bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of a Novel Bipolar/Monopolar Radiofrequency Ablation Device on the Beating Heart in an Acute Porcine Model
Authors: Saint Lindsey L. , Lawrance Christopher P. , Okada Shoichi , Kazui Toshinobu , Robertson Jason O. , Schuessler Richard B. , Damiano Ralph J.
Published: October 2013

Objective

Although the advent of ablation technology has simplified and shortened surgery for atrial fibrillation, only bipolar clamps have reliably been able to create transmural lesions on the beating heart. Currently, there are no devices capable of reproducibly creating the long linear lesions in the right and left atria needed to perform a Cox-Maze procedure. This study evaluated the performance of a novel suction-assisted radiofrequency device that uses both bipolar and monopolar energy to create lesions from an epicardial approach on the beating heart.

Methods

Six domestic pigs underwent median sternotomy. A dual bipolar/monopolar radiofrequency ablation device was used to create epicardial linear lesions on the superior and inferior vena cavae, the right and left atrial free walls, and the right and left atrial appendages. The heart was stained with 2,3,5-triphenyl-tetrazolium chloride, and each lesion was cross-sectioned at 5-mm intervals. Lesion depth and transmurality were determined.

Results

Transmurality was documented in 94% of all cross sections, and 68% of all ablation lines were transmural along their entire length. Tissue thickness was not different between the transmural and nontransmural cross sections (3.1 ± 1.3 and 3.4 ± 2.1, P = 0.57, respectively), nor was the anatomic location on the heart ( P = 0.45 for the distribution). Of the cross sections located at the end of the ablation line, 11% (8/75) were found to be nontransmural, whereas only 4% (8/195) of the cross sections located within the line of ablation were found to be nontransmural ( P = 0.04). Logistic regression analysis demonstrated that failure of the device to create transmural lesions was associated with low body temperature ( P = 0.006) but not with cardiac output ( P = 0.54).

Conclusions

This novel device was able to consistently create transmural epicardial lesions on the beating heart, regardless of anatomic location, cardiac output, or tissue thickness. The performance of this device was improved over most devices previously tested but still falls short of ideal clinical performance. Transmurality was lower at the end of the lesions, highlighting the importance of overlapping lines of ablation in the clinical setting.
Effect of a Low‐Intensity Parent‐Focused Nutrition Intervention on Dietary Intake of 2‐ to 5‐Year Olds
Authors: Duncanson Kerith , Burrows Tracy , Collins Clare
Published: October 2013

Objectives:

Community‐based nutrition interventions aimed at influencing child dietary intake are rarely evaluated. We hypothesised that providing self‐directed nutrition and parenting resources to parents living in rural northern New South Wales, Australia, would positively affect the dietary patterns of children ages 2 to 5 years.

Methods:

A total of 146 parent–child dyads (76 boys, ages 2.0–5.9 years) were randomly assigned to either a 12‐month parent‐centred intervention involving self‐directed education provided in CD and DVD formats, or a participant‐blinded control group who received generic nutrition and physical activity information. Data were collected at baseline, 3, and 12 months.

Results:

Total reported energy from nutrient‐dense food groups and percentage energy from energy‐dense, nutrient‐poor foods were high at baseline relative to estimated total energy expenditure for child age. Using random effects modelling, there were significant group‐by‐time effects for a reduction in mean (standard deviation) total energy intake (EI) at 12 months (−461 kJ/day (196); P = 0.04). An intervention group‐by‐time effect on carbohydrate intake (−17.4 g/day (10.6); P < 0.05) was largely attributable to decreased consumption of breads and cereals (−180 g/day (80); P = 0.007). Decreases in energy‐dense, nutrient‐poor foods were not statistically significant.

Conclusions:

The proportion of total EI from noncore foods in children in rural New South Wales is high and did not improve in response to a low‐intensity nutrition intervention. Parents reported small changes in consumption frequency for core and noncore food intakes, leading to a reduction in total EI. Strategies to increase resource use such as prompting via e‐mail are required to further explore the effectiveness of nutrition resource dissemination at a population level.
Early‐Life Factors Associated With Pediatric Functional Constipation
Authors: Turco Rossella , Miele Erasmo , Russo Marina , Mastroianni Rossella , Lavorgna Alessandra , Paludetto Roberto , Pensabene Licia , Greco Luigi , Campanozzi Angelo , Borrelli Osvaldo , Romano Claudio , Chiaro Andrea , Guariso Graziella , Staiano Annamaria
Published: October 2013

Objective:

This multicenter prospective study aimed to establish possible risk factors for functional constipation (FC) in the first year of life.

Methods:

At the infant's age of 3, 6, and 12 months, parents of all included infants completed 2 questionnaires: one about the presence of FC and the other screened the possible risk factors for FC. Parents of 465 infants completed the questionnaires at 3 and 6 months and of 402 infants at 12 months of life.

Results:

According to the Rome III criteria, FC was found in 11.6% of the infants at 3 months, in 13.7% at 6 months, and in 10.7% at 12 months after birth. Family history of atopy was present in 38.8% and 45.3% of infants with constipation at 3 and 6 months (P = 0.04 and P = 0.02, respectively), but no significant association was found at 12 months (P = 0.80). Breast‐feeding was significantly related to a normal evacuation pattern at 3 months (P = 0.05), but not at 6 and 12 months (P = 0.12 and P = 0.9, respectively). Acetaminophen and female sex appeared to be risk factors for FC at 12 months. After the adjustment for all analyzed variables, FC in infants was significantly associated with the use of acetaminophen (odds ratio 6.98, 95% confidence interval 0.82–13.50).

Conclusions:

Our results confirmed that breast‐feeding is a protective factor for FC in the first 3 months of life and that the female sex is at risk to have FC. We found that the use of acetaminophen was associated with a higher incidence of FC in the first year of life.
X-ray reflectivity measurements of liquid/solid interfaces under high hydrostatic pressure conditions
Authors: Wirkert Florian J. , Paulus Michael , Nase Julia , Möller Johannes , Kujawski Simon , Sternemann Christian , Tolan Metin
Published: October 2013

A high-pressure cell forin situX-ray reflectivity measurements of liquid/solid interfaces at hydrostatic pressures up to 500 MPa (5 kbar), a pressure regime that is particularly important for the study of protein unfolding, is presented. The original set-up of this hydrostatic high-pressure cell is discussed and its unique properties are demonstrated by the investigation of pressure-induced adsorption of the protein lysozyme onto hydrophobic silicon wafers. The presented results emphasize the enormous potential of X-ray reflectivity studies under high hydrostatic pressure conditions for thein situinvestigation of adsorption phenomena in biological systems.
Study on the reflectivity properties of spherically bent analyser crystals
Authors: Honkanen Ari-Pekka , Verbeni Roberto , Simonelli Laura , Moretti Sala Marco , Monaco Giulio , Huotari Simo
Published: October 2013

Theoretical and experimental studies are presented on properties of spherically bent analyser crystals for high-resolution X-ray spectrometry. A correction to the bent-crystal strain field owing to its finite surface area is derived. The results are used to explain the reflectivity curves and anisotropic properties of Si(660) and Si(553) analysers in near-backscattering geometry. The results from the calculation agree very well with experimental results obtained using an inelastic X-ray scattering synchrotron beamline.
The status of strontium in biological apatites: an XANES/EXAFS investigation
Authors: Bazin Dominique , Dessombz Arnaud , Nguyen Christelle , Ea Hang Korng , Lioté Frédéric , Rehr John , Chappard Christine , Rouzière Stephan , Thiaudière Dominique , Reguer Solen , Daudon Michel
Published: October 2013

Osteoporosis represents a major public health problem through its association with fragility fractures. The public health burden of osteoporotic fractures will rise in future generations, due in part to an increase in life expectancy. Strontium-based drugs have been shown to increase bone mass in postmenopausal osteoporosis patients and to reduce fracture risk but the molecular mechanisms of the action of these Sr-based drugs are not totally elucidated. The local environment of Sr2+cations in biological apatites present in pathological and physiological calcifications in patients without such Sr-based drugs has been assessed. In this investigation, X-ray absorption spectra have been collected for 17 pathological and physiological calcifications. These experimental data have been combined with a set of numerical simulations using theab initioFEFF9X-ray spectroscopy program which takes into account possible distortion and Ca/Sr substitution in the environment of the Sr2+cations. For selected samples, Fourier transforms of the EXAFS modulations have been performed. The complete set of experimental data collected on 17 samples indicates that there is no relationship between the nature of the calcification (physiological and pathological) and the adsorption mode of Sr2+cations (simple adsorption or insertion). Such structural considerations have medical implications. Pathological and physiological calcifications correspond to two very different preparation procedures but are associated with the same localization of Sr2+versusapatite crystals. Based on this study, it seems that for supplementation of Sr at low concentration, Sr2+cations will be localized into the apatite network.
Coherence properties of focused X-ray beams at high-brilliance synchrotron sources
Authors: Singer Andrej , Vartanyants Ivan A.
Published: October 2013

An analytical approach describing properties of focused partially coherent X-ray beams is presented. The method is based on the results of statistical optics and gives both the beam size and transverse coherence length at any distance behind an optical element. In particular, here Gaussian Schell-model beams and thin optical elements are considered. Limiting cases of incoherent and fully coherent illumination of the focusing element are discussed. The effect of the beam-defining aperture, typically used in combination with focusing elements at synchrotron sources to improve transverse coherence, is also analyzed in detail. As an example, the coherence properties in the focal region of compound refractive lenses at the PETRA III synchrotron source are analyzed.
Structural, compositional and trait differences between native‐ and non‐native‐dominated grassland patches
Authors: Molinari Nicole A. , D'Antonio Carla M.
Published: October 2013

Non‐native species with growth forms that are different from the native flora may alter the physical structure of the area they invade, thereby changing the resources available to resident species. This in turn can select for species with traits suited for the new growing environment.

We used adjacent uninvaded and invaded grassland patches to evaluate whether the shift in dominance from a native perennial bunchgrass, Nassella pulchra, to the early season, non‐native annual grass, Bromus diandrus, affects the physical structure, available light, plant community composition and community‐weighted trait means.

Our field surveys revealed that the exotic grass B. diandrus alters both the vertical and horizontal structure creating more dense continuous vegetative growth and dead plant biomass than patches dominated by N. pulchra. These differences in physical structure are responsible for a threefold reduction in available light and likely contribute to the lower diversity, especially of native forbs in B. diandrus‐dominated patches. Further, flowering time began earlier and seed size and plant height were higher in B. diandrus patches relative to N. pulchra patches.

Our results suggest that species that are better suited (earlier phenology, larger seed size and taller) for low light availability are those that coexist with B. diandrus, and this is consistent with our hypothesis that change in physical structure with B. diandrus invasion is an important driver of community and trait composition.

The traits of species able to coexist with invaders are rarely considered when assessing community change following invasion; however, this may be a powerful approach for predicting community change in environments with high anthropogenic pressures, such as disturbance and nutrient enrichment. It also provides a means for selecting species to introduce when trying to enhance native diversity in an otherwise invaded community.
Quasi‐continuous reservoir monitoring with surface seismic data
Authors: Arogunmati Adeyemi , Harris Jerry M.
Published: October 2013

We present an approach that creates the possibility of reservoir monitoring on a quasi‐continuous basis using surface seismic data. Current strategies and logistics for seismic data acquisition impose restrictions on the calendar‐time temporal resolution obtainable for a given surface‐seismic time‐lapse monitoring program. One factor that restricts the implementation of a quasi‐continuous monitoring program using conventional strategies is the time it takes to acquire a complete survey. Here quasi‐continuous monitoring describes the process of reservoir monitoring at short‐time intervals. Our approach circumvents the restriction by requiring only a subset of complete survey data each time an image of the reservoir is needed using surface seismic data. Ideally, the time interval between survey subset acquisitions should be short so that changes in the reservoir properties are small. The accumulated data acquired are used to estimate the unavailable data at the monitor survey time and the combined recorded and estimated data are used to produce an image of the subsurface for monitoring. We will illustrate the effectiveness of our approach using 2D and 3D synthetic seismic data and 3D field seismic data. We will explain the benefits and drawbacks of the proposed approach.
Aeromagnetic surveying using a simulated unmanned aircraft system
Authors: Caron Raymond M. , Samson Claire , Straznicky Paul , Ferguson Stephen , Sander Luise
Published: October 2013

Carleton University and Sander Geophysics are developing an unmanned aircraft system (UAS) for aeromagnetic surveying. As an early indication of the expected performance of the unmanned aircraft system, a simulated unmanned aircraft system (sUAS) was built. The simulated unmanned aircraft system is a T‐shaped structure configured as a horizontal gradiometer with two cesium magnetometers spaced 4.67 m apart, which is the same sensor geometry as planned for the unmanned aircraft system. The simulated unmanned aircraft system is flown suspended beneath a helicopter.

An 8.5 km2 area in the Central Metasedimentary Belt of the Grenville Province, near Plevna, Ontario, Canada, was surveyed with the simulated unmanned aircraft system suspended 50 m above ground. The survey site was chosen on the basis of its complex geological structure. The total magnetic intensity (TMI) data recorded were compared to that obtained during a conventional fixed‐wing survey and a ground survey. Transverse magneto‐gradiometric data were also recorded by the simulated unmanned aircraft system.

The simulated unmanned aircraft system total magnetic intensity data have a higher resolution than the conventional fixed‐wing data and were found to have a similar resolution to that of the ground survey data. The advantages of surveying with the simulated unmanned aircraft system were: (1) the acquisition of a detailed data set free of gaps in coverage at a low altitude above the terrain and (2) substantial saving of time and effort.

In the survey site, the 4.67 m simulated unmanned aircraft system gradiometer measured the transverse magnetic gradient reliably up to an altitude of 150 m above ground.
The Curious Absence of Love Stories in Women's Talk
Authors: Carter Julia
Published: October 2013

Sociological debate has dealt with love in a number of different ways. For some, love offers a unique opportunity; it is a path to salvation ( Jackson, 1993 ; Langford, 1999 ). Others, however, take a more sceptical approach to love in modern society: for Beck and Beck-Gernsheim (1995) love represents the path to extreme individualization, for Illouz (1997) it is ultimately underpinned by consumerism, and perhaps most extreme, for Bauman (2003) love has been destroyed. Giddens offers a slightly different (and more hopeful) perspective and suggests that with growing choice and freedom, love has become ‘confluent’ and temporary subject to individuals' needs ( Giddens, 1992 ). When adult women were asked about love and how they have experienced love in their own lives, however, few of these themes emerged. Instead many women found it difficult to talk about their feelings generally and love in particular. There was an absence of falling in love stories and rather, women explained that they ‘drifted’ into relationships, or they ‘just happened’. The discourses and languages that these women used to explain love and their relationships will be explored in this paper. Love was simultaneously loudly absent and quietly present.
Forced to Deal with the Future: Uncertainty and Risk in Vocational Choices among Portuguese Secondary School Students
Authors: Vieira Maria Manuel , Pappámikail Lia , Resende José
Published: October 2013

In contemporary societies, adolescents' individuation is largely staged within the educational system, and is defined by several schooling options. This is particularly true when young people reach upper secondary education, as this transition implies the definition of a personal project. In the Portuguese context, authenticity is linked to the ‘obligation’ of choosing – by means of a compulsory vocational choice. To define a personal project that gives studies a meaning becomes a problem pupils have to deal with. Supported on empirical data based on in-depth interviews to pupils attending 10th and 12th years of upper secondary education in Portuguese public schools, this article discusses some of these issues. Specially, we intend to explore pupils' obligation to exhibit their autonomy by choosing a school path with the awareness of risks that may emerge along with their options.
Revisiting Middle-Class Politics: A Multidimensional Approach – Evidence from Spain
Authors: Gayo Modesto
Published: October 2013

The sociological tradition of thinking about the middle class has made a very significant contribution to the understanding of politics in advanced contemporary societies. This paper approaches the case of Spain within a conceptual and empirical framework derived from that work. Its point of departure is that most analysis of social class in sociology and political science to date has relied on class schemes that attempt to explain single subjects or dimensions of particular phenomena. Political sociology, for example, has produced numerous single-dimension studies on issues such as voting, political participation, and political values or attitudes. These kinds of study tend to produce neat and unambiguous conclusions. A more nuanced picture emerges from the present study, which adopts an alternative, multidimensional analysis. The study compares the behaviour of social classes, and above all of fractions of the middle class, in each of the four areas of voting, political ideology, political participation, and political values. Doing so, the results present a much more complex picture of middle-class politics than has traditionally been available. The significance of these results is twofold. First, we see that an accurate description of the political behaviour of the middle class cannot be reduced to a dichotomous unitary versus heterogeneous dilemma, or to conservative versus leftist views, since the political stand of this social class is essentially ‘ambivalent’. Secondly, these results strongly suggest that theoretical work on this and similar types of phenomena should more frequently take into account the complexity of actually observed behaviour, rather than relying on the often thinner or simpler patterns from which sociological knowledge has too often been derived.
Implementation of Evidence‐Based Employment Services in Specialty Mental Health
Authors: Hamilton Alison B. , Cohen Amy N. , Glover Dawn L. , Whelan Fiona , Chemerinski Eran , McNagny Kirk P. , Mullins Deborah , Reist Christopher , Schubert Max , Young Alexander S.
Published: October 2013

Objective

Study a quality improvement approach for implementing evidence‐based employment services at specialty mental health clinics.

Data Sources/Study Setting

Semistructured interviews with clinicians and administrators before, during, and after implementation. Qualitative field notes, structured baseline and follow‐up interviews with patients, semistructured interviews with patients after implementation, and administrative data.

Study Design

Site‐level controlled trial at four implementation and four control sites. Hybrid implementation–effectiveness study with mixed methods intervention evaluation design.

Data Collection/Extraction Methods

Site visits, in‐person and telephone interviews, patient surveys, patient self‐assessment. A total of 801 patients completed baseline surveys and 53 clinicians and other clinical key stakeholders completed longitudinal qualitative interviews.

Principal Findings

At baseline, sites varied in the availability, utilization, and quality of supported employment. Each site needed quality improvement for this service, though for differing reasons, with some needing development of the service itself and others needing increased service capacity. Improvements in knowledge, attitudes, beliefs, and referral behaviors were evident in mid‐ and postimplementation interviews, though some barriers persisted. Half of patients expressed an interest in working at baseline. Patients at implementation sites were 2.3 times more likely to receive employment services during the study year. Those who had a service visit were more likely to be employed at follow‐up than those who did not.

Conclusions

Studies of implementation and effectiveness require mixed methods to both enhance implementation in real time and provide context for interpretation of complex results. In this study, a quality improvement approach resulted in superior patient‐level outcomes and improved clinician knowledge, attitudes, and behaviors, in the context of substantial variation among sites.
Latitudinal and seasonal variation in reproductive effort of the eastern fence lizard (Sceloporus undulatus)
Authors: DU Weiguo , ROBBINS Travis R. , WARNER Daniel A. , LANGKILDE Tracy , SHINE Richard
Published: October 2013

Geographic variation in life‐history traits among populations of wide‐ranging species is influenced by both spatial and temporal aspects of the environment. Rarely, however, are the effects of both aspects examined concurrently. We collected gravid female lizards (Sceloporus undulatus) from northern (Indiana), central (Mississippi) and southern (Florida) populations, spanning nearly the full latitudinal range of the species, to examine amongpopulation differences in strategies of reproductive energy allocation. Adult females from the southern population were smaller, and produced fewer and smaller eggs in their first clutches than did females from the more northern populations. Southern females were more likely to produce a second clutch, and second clutches were smaller than first clutches for females from the 2 northern populations. Together these trends eliminated population differences in overall reproductive output after accounting for body size. The trend for greater reproductive energy to be allocated to first clutches at higher latitudes, and to later clutches at lower latitudes is corroborated by published data from field studies on multiple populations. Distributing reproductive effort by producing more clutches of smaller eggs may be an adaptive response to the long season available for egg incubation and lizard activity in sub‐tropical southern environments. In contrast, allocating greater resources to early reproduction may enhance maternal fitness in the relatively short activity seasons that characterize more northern sites.
Small mammal community succession on the beach of Dongting Lake, China after the Three Gorges Project
Authors: ZHANG Meiwen , WANG Yong , LI Bo , GUO Cong , HUANG Guoxian , SHEN Guo , ZHOU Xunjun
Published: October 2013

Although the Three Gorges Project (TGP) may have affected the population structure and distribution of plant and animal communities, few studies have analyzed the effect of this project on small mammal communities. Therefore, the present paper compares the small mammal communities inhabiting the beaches of Dongting Lake using field investigations spanning a 20‐year period, both before and after the TGP was implemented. Snap traps were used throughout the census. The results indicate that the TGP caused major changes to the structure of the small mammal community at a lake downstream of the dam. First, species abundance on the beaches increased after the project commenced. The striped field mouse (Apodemus agrarius) and the Norway rat (Rattus norvegicus), which rarely inhabited the beach before the TGP, became abundant (with marked population growth) once water was impounded by the Three Gorges Reservoir. Second, dominant species concentration indices exhibited a stepwise decline, indicating that the community structure changed from a single dominant species to a more diverse species mix after TGP implementation. Third, the regulation of water discharge release by the TGP might have caused an increase in the species diversity of the animal community on the beaches. A significant difference in diversity indices was obtained before and after the TGP operation. Similarity indices also indicate a gradual increase in species numbers. Hence, a long‐term project should be established to monitor the population fluctuations of the Yangtze vole (Microtus fortis), the striped field mouse and the Norway rat to safeguard against population outbreaks (similar to the Yangtze vole outbreak in 2007), which could cause crop damage to adjacent farmland, in addition to documenting the succession process of the small mammal community inhabiting the beaches of Dongting Lake.
Triassic actinopterygian fishes: the recovery after the end‐Permian crisis
Authors: TINTORI Andrea , HITIJ Tomaž , JIANG Dayong , LOMBARDO Cristina , SUN Zuoyu
Published: October 2013

In the last 15 years, the discovery of several new actinopterygian fish faunas from the Early and Middle Triassic of the Tethys, cast new light on the timing, speed and range of their recovery after the end‐Permian crisis. In addition to several new taxa having been described, the stratigraphical and geographical record of many others have been greatly extended. In fact, most of the new fossiliferous sites are in southern China, thus at the Eastern end of the Tethys, and furthermore a few are somewhat older (Chaohu, Panxian, Luoping) than the major classical Western Tethys sites (Monte San Giorgio). Following these new finds, it is possible to have a better definition of the Triassic recovery stages. Indeed, after a quite short phase till the end of the Smithian (Olenekian, Early Triassic) in which a rather consistent fauna was present all around the Pangea coasts, a major radiation occurred in the Early–Middle Anisian after the new Middle Triassic fish fauna already appeared in the late Early Triassic, thus occuring well before what was previously supposed from the Alps localities. Furthermore, the new assemblages from southern China point to an early broader differentiation among the basal neopterygians rather than in the ‘subholosteans', the group that was then dominant in the Western Tethys since the Late Anisian. It stands that during the Norian a new basal neopterygian radiation gave rise to several new branches that dominated the remaining part of the Mesozoic.
Effects of human disturbance on nest placement of the woodpigeon (Columba palumbus): a case study from the Middle Atlas, Morocco
Authors: HANANE Saâd
Published: October 2013

The woodpigeon (Columba palumbus) is a common and widespread bird in Morocco (North Africa). I examined, over 2 years (2010 and 2011), the breeding density and nest placement of this game species in relation to nest site habitat and degree of human disturbance. The study area was in the Middle Atlas Tighboula mountain forest, Morocco, in a disturbed and an undisturbed site. Using data collected in the 2 study sites, I aimed to identify the factors influencing the placement of nests within holm oak trees (Quercus rotundifolia) and their densities. I found that habitat structures, influenced by grazing disturbance, have affected nesting density and the location of nests of this species. Woodpigeons place their nests in a higher position (3.42 ± 0.19 m) when disturbance intensity is high and lower (1.68 ± 0.1 m) when disturbance intensity is low, and show higher nesting density in less disturbed zone (3.1 ± 0.4 nests/ha) than in highly disturbed zones (1.4 ± 0.2 nests/ha). Grazing disturbance could pose a threat to population persistence at a broader scale and could potentially reduce the abundance of this species by altering the composition and the structure of the forest nesting habitat. Further multi‐scale studies are needed to assess the effects of different levels of grazing disturbance on woodpigeon nest density and placement, and to enhance our knowledge of the breeding behavior of this game species under variable environments.
Systematic review with network meta‐analysis: pharmacological prophylaxis against post‐ERCP pancreatitis
Authors: Akshintala V. S. , Hutfless S. M. , Colantuoni E. , Kim K. J. , Khashab M. A. , Li T. , Elmunzer B. J. , Puhan M. A. , Sinha A. , Kamal A. , Lennon A. M. , Okolo P. I. , Palakurthy M. K. , Kalloo A. N. , Singh V. K.
Published: October 2013

Background

The efficacy of many pharmacological agents for preventing post‐ERCP pancreatitis (PEP) has been evaluated in randomised controlled trials (RCTs), but it is unclear which agent(s) should be used in clinical practice. Network meta‐analyses of RCTs are used to simultaneously compare several agents to determine their relative efficacy and identify priority agents for comparison in future RCTs.

Aim

To evaluate pharmacological agents for the prevention of PEP by conducting a network meta‐analysis of RCTs.

Methods

We searched MEDLINE, EMBASE and Cochrane Library databases for RCTs that evaluated the efficacy of agents for preventing PEP. RCTs were simultaneously analysed using random‐effects network meta‐analysis under the Bayesian framework to identify the best agents. The efficacy of agents was ordered according to the probability of being ranked as any of the top three best performing agents.

Results

The network meta‐analysis included 99 RCTs evaluating 16 agents in 25 313 patients. Topical epinephrine (adrenaline) was the most efficacious agent with 85.9% probability of ranking among the top three agents, followed by nafamostat (51.4%), antibiotics (44.5%) and NSAIDs (42.8%). However, in a sensitivity analysis including only rectal NSAIDs, NSAIDs moved from fourth rank to second (58.1%). Patients receiving topical epinephrine, compared with placebo, had a 75% reduced risk of PEP (OR 0.25, 95% probability interval 0.06–0.66).

Conclusions

Topical epinephrine and rectal NSAIDs are the most efficacious agents for preventing post‐ERCP pancreatitis, based on existing RCTs. Combinations of these agents, which act on different steps in the pathogenesis of post‐ERCP pancreatitis, should be evaluated in future trials.
Reviewing the differences in size, composition and structure between the personal networks of high‐ and low‐performing students
Authors: Casquero Oskar , Ovelar Ramón , Romo Jesús , Benito Manuel
Published: October 2013

An interesting aspect in the current literature about learning networks is the shift of focus from the understanding of the “whole network” of a course to the examination of the “personal networks” of individual students. This line of research is relatively new, based on small‐scale studies and diverse analysis techniques, which demands for more empirical research in order to contextualize the findings and to meta‐analyze the research methods. The main objective of this paper is to review two research questions posed by a previous British Journal of Educational Technology contribution by Shane Dawson in order to know whether the differences in personal network composition impact on the performance of students. The two questions were defined by Dawson as follows: (1) Are there significant differences in personal network composition between high‐ and low‐performing students? and (2) Do high‐performing students have larger personal networks than their low‐performing peers? In addition, the “clustered graphs” method used in this study allows the inclusion of the structural analysis of personal networks. In doing so, a new research question is addressed: (3) Are there significant differences in personal network structure between high‐ and low‐performing students? This paper tries to answer these questions in the context of two undergraduate, inter‐university and fully online courses, and two different technology‐enhanced learning environments (a virtual learning environment and a personal learning environment) where interactions took place indirectly through shared resources. The results show that the network behaviors of high‐ and low‐performing students' are strongly correlated, and that high‐performing students developed larger personal networks than low performers.
Delineating the effects BRCA1 and BRCA2 loss of heterozygosity in pancreatic cancer progression
Authors: Fam HK
Published: October 2013

High prevalence of BRCA1 and BRCA2 germline mutations with loss of heterozygosity in a series of resected pancreatic adenocarcinoma and other neoplastic lesions

Lucas et al. (2013)

Clinical Cancer Research 19(13): 3396–3403.
Effect of adenotonsillectomy on visual attention tests among children with sleep‐disordered breathing: a controlled prospective cohort study
Authors: Abreu C.B. , Fuchs S.C. , Pascoto G.R. , Weber R. , Guedes M.C. , Pignatari S.S. , Stamm A.C.
Published: October 2013

Objective

This study aimed to evaluate the effect of adenotonsillectomy on visual attention and daytime sleepiness in children with sleep‐disordered breathing.

Design

This was a controlled prospective cohort study.

Setting

Outpatients from the Otorhinolaryngology Division of Edmundo Vasconcelos Hospital Complex, São Paulo, Brazil.

Participants

Patients aged 6–17 years with upper airway obstruction scheduled to undergo adenotonsillectomy (treatment group) in the Otorhinolaryngology Division of Edmundo Vasconcelos Hospital Complex, in São Paulo, Brazil. Participants of control group were consecutively selected from another outpatient clinic of paediatric surgery, but those with symptoms of sleep‐disordered breathing were excluded.

Main outcome measures

Children were submitted to visual attention tests (TAVIS‐3) that discriminates normal subjects from those with attentional disorders in advance of the surgery and 2 months later, and in the same period for the control group. Parents were interviewed about lifestyle, sleep characteristics and daytime sleepiness.

Results

The analysis included 27 patients in the adenotonsillectomy group and 30 controls, who had similar age (10.0 ± 3.3 versus 10.3 ± 3.7 years; P = 0.8), gender (41% boys versus 57%, respectively) and body mass index. There was marked decrease in daytime sleepiness after surgery (delta between groups: −4.7 ± 3.8; P < 0.001), as well as reductions in reaction time, errors of omission and errors of commission in the treatment compared with the control group at both time points, before and after surgery.

Conclusions

This study shows that adenotonsillectomy in children and adolescents with sleep‐disordered breathing reduces daytime sleepiness and improves the performance in tests of visual attention.
The clinical value of cardiac sympathetic imaging in heart failure
Authors: Christensen Thomas Emil , Kjaer Andreas , Hasbak Philip
Published: October 2013

The autonomic nervous system plays an important role in the pathology of heart failure. The single‐photon emission computed tomography tracer iodine‐123‐metaiodobenzylguanidine (123I‐MIBG) can be used to investigate the activity of the predominant neurotransmitter of the sympathetic nervous system, norepinephrine. Also, positron emission tomography tracers are being developed for the same purpose. With 123I‐MIBG as a starting point, this brief review introduces the modalities used for cardiac sympathetic imaging.
Peritoneal dialysis versus hemodialysis in patients with delayed graft function
Authors: Thomson B. K. A. , Moser M. A. J. , Marek C. , Bloch M. , Weernink C. , Shoker A. , Luke P. P.
Published: October 2013

Delayed graft function (DGF) in kidney transplantation affects adverse outcomes. It remains unclear whether the post‐transplant dialysis modality alters perioperative or long‐term graft outcomes. We performed a retrospective observational quality initiative at two Canadian renal transplant centers, in which DGF occurred in the recipient, necessitating one of peritoneal dialysis (PD) or hemodialysis (HD). There was no difference in baseline factors between patients with post‐transplant PD (n = 14) or HD (n = 63). The use of PD was associated with an increased risk of wound infection/leakage (PD 5/14 vs. HD 6/63, p = 0.024), shorter length of hospitalization (13.7 vs. 18.7 d, p = 0.009) and time requiring dialysis post‐operatively (6.5 vs 11.0 d, p = 0.043). There were no differences in readmission to hospital within 6 months (4/14 vs. 23/63, p = 0.759), graft loss (0/14 vs. 2/63, p = 1.000) or acute rejection episodes (1/14 vs. 4/63, p = 1.000) at one yr, and GFR did not differ between the PD or HD groups at 30 d (35.7 vs. 33.8 mL/min/m2, p = 0.731), six months (46.9 vs. 45.5 mL/min/m2, p = 0.835) or one yr (46.6 vs. 44.5 mL/min/m2, p = 0.746). Further research is needed to determine which transplant patients are most appropriate to undergo PD catheter removal at the time of transplantation.
Fine needle biopsy with cytology in paediatrics: the importance of a multidisciplinary approach and the role of ancillary techniques
Authors: Barroca H. , Bom‐Sucesso M.
Published: October 2013

Fine needle biopsy (FNB) with cytology has long been regarded as an excellent technique as the first choice for diagnosing adult tumours. Being an inexpensive minimally invasive technique with high accuracy and diagnostic immediacy through rapid on‐site evaluation, it is also ideal for implementation in the paediatric setting, particularly in developing countries. Furthermore, it allows complementary and advanced procedures such as flow cytometry, polymerase chain reaction (PCR) or fluorescence in situ hybridization (FISH), among others, which enhances the diagnostic capacity of this technique and gives it a key role in risk stratification and therapeutic decision‐making for several tumours. The advantages of FNB are optimized in the setting of a multidisciplinary team where cytologist, clinician and radiologist play leading roles. Paediatric tumours are rare and most ancillary techniques are cost‐effective but complex to be implemented in small centres with limited experience in paediatric pathology. Therefore reference centres are essential, in order to establish teams with extensive experience and expertise. Hence, any child with a suspected malignancy should be directly referred to a paediatric oncology unit. Focusing on a practical approach to the assessment of paediatric lymphadenopathies and non‐central nervous system solid tumours we review the effectiveness of FNB as applied concurrently with ancillary techniques in a multidisciplinary approach to the diagnosis, prognosis and therapeutic decisions of paediatric tumours and tumour‐like lesions.
Assessment of Right Ventricular Function by Transthoracic Echocardiography Following Aortic Valve Replacement
Authors: Okada David R. , Rahmouni Hind W. , Herrmann Howard C. , Bavaria Joseph E. , Forfia Paul R. , Han Yuchi
Published: October 2013

Background

Tricuspid annular plane systolic excursion (TAPSE) is a widely used clinical measure of right ventricular (RV) systolic performance. However, postsurgical changes in the pattern of RV contraction may limit the utility of TAPSE for assessing global RV function. We retrospectively examined pre‐ and postoperative TAPSE and RV fractional area change (FAC) in patients undergoing 3 different types of aortic valve replacement (AVR).

Methods

Fifty‐two patients enrolled in the Placement of AoRTic TraNscathetER Valve Trial at our institution were randomized to receive open AVR or transcatheter AVR (TAVR) by either the transapical or transfemoral access routes. Thirty‐seven of these patients had analyzable transthoracic echocardiography (TTE) before and after AVR. Using M‐mode echocardiography, TAPSE was measured in the apical four‐chamber view. Using two‐dimensional echocardiography, RV FAC was measured in the apical four‐chamber view.

Results

The mean change in TAPSE was −0.7 ± 0.6 cm for open AVR (P = 0.002), −0.2 ± 0.4 cm for transapical TAVR (P = 0.26), and 0.1 ± 0.5 cm for transfemoral TAVR (P = 0.64). The mean change in RV FAC was −1 ± 5% for open AVR (P = 0.91), 2 ± 4% for transapical TAVR (P = 0.37), and 7 ± 10% for transfemoral TAVR (P = 0.07).

Conclusions

The normal pattern of RV contraction was unchanged by transapical and transfemoral TAVR, while open AVR led to a significant decrease in TAPSE with preserved RV FAC. Thus, RV FAC is a preferable method for assessing RV function in the postoperative patient.
Effect of adult females' predation risk on oviposition site selection in a water strider
Authors: Hirayama Hiroyuki , Kasuya Eiiti
Published: October 2013

In many egg‐laying species, females avoid ovipositing at sites where the predation risk is high. Previous studies have mainly focused on the risk for offspring. The effect of predation risk for the females has been considered in some taxa in which parents spend much time at an oviposition site for parental care or mating (e.g., birds, amphibians). In species in which females do not perform activities other than oviposition at sites, the effect of predation risk for females on oviposition site selection has been rarely investigated. We examined whether the predation risk for ovipositing females affects the decision on oviposition in the water strider Aquarius paludum insularis (Motschulsky) (Heteroptera: Gerridae). Adult A. paludum are preyed upon by a backswimmer, Notonecta triguttata (Motschulsky) (Heteroptera: Notonectidae), but N. triguttata does not prey upon eggs or early instars of A. paludum. We allowed female A. paludum to oviposit under one of three conditions: in presence of N. triguttata, in presence of its chemicals, and in absence of the predator or its cues (control). Female A. paludum less frequently oviposited in presence of N. triguttata than in its absence. Oviposition frequency did not differ between females in presence of chemicals of N. triguttata vs. those in the control. Female A. paludum recognized the predation risk upon themselves from the presence of N. triguttata and avoided ovipositing. This study is the first to directly show that the predation risk upon ovipositing females changes oviposition site selection in species in which the time spent at an oviposition site is short.
Material flow analysis of feedstock for enhancing its conversion efficiency during continuous photo‐hydrogen production
Authors: Xie Guo‐Jun , Liu Bing‐Feng , Ren Hong‐Yu , Xing De‐Feng , Nan Jun , Ren Nan‐Qi
Published: October 2013

The practical application of photofermentative hydrogen production process has been generally limited by the low feedstock conversion efficiency. In this work, material flow analysis (MFA) was applied into continuous photohydrogen to investigate the material flow of feedstock. Maximum feedstock utilization for hydrogen production (31.87%) was obtained at an hydraulic retention time of 60 h and influent acetate concentration of 40 mmol l−1, corresponding to maximum hydrogen yield of 1.89 mol H2 mol−1 acetate. MFA showed that due to the poor flocculation, photofermentative bacteria (PFB) cannot be efficiently separated from supernatant and rushed out with effluent continuously. To replenish the biomass washout, most of feedstock was continuously utilized for cell growth rather than hydrogen production, which caused low feedstock conversion efficiency. The results showed that poor flocculation of PFB resulting in low biomass retention capacity of photobioreactor was the origin of low feedstock conversion efficiency. Therefore, enhancing flocculation of PFB and using high biomass retaining operation modes are essential to further develop photofermentative hydrogen production process.
Plaque at RISK (PARISK): Prospective Multicenter Study to Improve Diagnosis of High-Risk Carotid Plaques
Authors: Truijman M. T. B. , Kooi M. E. , van Dijk A. C. , de Rotte A. A. J. , van der Kolk A. G. , Liem M. I. , Schreuder F. H. B. M. , Boersma E. , Mess W. H. , van Oostenbrugge R. J. , Koudstaal P. J. , Kappelle L. J. , Nederkoorn P. J. , Nederveen A. J. , Hendrikse J. , van der Steen A. F. W. , Daemen M. J. A. P. , van der Lugt A.
Published: October 2013

Background

Patients with symptomatic carotid artery stenosis are at high risk for recurrent stroke. To date, the decision to perform carotid endarterectomy in patients with a recent cerebrovascular event is mainly based on degree of stenosis of the ipsilateral carotid artery. However, additional atherosclerotic plaque characteristics might be better predictors of stroke, allowing for more precise selection of patients for carotid endarterectomy.

Aims and hypothesis

We investigate the hypothesis that the assessment of carotid plaque characteristics with magnetic resonance imaging, multidetector-row computed tomography angiography, ultrasonography, and transcranial Doppler, either alone or in combination, may improve identification of a subgroup of patients with <70% carotid artery stenosis with an increased risk of recurrent stroke.

Methods

The Plaque At RISK (PARISK) study is a prospective multicenter cohort study of patients with recent (<3 months) neurological symptoms due to ischemia in the territory of the carotid artery and < 70% ipsilateral carotid artery stenosis who are not scheduled for carotid endarterectomy or stenting. At baseline, 300 patients will undergo magnetic resonance imaging, multidetector-row computed tomography angiography, and ultrasonography examination of the carotid arteries. In addition, magnetic resonance imaging of the brain, ambulatory transcranial Doppler recording of the middle cerebral artery and blood withdrawal will be performed. After two-years, imaging will be repeated in 150 patients. All patients undergo a follow-up brain magnetic resonance imaging, and there will be regular clinical follow-up until the end of the study. Study outcomes The combined primary end-point contains ipsilateral recurrent ischemic stroke or transient ischemic attack or new ipsilateral ischemic brain lesions on follow-up brain magnetic resonance imaging.