bluuebunny/crossref_metadata_2025 huggingface dataset:
An ADH1B Variant and Peer Drinking in Progression to Adolescent Drinking Milestones: Evidence of a Gene‐by‐Environment Interaction
Authors: Olfson Emily , Edenberg Howard J. , Nurnberger John , Agrawal Arpana , Bucholz Kathleen K. , Almasy Laura A. , Chorlian David , Dick Danielle M. , Hesselbrock Victor M. , Kramer John R. , Kuperman Samuel , Porjesz Bernice , Schuckit Marc A. , Tischfield Jay A. , Wang Jen‐Chyong , Wetherill Leah , Foroud Tatiana M. , Rice John , Goate Alison , Bierut Laura J.
Published: September 2014

Background

Adolescent drinking is an important public health concern, one that is influenced by both genetic and environmental factors. The functional variant rs1229984 in alcohol dehydrogenase 1B (ADH1B) has been associated at a genome‐wide level with alcohol use disorders in diverse adult populations. However, few data are available regarding whether this variant influences early drinking behaviors and whether social context moderates this effect. This study examines the interplay between rs1229984 and peer drinking in the development of adolescent drinking milestones.

Methods

One thousand five hundred and fifty European and African American individuals who had a full drink of alcohol before age 18 were selected from a longitudinal study of youth as part of the Collaborative Study on the Genetics of Alcoholism (COGA). Cox proportional hazards regression, with G × E product terms in the final models, was used to study 2 primary outcomes during adolescence: age of first intoxication and age of first DSM‐5 alcohol use disorder symptom.

Results

The minor A allele of rs1229984 was associated with a protective effect for first intoxication (HR = 0.56, 95% CI 0.41 to 0.76) and first DSM‐5 symptom (HR = 0.45, 95% CI 0.26 to 0.77) in the final models. Reporting that most or all best friends drink was associated with a hazardous effect for first intoxication (HR = 1.81, 95% CI 1.62 to 2.01) and first DSM‐5 symptom (HR = 2.17, 95% 1.88 to 2.50) in the final models. Furthermore, there was a significant G × E interaction for first intoxication (p = 0.002) and first DSM‐5 symptom (p = 0.01). Among individuals reporting none or few best friends drinking, the ADH1B variant had a protective effect for adolescent drinking milestones, but for those reporting most or all best friends drinking, this effect was greatly reduced.

Conclusions

Our results suggest that the risk factor of best friends drinking attenuates the protective effect of a well‐established ADH1B variant for 2 adolescent drinking behaviors. These findings illustrate the interplay between genetic and environmental factors in the development of drinking milestones during adolescence.
Acute Alcohol Intoxication‐Induced Microvascular Leakage
Authors: Doggett Travis M. , Breslin Jerome W.
Published: September 2014

Background

Alcohol intoxication can increase inflammation and worsen injury, yet the mechanisms involved are not clear. We investigated whether acute alcohol intoxication increases microvascular permeability and investigated potential signaling mechanisms in endothelial cells that may be involved.

Methods

Conscious rats received a 2.5 g/kg alcohol bolus via gastric catheters to produce acute intoxication. Microvascular leakage of intravenously administered fluorescein isothiocyanate (FITC)‐conjugated albumin (FITC‐albumin) from the mesenteric microcirculation was assessed by intravital microscopy. Endothelial‐specific mechanisms were studied using cultured endothelial cell monolayers. Transendothelial electrical resistance (TER) served as an index of barrier function, before and after treatment with alcohol or its metabolite acetaldehyde. Pharmacologic agents were used to test the roles of alcohol metabolism, oxidative stress, p38 mitogen‐activated protein kinase (MAPK), myosin light‐chain kinase (MLCK), rho kinase (ROCK), and exchange protein activated by cAMP (Epac). VE‐cadherin localization was investigated to assess junctional integrity. Rac1 and RhoA activation was assessed by ELISA assays.

Results

Alcohol significantly increased FITC‐albumin extravasation from the mesenteric microcirculation. Alcohol also significantly decreased TER and disrupted VE‐cadherin organization at junctions. Acetaldehyde significantly decreased TER, but inhibition of alcohol dehydrogenase or application of a superoxide dismutase mimetic failed to prevent alcohol‐induced decreases in TER. Inhibition of p38 MAPK, but not MLCK or ROCK, significantly attenuated the alcohol‐induced barrier dysfunction. Alcohol rapidly decreased GTP‐bound Rac1 but not RhoA during the drop in TER. Activation of Epac increased TER, but did not prevent alcohol from decreasing TER. However, activation of Epac after initiation of alcohol‐induced barrier dysfunction quickly resolved TER to baseline levels.

Conclusions

Our results suggest that alcohol intoxication increases microvascular permeability to plasma proteins. The data also suggest the endothelial‐specific mechanism involves the p38 MAPK, Rac1, and reorganization of VE‐cadherin at junctions. Last, activation of Epac can quickly resolve alcohol‐induced endothelial barrier dysfunction.
Do investors misprice components of net periodic pension cost?
Authors: Shin Yong‐Chul , Yu Kun
Published: September 2014

We examine whether and how investors misprice the components of net periodic pension cost under SFAS No. 87 and 158. We find that investors appear to have difficulty in understanding the transitory feature of other net periodic pension cost (PPOPCC) and thus overestimate its persistence, which in turn leads to the mispricing of PPOPCC in the pre‐158 period. We also find that SFAS No. 158 appears to reduce the mispricing of PPOPCC, suggesting a positive effect of SFAS No. 158 on investors' valuation of pension items in the income statement. Additional analysis suggests that investors also overestimate the persistence of, and thus misprice, pension‐related cash flows and accruals in the pre‐158 period and that SFAS No. 158 reduces the mispricing of pension‐related cash flows and accruals.
Low IL‐8 is associated with anxiety in suicidal patients: genetic variation and decreased protein levels
Authors: Janelidze S. , Suchankova P. , Ekman A. , Erhardt S. , Sellgren C. , Samuelsson M. , Westrin A. , Minthon L. , Hansson O. , Träskman‐Bendz L. , Brundin L.
Published: September 2014

Objective

Recent studies indicate that inflammation may play a role in the pathophysiology of suicidality. Interleukin‐8 (IL‐8) is a chemokine that in addition to its function in the immune system also exert neuroprotective properties. The involvement of this chemokine in neuropsychiatric conditions is incompletely known.

Method

We measured plasma and cerebrospinal fluid (CSF) IL‐8, as well as the genotype frequency of a single nucleotide polymorphism (‐251A/T, rs4073) in the promoter region of the IL8 gene, in suicide attempters (n = 206) and healthy controls (n = 578).

Results

Plasma and CSF levels of IL‐8 were significantly lower in suicide attempters with anxiety than in healthy controls. IL‐8 in both plasma and CSF correlated negatively with symptoms of anxiety. Compared with the population‐based cohort, the IL‐8‐251T allele was more prevalent among female suicide attempters. Furthermore, suicide attempters carrying this allele showed more severe anxiety. This correlative study warrants further mechanistic studies on the effects of IL‐8 in the central nervous system.

Conclusion

We suggest that IL‐8 might be involved in the biological mechanisms mediating resilience to anxiety. Thus, our findings highlight the chemokine IL‐8 as a potential target for future development of anti‐anxiety treatments and suicide prevention.
Association between Plasminogen Activator Inhibitor‐1 Gene Polymorphisms and Recurrent Pregnancy Loss: A Systematic Review and Meta‐Analysis
Authors: Chen Hui , Nie Shuping , Lu Ming
Published: September 2014

Human plasminogen activator inhibitor‐1 (PAI‐1) is closely related to embryonic development and pregnancy success. The association between PAI‐1 gene polymorphisms (PAI‐1‐844G/A and PAI‐1‐675G/A) and the risk of recurrent pregnancy loss (RPL) is controversial. Therefore, we perform this review to clarify the association between PAI‐1 gene polymorphisms and RPL risk. We performed a systematic search for studies that described the effect of PAI‐1 polymorphisms on RPL risk. The odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were considered under recessive genetic models. Furthermore, we conducted a subgroup analysis based on the studies' geographic regions of origin. Data were analyzed using Stata 11.2 software. Eighteen studies were included, and a high degree of statistical heterogeneity existed among the studies. In this study, we found a significant association between the PAI‐1‐675G/A polymorphism and the risk of RPL under the recessive model (OR = 1.70, 95% CI = 1.21–2.38). However, no significant association between the PAI‐1‐844G/A polymorphism and RPL was noted. PAI‐1‐675G/A (4G/5G) polymorphisms play a potential role in RPL. The screening of PAI‐1 (4G/5G) gene mutations should be included during an RPL diagnostic workup, and patients should be treated using anticoagulant therapy during pregnancy if necessary.
Adenosine A1 receptor‐dependent and independent pathways in modulating renal vascular responses to angiotensin II
Authors: Gao X. , Peleli M. , Zollbrecht C. , Patzak A. , Persson A. E. G. , Carlström M.
Published: September 2014

Aim

Renal afferent arterioles are the effector site for autoregulation of glomerular perfusion and filtration. There is synergistic interaction between angiotensin II (ANG II) and adenosine (Ado) in regulating arteriolar contraction; however, the mechanisms are not clear. In this context, this study investigated the contribution of A1 receptor‐dependent and independent signalling mechanisms.

Methods

Isolated perfused afferent arterioles from transgenic mice (A1+/+ and A1−/−) were used for vascular reactivity studies. Cultured vascular smooth muscle cells (VSMC) were used for phosphorylation studies of signalling proteins that induce arteriolar contraction.

Results

Maximal arteriolar contraction to ANG II was attenuated in A1−/− (22%) compared with A1+/+ (40%). Simultaneous incubation with low‐dose ado (10−8 mol L−1) enhanced ANG II‐induced contraction in A1+/+ (58%), but also in A1−/− (42%). An ado transporter inhibitor (NBTI) abolished this synergistic effect in A1−/−, but not in wild‐type mice. Incubation with Ado + ANG II increased p38 phosphorylation in aortic VSMC from both genotypes, but treatment with NBTI only blocked phosphorylation in A1−/−. Combination of ANG II + Ado also increased MLC phosphorylation in A1+/+ but not significantly in A1−/−, and NBTI had no effects. In agreement, Ado + ANG II‐induced phosphorylation of p38 and MLC in rat pre‐glomerular VSMC was not affected by NBTI. However, during pharmacological inhibition of the A1 receptor simultaneous treatment with NBTI reduced phosphorylation of both p38 and MLC to control levels.

Conclusion

Interaction between ANG II and Ado in VSMC normally involves A1 receptor signalling, but this can be compensated by receptor independent actions that phosphorylate p38 MAPK and MLC.
Effects of Cucurbitacin E, a Tetracyclic Triterpene Compound from Cucurbitaceae, on the Pharmacokinetics and Pharmacodynamics of Warfarin in Rats
Authors: Ding Tonggui , Zhang Yuanjin , Chen Ang , Tang Yu , Liu Mingyao , Wang Xin
Published: September 2014

This study firstly investigated the effects of cucurbitacin E (CuE), a tetracyclic triterpene compound from Cucurbitaceae, on the pharmacokinetics (PK) and pharmacodynamics (PD) of warfarin, a model CYP2C probe substrate, in the rat. In PK studies, the concentration of warfarin in blood samples was determined by HPLC‐DAD, and the PK parameters were analysed using non‐compartmental methods. In PD studies, the prothrombin time (PT) in blood plasma at each sample point was measured via thromboplastin reagents. CuE treatment (50, 100 and 200 μg/kg, i.p.) decreased warfarin clearance (28–32%), increased the area under the curve (AUC0–∞; 55–62%) and prolonged plasma half‐life (t1/2; 58–72%). At the same time, the anticoagulation effect of warfarin (PTmax) was also significantly increased in the presence of CuE. These data demonstrated that CuE affected the PK and PD of warfarin, and these effects may be due to the inhibition of CYP2C activity by CuE. Hence, careful monitoring should be carried out during concomitant use of herbal products containing CuE with drugs that are metabolized by CYP2C enzymes.
Altered Frequency Distribution in the Electroencephalogram is Correlated to the Analgesic Effect of Remifentanil
Authors: Graversen Carina , Malver Lasse P. , Kurita Geana P. , Staahl Camilla , Christrup Lona L. , Sjøgren Per , Drewes Asbjørn M.
Published: September 2014

Opioids alter resting state brain oscillations by multiple and complex factors, which are still to be elucidated. To increase our knowledge, multi‐channel electroencephalography (EEG) was subjected to multivariate pattern analysis (MVPA), to identify the most descriptive frequency bands and scalp locations altered by remifentanil in healthy volunteers. Sixty‐two channels of resting EEG followed by independent measures of pain scores to heat and bone pain were recorded in 21 healthy males before and during remifentanil infusion in a placebo‐controlled, double‐blind crossover study. EEG frequency distributions were extracted by a continuous wavelet transform and normalized into delta, theta, alpha, beta and gamma bands. Alterations relative to pre‐treatment responses were calculated for all channels and used as input to the MVPA. Compared to placebo, remifentanil increased the delta band and decreased the theta and alpha band oscillations as a mean over all channels (all p ≤ 0.007). The most discriminative channels in these frequency bands were F1 in delta (83.33%, p = 0.0023) and theta bands (95.24%, p < 0.0001), and C6 in the alpha band (80.95%, p = 0.0054). These alterations were correlated to individual changes in heat pain in the delta (p = 0.045), theta (p = 0.038) and alpha (p = 0.039) bands and to bone pain in the alpha band (p = 0.0092). Hence, MVPA of multi‐channel EEG was able to identify frequency bands and corresponding channels most sensitive to altered brain activity during remifentanil treatment. As the EEG alterations were correlated to the analgesic effect, the approach may prove to be a novel methodology for monitoring individual efficacy to opioids.
Group Variable Selection via Convex Log-Exp-Sum Penalty with Application to a Breast Cancer Survivor Study
Authors: Geng Zhigeng , Wang Sijian , Yu Menggang , Monahan Patrick O. , Champion Victoria , Wahba Grace
Published: September 2014

In many scientific and engineering applications, covariates are naturally grouped. When the group structures are available among covariates, people are usually interested in identifying both important groups and important variables within the selected groups. Among existing successful group variable selection methods, some methods fail to conduct the within group selection. Some methods are able to conduct both group and within group selection, but the corresponding objective functions are non-convex. Such a non-convexity may require extra numerical effort. In this article, we propose a novel Log-Exp-Sum(LES) penalty for group variable selection. The LES penalty is strictly convex. It can identify important groups as well as select important variables within the group. We develop an efficient group-level coordinate descent algorithm to fit the model. We also derive non-asymptotic error bounds and asymptotic group selection consistency for our method in the high-dimensional setting where the number of covariates can be much larger than the sample size. Numerical results demonstrate the good performance of our method in both variable selection and prediction. We applied the proposed method to an American Cancer Society breast cancer survivor dataset. The findings are clinically meaningful and may help design intervention programs to improve the qualify of life for breast cancer survivors.
Emotions in action: Telephone‐mediated dispute resolution
Authors: Weatherall Ann , Stubbe Maria
Published: September 2014

The present study investigated emotions as they were made visible and responded to in a particular institutional setting. Following discursive psychology the aim was to provide a rigorous account of emotion as observable in talk‐in‐interaction. Using conversation analysis a focus was on the temporality of emotion in turns of talk and over the course of an interaction. Data were recordings and transcriptions of calls to a dispute resolution service for consumers' problems with electricity and gas. The analysis identified systematic practices callers' use for describing and doing upset. Call‐takers rarely displayed emotion in the body of the calls and typically responded to institutionally relevant aspects of the callers' troubles and not the emotional ones. In the absence of any kind of endorsement of the callers' emotional stance, emotionality could escalate. Emotional affiliation regularly occurred at the end of the calls. The escalation of emotion in the absence of its endorsement and the occurrence of emotional affiliation at call‐closing evidences a sequential property of emotion that has been largely overlooked.
Autism spectrum disorders: a qualitative study of attitudes toward prenatal genetic testing and termination decisions of affected pregnancies
Authors: Chen L.S. , Xu L. , Dhar S.U. , Li M. , Talwar D. , Jung E.
Published: September 2014

In the United States, prenatal genetic testing (PGT) for Autism Spectrum Disorders (ASD) is currently available via clinical genetic services. Such testing may inform parents about their unborn child's risk for ASD, prepare parents for the birth of an affected infant, and allow them to arrange for early interventions. Although PGT for autism has potential benefits, the associated ethical, legal, and social implications (ELSI) should be considered. This first qualitative study employed a hypothetical scenario to explore the attitudes toward PGT and termination decisions of 42 parents of children with ASD. Over half of the participants expressed willingness to undergo PGT for autism. Reasons included better preparation for birth, early and better treatment, termination of affected pregnancy, contribution to research, and curiosity. Of the 31 parents who were either willing or unsure about undergoing the PGT, approximately three‐fourths would continue their hypothetical affected pregnancies. Explanations included preparation for birth of the child, bonding or acceptance of existing ASD‐affected children, apprehensions about test limitations, and religious concerns. Parents who reported they would terminate the affected pregnancy in this hypothetical situation were primarily Asians. This study contributes to the growing understanding of the ELSI aspects of PGT in clinical practice.
Changing Neighborhood Determinants of Housing Price Trends in Southern California, 1960–2009
Authors: Hipp John R. , Singh Amrita
Published: September 2014

Research has generally failed to explore whether the effect of neighborhood characteristics on home values has changed over time. We take a long–range view and study decadal changing home values in the southern California region over a 50–year period, from 1960 to 2009. We focus on the effects of racial composition and measures associated with the New Urbanism on changing home values. We find that whereas neighborhoods with more racial/ethnic minorities and racial mixing experienced relative decreases in home values in the earlier decades, this effect has effectively disappeared in the most recent decade and actually became positive for some measures. We also found that certain characteristics associated with the New Urbanism—population density, older homes, a lack of concentration of single family units—show stronger positive effects on home values in the most recent decades.
Urinary tract infections during the first year after renal transplantation: one center's experience and a review of the literature
Authors: Gołębiewska Justyna E. , Dębska‐Ślizień Alicja , Rutkowski Bolesław
Published: September 2014

Background

The aim of the study was to evaluate the incidence, clinical manifestations, microbiology, risk factors, and the influence of UTIs on renal graft function.

Methods

We analyzed clinical data, urine cultures performed within the first 12 months after RTx, and renal function within 24 months in consecutive patients undergoing RTx at Gdańsk Transplantation Centre between January 2007 and December 2009.

Results

We studied data from 209 RTx recipients, 59.3% men, with a mean age of 46.4 ± 14 yr. We observed 322 UTI episodes in 111 patients, including asymptomatic bacteriuria (53%, n = 170), lower UTIs (25%, n = 82), upper UTIs (22%, n = 57), and 13 cases of urosepsis. Thirty‐eight percent of UTIs were diagnosed during the first post‐transplant month. The most frequently isolated uropathogen was Enterococcus faecium (36%, n = 44) and from the second month E. coli (58%, n = 114). Risk factors were female gender, induction use, history of recurrent UTIs before RTx, acute rejection (AR), CMV infection, vesico‐ureteral reflux or strictures at uretero‐vesical junction, and high comorbidity. Renal graft function measured by eGFR was significantly worse in patients suffering from UTIs from the baseline. However, the evolution of renal graft function did not differ significantly between patients with and without UTIs.

Conclusions

Lower renal graft function may promote UTIs or UTIs may not allow a complete recovery of graft function after transplantation.
Contribution of impaired renal function to cardiovascular risk prediction models in renal transplant recipients
Authors: Benguzzi Mowad , Mansell Holly , Hassan Abubakar , Elmoselhi Hamdi , Mainra Rahul , Shoker Ahmed
Published: September 2014

Background

The Framingham risk score (FRS) and cardiovascular risk calculator for renal transplant recipients (CRCRTR‐MACE) quantify cardiovascular risk in renal transplant recipients (RTR). In contrast to the FRS, the CRCRTR‐MACE includes serum creatinine as a variable in the risk prediction equation.

Objective

To determine the influence of impaired renal function on performances of the two equations.

Methods

A chart review of 270 RTR transplanted from 1979 to 2012. High risk was defined at scores ≥20%. Standard statistical analyses included multivariate analysis (MVA), stepwise analysis, and odds ratio to estimate contributions of risk factors.

Results

Mean transplant duration was 9.51 ± 6.65 yr. Mean eGFR was 59.19 ± 28.26 mL/min/1.73 m2. FRS and CRCRTR‐MACE scores of least 20% were present in 9.3% and 24.8%, respectively, while 7.2% and 11.2% of RTR with eGFR ≥60 mL/min/1.73 m2 were high risk, respectively. Mean age, blood pressure, TC:HDL ratio, smoking, and diabetes were evenly distributed in patients with varying eGFR. FRS scores remained similar at wide eGFR range (≤30 mL/min/1.73 m2–≥90 mL/min/1.73 m2), while CRCRTR‐MACE scores significantly increased as eGFR decreased.

Conclusions

CRCRTR‐MACE identified more patients at high cardiovascular risk, even in those with more favorable renal function, suggesting a fundamental difference between the two calculators beyond renal function.
Emerging technological advancements in colonoscopy: Third Eye® Retroscope® and Third Eye® PanoramicTM, Fuse® Full Spectrum Endoscopy® colonoscopy platform, Extra‐Wide‐Angle‐View colonoscope, and NaviAidTM G‐EYETM balloon colonoscope
Authors: Gralnek Ian M.
Published: September 2014

Colonoscopy is the criterion standard for detecting colorectal adenomas and cancers. However, multiple studies have reported a significant percentage of adenomas are missed during standard, forward‐viewing colonoscopy. Missed adenomas can lead to interval colorectal cancers. Aside from inadequate colon preparation, incomplete examinations (e.g. failure to intubate the cecum), short withdrawal times, and patient‐related factors, the primary reason for missing colorectal adenomas and early cancers is poor visualization of the proximal aspect of colonic folds, at anatomical flexures, and in the ileocecal valve area. These anatomical sites tend to be hidden from the standard forward‐viewing colonoscope (170‐degree angle of view) and can often only be seen through manipulation of the colonoscope by the endoscopist. Thus, there is mounting evidence supporting the need to reduce the adenoma ‘miss rate’ of standard forward‐viewing colonoscopy by improving upon current colonoscope technology and its current visualization/optics limitations. Recently, there are a number of emerging technologies that may help revolutionize how colonoscopy is carried out and that will significantly reduce adenoma miss rates. These include the Third Eye® Retroscope® and Third Eye® PanoramicTM (Avantis Medical Systems, Sunnyvale, CA, USA); Fuse® Full Spectrum Endoscopy® colonoscopy platform (EndoChoice Inc., Alpharetta, GA, USA); Extra‐Wide‐Angle‐View colonoscope (Olympus, Tokyo, Japan), and the NaviAidTM G‐EYETM balloon colonoscope (SMART Medical Systems Ltd, Ra'anana, Israel).
Randomized comparison of recovery time after use of remifentanil alone versus midazolam and meperidine for colonoscopy anesthesia
Authors: Hong Mi Jin , Sung In‐Kyung , Lee Sang Pyo , Cheon Bo‐Kyung , Kang Hyun , Kim Tae‐Yop
Published: September 2014

Background and Aim

Although the combination of midazolam‐meperidine has been widely used as a sedation regimen for colonoscopy, its residual effect which is longer than the duration of a colonoscopy procedure can delay patient recovery and discharge. Remifentanil, an ultra‐short‐acting opioid, has a very brief duration of action. We hypothesized that using remifentanil alone for colonoscopy would provide shorter recovery time compared with the midazolam‐meperidine combination.

Methods

Time to achieve Aldrete score = 10 was determined and compared in patients who were randomly allocated to receive remifentanil alone (group‐R, n = 27) or a midazolam‐meperidine combination (group‐MM, n = 27) for colonoscopy. Intergroup differences in sedation, recall analgesia, cardio‐respiratory profiles, and satisfaction of patient and endoscopist were also determined during and after colonoscopy.

Results

Group‐R showed a significantly shorter recovery time than group‐MM (median [25–75%], 0 [0–10] vs 30 [15–30] min, P < 0.001). Group‐R showed significantly higher bispectral‐index values during colonoscopy (92 [85–96] vs 84 [80–87], P = 0.001); a higher incidence of recall of explanations given during and after colonoscopy (100 vs 48% and 96 vs 52%, both P < 0.001); and a lower distress score (visual analog scale 30/100 vs 37/100 mm, P = 0.002), than did group‐MM. Neither extent of pain, incidence of hemodynamic instability nor incidence of respiratory depression differed between the groups.

Conclusions

Remifentanil for colonoscopy afforded faster recovery compared to midazolam‐meperidine combination. It also provided greater patient–endoscopist communication and satisfaction with comparable patient analgesia and cardiorespiratory profile during colonoscopy.
Acknowledging and allocating responsibility for clinical inertia in the management of Type 2 diabetes in primary care: a qualitative study
Authors: Zafar A. , Stone M. A. , Davies M. J. , Khunti K.
Published: September 2014

Aims

Failure to intensify treatment in patients with Type 2 diabetes with suboptimal blood glucose control has been termed clinical inertia and has been shown to contribute to poorer patient outcomes. We aimed to identify and explore perceptions about clinical inertia from the perspective of primary healthcare providers.

Methods

A qualitative study was conducted in Leicestershire and Northamptonshire, UK. Purposive sampling was based on healthcare providers working in primary care settings with ‘higher’ and ‘lower’ target achievement based on routine data. Twenty semi‐structured interviews were conducted, face‐to‐face or by telephone. Thematic analysis was informed by the constant comparative approach.

Results

An important broad theme that emerged during the analysis was related to attribution and explanation of responsibility for clinical inertia. This included general willingness to accept a degree of responsibility for clinical inertia. In some cases, however, participants had inaccurate perceptions about levels of target achievement in their primary care centres, as indicated by routine data. Participants sought to lessen their own sense of accountability by highlighting patient‐level barriers such as comorbidities and human fallibility, and also system‐level barriers, particularly time constraints. Perceptions about ways of addressing the problem of clinical inertia were not seen as straightforward, further emphasizing a complex and cumulative pattern of barriers.

Conclusions

In order to understand and address the problem of clinical inertia, provider, patient‐ and system‐level barriers should be considered together rather than as separate issues. Acknowledgement of responsibility should be regarded positively as a motivator for change.
Time course and mechanisms of the anti‐hypertensive and renal effects of liraglutide treatment
Authors: von Scholten B. J. , Lajer M. , Goetze J. P. , Persson F. , Rossing P.
Published: September 2014

Aims

Glucagon‐like peptide–1 receptor agonist studies have revealed clinically significant reductions in systolic blood pressure (SBP). The aim was to investigate the time course of the anti‐hypertensive effect of liraglutide treatment and potential underlying mechanisms.

Methods

We used an open‐label, single‐centre trial; 31 participants with Type 2 diabetes and hypertension completed the study. All participants were treated with liraglutide escalated to a maximum dose of 1.8 mg/day for 7 weeks, followed by a 21–day washout period. The primary outcome was a change in 24–h SBP.

Results

Twenty‐four‐h SBP increased by 10 mmHg on day 3 (P = 0.008) and 7 mmHg on day 7 (P = 0.033, 0.6 mg/day). On day 29, (1.8 mg/day), 24–h SBP was 7 mmHg lower compared with baseline (P = 0.11). Following the treatment period (day 49) and after washout (day 70), 24–h BP was equivalent to baseline. In addition, extracellular volume (ECV) was reduced by 2.0 l [95% confidence interval (CI) = 1.0–3.1 l, P < 0.001] and midregional‐pro‐atrial natriuretic peptide (MR–proANP) was reduced by 20% (95% CI = 12–28%, P < 0.001). Also, urinary albumin excretion declined by 30% (95% CI = 12–44%, P = 0.003), GFR by 11 ml/min/1.73 m2 (95% CI = 7.2–14.4 ml/min/1.73 m2, P < 0.001) and fractional albumin excretion by 29% (95% CI = 3–48%, P = 0.032).

Conclusions

Liraglutide treatment was associated with an initial increase in 24–h SBP, followed by a 7 mmHg reduction after escalation to 1.8 mg/day. This effect subsided after 4 weeks of maximum dose. Reductions in ECV and MR–proANP may explain the anti‐hypertensive potential. Liraglutide treatment was associated with reversible reductions in albuminuria and GFR, which has to be confirmed in randomized trials.
Fibrous Cyst of the Chordae Tendineae of the Mitral Valve: Echocardiographic Appearance and Literature Review
Authors: Zhu Yan‐Bo , Zhang Xiu‐Hong , Wang Lian‐Qun , Guan Xin
Published: September 2014

Fibrous cyst of the chordae tendineae of the mitral valve (MV) is defined as a fibrous cyst arising from the chordae tendineae of the MV. It is extremely rare and its etiology is not clear. We present a case of a cystic structure within the left ventricle. This structure is connected to the anterior MV leaflet and the posterior chordae tendineae. It moves freely, resulting in stenosis of inflow tract and outflow tract of the left ventricle. Intraoperative assessment and histopathologic examination revealed it as a fibrous cyst. Its echocardiographic appearance is unique and it must be resected immediately.
Respiratory Hemodynamics in the Hepatic Veins—Abnormal Patterns
Authors: Fadel Bahaa M. , Alkalbani Ahmad , Husain Aysha , Dahdouh Ziad , Di Salvo Giovanni
Published: September 2014

The flow pattern in the hepatic veins (HVs) is dependent on the cardiac cycle and right heart hemodynamics and influenced by the respiratory cycle and the liver parenchyma. Most disease states that affect the right heart alter the HV Doppler in a manner independent of the respiratory cycle. Some diseases that typically involve the pericardium, right ventricular myocardium, or respiratory system confer characteristic changes to the HV flow in a manner dependent on the respiratory cycle. Analysis of the HV Doppler with assessment of the respiratory changes in flow and their timing helps to distinguish among the various disease states. In this manuscript, we discuss the effect of respiration on HV flow in patients with abnormal right heart function and illustrate the use of the respiratory changes in the HV Doppler as a tool for diagnosis.
Feature selection for clustering categorical data with an embedded modelling approach
Authors: Silvestre Cláudia , Cardoso Margarida G. M. S. , Figueiredo Mário
Published: September 2014

Research on the problem of feature selection for clustering continues to develop. This is a challenging task, mainly due to the absence of class labels to guide the search for relevant features. Categorical feature selection for clustering has rarely been addressed in the literature, with most of the proposed approaches having focused on numerical data. In this work, we propose an approach to simultaneously cluster categorical data and select a subset of relevant features. Our approach is based on a modification of a finite mixture model (of multinomial distributions), where a set of latent variables indicate the relevance of each feature. To estimate the model parameters, we implement a variant of the expectation‐maximization algorithm that simultaneously selects the subset of relevant features, using a minimum message length criterion. The proposed approach compares favourably with two baseline methods: a filter based on an entropy measure and a wrapper based on mutual information. The results obtained on synthetic data illustrate the ability of the proposed expectation‐maximization method to recover ground truth. An application to real data, referred to official statistics, shows its usefulness.
‘A WONDERFULL MONSTER BORNE IN GERMANY’: HAIRY GIRLS IN MEDIEVAL AND EARLY MODERN GERMAN BOOK, COURT AND PERFORMANCE CULTURE
Authors: Katritzky M. A.
Published: September 2014

Human hirsuteness, or pathological hair growth, can be symptomatic of various conditions, including genetic mutation or inheritance, and some cancers and hormonal disturbances. Modern investigations into hirsuteness were initiated by nineteenth‐century German physicians. Most early modern European cases of hypertrichosis (genetically determined all‐over body and facial hair) involve German‐speaking parentage or patronage, and are documented in German print culture. Through the Wild Man tradition, modern historians routinely link early modern reception of historical hypertrichosis cases to issues of ethnicity without, however, recognising early modern awareness of links between temporary hirsuteness and the pathological nexus of starvation and anorexia. Here, four cases of hirsute females are reconsidered with reference to this medical perspective, and to texts and images uncovered by my current research at the Herzog August Library and German archives. One concerns an Italian girl taken to Prague in 1355 by the Holy Roman Empress, Anna von Schweidnitz. Another focuses on Madeleine and Antonietta Gonzalez, daughters of the ‘Wild Man’ of Tenerife, documented at German courts in the 1580s. The third and fourth cases consider the medieval bearded Sankt Kümmernis (also known as St Wilgefortis or St Uncumber), and the seventeenth‐century Bavarian fairground performer Barbara Urslerin.
FROM READING TO WRITING: WOMEN AUTHORS AND BOOK COLLECTORS AT THE WOLFENBÜTTEL COURT – A CASE STUDY OF GEORG PHILIPP HARSDÖRFFER'S FRAUENZIMMER GESPRÄCHSPIELE
Authors: Wade Mara R.
Published: September 2014

Marks of ownership and book inventories attest that several women from the court at Wolfenbüttel owned copies of Georg Philipp Harsdörffer's Frauenzimmer Gesprächspiele (1641–57), one of the earliest literary works in the German language to be directed specifically at women as well as men. These books were often treasured objects of matrilineal inheritance. The dynastic women from Wolfenbüttel who owned the Gesprächspiele were authors in their own right, demonstrating a correlation between ownership of the Gesprächspiele and female literary agency.
CHILDREN OF THE REVOLUTION? A CASE STUDY OF THE MISSING NEXT GENERATION IN WOMEN'S POLITICAL WRITINGS IN THE NINETEENTH CENTURY AND HEDWIG DOHM'S NOVELS
Authors: Mikus Birgit
Published: September 2014

A recurring argument in political texts written by female authors in the second half of the nineteenth century is that women's emancipation and equal rights are a multi‐generational project. The so‐called ’48ers were the first generation to fight for the most basic equal rights, and on this basis they argued that they would raise the next generation in the spirit of equality. These children of revolutionary parents would in their turn take up the fight for legal and social progress, so that, one step at a time, one generation at a time, full equality would be closer to being achieved. Over the course of the century, the generational argument was taken up by groups with different political interests and was adapted to reflect these. However, the same authors who called in their pamphlets for the passing‐on of democratic principles created female protagonists in their novels who are politically engaged in one form or another, but who do not have children. At the turn of the century, the author Hedwig Dohm published a trilogy of novels which appears to comment subliminally on the instrumentalisation of the idealised ‘next generation’ in political contexts. This article analyses the prevalence of the generational argument in several political texts written by women, and Dohm's retrospective evaluation of its feasibility in her trilogy, Schicksale einer Seele (1899), Sibilla Dalmar (1896), and Christa Ruland (1902).
‘…DAS NORMALE WEIB GEHÖRT DER ZUKUNFT’: EVOLUTIONISM AND THE NEW WOMAN IN LEOPOLD VON SACHER‐MASOCH, FRIEDA VON BÜLOW AND LOU ANDREAS‐SALOMÉ
Authors: Saul Nicholas
Published: September 2014

Whilst the treatment of Darwinian and other concepts of evolution in literary theory and writing by men around 1900 has recently received attention, little has been written on their influence over women writers and their theorisation of gender at this epoch. This paper addresses the impact of ‘Darwinism’, in particular sexual selection, on concepts of gender and writing practice in the representative women writers Bülow and Andreas‐Salomé. These are contrasted with works by Sacher‐Masoch and with Bölsche's construction of the feminine in Das Liebesleben in der Natur. It is argued that radical feminism emerged even in prominent feminist writers around 1900 in an inhibited form, and that the authority attributed to Darwinistic constructions of sexual selection was a factor in that phenomenalisation.
DIE JÜDIN IN WERNER TÜBKES LEBENSERINNERUNGEN DES DR. JUR. SCHULZE III (1965)
Authors: Hoffmann‐Curtius Kathrin
Published: September 2014

The article will focus on Werner Tübke's artistic engagement with the Nazis’ persecution of the Jews, examining the allegorical presentation of one female figure in his monumental painting Die Lebenserinnerungen des Dr. jur. Schulze III, completed in Leipzig in 1965. In his painting, Tübke uses several quotations from photography used by the SS depicting the Jewish revolt in the Warsaw Ghetto. Here, the question is asked whether and in what manner Tübke succeeded in transforming the quoted image from the Nazi years into a critical commentary on the Auschwitz trials which were taking place at the same time in Frankfurt am Main.
DANCING THROUGH THE (NEXT) MINEFIELD, OR HOW AND WHY SHOULD WE READ THE STORIES OF GERMAN WOMEN PRISONERS?
Authors: Colvin Sarah
Published: September 2014

This article considers the circumstances of production and reception of texts by women prisoners in Germany since 1949, and what makes such writing ‘worth reading’. I suggest that (a) some of the issues faced by a researcher of prisoner writing now – particularly those around the visibility of the writing and its perceived aesthetic status – reprise issues faced by feminist literary critics in years gone by, and (b) that recognition might assist in the development of appropriate methodologies for approaching prisoner texts by men and women writers.
THE POLITICS OF MEMORY AND GENDER: WHAT HAPPENED TO SECOND‐WAVE FEMINISM IN GERMANY?
Authors: Becker‐Cantarino Barbara
Published: September 2014

’68 has become a powerful cipher for the political renewal of post‐war (West) Germany, but references to women and their impact on social (and political) changes are mostly absent from personal and collective memorials. Using the notion of cultural memory work as social constructivism, the paper explores how the politics of memory, femininity and gender reflecting un‐negotiated gender issues, especially the lingering myth of traditional femininity, are pivotal in second‐wave feminism's low visibility and esteem in spite of the movement's apparent success in promoting women's legal and social equality. Dating back to the contested relationship between '68ers and second‐wave feminism, anti‐feminist discourse in the media employs strategies of displacing the social arguments of equality feminism into the erotic and personal, presenting feminist gender negotiations as ridiculous, irrational, prudish, anti‐democratic, and even dangerous. Equality feminism as a social movement promoted and supported mostly by women does not easily fit into the traditional categories of German paternalistic national history and present memory culture in Germany.
‘DAMIT DIE SEELE DIESER FRAU NICHT ÜBERSEHEN WERDE BEIM SAMMELN DES LEBENS’: RE‐ENACTMENT AND THE SEARCH FOR KNOWLEDGE IN VIOLA ROGGENKAMP'S DIE FRAU IM TURM (2009)
Authors: Brook Madeleine
Published: September 2014

Telling history is, famously, a process of ‘re‐enacting’ past experience through ‘re‐thinking’ it – and in ‘re‐thinking’ that past experience, the historian also understands something about himself (Collingwood). These ideas are at the root of a great deal of modern pedagogical thought with reference to teaching history. The character of Masia Bleiberg in Viola Roggenkamp's novel, Die Frau im Turm (2009), however, takes a more subjective and emotionally driven approach to employing re‐enactment as a way to find out about herself. As the thirty‐something daughter of a Jewish Holocaust survivor now living in the GDR and a West German mother, she tries to establish her identity through exploring a number of ‘re‐enactment’ strategies, many of which prove unsatisfactory. Masia's search for knowledge proves to be highly gendered: while female characters produce knowledge and the record of it, it is the male characters who act as the gatekeepers to the (self‐)knowledge Masia seeks.
An Unusual Case of Episodic SUNCT Responding to High Doses of Topiramate
Authors: Khalil Modar , Maniyar Farooq , Ahmed Fayyaz
Published: September 2014

Trigeminal autonomic cephalalgias (TAC) are rare. Cluster headaches comprise the majority, with short‐lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) being the rarest and shortest in duration. The majority of SUNCT are primary with a few cases occurring secondary to posterior fossa or pituitary lesions. Although activities like exercise or blowing of the nose can trigger SUNCT, onset during orgasm has not been described. Short‐lasting aura has been described in TACs including SUNCT, but persistence of focal symptoms and signs without an underlying structural lesion have not been described. Lastly, treatment of SUNCT is difficult, with lamotrigine being the most common effective reported. We report a case of episodic SUNCT with symptoms suggestive of brainstem stroke that completely resolved spontaneously for which no underlying structural cause was found. The onset of first attack occurred during orgasm, and the patient responded to a high dose of topiramate.
Economic Incorporation, Civil Inclusion, and Social Ties: Plans to Return Home among Central Asian Migrant Women in Moscow, Russia
Authors: Agadjanian Victor , Gorina Evgenia , Menjívar Cecilia
Published: September 2014

This study uses data from a survey of female labor migrants from three Central Asian countries – Kyrgyzstan, Tajikistan, and Uzbekistan – in Moscow, Russia, to examine factors that influence these women's plans to return to their home countries. The conceptual framework considers three types of factors of migrants’ attachment to the host society – economic incorporation, civil inclusion, and social connectedness – while also accounting for migrants’ ties to their homelands. The results of multivariate analyses point to the importance of sector and type of employment, income, legal status, experience of ethnically motivated harassment, and social ties to adults relatives and friends in the host society in shaping return plans. In contrast, connections in the home country do not appear to influence the likelihood of having plans to return. These findings are contextualized within the political, socioeconomic, and ethnocultural reality of the post-Soviet world and related to the cross-national scholarship on return migration.
U.S. Immigration Policy at a Crossroads: Should the U.S. Continue Its Family-Friendly Policy?
Authors: Duleep Harriet , Regets Mark
Published: September 2014

An ongoing debate is whether the U.S. should continue its family-based admission system, which favors visas for family members of U.S. citizens and residents, or adopt a more skills-based system, replacing family visas with employment-based visas. In many ways, this is a false dichotomy: family-friendly policies attract highly-skilled immigrants regardless of their own visa path, and there are not strong reasons why a loosening of restrictions on employment migrants need be accompanied by new restrictions on family-based immigration. Moreover, it is misleading to think that only employment-based immigrants contribute to the U.S. economy. Recent immigrants, who have mostly entered via kinship ties, are economically productive, a fact hidden by a flawed methodology that underlies most economic analyses of immigrant economic assimilation.
Immigration Policy in Australia, Canada, New Zealand, and the United States: An Overview of Recent Trends
Authors: Akbari Ather H. , MacDonald Martha
Published: September 2014

Immigration policies in most host nations of the west have undergone significant changes in recent years. Based on the four country-specific papers that appear in this section of the journal, and also on our own research, we present an overview of these changes and their context. In all countries, economic considerations play a central role in shaping immigration policy and greater importance is given to scientific research. Several common policy changes are noted in Australia, Canada and New Zealand which include: a shift away from a human capital focus toward more targeted selection based on labor market demand for specific skills, increased emphasis on temporary foreign worker programs, attraction of international students, an overhauling of the refugee system, and regionalization of immigration. In the U.S., while adoption of some of these changes has often surfaced in public policy and academic discussions, legalization of unauthorized migrants remains an important policy debate, with recent arguments focusing on the economic benefits of legalization.
Has the age of political giants passed?
Authors: Runciman David
Published: September 2014

Today's politicians start and exit politics younger; they lack heft, stature and outside interests; they are bred into an ever‐narrower political class; and they preside over tame and depleted political parties. Should we be waiting for another Churchill, asks David Runciman, or are we measuring today's politicians against the wrong yardsticks?