although there are general guidelines concerning hair transplantation, certain factors need to be addressed to make the guidelines more specific and suitable to East Asian requirements.

OBJECTIVE

To provide guidelines for hairline design, donor harvesting, graft preparation and placement, and medical treatment that are appropriate for hair transplantation in East Asian patients.

METHODS

Recommendations are based on the experience of the authors, surgeons who perform hair transplantation, and a comprehensive review of the available literature on hair transplantation in East Asians.

RESULTS

Data on hair thickness and graft density, hairline design, and graft creation and placement techniques have been collaboratively evaluated and used to establish overall guidelines.

CONCLUSION

The use of the proposed guidelines by surgeons will hopefully enhance outcomes and bring greater consistency to hair transplantation procedures for East Asian patients.
N-Oleoylethanolamine Reduces Inflammatory Cytokines and Adhesion Molecules in TNF-α-induced Human Umbilical Vein Endothelial Cells by Activating CB2 and PPAR-α
Authors: Xu Xudong , Guo Han , Jing Zuo , Yang Lichao , Chen Caixia , Peng Lu , Wang Xiaoqing , Yan Lu , Ye Rongting , Jin Xin , Wang Yiqing
Published: June 2016

Inflammation plays a pivotal role in the pathogenesis of atherosclerosis. Peroxisome proliferator-activated receptor-alpha (PPAR-α) and cannabinoid receptor 2 (CB2) crucially impact the modulation of inflammation. N-Oleoylethanolamine (OEA), a natural agonist of PPAR-α, can also up-regulate the expression of CB2 in human umbilical vein endothelial cells (HUVECs) and further shows an antiatherosclerotic effect. Our study was designed to determinate whether OEA could inhibit inflammation in HUVECs induced by tumor necrosis factor-α (TNF-α) and to identify the mechanism of OEA function. Interleukin-6 (IL-6), interleukin-8 (IL-8), vascular adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 (ICAM-1) levels were detected in HUVECs exposed to tumor necrosis factor-α in the presence of OEA. The results showed that OEA suppressed the expression of interleukin-6, interleukin-8, vascular adhesion molecule-1, and intercellular adhesion molecule-1 in a dose-dependent manner. OEA also enhanced CB2 and PPAR-α receptor expression, which contributed to its anti-inflammatory effect. OEA inhibited the nuclear factor-κB (NF-κB) pathway, and the effect of OEA on nuclear factor-κB was partly abolished when HUVECs were pretreated with either CB2 or PPAR-α antagonist. OEA attenuated tumor necrosis factor-α-induced inflammation in HUVECs by up-regulating the expression of CB2 and PPAR-α receptors. Furthermore, OEA suppresses the nuclear factor-κB pathway. These results suggest that OEA exerts anti-inflammatory and anti-adhesive effects on HUVECs.
Cigarette smoking and hormones
Authors: Marom-Haham Lilach , Shulman Adrian
Published: June 2016

Purpose of review

The purpose is to provide a summary of the effects of cigarette smoking on steroid hormone metabolism and how it affects female fertility.

Recent findings

Components of tobacco smoke such as polycyclic aromatic hydrocarbons lead to transcriptional upregulation of a number of genes, including members of the cytochrome P450 (CYP) family, in particular CYP1B1 and CYP1A1. In humans, CYP1A1 and CYP1A2 are the primary enzymes catalyzing the 2-hydroxylation of estradiol. This pathway shunts available estrogen away from the more estrogenically potent 16α-hydroxylation to the production of catechol estrogens, mainly 2 and 4 hydroxyestradiol.

Smoking has multiple effects on hormone secretion and metabolism. These effects are mainly mediated by the pharmacological action of tobacco alkaloids (nicotine and its metabolite cotinine). A strong body of evidence indicates that the negative effects of cigarette smoking on fertility compromises nearly every system involved in the reproductive process.
Clinical Response to Tocilizumab in Severe Thyroid Eye Disease
Authors: Sy Aileen , Eliasieh Kasra , Silkiss Rona Z.
Published: June 2016

Tocilizumab, in a preliminary study, was reported to be an effective therapy for moderate to severe thyroid eye disease. The authors describe the clinical response of 2 severe thyroid eye disease cases refractory to intravenous steroids and orbital decompression. Both patients demonstrated improved clinical activity scores with minimal side effects after tocilizumab therapy. In addition, post tocilizumab orbital fat biopsies demonstrated benign adipose tissue without evidence of inflammatory cells.
Educational Preparation, Roles, and Competencies to Guide Career Development for Cardiac Rehabilitation Nurses
Authors: Lin Stella H. M. , Neubeck Lis , Gallagher Robyn
Published: June 2016

Background:

Cardiac rehabilitation is one of the most widely recommended strategies to reduce the burden of cardiovascular disease. The multicomponent nature of cardiac rehabilitation programs requires a multidisciplinary team of healthcare professionals including nurses who are equipped with extensive knowledge and skills. However, there is a lack of a comprehensive, explicit career pathway that contains academic and clinical development to prepare nurses to become cardiac rehabilitation specialists.

Objective:

The aim of this study is to identify the 3 essential components for cardiac rehabilitation professionals: (1) educational preparation, (2) role/responsibility, and (3) competency to inform the framework of career development for cardiac rehabilitation nurses.

Methods:

Through scoping review, 4 stages from the methodological framework of scoping review by Arksey and O’Malley (Int J Soc Methodol. 2005;8:19–32) were used.

Results:

Some attempts have been made in developing frameworks of career development for cardiac rehabilitation professionals with these 3 components through guidelines/standards and core curriculum development worldwide, among which the United States is the only country with a well-established system including guidelines for cardiac rehabilitation/secondary prevention programs, a position statement in terms of competencies, and certification examination for cardiac rehabilitation professionals. Nevertheless, further development and integration of these efforts, specifically for cardiac rehabilitation nurses, are required.

Conclusions:

It is vital to raise the awareness of the significant contribution that appropriately educated and trained nurses make in reducing the global burden of cardiovascular disease through cardiac rehabilitation. Therefore, action on establishing a system of comprehensive, clearly defined career development pathway for cardiac rehabilitation nurses worldwide is of immediate priority.
Antidepressant Use and Subclinical Measures of Atherosclerosis
Authors: Camacho Álvaro , McClelland Robyn L. , Delaney Joseph A. , Allison Matthew A. , Psaty Bruce M. , Rifkin Dena E. , Rapp Stephen R. , Szklo Moyses , Stein Murray B. , Criqui Michael H.
Published: June 2016

Background

Antidepressants are commonly prescribed medications used in primary care. The cardiovascular safety profile of antidepressant medications, in terms of subclinical atherosclerosis, is underexamined.

Methods

A total of 6814 participants in the Multi-Ethnic Study of Atherosclerosis were examined. At baseline, the mean age was 62 years with 4 race/ethnic groups represented: European Americans (38%), Hispanic Americans (23%), African Americans (28%), and Chinese Americans (11%). Antidepressants were subgrouped as serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and “other” (bupropion, nefazodone, trazodone, mirtazapine). After adjusting for potential confounders, we estimated the association between antidepressant use and the following measures of subclinical atherosclerosis: coronary artery calcium (CAC), the ankle-brachial index, and carotid intima-media thickness, both cross-sectionally and prospectively.

Results

A total of 324 participants were exposed to SSRIs, 88 to TCAs, 41 to SNRIs, and 123 to other antidepressants. For CAC incidence, the fully adjusted longitudinal analyses revealed no consistent associations with SSRIs (relative risk [RR], 0.99; 95% confidence interval [CI], 0.71–1.37), SNRIs (RR, 0.49; 95% CI, 0.13–1.86), TCAs (RR, 0.94; 95% CI, 0.50–1.77), other antidepressant (RR, 0.87; 95% CI, 0.73–1.03) exposure, and subclinical disease. Similar null results were obtained in the cross-sectional and longitudinal exposure to antidepressants with changes in baseline CAC greater than 0, ankle-brachial index, and carotid intima-media thickness.

Conclusions

The results of the current study do not support an association between antidepressants and subclinical atherosclerosis.
Immunogenetics of cutaneous lupus erythematosus
Authors: Hersh Aimee O. , Arkin Lisa M. , Prahalad Sampath
Published: June 2016

Purpose of review

Systemic lupus erythematosus (SLE) is the prototypic autoimmune condition, often affecting multiple organ systems, including the skin. Cutaneous lupus erythematosus (CLE) is distinct from SLE and may be skin limited or associated with systemic disease. Histopathologically, the hallmark of lupus-specific manifestations of SLE and CLE is an interface dermatitis. The cause of SLE and CLE is likely multifactorial and may include shared genetic factors. In this review, we will discuss the genetic findings related to the cutaneous manifestations of SLE and isolated CLE, with a particular focus on the lupus-specific CLE subtypes.

Recent findings

Several major histocompatibility complex and nonmajor histocompatibility complex genetic polymorphisms have been identified which may contribute to the cutaneous manifestations of SLE and to CLE. Most of these genetic variants are associated with mechanisms attributed to the pathogenesis of SLE, including pathways involved in interferon and vitamin D regulation and ultraviolet light exposure. Although there is overlap between the genetic factors associated with SLE and CLE, there appear to be unique genetic factors specific for CLE.

Improved understanding of the genetics of CLE may lead to the creation of targeted therapies, improving outcomes for patients with this challenging dermatologic condition.
Exploring Chinese Women’s Perception of Cervical Cancer Risk as It Impacts Screening Behavior
Authors: Gu Can , Chen Wei-Ti , Zhang Qiue , Chow Ka Ming , Wu Jianzhen , Tao Lijian , Chan Carmen W.H.
Published: June 2016

Background:

Chinese women rarely undergo regular cervical screening. Women’s decisions about cervical screening may be influenced by their perception of the risk of cervical cancer. Therefore, understanding how women perceive the risk of cervical cancer, how personal risk factors are interpreted, and the influence of cultural issues on cervical screening behavior is important.

Objective:

The aim of this study is to understand cervical cancer risk perception and the role of personal risk factors as they influence screening behavior among Chinese women.

Method:

An exploratory qualitative research design was used. We conducted semistructured, in-depth interviews of 27 women in Changsha, a medium-size city in Hunan province, China.

Results:

Participants identified that cervical cancer had serious consequences, but they distanced themselves psychologically from the disease because they felt that “cervical cancer is a shameful and deadly disease.” Although women identified some of the risk factors for the disease, they had little specific knowledge of human papillomavirus infection, its association with cervical cancer, and the importance of cervical screening.

Conclusion:

This study contributes new knowledge to the understanding of cervical screening behavior within a specific social and cultural context. Better efforts should be made to educate Chinese women on the risk of cervical cancer and emphasize that effective cancer treatments are available and that there is a good chance of survival.

Implications for Practice:

Nurses working with Chinese women should ensure that the information they provide is culturally sensitive, particularly by acknowledging the normative beliefs of this population group.
The Role of Age in Change in Unmet Supportive Care Needs in Hepatocellular Carcinoma Patients During Transition From Hospital to Home
Authors: Shun Shiow-Ching , Lai Yeur-Hur , Hung Hung , Chen Chien-Hung , Liang Ja-Der , Chou Yun-Jen
Published: June 2016

Background:

Age might affect the change in care needs in patients with hepatocellular carcinoma after treatment during their transition process from hospital to home. However, there have been no studies that focus on this.

Objective:

The aim of this study is to examine changes in unmet supportive care needs in young (<65 years old) and elderly (≥65 years old) groups of patients with hepatocellular carcinoma from before discharge to 2 months after discharge.

Methods:

A longitudinal prospective study design was used with recruited participants at a teaching hospital in Taiwan. Data were collected 3 times: within 3 days before discharge and at 1 and 2 months after discharge. A set of questionnaires was used to assess participants’ levels of supportive care needs, symptom distress, anxiety, and depression.

Results:

A total of 104 patients completed the data collection process. Supportive care needs decreased monthly after discharge, with health system and information being the domain with the highest level of unmet needs in the 2 groups. The young group had a higher level of overall unmet needs before discharge, but they had a lower level of overall needs compared with the elderly group after 2 months of discharge.

Conclusions:

Age could be a significant potential factor to affect change in unmet needs during transition.

Implications for Practice:

Comprehensive assessment in care needs especially in the health system and information and physical and daily living domains before discharge is recommended to design personalized education programs before discharge.
Patients' Perceptions of Bedside Handoff
Authors: Ford Yvonne , Heyman Anita
Published: June 2016

Patients' perceptions of satisfaction, understanding, participation, and feelings of safety were significantly correlated with the frequency of bedside handoff. Mean responses to survey items in these areas were significantly higher for patients who “always” experienced bedside handoff than for those who experienced it sporadically. Quality improvement strategies were effective in increasing the frequency of bedside handoff.
Posttraumatic Growth After Birth Trauma
Authors: Beck Cheryl Tatano , Watson Sue
Published: June 2016

Purpose:

The aim of this study was to investigate women's experiences of posttraumatic growth following traumatic childbirth.

Study Design and Methods:

A descriptive phenomenological study was conducted using Colaizzi's data analysis method. The Internet sample of 15 mothers was recruited from the Trauma and Birth Stress Web site. Women were asked to describe in as much detail as they could remember, their experiences of any positive changes in their beliefs or life as a result of their traumatic childbirth.

Results:

Using Calhoun and Tedeschi's metaphor of an earthquake to help explain posttraumatic growth, the seismic waves of birth trauma had enough power to lead to four themes of posttraumatic growth revealed in this phenomenological study: (1) Opening oneself up to a new present, (2) Achieving a new level of relationship nakedness, (3) Fortifying spiritual-mindedness, and (4) Forging new paths.

Clinical Implications:

Mothers' experiences of their personal growth after birth trauma can help inform future research that can promote posttraumatic growth in mothers. Clinicians can share results of this study with their patients to provide some hope to mothers struggling with the aftermath of a traumatic birth that some women have reported positive growth. Healthcare providers need to respect trauma survivors' struggles while at the same time permitting mothers to explore possibilities for growth. Clinicians must not, however, create the false expectation that posttraumatic growth will happen in most trauma survivors.
Erythropoietin either Prevents or Exacerbates Retinal Damage from Eye Trauma Depending on Treatment Timing
Authors: Bricker-Anthony Courtney , D’Surney Lauren , Lunn Brendan , Hines-Beard Jessica , Jo Minhee , Bernardo-Colon Alexandra , Rex Tonia S.
Published: June 2016

Purpose

Erythropoietin (EPO) is a promising neuroprotective agent and is currently in Phase III clinical trials for the treatment of traumatic brain injury. The goal of this study was to determine if EPO is also protective in traumatic eye injury.

Methods

The left eyes of anesthetized DBA/2J or Balb/c mice were exposed to a single 26 psi overpressure air-wave while the rest of the body was shielded. DBA/2J mice were given intraperitoneal injections of EPO or buffer and analyses were performed at 3 or 7 days post-blast. Balb/c mice were given intramuscular injections of rAAV.EpoR76E or rAAV.eGFP either pre- or post-blast and analyses were performed at 1 month post-blast.

Results

EPO had a bimodal effect on cell death, glial reactivity, and oxidative stress. All measures were increased at 3 days post-blast and decreased at 7-days post-blast. Increased retinal ferritin and NADPH oxygenases were detected in retinas from EPO-treated mice. The gene therapy approach protected against axon degeneration, cell death, and oxidative stress when given after blast, but not before.

Conclusions

Systemic, exogenous EPO and EPO-R76E protects the retina after trauma even when initiation of treatment is delayed by up to 3 weeks. Systemic treatment with EPO or EPO-R76E beginning before or soon after trauma may exacerbate protective effects of EPO within the retina as a result of increased iron levels from erythropoiesis and, thus, increased oxidative stress within the retina. This is likely overcome with time as a result of an increase in levels of antioxidant enzymes. Either intraocular delivery of EPO or treatment with non-erythropoietic forms of EPO may be more efficacious.
Court Decisions on Medical Malpractice in China After the New Tort Liability Law
Authors: Zhang Kui , Li Yuan , Fan Fei , Liu Xin , Deng Zhen-hua
Published: June 2016

A new Tort Law of the People's Republic of China became effective on July 1, 2010. We undertook an analysis of medical malpractice lawsuits brought before regional courts in Beijing districts after this new Tort Liability Law went into effect. In total, 726 cases eventuating in a final verdict were collected from the Beijing district courts from 2011 to 2013 in this retrospective study; 83.7% of the 726 alleged instances of medical malpractice were confirmed to be malpractice by the final verdict. The disciplines most frequently involved with claims of medical malpractice were obstetrics and gynecology, the most frequent outcomes was death, and the most common types of case associated with malpractice was surgery related. The average length of time between the occurrence of the injury and closure of the claim was 9.2 months, and the average payment was ¥163,000. Since the introduction of the new Tort Liability Law, the average time to complete a litigation was shortened, but it has made little apparent difference otherwise.
Dispositional Optimism and Incidence of Cognitive Impairment in Older Adults
Authors: Gawronski Katerina A.B. , Kim Eric S. , Langa Kenneth M. , Kubzansky Laura D.
Published: June 2016

Objective

Higher levels of optimism have been linked with positive health behaviors, biological processes, and health conditions that are potentially protective against cognitive impairment in older adults. However, the association between optimism and cognitive impairment has not been directly investigated. We examined whether optimism is associated with incident cognitive impairment in older adults.

Methods

Data are from the Health and Retirement Study. Optimism was measured by using the Life Orientation Test-R and cognitive impairment with a modified version of the Telephone Interview for Cognitive Status derived from the Mini-Mental State Examination. Using multiple logistic regression models, we prospectively assessed whether optimism was associated with incident cognitive impairment in 4624 adults 65 years and older during a 4-year period.

Results

Among participants, 312 women and 190 men developed cognitive impairment during the 4-year follow-up. Higher optimism was associated with decreased risk of incident cognitive impairment. When adjusted for sociodemographic factors, each standard deviation increase in optimism was associated with reduced odds (odds ratio [OR] = 0.70, 95% confidence interval [CI] = 0.61–0.81) of becoming cognitively impaired. A dose-response relationship was observed. Compared with those with the lowest levels of optimism, people with moderate levels had somewhat reduced odds of cognitive impairment (OR = 0.78, 95% CI = 0.59–1.03), whereas people with the highest levels had the lowest odds of cognitive impairment (OR = 0.52, 95% CI = 0.36–0.74). These associations remained after adjusting for health behaviors, biological factors, and psychological covariates that could either confound the association of interest or serve on the pathway.

Conclusions

Optimism was prospectively associated with a reduced likelihood of becoming cognitively impaired. If these results are replicated, the data suggest that potentially modifiable aspects of positive psychological functioning such as optimism play an important role in maintaining cognitive functioning.
Can pornography be addictive? An fMRI study of men seeking treatment for problematic pornography use
Authors: Gola Mateusz , Wordecha Małgorzata , Sescousse Guillaume , Lew-Starowicz Michał , Kossowski Bartosz , Wypych Marek , Makeig Scott , Potenza Marc N. , Marchewka Artur
Published: June 2016

Pornography consumption is highly prevalent, particularly among young adult males. For some individuals, problematic pornography use (PPU) is a reason for seeking treatment. Despite the pervasiveness of pornography, PPU appears under-investigated, including with respect to the underlying neural mechanisms.

Using functional magnetic resonance imaging (fMRI), we examined ventral striatal responses to erotic and monetary stimuli, disentangling cue-related ‘wanting’ from reward-related ‘liking’ among 28 heterosexual males seeking treatment for PPU and 24 heterosexual males without PPU. Subjects engaged in an incentive delay task in the scanner, in which they received erotic or monetary rewards preceded by predictive cues. BOLD responses to erotic and monetary cues were analyzed and examined with respect to self-reported data on sexual activity collected over the 2 preceding months.

Men with and without PPU differed in their striatal responses to cues predicting erotic pictures, but not in their responses to erotic pictures. PPU subjects when compared to control subjects showed increased activation of ventral striatum specifically for cues predicting erotic pictures but not for cues predicting monetary gains. Relative sensitivity to cues predicting erotic pictures versus monetary gains was significantly related to the increased behavioral motivation to view erotic images (suggestive of higher ‘wanting’), severity of PPU, amount of pornography use per week and number of weekly masturbations.

Our findings suggest that, similar to what is observed in substance and gambling addictions, the neural and behavioral mechanisms associated with the anticipatory processing of cues specifically predicting erotic rewards relate importantly to clinically relevant features of PPU. These findings suggest that PPU may represent a behavioral addiction and that interventions helpful in targeting behavioral and substance addictions warrant consideration for adaptation and use in helping men with PPU.
Synergistic elimination of bacteria by phage and the innate immune system
Authors: Leung Chung Yin (Joey) , Weitz Joshua S.
Published: June 2016

Phage therapy has been viewed as a potential treatment for bacterial infections for over a century. Yet, the year 2016 marks the first phase I/II human trial of a phage therapeutic - to treat burn wound patients in Europe. The slow progress in realizing clinical therapeutics is matched by a similar dearth in principled understanding of phage therapy. Theoretical models andin vitroexperiments find that combining phage and bacteria often leads to coexistence of both phage and bacteria or phage elimination altogether. Both outcomes stand in contrast to the stated goals of phage therapy. A potential resolution to the gap between models, experiments, and therapeutic use of phage is the hypothesis that the combined effect of phage and host immune system can synergistically eliminate bacterial pathogens. Here, we propose a phage therapy model that considers the nonlinear dynamics arising from interactions between bacteria, phage and the host innate immune system. The model builds upon earlier efforts by incorporating a maximum capacity of the immune response and density-dependent immune evasion by bacteria. We analytically identify a synergistic regime in this model in which phage and the innate immune response jointly contribute to the elimination of the target bacteria. Crucially, we find that in this synergistic regime, neither phage alone nor the innate immune system alone can eliminate the bacteria. We confirm these findings using numerical simulations in biologically plausible scenarios. We utilize our numerical simulations to explore the synergistic effect and its significance for guiding the use of phage therapy in clinically relevant applications.
Centrosome centering and Decentering by microtubule network rearrangement
Authors: Letort Gaëlle , Nedelec Francois , Blanchoin Laurent , Théry Manuel
Published: June 2016

The centrosome is positioned at the cell center by pushing and pulling forces transmitted by microtubules (MTs). Centrosome decentering is often considered to result from asymmetric, cortical pulling forces exerted in particular by molecular motors on MTs, and controlled by external cues affecting the cell cortex locally. Here we used numerical simulations to investigate the possibility that it could equally result from the redistribution of pushing forces due to a reorientation of MTs. We first showed that MT gliding along cell edges and pivoting around the centrosome regulate MT rearrangement and thereby direct the spatial distribution of pushing forces, while the number, dynamics and stiffness of MTs determine the magnitude of these forces. By modulating these parameters, we identified different regimes, involving both pushing and pulling forces, characterized either by robust centrosome centering, robust off-centering or “reactive” positioning. In those latter conditions weak asymmetric cues can induce a misbalance of pushing and pulling forces resulting in an abrupt transition from a centered to an off-centered position. Altogether these results point at the central role played by the configuration of the MTs on the distribution of pushing forces that position the centrosome. We suggest that asymmetric external cues should not be seen as direct driver of centrosome decentering and cell polarization, but rather as inducers of an effective reorganization of the MT network, fostering centrosome motion to the cell periphery.
The CENP-T/-W complex is a binding partner of the histone chaperone FACT
Authors: Prendergast Lisa , Müller Sebastian , Liu Yiwei , Huang Hongda , Dingli Florent , Loew Damarys , Vassias Isabelle , Patel Dinshaw J. , Sullivan Kevin F. , Almouzni Geneviève
Published: June 2016

The CENP-T/-W histone fold complex, as an integral part of the inner kinetochore, is essential for building a proper kinetochore at the centromere in order to direct chromosome segregation during mitosis. Notably, CENP-T/-W is not inherited at centromeres, and new deposition is absolutely required at each cell cycle for kinetochore function. However, the mechanisms underlying this new deposition of CENP-T/-W at centromeres are unclear. Here, we found that CENP-T deposition at centromeres is uncoupled from DNA synthesis. We identified Spt16 and SSRP1, subunits of the H2A–H2B histone chaperone facilitates chromatin transcription (FACT), as CENP-W binding partners through a proteomic screen. We found that the C-terminal region of Spt16 binds specifically to the histone fold region of CENP-T/-W. Furthermore, depletion of Spt16 impairs CENP-T and CENP-W deposition at endogenous centromeres, and site-directed targeting of Spt16 alone is sufficient to ensure local de novo CENP-T accumulation. We propose a model in which the FACT chaperone stabilizes the soluble CENP-T/-W complex in the cell and promotes dynamics of exchange, enabling CENP-T/-W deposition at centromeres.