bluuebunny/crossref_metadata_2025 huggingface dataset:
Explaining the (Lack of) Use of Radical Candidate Selection Methods by Australia's Major Parties
Authors: Miragliotta Narelle
Published: March 2013

Australia's main parties have experienced rapid deterioration in levels of membership but most have been reluctant to follow the lead of many of their counterparts in Western Europe and embrace more radical, inclusive pre‐selection formats to arrest declining numbers. This paper offers a partial explanation of why the Liberal and Labor parties have been disinclined to look to reforming candidate selection as a strategy to combat their shrinking rank‐and‐file membership. It argues that compulsory voting in conjunction with high levels of party identification has reduced the imperative for Australia's major parties to resort to candidate selection reform as a device to stabilise their voter base. This study underscores the important role of the institutional setting in affecting the incentives for parties to use pre‐selection reform to combat a shrinking membership base.
Defining peripherally inserted central catheter tip position and an evaluation of insertions in one unit
Authors: Johnston A. J. , Bishop S. M. , Martin L. , See T. C. , Streater C. T.
Published: March 2013

Peripherally inserted central catheters are increasingly used to provide access to the central venous circulation. They are commonly positioned ‘blind’ using a variety of anthropometric techniques and operator experience to direct insertion length. Malposition rates are poorly defined because of differing insertion techniques, difficulties defining anatomical tip position on chest radiographs, controversy over what constitutes an adequate catheter position and possible differences between patient groups. We have developed a reproducible method to define catheter positions on chest radiograph and have applied this in a retrospective analysis of 256 ICU and 243 non‐ICU catheter insertions over a 6‐month period. Two different definitions were used for adequate position. ‘Blind’ positioning of peripherally inserted central catheters was associated with a definition‐dependent malposition rate of 42–76%. Malposition rates were significantly higher in ICU patients. Emerging technologies may assist in reducing these high rates.
Comparative analysis of adiponectin isoform distribution in pregnant women with gestational diabetes mellitus and after delivery
Authors: Matuszek Beata , Burska Agata , Leszczyńska–Gorzelak Bożena , Donica Helena , Nowakowski Andrzej
Published: March 2013

Objective

To evaluate the distribution of circulating adiponectin isoforms in pregnant women with gestational diabetes mellitus (GDM) and compare isoform distribution changes 12 months after delivery.

Design

Cross‐sectional study

Setting

University Hospital.

Population

Sixty‐four consecutive pregnant women who underwent routine prenatal tests for GDM between 24 and 28 weeks of gestation. The study group included 36 women diagnosed with GDM, 30 of whom underwent re‐testing for diabetes 12 months after delivery. The control group included 28 healthy pregnant women.

Methods

Quantitative determination of total adiponectin and its isoforms in serum was performed with the multimeric adiponectin enzyme‐linked immunosorbent assay.

Results

Total adiponectin concentration in women with GDM was significantly lower than in women without GDM. Among adiponectin isoforms, significantly lower concentrations of multimers and trimers in women with GDM were found in comparison to controls, while the concentration of hexamers did not differ between the groups. After delivery, a significant increase in total adiponectin and in the concentration of multimers and trimers was found in women with history of GDM. Additionally, we found that multimers and hexamers were negatively correlated with body mass index before and during gestation, as well as after delivery, and middle molecular weight isoforms in gestation were negatively correlated with birthweight.

Conclusions

Hypoadiponectinemia during GDM was characterized by a significant, reversible decrease in multimeric levels; thus this isoform seems to function in a cohesive way with total adiponectin. Negative correlations of adiponectin isomers with body mass index indicate that there is a possibility to normalize total adiponectin and prevent GDM.
Phosphene Object Perception Employs Holistic Processing During Early Visual Processing Stage
Authors: Guo Hong , Yang Yuan , Gu Guan , Zhu Yisheng , Qiu Yihong
Published: March 2013

Psychophysical studies have verified the possibility of recovering the visual ability by the form of low‐resolution format of images, that is, phosphene‐based representations. Our previous study has found that early visual processing for phosphene patterns is configuration based. This study further investigated the configural processing mechanisms of prosthetic vision by analyzing the event‐related potential components (P1 and N170) in response to phosphene face and non‐face stimuli. The results reveal that the coarse processing of phosphenes involves phosphene‐specific holistic processing that recovers separated phosphenes into a gestalt; low‐level feature processing of phosphenes is also enhanced compared with that of normal stimuli due to increased contrast borders introduced by phosphenes; while fine processing of phosphene stimuli is impaired reflected by reduced N170 amplitude because of the degraded detailed features in the low‐resolution format representations. Therefore, we suggest that strategies that can facilitate the specific holistic processing stages of prosthetic vision should be considered in order to improve the performance when designing the visual prosthesis system.
Different cytokine production and toll‐like receptor expression induced by heat‐killed invasive and carrier strains of Neisseria meningitidis
Authors: Potmesil Roman , Beran Ondrej , Musilek Martin , Kriz Pavla , Holub Michal
Published: March 2013

Neisseria meningitidis may cause severe invasive disease. The carriage state of the pathogen is common, and the reasons underlying why the infection becomes invasive are not fully understood. The aim of this study was to compare the differences between invasive and carrier strains in the activation of innate immunity. The monocyte expression of TLR2, TLR4, CD14, and HLA‐DR, cytokine production, and the granulocyte oxidative burst were analyzed after in vitro stimulation by heat‐killed invasive (n = 14) and carrier (n = 9) strains of N. meningitidis. The expression of the cell surface markers in monocytes, the oxidative burst, and cytokine concentrations were measured using flow cytometry. Carrier strains stimulated a higher production of inflammatory cytokines and oxidative burst in granulocytes than invasive strains (all p < 0.001), whereas invasive strains significantly up‐regulated TLR2, TLR4 (p < 0.001), and CD14 (p < 0.01) expression on monocytes. Conversely, the monocyte expression of HLA‐DR was higher after the stimulation by carrier strains (p < 0.05) in comparison to invasive strains. The LPS inhibitor polymyxin B abolished the differences between the strains. Our findings indicate different immunostimulatory potencies of invasive strains of N. meningitidis compared with carrier strains.
Baicalein Abrogates Reactive Oxygen Species (ROS)‐mediated Mitochondrial Dysfunction during Experimental Pulmonary Carcinogenesis In Vivo
Authors: Naveenkumar Chandrashekar , Raghunandhakumar Subramanian , Asokkumar Selvamani , Devaki Thiruvengadam
Published: March 2013

Our current study aimed to evaluate the chemotherapeutic efficacy of baicalein (BE) in Swiss albino mice, which is exposed to benzo(a)pyrene [B(a)P] for its ability to alleviate mitochondrial dysfunction and systolic failure. Here, we report that oral administration of B(a)P (50 mg/kg body weight)‐induced pulmonary genotoxicities in mice was assessed in terms of elevation in reactive oxygen species (ROS) generation and DNA damage in lung mitochondria. MDA‐DNA adducts were formed in immunohistochemical analysis, which confirmed nuclear DNA damage. mRNA expression levels studied by RT‐PCR analysis of voltage‐dependent anion channel (VDAC) and adenine nucleotide translocase (ANT) were found to be significantly decreased and showed a marked increase in membrane permeability transition pore (MPTP) opening. Accompanied by up‐regulated Bcl‐xL and down‐regulated Bid, Bim and Cyt‐c proteins studied by immunoblot were observed in B(a)P‐induced lung cancer–bearing animals. Administration of BE (12 mg/kg body weight) significantly reversed all the above deleterious changes. Moreover, assessment of mitochondrial enzyme system revealed that BE treatment effectively counteracts B(a)P‐induced down‐regulated levels/activities of isocitrate dehydrogenase, α‐ketoglutarate dehydrogenase, succinate dehydrogenase, malate dehydrogenase, NADH dehydrogenase, cytochrome‐C‐oxidase and ATP levels. Restoration of mitochondria from oxidative damage was further confirmed by transmission electron microscopic examination. Further analysis of lipid peroxidation, superoxide dismutase, catalase, glutathione peroxidase, glutathione‐S‐transferase, glutathione reductase, reduced glutathione, vitamin E and vitamin C in lung mitochondria was carried out to substantiate the antioxidant effect of BE. The overall data conclude that chemotherapeutic efficacy of BE might have strong mitochondria protective and restoration capacity in sub‐cellular level against lung carcinogenesis in Swiss albino mice.
Acute Poisoning with Neonicotinoid Insecticides: A Case Report and Literature Review
Authors: Lin Pei‐Chen , Lin Hung‐Jung , Liao Yu‐Ying , Guo How‐Ran , Chen Kuo‐Tai
Published: March 2013

Neonicotinoids are a new class of insecticides widely applied for crop protection. These insecticides act as agonists at nicotinic acetylcholine receptors, which cause insect paralysis and death. The high specificity for receptors in insects was considered to possess highly selective toxicity to insects and relative sparing of mammals. However, an increasing number of cases of acute neonicotinoid poisoning have been reported in recent years. We reported a man who developed respiratory failure and shock after ingestion of neonicotinoid insecticide. A detailed literature review found that respiratory, cardiovascular and certain neurological presentations are warning signs of severe neonicotinoid intoxication. The amounts of ingested neonicotinoid insecticide and the plasma neonicotinoid concentration are not useful guides for the management of intoxicated patients. Supportive treatment and decontamination are the practical methods for the management of all neonicotinoid‐poisoned patients.
Cesarean Section for the Second Twin: A Population‐Based Study of Occurrence and Outcome
Authors: Engelbrechtsen Line , Nielsen Elise Hoffmann , Perin Trine , Oldenburg Anna , Tabor Ann , Skibsted Lillian ,   Danish Fetal Medicine Study Group
Published: March 2013

Background

Although management of twin deliveries has been a topic of discussion for decades, a consensus on how to deliver twins is lacking. The objective of this study was to examine short‐term neonatal outcome of the second twin delivered by cesarean section after vaginal delivery of the first‐born twin (combined delivery) and to identify predictors of combined delivery.

Methods

This study was a 3‐year, population‐based, retrospective cohort investigation of 1,254 twin births in Denmark. The twin births were divided into three groups: vaginal deliveries, planned cesarean deliveries, and combined deliveries. Data were extracted from medical records, a fetal medicine software program (Astraia), and the National Birth Registry. Short‐term poor neonatal outcome was measured as a 5‐minute Apgar score ≤ 7, umbilical cord pH ≤ 7.10, and admission to neonatal intensive care unit for more than 3 days.

Results

Vertex‐nonvertex fetal presentations were more prevalent in combined deliveries than vaginal deliveries (OR 4.4, 2.5–7.8). Nonvertex second twins born by combined delivery had a higher risk of Apgar score ≤ 7 and umbilical cord pH ≤ 7.10 compared with vaginal delivery, unadjusted OR 6.2 (2.1–18), and unadjusted OR 3.9 (1.6–9.5). Prenatal ultrasound scans were evaluated in combined deliveries, of which 48 percent were vertex‐vertex at the last ultrasound scan in pregnancy (mean gestational age 34 + 0) and 37 percent were vertex‐vertex at birth.

Conclusions

Vertex‐nonvertex presenting twins have an increased risk of combined delivery. Combined deliveries are associated with increased neonatal morbidity for the second twin. (BIRTH 40:1 March 2013)
Botulinum toxin type A for the treatment of non‐neurogenic overactive bladder: does using onabotulinumtoxinA (Botox®) or abobotulinumtoxinA (Dysport®) make a difference?
Authors: Ravindra Pravisha , Jackson Benjamin L. , Parkinson Richard J.
Published: March 2013

Objective

To compare the clinical effects of two different commercially available botulinum toxin type A products, onabotulinumtoxinA (Botox®; Allergan Inc., Irvine, CA, USA) and abobotulinumtoxinA (Dysport®; Ipsen Ltd, Slough, UK), on non‐neurogenic overactive bladder (OAB).

Patients and Methods

We included 207 patients, who underwent treatment with botulinum toxin type A for non‐neurogenic OAB from January 2009 to June 2012 at our institution, in a prospective database that recorded details of their presentation, treatment and outcomes.

In December 2009, our institution switched from using onabotulinumtoxinA to using abobotulinumtoxinA.

Results

Results from the onabotulinumtoxinA cohort (n = 101) and the abobotulinumtoxinA cohort (n = 106) were compared.

Similar reductions in daytime frequency, nocturia and incontinence episodes were observed after treatment, with no difference in duration of effect.

The abobotulinumtoxinA cohort had almost twice the rate of symptomatic urinary retention (23 vs 42%) requiring intermittent self‐catheterisation (ISC).

Conclusions

AbobotulinumtoxinA use was complicated by a significantly higher risk of requiring ISC.

The study suggests that these two toxins are not interchangeable at the doses used.
S 50131 and S 51434, two novel small molecule glucokinase activators, lack chronic efficacy despite potent acute antihyperglycaemic activity in diabetic mice
Authors: De Ceuninck Frédéric , Kargar Catherine , Charton Yves , Goldstein Solo , Perron‐Sierra Françoise , Ilic Catherine , Caliez Audrey , Rolin Jean‐Olivier , Sadlo Marjorie , Harley Elizabeth , Vinson Cédric , Ktorza Alain
Published: March 2013

Background and Purpose

Small molecule glucokinase activators (GKAs) have been associated with potent antidiabetic efficacy and hepatic steatosis in rodents. This study reports the discovery of S 50131 and S 51434, two novel GKAs with an original scaffold and an atypical pharmacological profile.

Experimental Approach

Activity of the compounds was assessed in vitro by measuring activation of recombinant glucokinase, stimulation of glycogen synthesis in rat hepatocytes and increased insulin secretion from rat pancreatic islets of Langerhans. Efficacy and safety in vivo were evaluated after oral administration in db/db mice by measuring glycaemia, HbA1c and dyslipidaemia‐associated events.

Key Results

S 50131 and S 51434 activated GK and stimulated glycogen synthesis in hepatocytes and insulin secretion from pancreatic islets. Unexpectedly, while both compounds effectively lowered glycaemia after acute oral administration, they did not decrease HbA1c after a 4‐week treatment in db/db mice. This lack of antidiabetic efficacy was associated with increased plasma free fatty acids (FFAs), contrasting with the effect of GKA50 and N00236460, two GKAs with sustained HbA1c lowering activity but neutral regarding plasma FFAs. S 50131, but not S 51434, also induced hepatic steatosis, as did GKA50 and N00236460. However, a shorter, 4‐day treatment resulted in increased hepatic triglycerides without changing the plasma FFA levels, demonstrating dynamic alterations in the lipid profile over time.

Conclusions and Implications

In addition to confirming the occurrence of dyslipidaemia with GKAs, these findings provide new insights into understanding how such compounds may sustain or lose efficacy over time.
Reliability and concurrent validity of the Infant Motor Profile
Authors: Heineman Kirsten R , Middelburg Karin J , Bos Arend F , Eidhof Lieke , La Bastide‐Van Gemert Sacha , Van Den Heuvel Edwin R , Hadders‐Algra Mijna
Published: March 2013

Aim

The Infant Motor Profile (IMP) is a qualitative assessment of motor behaviour in infancy. It consists of five domains: movement variation, variability, fluency, symmetry, and performance. The aim of this study was to assess interobserver reliability and concurrent validity of the IMP with the Alberta Infant Motor Scale (AIMS) and an age‐specific neurological examination.

Method

Fifty‐nine preterm infants (25 females, 34 males; median gestational age 29.7wks, median birthweight 1285g) and 146 term infants (74 females, 72 males; median gestational age 40.1wks, birthweight 3500g) were included. Assessments were performed at corrected ages of 4, 6, 10, 12, and 18 months and consisted of the IMP, AIMS, and an age‐specific neurological examination. Interobserver reliability was investigated on a sample of 25 video recordings. Non‐parametric statistics were used to analyse the data.

Results

Interobserver reliability was high (intraclass correlation coefficient 0.95). At all ages, AIMS scores correlated weakly to fairly with total IMP scores (Spearman's ρ 0.36–0.55), but moderately to strongly with scores on the performance domain of the IMP (Spearman's ρ 0.47–0.84). A clear relation was found between total IMP score and outcome of the neurological examination (Kruskal–Wallis p<0.001 at all ages).

Interpretation

Interobserver reliability of the IMP is good. Concurrent validity with the AIMS is best for the IMP performance domain. Concurrent validity with age‐specific neurological examination is very good.
Prevalence of early childhood disability in a rural district of Sind, Pakistan
Authors: Donald Kirsty
Published: March 2013

This commentary is on the original article by Ibrahim and Bhutta on pages 357–363 of this issue.
The Relationship between Coronary Sinus and Impaired Right Ventricular Myocardial Performance Index in Mitral Stenosis
Authors: Vatankulu Mehmet Akif , Koc Fatih , Gul Enes Elvin , Bacaksiz Ahmet , Sonmez Osman , Demir Kenan , Alihanoglu Yusuf , Ari Hatem , Ayhan Selim , Tokac Mehmet
Published: March 2013

Objectives

We aimed to investigate whether coronary sinus (CS) dilatation develops in patients with mitral stenosis (MS) and to demonstrate its relationship with the global myocardial performance of the right ventricle (RV).

Methods

We enrolled 34 patients with MS who underwent echocardiography after exhibiting typical symptoms (31 female; mean age 41 ± 12 years) and 20 age‐ and sex‐matched controls without MS who underwent echocardiography (16 female; mean age 38 ± 13 years). The RV myocardial performance index (MPI) was detected using tissue Doppler echocardiography (TDE), and maximum CS diameter was measured from the posterior atrioventricular groove in the apical four‐chamber view during the ventricular systole.

Results

The RV MPI was significantly higher in the MS group compared to the control group (0.60 ± 0.11 vs. 0.41 ± 0.08, P < 0.001). Moreover, the maximum CS dimension was higher in the MS group compared to the control group (8.5 ± 1.1 mm vs. 6.5 ± 1.4 mm, P < 0.001). The maximum CS dilatation was positively correlated with the RV MPI (r = 0.691; P < 0.001).

Conclusion

The RV MPI, which represents both systolic and diastolic functions, is increased in patients with MS and correlates with CS dilatation.
Acute Mitral Regurgitation in Suspected Acute Coronary Syndrome: What Is the Cause?
Authors: Rao Rajeev V. , Wright Douglas , Dokainish Hisham
Published: March 2013

Patients presenting with acute chest pain and suspected acute coronary syndrome (ACS) who have nonobstructive coronary disease on angiography, but new regional wall motion abnormalities are often diagnosed with takotsubo cardiomyopathy (TTC). The cause of TTC is often physical or emotional stress, and this clinical syndrome occurs more often in women than men. When hemodynamically significant mitral regurgitation (MR) accompanies TTC, the mechanism must be carefully elucidated, as systolic anterior motion (SAM) of the mitral valve can cause significant MR and left ventricular outflow tract (LVOT) obstruction. These patients can be conservatively managed, with SAM‐associated MR and LVOT obstruction resolving with medical therapy as TTC‐associated left ventricular (LV) dysfunction resolves, as opposed to true ACS where further intervention for MR is often necessary. This case report describes 2 cases of TTC presenting with severe MR, who were initially thought to have ACS‐associated MR caused by ischemia, but on further echocardiographic interrogation were found to have SAM‐associated MR which resolved along with resolution of LV wall motion abnormalities on medical therapy by follow‐up echocardiography.
Establishing the Diagnosis of Inverted Stress Cardiomyopathy in a Patient with Cardiac Arrest during General Anesthesia: A Potential Role of Myocardial Strain?
Authors: Cvorovic Vojkan , Stankovic Ivan , Panic Milos , Stipac Alja Vlahovic , Zivkovic Aleksandra , Neskovic Aleksandar N. , Putnikovic Biljana
Published: March 2013

In cardiac arrest survivors, postresuscitation myocardial stunning usually presents as either global left ventricular dysfunction or regional dyssynergy including the various forms of stress cardiomyopathy, in which rare variants may be difficult to diagnose. We present a patient with cardiac arrest during general anesthesia, in whom speckle tracking–derived myocardial strain helped to distinguish between the inverted variant of stress cardiomyopathy and global postresuscitation myocardial stunning.
Temperature effect onChalara fraxinea: heat treatment of saplings as a possible disease control method
Authors: Hauptman T. , Piškur B. , de Groot M. , Ogris N. , Ferlan M. , Jurc D.
Published: March 2013

Ash dieback is an emerging disease caused by the fungusChalara fraxineathat severely affectsFraxinus excelsiorandF. angustifoliastands inEurope. Previous studies have shown that this pathogen prefers temperatures around 20°C, while its growth in pure cultures at 30°C proved to be very limited. The purpose of this study was to determine the effects of temperature on the development and growth ofC. fraxineain pure cultures and in plant tissues, as well as to test the heat tolerance ofF. excelsiorsaplings. The sensitivity of fungus to heat in ash tissues was higher than in pure cultures. Low isolation success rate from diseased ash tissue after a five‐hour hot water treatment at 36°C and the relatively high survival rate of ash saplings after hot water treatments at 36°C and 40°C indicate possibilities for the development of aC. fraxineaeradication method in ash saplings. Field monitoring showed that in hot weather periods, thermal conditions inside the ash tissues can be extreme enough to markedly decrease the viability ofC. fraxineain infected plant tissues.
Determination of lattice level energy efficiency for fatigue crack initiation
Authors: Voothaluru R. , Richard Liu C.
Published: March 2013

Fatigue crack initiation life prediction is a fundamentally challenging problem that is of prime importance as a significant portion of the fatigue life is spent in the initiation phase. In spite of the extensive efforts of research over the past two decades, the concept of crack initiation still remains as an enigma in science. The major challenges in predicting crack initiation life in industry are the evaluation of the crack initiation parameters such as the maximum resolved shear stress range, maximum slip band width and the energy efficiency coefficient. In this paper, we show that the energy efficiency can be successfully estimated with good accuracy by performing lattice level crystal plasticity‐based computational simulations on representative models. The lattice level plasticity‐based finite element computations are reported for the case of single crystal copper in this work, and the results show that this strategy leads to higher accuracy than the existing idea of approximating the efficiency factor. The results show that this strategy could be of great use in improving the reliability in prediction of crack initiation life. The effectiveness of this computational procedure would greatly reduce the financial investments necessary to perform experimental analysis of all structures to determine the crack initiation parameters, as it would require just a single measurement to quantify the measurement of efficiency.
Thermal niches are more conserved at cold than warm limits in arctic‐alpine plant species
Authors: Pellissier Loïc , Bråthen Kari Anne , Vittoz Pascal , Yoccoz Nigel G. , Dubuis Anne , Meier Eliane S. , Zimmermann Niklaus E. , Randin Christophe F. , Thuiller Wilfried , Garraud Luc , Van Es Jérémie , Guisan Antoine
Published: March 2013

Aim

Understanding the stability of realized niches is crucial for predicting the responses of species to climate change. One approach is to evaluate the niche differences of populations of the same species that occupy regions that are geographically disconnected. Here, we assess niche conservatism along thermal gradients for 26 plant species with a disjunct distribution between the Alps and the Arctic.

Location

European Alps and Norwegian Finnmark.

Methods

We collected a comprehensive dataset of 26 arctic‐alpine plant occurrences in two regions. We assessed niche conservatism through a multispecies comparison and analysed species rankings at cold and warm thermal limits along two distinct gradients corresponding to (1) air temperatures at 2 m above ground level and (2) elevation distances to the tree line (TLD) for the two regions. We assessed whether observed relationships were close to those predicted under thermal limit conservatism.

Results

We found a weak similarity in species ranking at the warm thermal limits. The range of warm thermal limits for the 26 species was much larger in the Alps than in Finnmark. We found a stronger similarity in species ranking and correspondence at the cold thermal limit along the gradients of 2‐m temperature and TLD. Yet along the 2‐m temperature gradient the cold thermal limits of species in the Alps were lower on average than those in Finnmark.

Main conclusion

We found low conservatism of the warm thermal limits but a stronger conservatism of the cold thermal limits. We suggest that biotic interactions at the warm thermal limit are likely to modulate species responses more strongly than at the cold limit. The differing biotic context between the two regions is probably responsible for the observed differences in realized niches.
Reversible Cerebral Vasoconstriction Syndrome
Authors: Yancy Holly , Lee‐Iannotti Joyce K. , Schwedt Todd J. , Dodick David W.
Published: March 2013

Reversible cerebral vasoconstriction syndrome (RCVS) is a cerebrovascular disorder with a clinical picture that continues to be refined. It has presented to multiple subspecialties over the past several decades, bringing with it many questions regarding risk factors, diagnosis, and management. Answers have been forthcoming but many questions remain. RCVS presents with recurrent, secondary thunderclap headaches and predominantly affects young women. The mechanism of vasoconstriction is unclear, but there has been speculation regarding a hyperadrenergic state. Diagnosis requires physician awareness, vascular imaging, and knowledge of the differential. The hallmark of its diagnosis is reversibility. Management is empiric, usually with calcium‐channel blockers, as there are no controlled treatment trials for RCVS. Randomized controlled trials are needed.
Dual Antiplatelets Reduce Microembolic Signals in Patients with Transient Ischemic Attack and Minor Stroke: Subgroup Analysis of CLAIR Study
Authors: Lau Alexander Y. , Zhao Yudong , Chen Christopher , Leung Thomas W. , Fu Jianhui , Huang Yining , Suwanwela Nijasri C. , Han Zhao , Tan Kay Sin , Ratanakorn Disya , Markus Hugh S. , Wong Ka Sing ,   for the CLAIR Study Investigators
Published: March 2013

Background

Short course of dual antiplatelet therapy for early secondary prevention is a promising treatment for patients with minor stroke or transient ischemic attack at high risk of recurrence.

Methods

We examined the efficacy and safety of dual antiplatelets in patients with transient ischemic attack or minor stroke, defined as National Institute of Health Stroke Scale scores 0–3, in a subgroup analysis of Clopidogrel plus aspirin versus Aspirin alone for Reducing embolization in patients with acute symptomatic cerebral or carotid artery stenosis (CLAIR) study. Microembolic signals on transcranial Doppler monitoring was used as surrogate marker for recurrent stroke risk. Patients with ≥1 microembolic signals at baseline were randomized to receive dual therapy (aspirin 75–160 mg daily and clopidogrel 300 mg day 1 then 75 mg daily) or monotherapy (aspirin 75–160 mg daily) for seven-days.

Results

Sixty-five of 100 patients recruited had transient ischemic attack or minor stroke: 30 received dual therapy and 35 received monotherapy. Mean onset-to-randomization was 2·3 days in dual therapy group and 3·2 days in monotherapy group ( P = 0·03). At day 7, the proportion of patients with ≥1 microembolic signals was 9 of 29 patients in dual therapy group and 18 of 34 patients in monotherapy group (adjusted relative risk reduction 41·4%, 95% CI 29·8–51·1, P < 0·001). The median number of microembolic signals on day 7 was 0 in dual therapy group and 1·0 in monotherapy group ( P = 0·046). No patients had intracranial or severe systemic hemorrhage.

Conclusions

Early dual therapy with clopidogrel and aspirin reduces microembolic signals in patients with minor ischemic stroke or transient ischemic attack, without causing significant bleeding complications.
Referral and Triage of Patients with Transient Ischemic Attacks to an Acute Access Clinic: Risk Stratification in an Australian Setting
Authors: Magin Parker , Lasserson Daniel , Parsons Mark , Spratt Neil , Evans Malcolm , Russell Michelle , Royan Angela , Goode Susan , McElduff Patrick , Levi Christopher
Published: March 2013

Background

Transient ischemic attacks and minor stroke entail considerable risk of completed stroke but this risk is reduced by prompt assessment and treatment. Risk can be stratified according to the ABCD2 prediction score. Current guidelines suggest specialist assessment and treatment within 24 h for high-risk event (ABCD2 score 4–7) and seven-days for low-risk event (ABCD2 score ≤ 3).

Aims

The study aims to establish paths to care and outcomes for patients referred by general practitioners and emergency departments to an Australian acute access transient ischemic attack service.

Methods

This is a prospective audit. Primary outcomes were time from event to referral, from referral to clinic appointment, and from event to appointment. ABCD2 score was calculated for each event. Time from event was modeled using Cox proportional hazards regression.

Results

There were 231 clinic attendees (general practitioner: 127; emergency department: 104). Mean time from event to referral was 9·2 days (SD 23·7, median 2), from referral to being seen in the clinic was 13·6 days (SD 19·0, median 7), and from event to being seen in the clinic was 17·2 days (SD 27·1, median 10). Of low-risk patients, 38·5% were seen within seven-days of event. Of high-risk patients, 36·7% were seen within one-day. ABCD2 score was not a significant predictor of any time interval from event to clinic attendance. There were no completed strokes prior to clinic attendance.

Conclusions

Times from event to clinic assessment were in excess of current recommendations and risk stratification was suboptimal, though short-term outcomes were good. Improvements in referral mechanisms may enhance risk-stratification and triage.
Pain and trauma in negative pressure wound therapy: a review
Authors: Upton Dominic , Andrews Abbye
Published: March 2013

Negative pressure wound therapy (NPWT) is considered an effective wound treatment, but there are a number of issues that need to be addressed for improvements to be made. This review aimed to explore the literature relating to the pain and skin trauma that may be experienced during NPWT. A literature search was carried out using the following databases: Academic Search Complete, CINAHL, PsychINFO, MEDLINE and PsyARTICLES. A total of 30 articles were reviewed. Studies reported varying levels of pain in patients undergoing NPWT, with certain treatment factors affecting the level of pain, such as the NPWT system and the dressing/filler used. Similarly, although there is much less research exploring NPWT‐related trauma, findings suggest that dressing and filler type may impact on whether trauma occurs. However, further research needs to consider the different stages of NPWT and how pain and trauma can be minimised during the whole procedure. As both pain and skin trauma impact on the patient's well‐being and on wound healing, it is essential that research further explores the factors that may affect the experience of pain and trauma, so as to inform developments in wound care.
Climate‐change impact considerations for freshwater‐fish conservation, with special reference to the aquarium and zoo community
Authors: Pearce‐Kelly P. , Khela S. , Ferri C. , Field D.
Published: March 2013

Freshwater systems are already in a worse condition overall than any other broad ecosystem type and have long suffered from a lack of adequate conservation attention. Likewise, relatively little attention is given to the climate‐change impact vulnerability and response requirements of these systems. However, it is clear that freshwater habitats and their rich biodiversity are acutely vulnerable to a wide range of direct and indirect climate‐change impacts. In addition to the severe socio‐economic implications, these impact and response issues present an urgent engagement challenge for the conservation community. Although species‐level conservation options are limited in the context of the overall biodiversity threat, it is evident that even under the most optimistic of climate‐change impact scenarios many more species will require ex situ management for their survival. This conservation challenge will be compounded by a growing number of species for which there is no realistic likelihood of eventual persistence in the natural state. These issues highlight an urgent need for realistic climate‐change impact considerations to be factored into threat evaluations, conservation planning and public‐engagement initiatives.
Palmoplantar subcorneal pustular dermatosis following adalimumab therapy for rheumatoid arthritis
Authors: Sauder Maxwell B. , Glassman Steven J.
Published: March 2013

Background

Tumour necrosis factor (TNF)‐α inhibitors represent potent new therapies for severe forms of psoriasis, psoriatic arthritis, and several other immune‐mediated disorders. Paradoxical worsening or de novo development of psoriasis has been documented with their use. Palmoplantar pustulosis has been one of the commoner presentations of this unusual side effect. Subcorneal pustular dermatosis (SPD) has some similarity to pustular psoriasis, particularly the acral form of SPD. Thus far there have been no biopsy‐proven cases of SPD associated with TNF‐α inhibitor use.

Methods

We describe clinical and histopathological features of a pustular skin condition which occurred in a 48‐year‐old woman with rheumatoid arthritis who had started adalimumab four months prior. The adalimumab had been added to her usual treatment with methotrexate because of incomplete symptom control.

Results

Painful and pruritic skin lesions were noted on her palms and soles primarily, with some extension to the limbs and abdomen. Examination revealed relatively non‐inflamed pustules with fluid levels, together with sparse crusted papules. Histopathology showed subcorneal pustules more suggestive of SPD than pustular psoriasis. The eruption resolved completely when adalimumab was withdrawn; methotrexate was continued.

Conclusion

Subcorneal pustular dermatosis, in addition to psoriasis vulgaris and pustular psoriasis, may occur in patients treated with TNF‐α inhibitors like adalimumab.
Intravenous immunoglobulins in difficult‐to‐treat ulcerated livedoid vasculopathy: five cases and a literature review
Authors: Bounfour Touda , Bouaziz Jean‐David , Bézier Maud , Petit Antoine , Viguier Manuelle , Rybojad Michel , Bagot Martine
Published: March 2013

Background

Livedoid vasculopathy (LV) is a thrombotic vasculopathy of the skin of unknown origin. No treatment has been validated in this indication, but case reports suggest the successful use of intravenous immunoglobulins (IVIG) in LV.

Methods

Outcomes in five patients treated with IVIG for treatment‐resistant ulcerated LV were retrospectively analyzed.

Results

Treatment with IVIG induced complete remission (based on clinical evaluation and a pain‐related visual analog scale) in four patients but was ineffective in one patient. Three patients relapsed; the median time to relapse was 10.7 months. Re‐treatment with IVIG in these three patients was successful.

Conclusions

These cases confirm previous reports that IVIG seems to be a rapid, effective, and safe treatment for patients with idiopathic refractory ulcerated LV. However, a placebo‐controlled study is mandatory to confirm these results.
A 17‐element conodont apparatus from the Soom Shale Lagerstätte (Upper Ordovician), South Africa
Authors: ALDRIDGE RICHARD J. , MURDOCK DUNCAN J. E. , GABBOTT SARAH E. , THERON JOHANNES N.
Published: March 2013

Abstract: Natural assemblages of a new conodont taxon,Notiodella keblon, from the Upper Ordovician Soom Shale Lagerstätte of South Africa contain 17 elements. This is the first time that a 17‐element apparatus plan has been unequivocally demonstrated in conodonts. The apparatus comprises paired P1, P2, P3, M, S1, S2, S3and S4elements and an unpaired, axial S0element and provides a new template for use in the reconstruction of apparatuses from the collections of dispersed elements, particularly for those with icrion‐bearing P1elements and perhaps for other balognathids.
A new diverse shark fauna from the Wordian (Middle Permian) Khuff Formation in the interior Haushi‐Huqf area, Sultanate of Oman
Authors: KOOT MARTHA B. , CUNY GILLES , TINTORI ANDREA , TWITCHETT RICHARD J.
Published: March 2013

Abstract:  Chondrichthyans are newly reported from the autochthonous Wordian Khuff Formation (middle Permian), cropping out in well‐exposed, low‐palaeolatitude sections in the interior Haushi‐Huqf area of Oman. The shark remains comprise isolated teeth, dermal denticles and fin spines and have been recovered by processing limestone in buffered acetic acid from bulk rock samples. The fauna consists of mainly ctenacanthiform and hybodontiform taxa, identified as Glikmanius cf. myachkovensis, Glikmanius culmenis sp. nov., Omanoselache hendersoni gen. et sp. nov., Omanoselache angiolinii gen. et sp. nov., cf. Omanoselache sp., Reesodus underwoodi gen et sp. nov., Teresodus amplexus gen. et sp. nov., Gunnellodus bellistriatus, Khuffia lenis gen. et sp. nov., Khuffia prolixa gen. et sp. nov. and Euselachii sp. indet. Additional specimens include rare teeth of the lonchidiid cf. ‘Palaeozoic Genus 1’ sp., of the neoselachian Cooleyella cf. fordi and a further indeterminate neoselachian, of an indeterminate petalodont and of the holocephalan Deltodus aff. mercurei and Solenodus cf. crenulatus. Fin spines add a further two taxa, Nemacanthus sp. and Amelacanthus cf. sulcatus, which have neoselachian affinities and therefore an unclear relationship to the recovered teeth. The occurrence of Nemacanthus within this Wordian fauna represents the oldest record of this taxon and its only known occurrence in the Palaeozoic. Of the remaining genera, Glikmanius has previously been recorded from the Wordian, whereas for all the others, this study represents their youngest known stratigraphic occurrence and first occurrence in Guadalupian (middle Permian) strata. This adds significantly to our knowledge of the global diversity of chondrichthyans preceding the end‐Guadalupian biotic crisis. Palaeogeographically, for all taxa, this study represents the first record from the western fringe of the marine Neotethyan basin, and only Cooleyella was previously known from the southern (Gondwanan) part of the Pangaean continental margin.
MAGNETIC RESONANCE IMAGING OF NAVICULAR BURSA ADHESIONS
Authors: Holowinski Maureen E. , Solano Mauricio , Maranda Louise , García‐López José M.
Published: March 2013

Adhesions occur in the navicular bursa between the deep digital flexor tendon (DDFT) and other structures. Our objectives were to describe the appearance of navicular bursa adhesions on high‐field magnetic resonance (MR) images, to compare these findings to findings at navicular bursoscopy, and to determine the prevalence of lesions in the remainder of the podotrochlear apparatus. Sixteen forelimbs from 14 horses that underwent MR imaging and navicular bursoscopy were evaluated. Adhesions were considered type 1 when characterized by a discontinuity in the navicular bursa fluid signal between two structures, type 2 when the navicular bursa fluid signal was disrupted and ill‐defined tissue was present between two structures, and type 3 when the fluid signal was disrupted and well‐defined tissue was present between two structures. Twenty‐six adhesions were suspected on MR images and nineteen were visualized at surgery. The positive predictive value was 50% for type 1 adhesions, 67% for type 2 adhesions, and 100% for type 3 adhesions. Additional lesions were detected in the navicular bursa in 15 limbs, the DDFT in 13, the navicular bone in 15, the collateral sesamoidean ligaments in 9, and the distal sesamoidean impar ligament in 8. A discontinuity in the navicular bursa fluid signal with well‐defined tissue between two structures detected on high‐field MR images is diagnostic for a navicular bursa adhesion. Additional lesions in the podotrochlear apparatus are common in horses with navicular bursa adhesions.
CT AND MRI EVALUATION OF SKULL BONES AND SOFT TISSUES IN SIX CATS WITH PRESUMED ACROMEGALY VERSUS 12 UNAFFECTED CATS
Authors: Fischetti Anthony J. , Gisselman Kelly , Peterson Mark E.
Published: March 2013

Feline acromegaly is predominantly caused by an adenoma of the pituitary gland, resulting in excessive growth hormone and insulin‐like growth factor (IGF‐1) secretion. In advanced cases, cats will display prominent facial features and upper airway congestion secondary to bony and soft tissue proliferation. The purpose of this study was to describe CT and MRI characteristics of soft tissues and skull bones in six cats with presumed acromegaly and to compare findings with those observed in 12 unaffected cats. In the five acromegalic cats with CT or MRI evidence of a pituitary tumor, frontal bone thickness was greater than age‐matched controls with and without a history of upper airway disease. These five cats also had evidence of soft tissue accumulation in the nasal cavity, sinuses, and pharynx. One cat with insulin‐resistant diabetes mellitus, elevated IGF‐1, and a normal pituitary size did not have evidence of frontal bone thickening or upper airway congestion.
OCCUPATIONAL PER‐PATIENT RADIATION DOSE FROM A CONSERVATIVE PROTOCOL FOR VETERINARY 18F‐FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY
Authors: Martinez Nicole E. , Kraft Susan L. , Gibbons Debra S. , Arceneaux Billie K. , Stewart Jeffrey A. , Mama Khursheed R. , Johnson Thomas E.
Published: March 2013

The occupational external radiation dose to human medical personnel from positron emission tomography (PET) radiopharmaceuticals has been documented, but to date no corresponding veterinary staff dose data are available. Electronic personal dosimeters (EPDs) were used in this study to measure the per‐patient external radiation doses to veterinary staff using a PET/CT (PET combined with computed tomography) protocol in which the patient radiopharmaceutical dose was injected after anesthetic induction. Radiation doses were recorded for the nuclear medicine technologists, the on‐duty anesthesiology technologist, and an occasional observer from 19 veterinary 18F‐fluorodeoxyglucose PET/CT studies. Patient mass range was 2.8 to 61.0 kg (22.3 kg mean) and injected activity averaged 6 MBq kg−1. The dose range received by nuclear medicine technologists per procedure was 0–30 μSv (9.1 μSv mean), by anesthetists 1–22 μSv (8.2 μSv mean), and by the observer 0–2 μSv (0.5 μSv mean). In both feline and canine studies, placement of the EPD on staff was a significant predictor of radiation dose. Additional significant predictors of staff radiation dose from canine studies included job position and injected activity. The per‐patient occupational radiation doses to veterinary PET/CT technologists were slightly greater than those reported for human nuclear medicine PET/CT technologists, but were comparable to estimated radiation doses for nurses caring for nonambulatory human PET/CT patients. Efforts toward maintaining staff radiation doses as low as reasonably achievable (ALARA) will be important as veterinary PET/CT caseload increases.
REPEATABILITY OF A PLANNING TARGET VOLUME EXPANSION PROTOCOL FOR RADIATION THERAPY OF REGIONAL LYMPH NODES IN CANINE AND FELINE PATIENTS WITH HEAD TUMORS
Authors: Yoshikawa Hiroto , Harmon Joseph F. , Custis James T. , LaRue Susan M.
Published: March 2013

For canine and feline patients with head tumors, simultaneous irradiation of the primary tumor and mandibular and retropharyngeal lymph nodes (LNs) is often indicated. The purpose of this study was to assess the repeatability of a planning target volume (PTV) expansion protocol for these LNs. Two CT image sets from 44 dogs and 37 cats that underwent radiation therapy for head tumors were compared to determine LN repositioning accuracy and precision; planning‐CT (for radiation therapy planning) and cone‐beam CT (at the time of actual treatment sessions). Eleven percent of dogs and 65% of cats received treatment to their LNs. In dogs, the mandibular LNs were positioned more caudally (P = 0.0002) and the right mandibular and right retropharyngeal LNs were positioned more to the left side of the patient (P = 0.00015 and P = 0.003, respectively). In cats, left mandibular LN was positioned higher (toward roof) than the planning‐CT (P = 0.028). In conclusion, when the patient immobilization devices and bony anatomy matching are used to align the primary head target and these LNs are treated simultaneously, an asymmetrical PTV expansion that ranges 4–9 mm (dogs) and 2–4 mm (cats), depending on the directions of couch movement, should be used to include the LNs within the PTV at least 95% of the time.
IMAGING DIAGNOSIS—MULTICENTRIC LYMPHOMA OF GRANULAR LYMPHOCYTES IMAGED WITH FDG PET/CT IN A DOG
Authors: Ballegeer Elizabeth A. , Hollinger Charlotte , Kunst Chelsea M.
Published: March 2013

A 5‐year‐old female spayed bulldog was referred for mild dyspnea, decreased activity and appetite, occasional nonproductive cough, polydipsia, and polyuria. A 2‐deoxy‐2‐[18F]fluoro‐D‐glucose (FDG) positron emission tomography/computed tomography (PET/CT) scan revealed unexpected activity in the heart, lungs, and mild generalized lymphadenopathy that led to the diagnosis of lymphoma of granular lymphocytes after nonspecific findings on imaging with standard modalities of echocardiography, thoracic radiography, and abdominal ultrasound. PET/CT scanning is a useful whole body imaging modality with high sensitivity for changes associated with canine lymphoma.