bluuebunny/crossref_metadata_2025 huggingface dataset:
Maximal Electrogram Attenuation Recorded from Mini Electrodes Embedded on 4.5‐mm Irrigated and 8‐mm Nonirrigated Catheters Signifies Lesion Maturation
Authors: AVITALL BOAZ , HORBAL PIOTR , VANCE DAVID , KOBLISH JOSEF , KALINSKI ARTHUR
Published: October 2014

4.5‐mm Irrigated vs. 8‐mm Nonirrigated Catheters with Mini Electrode Technology

Background

The electrograms (EGMs) recorded from mini electrodes (ME) placed on the tip of the ablation electrode allow more precise EGM monitoring during lesion formation. Our objective was to define the lesion boundaries and extracardiac injuries resulting from 60‐second RF application versus RF application time titrated to maximal attenuation of the ME EGM in the atria and ventricles using 4.5‐mm irrigated and 8‐mm catheters.

Methods

RF lesions were placed in both atria and ventricles in 13 (30–35 kg) canines; 6 (4.5‐mm OI) and 7 (8 mm). The RF application time was fixed at 60 seconds or terminated at maximal ME EGM amplitude attenuation.

Results

Pre/postablation pacing thresholds, EGM amplitudes, and lesion dimensions were not significantly different between maximal EGM attenuation and 60‐second RF application using either catheter. Atrial lesion transmurality was also similar for both catheters and groups 91.2% (4.5 mm) and 96% (8 mm) when the RF was titrated to the maximal EGM attenuation and 94.2% (4.5 mm) and 95% (8 mm) with 60‐second RF. The 60‐second RF ablation, however, presented with significant extracardiac injuries to the lungs and esophagus, along with char formation. Deep ventricular lesions were noted with maximal EGM attenuation that were not different from the 60‐second RF ablation.

Conclusion

Titration of the RF application time to the maximal EGM attenuation based on the ME recordings represents atrial lesion maturation and deep ventricular lesions. Prolonging the RF application results in greater extracardiac injury and char formation without increasing lesion size.
Lactoferrin levels in gingival crevicular fluid and saliva of HIV‐infected patients with chronic periodontitis
Authors: Ferreira Sonia Maria Soares , Gonçalves Lucio Souza , Torres Sandra R. , Nogueira Susie A. , Meiller Timothy F.
Published: October 2014

Aim

This study compared lactoferrin (LF) levels in the gingival crevicular fluid (GCF) and saliva between HIV‐infected and noninfected patients with chronic periodontitis.

Methods

For each subject, LF levels were analyzed in one shallow site (SS; PD ≤3 mm), one deep site (DS; PD >5 mm) and in resting whole saliva. Two groups, 28 HIV‐infected and 10 noninfected, were selected.

Results

Although the salivary LF levels were higher in HIV‐infected than in noninfected individuals, especially in AIDS patients, this was not statistically significant (P > 0.05). Subgingival LF levels for SS and DS were lower among HIV‐infected individuals, although AIDS patients showed the lowest levels. Age, smoking, gender, T CD4 lymphocytes levels and viral load did not influence subgingival LF levels, neither for SS nor for DP. Positive fungal culture was observed in 24 HIV‐infected patients, but only observed in one in the control group. Overall, LF concentration was significantly higher in DS than SS, both in HIV‐infected and noninfected individuals (P < 0.05) and salivary LF levels were always higher than GCF levels.

Conclusion

The data indicate that LF levels in the GCF and saliva are not different between HIV‐infected and noninfected patients with chronic periodontitis.
Rare case of endometrioid adenocarcinoma arising from cystic adenomyosis
Authors: Mori Mayuyo , Furusawa Akiko , Kino Nao , Uno Masaya , Ozaki Yoshikazu , Yasugi Toshiharu
Published: October 2014

Few reports on malignant transformation of adenomyosis are available, and endometrioid adenocarcinoma arising from cystic adenomyosis is further rarely reported. We report a case of a 67‐year‐old asymptomatic woman who was referred to our hospital for evaluation of a cystic lesion in the pelvis, which had been diagnosed as cystic degeneration of leiomyoma for 3 years. Magnetic resonance imaging revealed a cystic mass measuring 11 cm in diameter, which was contiguous with uterine myometrium. The lesion contained solid areas enhanced on gadolinium‐enhanced T1‐weighted imaging. Transabdominal simple total hysterectomy with bilateral salpingo‐oophorectomy was performed. Pathological examination revealed endometrioid adenocarcinoma arising from cystic adenomyosis. The patient underwent six courses of adjuvant combination chemotherapy with paclitaxel and carboplatin. No metastasis or recurrence has been demonstrated for 16 months following surgery. Our case demonstrates that cystic adenomyoma possesses the risk of malignant transformation, indicating the importance of long‐term follow‐up with imaging examination.
Is ‘cold loop’ hysteroscopic myomectomy a better option for reproduction in women with diffuse uterine leiomyomatosis? A case report of successful repeated pregnancies
Authors: Mazzon Ivano , Favilli Alessandro , Grasso Mario , Morricone Daniela , Di Renzo Gian Carlo , Gerli Sandro
Published: October 2014

Diffuse uterine leiomyomatosis (DUL) is a rare clinical entity with important reproductive consequences. To date, only four pregnancies have been reported after hysteroscopic myomectomy. Here we describe the case of a 28‐year‐old infertile woman with diffuse uterine leiomyomatosis, who presented infertility and metrorrhagia lasting for 2 years. A countless number of subserous, intramural and submucous myomas were ultrasonographically revealed. Diagnostic hysteroscopy described a uterine cavity completely subverted by the presence of myomas. A two‐step ‘cold loop’ hysteroscopic myomectomy was performed following the technique previously described. One month after the treatment, there were no submucous myomas. A regular uterine cavity free of synechiae was endoscopically confirmed. After the treatment, the patient carried to term three consecutive, uneventful pregnancies. This is the first report of repeated successful pregnancies following the ‘cold loop’ hysteroscopic technique in DUL. We believe that ‘cold loop’ resectoscopic myomectomy may provide new advantageous perspectives for women with DUL seeking pregnancy.
Analysis of gene expression and preliminary study of methylation about 11β‐HSD2 gene in placentas of Chinese pre‐eclampsia patients of Han ethnicity
Authors: Hu Wensheng , Wang Hanzhi , Huang Hefeng
Published: October 2014

Aims

The aim of this study was to determine the promoter methylation status of type 2 isoform of 11β‐hydroxysteroid dehydrogenase (11β‐HSD2) and its regulatory correlation with 11β‐HSD2 gene expression in placentas of pre‐eclampsia (PE) patients of Chinese Han ethnicity.

Material and Methods

The pathological features of placental tissues were studied using hematoxylin–eosin staining and immunohistochemical staining. The 11β‐HSD2 mRNA and protein expressions were detected by real‐time polymerase chain reaction and Western blotting. The methylation of the 11β‐HSD2 promoter sequence was examined by bisulfite sequencing polymerase chain reaction.

Results

Trophoblast hyperplasia and discontinuous syncytial layer were observed in the PE group, and the 11β‐HSD2 was distributed irregularly and its immunoreactivity was weakened distinctly. The expressions of 11β‐HSD2 mRNA and protein decreased significantly in the PE group compared with the control group. Unexpectedly, almost no 11β‐HSD2 methylation was detected in PE placental tissue (two fragments, 0.6% vs 0%) or normal placental tissue (1% vs 0.6%). No significant difference in 11β‐HSD2 promoter methylation was found between the two groups.

Conclusions

The 11β‐HSD2 expression decreased in PE women of Chinese Han ethnicity, but was not interrelated with the promoter methylation status.
Disturbed release of cholecystokinin in pregnant women with hyperemesis gravidarum
Authors: Biberoglu Ebru , Kirbas Ayse , Iskender Cantekin , Dirican Aylin , Daglar Halil , Demirtas Canan , Doganay Beyza , Uygur Dilek , Biberoglu Kutay
Published: October 2014

Aims

We aimed to investigate cholecystokinin (CCK) release in pregnant women with and without hyperemesis gravidarum (HG).

Material and Methods

In this case–control study including 40 pregnant women with HG and 40 women with healthy uncomplicated pregnancies, serum CCK levels in addition to hematological, biochemical and hormonal parameters were investigated.

Results

Serum CCK values were found to be significantly lower in pregnant women with HG (P < 0.001). Additionally, while serum blood urea nitrogen and free thyroxine levels were significantly higher, sodium, potassium, and thyroid stimulating hormone levels were significantly lower in women with HG than in control women. No correlation was detected between CCK and other parameters like ketonuria and thyroid function tests.

Conclusions

CCK release has been found to be halved in pregnant women with HG, which supports the hypothesis that gastrointestinal motility is increased in pregnant women with HG. A causal effect remains to be confirmed.
Role of stress in low birthweight disparities between Black and White women: A population‐based study
Authors: Loggins Clay Shondra , Andrade Flavia Cristina Drumond
Published: October 2014

Aim

This study examines the role of stress in low birthweight (LBW) risk in Black and White women in the United States.

Methods

Data from the 1998–2000 Fragile Family and Child Wellbeing Study were used (n = 3869). We included several self‐reported conditions which we categorised as stressors (i.e. socio‐economic conditions, health behaviours, access to quality care and cultural factors), then we used logistic regression models to analyse the role of stressors in explaining the health disparities in LBW.

Results

Most women were unmarried (59% for White women and 87% for Black women). Among unmarried White women, the only stressor associated with a higher likelihood of LBW was smoking (odds ratio (OR) = 2.0, 95% confidence interval (CI) (1.2, 3.3)). Among unmarried Black women, smoking (OR = 1.7, 95% CI (1.2, 2.3)), drug use (OR = 1.7, 95% CI (1.0, 2.6)), paying for the baby's birth with government resources (OR = 1.6, 95% CI (1.1, 2.4)) and religious affiliation (OR = 1.6, 95% CI (1.0, 2.5)) were associated with higher likelihood of LBW. Among married White women, older age (OR = 1.1, 95% CI (1.0, 1.2)), smoking (OR = 5.2, 95% CI (1.7, 15.5)), using governmental resources to pay for birth (OR = 3.6, 95% CI (1.0, 12.4)) and living in governmental housing (OR = 9.1, 95% CI (2.0, 41.1)) were associated with higher likelihood of LBW. No stressors were statistically significant for married Black women.

Conclusion

We analysed a large number of stressors at the individual, household and societal levels and found differences on the stressors among Black and White women. However, the stressors included in the analyses did not fully explain the racial disparities in LBW.
Effects of Milling Ratio and Water‐to‐Rice Ratio on Mastication Effort for Cooked Rice Measured by Electromyography
Authors: Kohyama Kaoru , Sodhi Navdeep Singh , Sasaki Tomoko , Suzuki Keitaro
Published: October 2014

The objective of this study was to quantify the mastication effort for cooked rice with varying texture. We conducted electromyography (EMG) from both masseter muscles while normal subjects ate 6 g of cooked rice. Rice samples were prepared using different milling ratios and cooked with different amounts in weight of water. The texture of cooked rice samples was instrumentally analyzed. Hardness was similar between 2% milled and 1.80 times weight of water, 6% and 1.65, and 10% and 1.50; however, adhesiveness was lower in lesser milled samples. EMG results showed that the number of chews, mastication time and muscle activities per chew were higher in the harder rice samples that were milled less and cooked with less water. When the hardness of cooked rice was adjusted, EMG variables were not significantly different. The mastication effort per gram of solid content significantly differed with milling ratios.

Practical Application

Cooked rice is a staple food for many people. The texture of cooked rice can be easily modified by changing milling ratios and water‐to‐rice grain ratios. As mastication is the first process of digestion, understanding how milling and cooking conditions influence the texture of cooked rice and mastication behavior is important for palatability and nutrition. EMG variables can provide details on mastication effort, proving to be useful for preparing the best texture of cooked rice. As less milled rice requires more mastication per solid content, it is effective to increase number of chews and to decrease eating rate.
How will we manage acute HCV in men having sex with men in the era of all oral therapy?
Authors: Boesecke C. , Rockstroh J. K.
Published: October 2014

With the advent of direct‐acting antivirals (DAAs), the treatment of chronic hepatitis C virus (HCV) infection (CHC) has been revolutionized. Modern interferon‐ and potentially also ribavirin‐free combinations consisting of 2 or 3 direct‐acting antivirals (DAA) promise sustained virological response rates (SVR) of above 90%. This coincides with much shorter treatment durations and a much more favorable toxicity profile. Some DAAs even work across all HCV genotypes (pangenotypic) [BMJ, 349, 2014, g3308]. And lastly, HCV treatment in HIV‐coinfected patients will no longer differ from HCV‐monoinfected patients as response rates under DAA in the setting of HCV–HIV coinfection have been as good as in HCV‐monoinfected patients [J Hepatol, 61, 2014, 373]. Only drug–drug interactions with the new DAAs and concomitant antiretroviral therapy have to be accounted for due to shared metabolization pathways via the cytochrome p450 system.
Neoliberal Justice and the Transformation of the Moral: The Privatization of the Right to Health Care in Colombia
Authors: Abadía‐Barrero César Ernesto
Published: October 2014

Neoliberal reforms have transformed the legislative scope and everyday dynamics around the right to health care from welfare state social contracts to insurance markets administered by transnational financial capital. This article presents experiences of health care–seeking treatment, judicial rulings about the right to health care, and market‐based health care legislation in Colombia. When insurance companies deny services, citizens petition the judiciary to issue a writ affirming their right to health care. The judiciary evaluates the finances of all relevant parties to rule whether a service should be provided and who should be responsible for the costs. A 2011 law claimed that citizens who demand, physicians who prescribe, and judges who grant uncovered services use the system's limited economic resources and undermine the state's capacity to expand coverage to the poor. This article shows how the consolidation of neoliberal ideology in health care requires the transformation of moral values around life.
Fission and fusion in island taxa – serendipity, or something to be expected?
Authors: Emerson Brent C. , Faria Christiana M. A.
Published: October 2014

A well‐used metaphor for oceanic islands is that they act as ‘natural laboratories’ for the study of evolution. But how can islands or archipelagos be considered analogues of laboratories for understanding the evolutionary process itself? It is not necessarily the case that just because two or more related species occur on an island or archipelago, somehow, this can help us understand more about their evolutionary history. But in some cases, it can. In this issue of Molecular Ecology, Garrick et al. () use population‐level sampling within closely related taxa of Galapagos giant tortoises to reveal a complex demographic history of the species Chelonoidis becki – a species endemic to Isabela Island, and geographically restricted to Wolf Volcano. Using microsatellite genotyping and mitochondrial DNA sequencing, they provide a strong case for C. becki being derived from C. darwini from the neighbouring island of Santiago. But the interest here is that colonization did not happen only once. Garrick et al. () reveal C. becki to be the product of a double colonization event, and their data reveal these two founding lineages to be now fusing back into one. Their results are compelling and add to a limited literature describing the evolutionary consequences of double colonization events. Here, we look at the broader implications of the findings of Garrick et al. () and suggest genomic admixture among multiple founding populations may be a characteristic feature within insular taxa.
Correlation of structural and electrophysiological changes in the retina of young high myopes
Authors: Koh Victor , Tan Clement , Nah Gerard , Zhao Paul , Yang Adeline , Lin Sheng Tong , Wong Tien Yin , Saw Seang Mei , Chia Audrey
Published: October 2014

Purpose

Despite a high prevalence of myopia among young East Asian adults, there is a lack of data on the myopic retina structure‐function relationship in this group. We examined the association between optical coherence tomography (OCT) and electroretinogram (ERG) measurements in highly myopic young Asian adults to provide this information and also determined if OCT can be used as an alternative screening tool to assess retinal function in young myopic adults.

Methods

This was a prospective study comprising young adults aged between 18 and 25 years with spherical equivalent refraction of worse than −6.00 D. A comprehensive ophthalmic examination comprising fundus examination and grading, ocular biometry, time‐domain OCT (fovea, macular and retinal nerve fibre layer thickness) and ERG (full field and multifocal) were performed for all the eyes.

Results

A total of 32 eyes (mean spherical equivalent ± standard deviation −10.17 ± 1.51 D, mean age 23.8 ± 1.3 years) were included. None of the eyes showed visible myopic retinopathy and the central retina thickness of all eyes was classified as within the normal range. Full‐field ERG amplitude and multifocal ERG P1 amplitudes in the outer rings (R3‐R5) were, however, inversely associated with axial length. The multifocal ERG P1 amplitudes were also positively correlated with mean retinal nerve fibre layer thickness in R2, 4, 5 rings and outer macular thickness in R 2–5 rings.

Conclusion

These findings suggest that full field ERG changes may precede fundus and OCT changes in highly myopic young adults. Although there was some correlation between multifocal ERG amplitudes with OCT outer macular and retinal nerve fibre layer thickness, the OCT may not be useful as a retinal function screening tool, being within normal limits in all eyes. Further longitudinal studies are required to determine how the relationship between ERG and OCT will evolve over time.
Confirmation of local anesthetic distribution by radio‐opaque contrast spread after ultrasound guided infraclavicular catheters placed along the posterior cord in children: a prospective analysis
Authors: Ponde Vrushali , Shah Dipal , Johari Ashok
Published: October 2014

Background

The needle tip placed at the level of posterior cord under ultrasound guidance is described as the most effective way to obtain single shot successful block in adults, for forearm and hand surgeries.

Objective

The aim of this research was to study the spread of dye (depicting the local anesthetic) through catheters placed along the posterior cord. This was performed with continuous infraclavicular blocks placed under ultrasound guidance in children.

Methods

Twenty‐four ASA 1 and 2 children, aged 7 months to 8 years old, scheduled for upper limb orthopedic surgeries were included in this prospective descriptive study. They received continuous infraclavicular block under ultrasound guidance. Skin markings were obtained from catheters that were placed below the posterior cord inserted 2–3 cm beyond the tip of the Tuohy needle. A radio‐opaque dye was injected into the catheters and 5 min later, the dye spread was evaluated fluoroscopically. Postoperatively, all patients received a continuous infusion of 0.125% bupivacaine for pain relief.

Results

All 24 cases showed the presence of the dye along the neurovascular bundle in the infraclavicular region suggesting successful blocks. The mean ± standard deviation of the skin marking for the catheter was 5.61 ± 1.77 cm. Postoperatively, all patients had adequate pain relief with the catheters. One patient had break through pain on day 1 and four catheters were accidentally dislodged on day 2.

Conclusion

We conclude that continuous infraclavicular catheters can be accurately and effectively placed along the posterior cord exclusively under ultrasound guidance in infants and small children.
Dose effect of local anesthetics on analgesic outcomes for the transversus abdominis plane (TAP) block in children: a randomized, double‐blinded, clinical trial
Authors: Suresh Santhanam , Taylor Lauren J. , De Oliveira Gildasio S.
Published: October 2014

Background

Current knowledge on local anesthetic dosage for the TAP block in pediatric patients is very limited.

Objective

To evaluate the effect of two escalating local anesthetic doses on postsurgical analgesic outcomes in children receiving a TAP block.

Methods

The study was a prospective, randomized, double‐blinded, clinical trial. Children (<8 years) were randomized to one of the two intervention groups: TAP block with bupivacaine at a dose of 2.5 mg·kg−1 or 1.25 mg·kg−1. Analgesic outcomes included pain scores in the postanesthesia care unit (PACU), time to analgesic requirement and total number of analgesic requirements.

Results

Thirty‐six patients were recruited in the study. Pain scores in PACU were not different between study groups. The total number of analgesic dosage required in 24 h after surgery was higher in the lower dose group, median (IQR) of 4 (3 to 5) compared to 2.5 (1.5 to 3) in the greater dose group, P = 0.03. There was a clinically but not statistically significant difference in the time to first analgesic requirement in the 2.5 mg·kg−1 group, median (IQR) of 248 (130 to 367) minutes compared to 146 (95 to 261) minutes in the 1.25 mg·kg−1 dose group, P = 0.15.

Conclusions

The use of higher local anesthetic doses for the TAP block in children does not provide benefits on early pain scores but seems to improve analgesic duration and decrease the need for additional analgesics over 24 h after surgery. The use of higher, but yet safe, local anesthetic dosages for TAP blocks is a viable strategy to improve analgesia in children.
Systematic Review and Meta‐Analysis of benefits and risks between normothermia and hypothermia during cardiopulmonary bypass in pediatric cardiac surgery
Authors: Xiong Yaoyao , Sun Yanhua , Ji Bingyang , Liu Jinping , Wang Guyan , Zheng Zhe
Published: October 2014

Background

The controversy over the benefits between normothermic and hypothermic cardiopulmonary bypass (CPB) for children is still uncertain. The purpose of this systematic review and meta‐analysis is to investigate the benefits and risks of normothermia comparing with hypothermia in pediatric cardiac surgery by randomized controlled trials.

Methods

Pubmed, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies reported in English up to September 28, 2013. Eligible studies were those in which investigators enrolled pediatric patients, who had cardiac surgery, randomized them to normothermic or hypothermic CPB. We prespecified the use of random‐effects models to calculate risk ratios and 95% CIs for binary variables, weighted mean difference (WMD) or standard mean difference and 95% CIs for continuous variables. We assessed heterogeneity using I2. When heterogeneity was absent (I2 = 0%), we used fixed‐effects models. The endpoints were serum lactate, serum creatinine, duration of clamp, and duration of CPB in pediatrics who had cardiac surgery in normothermic CPB compared with those in hypothermic CPB.

Results

The initial search strategy identified 3910 citations, of which 10 trials compared pediatrics and seven trails were eligible. These seven trials included 419 participants from seven countries. The serum lactate and the serum creatinine had three time points. The outcomes had no different between normothermic group and hypothermic group. Duration of clamp (WMD = −10.793, 95% CI −28.89, 7.304; P = 0.242; I2 = 86.6%; 204 patients, three trials) and duration of CPB (WMD = −41.780, 95% CI −89.523, 5.963; P = 0.086; I2 = 95.6%; 199 patients, three trials) also had no significant differences between two groups.

Conclusion

Normothermic CPB is as safe as hypothermic CPB in children requiring correction of simple congenital cardiac defects.
Mammogram Use and Self‐Efficacy in an Urban Minority Population
Authors: Jerome‐D'Emilia Bonnie , Suplee Patricia Dunphy
Published: October 2014

Objectives

(1) To compare a sample of low‐income African American and Hispanic women in general and mammogram specific self‐efficacy and other factors potentially associated with screening to identify any differences related to ethnicity and in the use of mammogram screening; and (2) to examine the association of general self‐efficacy and mammography specific self‐efficacy and mammogram screening in these two ethnically different groups of women.

Design and Sample

Cross‐sectional. A convenience sample of 139 women.

Measures

General and mammogram specific self‐efficacy, having ever had a mammogram, acculturation, and demographics.

Results

Mammogram specific self‐efficacy was significantly associated with having had a mammogram (p < .001), as was insurance status (p = .027). Using logistic regression, older women (OR: 1.3) and those with insurance (OR: 4.8) were more likely to have been screened. When mammogram specific self‐efficacy was added to the model, overlap between this construct and insurance prevented insurance from reaching significance.

Conclusions

An association between insurance status and mammogram specific self‐efficacy was found. It is likely that mammogram specific self‐efficacy will vary with mammogram adherence and insurance status, rather than predict screening. General self‐efficacy, higher in screened women, may be an effective mediator through which to develop interventions to increase preventive health‐seeking behaviors.
Analysis of Oxyluciferin Photoluminescence Pathways in Aqueous Solutions
Authors: Hiyama Miyabi , Mochizuki Toshimitsu , Akiyama Hidefumi , Koga Nobuaki
Published: October 2014

We evaluated the pKa values of oxyluciferin and its conjugate acids and bases theoretically with the help of experimental correction values, from which free energies for the first excited and the ground states of all the species were estimated. On the basis of these results, we calculated pH‐dependent absorption spectra, where the relative absorption intensities of various species strongly depend on photoexcitation energy, and we further analyzed the photoluminescence pathways of oxyluciferin in aqueous solutions with various pH. In the case of 350 nm photoexcitation, in particular, experiments have shown that dominant emission color is green and it attenuates with pH decreasing, while blue (3 < pH < 8) and red (pH < 3) emissions appear. Our present results clarify the pathways of these photoluminescence depending on the pH values and thus should be useful in further analyses of photoluminescence pathways for other photoexcitation wavelength in comparison with experiments.
Seasonal Influenza Vaccination during Pregnancy and the Risks of Preterm Delivery and Small for Gestational Age Birth
Authors: Ahrens Katherine A. , Louik Carol , Kerr Stephen , Mitchell Allen A. , Werler Martha M.
Published: October 2014

Background

Influenza vaccination is routinely recommended for pregnant women, yet information on perinatal outcomes is sparse.

Methods

We investigated the associations between trivalent (seasonal) influenza vaccination during pregnancy and the risks of preterm delivery (PTD, live birth <37 weeks gestation) and small for gestational age birth (SGA, <10th percentile in weight for sex‐specific gestational age) during the influenza seasons 2006–07 through 2009–10. The study population included 1619 mothers of live‐born, non‐malformed singleton infants interviewed as part of the Slone Epidemiology Center's Birth Defects Study. Associations between influenza vaccination and PTD and SGA were assessed using Cox and logistic regression models, respectively, with propensity scores used to adjust for confounding. Women vaccinated against pandemic H1N1 were excluded from the analysis.

Results

Influenza vaccination during pregnancy showed a near null association with PTD for influenza seasons 2006–07 through 2008–09 compared with unvaccinated women [adjusted hazard ratios (aHR) ranged from 0.79 [95% confidence interval (CI) 0.28, 2.21] in 2007–08 to 1.08 [95% CI: 0.40, 2.95] in 2008–09]. For 2009–10, the risk of PTD was higher in vaccinated women (aHR, 7.81 [95% CI: 2.66, 23.0]). Influenza vaccination was not associated with appreciable risks for SGA for all seasons with sufficient numbers of exposed SGA.

Conclusion

Though limited by study size, these findings add support to previous observations of little or no increased risk of PTD or SGA associated with seasonal influenza vaccination for three of the four influenza seasons in our study. The increased risk of PTD observed for the 2009–10 influenza season warrants further investigation.
Selection and validation of reference genes for target gene analysis with quantitative RT‐PCR in leaves and roots of bermudagrass under four different abiotic stresses
Authors: Chen Yu , Tan Zhiqun , Hu Baoyun , Yang Zhimin , Xu Bin , Zhuang Lili , Huang Bingru
Published: October 2014

Quantitative real‐time reverse transcriptase polymerase chain reaction (qRT‐PCR) is an effective method for quantifying expression levels of target genes. The accuracy of qRT‐PCR results is largely dependent on the selection of stable reference genes. The stability of reference gene expression may vary with plant species and environmental conditions. The objective of this study was to select stable reference genes for qRT‐PCR analysis of target genes in different organs under different abiotic stresses for a perennial grass species, bermudagrass (Cynodon dactylon). The stability of eight potential reference genes (TUB, ACT, GAPDH, EF1α, TIP41, PP2A, CACS and UPL7) was evaluated under four different abiotic stresses (salt, drought, cold and heat) and in leaves and roots of bermudagrass. Four programs (geNorm, NormFinder, BestKeeper and RefFinder) were employed to evaluate the stability of reference gene expression and to identify the most stable reference genes for bermudagrass. Eight potential reference genes exhibited differential expression stability in leaves and roots under salt, drought, cold and heat stress. The expression levels of PP2A and CACS were stable in roots and leaves under salt stress, in leaves under drought stress and in roots exposed to cold and heat stress. EF1α and TIP41 expression was stable in roots of drought‐stressed plants. UPL7, TUB and GAPDH were stably expressed in leaves under cold stress. Expression levels of PP2A and TIP41 were stable in leaves under heat stress. The use of the reference genes identified as internal controls for examination of gene expression patterns and quantification of expression levels of target genes will enable accurate qRT‐PCR analysis in bermudagrass.
EPA Underestimates, Oversimplifies, Miscommunicates, and Mismanages Cancer Risks by Ignoring Human Susceptibility
Authors: Finkel Adam M.
Published: October 2014

If exposed to an identical concentration of a carcinogen, every human being would face a different level of risk, determined by his or her genetic, environmental, medical, and other uniquely individual characteristics. Various lines of evidence indicate that this susceptibility variable is distributed rather broadly in the human population, with perhaps a factor of 25‐ to 50‐fold between the center of this distribution and either of its tails, but cancer risk assessment at the EPA and elsewhere has always treated every (adult) human as identically susceptible. The National Academy of Sciences “Silver Book” concluded that EPA and the other agencies should fundamentally correct their mis‐computation of carcinogenic risk in two ways: (1) adjust individual risk estimates upward to provide information about the upper tail; and (2) adjust population risk estimates upward (by about sevenfold) to correct an underestimation due to a mathematical property of the interindividual distribution of human susceptibility, in which the susceptibility averaged over the entire (right‐skewed) population exceeds the median value for the typical human. In this issue of Risk Analysis, Kenneth Bogen disputes the second adjustment and endorses the first, though he also relegates the problem of underestimated individual risks to the realm of “equity concerns” that he says should have little if any bearing on risk management policy. In this article, I show why the basis for the population risk adjustment that the NAS recommended is correct—that current population cancer risk estimates, whether they are derived from animal bioassays or from human epidemiologic studies, likely provide estimates of the median with respect to human variation, which in turn must be an underestimate of the mean. If cancer risk estimates have larger “conservative” biases embedded in them, a premise I have disputed in many previous writings, such a defect would not excuse ignoring this additional bias in the direction of underestimation. I also demonstrate that sensible, legally appropriate, and ethical risk policy must not only inform the public when the tail of the individual risk distribution extends into the “high‐risk” range, but must alter benefit‐cost balancing to account for the need to try to reduce these tail risks preferentially.
Deriving island constraints with searle and grice. A pragmatic account of bridge verbs
Authors: Müller Sonja
Published: October 2014

This paper proposes a pragmatic account of restrictions on extractions fromthat‐complement clauses. Forthat‐complements, it is well known that their transparancy for extraction gets influenced by the matrix verb selecting them: So‐calledbridge verbsallow extraction from their complement,non‐bridge verbsdo not. Analysing the differentcontext changesinduced by the extraction constructions, an account is developed which proves a violation of very basic pragmatic principles (Searle's 1969felicity conditionsfor questions and Grice's 1975Cooperative Principle(plusConversational Maxims)) under the occurrence of the negatively influencingfactive,implicativeandmanner‐of‐speaking verbs. Evidence for an account of this nature in general as well as the particular one proposed in this paper comes from the observation that manipulating contextual factors in the shape of subtypes of the illocutionary force, the questions' intentions and intonational patterns has an impact on the structures’ acceptability.
Pepper pathogenesis‐related protein 4c is a plasma membrane‐localized cysteine protease inhibitor that is required for plant cell death and defense signaling
Authors: Kim Nak Hyun , Hwang Byung Kook
Published: October 2014

Xanthomonas campestris pv. vesicatoria (Xcv) type III effector AvrBsT triggers programmed cell death (PCD) and activates the hypersensitive response (HR) in plants. Here, we isolated and identified the plasma membrane localized pathogenesis‐related (PR) protein 4c gene (CaPR4c) from pepper (Capsicum annuum) leaves undergoing AvrBsT‐triggered HR cell death. CaPR4c encodes a protein with a signal peptide and a Barwin domain. Recombinant CaPR4c protein expressed in Escherichia coli exhibited cysteine protease‐inhibitor activity and ribonuclease (RNase) activity. Subcellular localization analyses revealed that CaPR4c localized to the plasma membrane in plant cells. CaPR4c expression was rapidly and specifically induced by avirulent Xcv (avrBsT) infection. Transient expression of CaPR4c caused HR cell death in pepper leaves, which was accompanied by enhanced accumulation of H2O2 and significant induction of some defense‐response genes. Deletion of the signal peptide from CaPR4c abolished the induction of HR cell death, indicating a requirement for plasma membrane localization of CaPR4c for HR cell death. CaPR4c silencing in pepper disrupted both basal and AvrBsT‐triggered resistance responses, and enabled Xcv proliferation in infected leaves. H2O2 accumulation, cell‐death induction, and defense‐response gene expression were distinctly reduced in CaPR4c‐silenced pepper. CaPR4c overexpression in transgenic Arabidopsis plants conferred greater resistance against infection by Pseudomonas syringae pv. tomato and Hyaloperonospora arabidopsidis. These results collectively suggest that CaPR4c plays an important role in plant cell death and defense signaling.
OsCERK1 and OsRLCK176 play important roles in peptidoglycan and chitin signaling in rice innate immunity
Authors: Ao Ying , Li Zhangqun , Feng Dongru , Xiong Feng , Liu Jun , Li Jian‐Feng , Wang Menglong , Wang Jinfa , Liu Bing , Wang Hong‐Bin
Published: October 2014

Microbe‐associated molecular pattern (MAMP)‐triggered immunity plays critical roles in the basal resistance defense response in plants. Chitin and peptidoglycan (PGN) are major molecular patterns for fungi and bacteria, respectively. Two rice (Oryza sativa) lysin motif‐containing proteins, OsLYP4 and OsLYP6, function as receptors that sense bacterial PGN and fungal chitin. These membrane receptors, which lack intracellular kinase domains, likely contain another component for transmembrane immune signal transduction. Here, we demonstrate that the rice LysM receptor‐like kinase OsCERK1, a key component of the chitin elicitor signaling pathway, also plays an important role in PGN‐triggered immunity in rice. Silencing of OsCERK1 suppressed PGN‐induced (and chitin‐induced) immunity responses, including reactive oxygen species generation, defense gene expression, and callose deposition, indicating that OsCERK1 is essential for both PGN and chitin signaling initiated by OsLYP4 and OsLYP6. OsLYP4 associated with OsLYP6 and the rice chitin receptor chitin oligosaccharide elicitor‐binding protein (CEBiP) in the absence of PGN or chitin, and treatment with PGN or chitin led to their disassociation in vivo. OsCERK1 associated with OsLYP4 or OsLYP6 when induced by PGN but it associated with OsLYP4, OsLYP6, or CEBiP under chitin treatment, suggesting the presence of different patterns of ligand‐induced heterooligomeric receptor complexes. Furthermore, the receptor‐like cytoplasmic kinase OsRLCK176 functions downstream of OsCERK1 in the PGN and chitin signaling pathways, suggesting that these MAMPs share overlapping intracellular signaling components. Therefore, OsCERK1 plays dual roles in PGN and chitin signaling in rice innate immunity and as an adaptor involved in signal transduction at the plasma membrane in conjunction with OsLYP4 and OsLYP6.
Umbilical cord blood CD34+ stem cells and other mononuclear cell subtypes processed up to 96 h from collection and stored at room temperature maintain a satisfactory functionality for cell therapy
Authors: Pereira‐Cunha F. G. , Duarte A. S. S. , Reis‐Alves S. C. , Olalla Saad S. T. , Metze K. , Lorand‐Metze I. , Luzo Â. C. M.
Published: October 2014

Background and Objectives

Umbilical cord blood (UCB) is a good stem cell source for cell therapy. We recently demonstrated that cord blood mononuclear cell (MNCs) subtypes were viable and functional until 96 h after collection, even stored at room temperature. Now, we analyzed the viability and functionality of the cells before and after cryopreservation.

Materials and Methods

Twenty UCB units were analyzed at 24 and 96 h after collection, frozen for 6 months, thawed and re‐evaluated. MNCs were analyzed by flow cytometry, viability by 7‐AAD and clonogenic assays (CFU) were performed.

Results

After 96 h of storage, no substantial loss of MNC was found (median 7·320 × 106 × 6·305 × 106). Percentage and viability CD34+ cells, B‐cell precursors and mesenchymal stem cells were not affected. However, mature B and T lymphocytes as well as granulocytes had a substantial loss. CFU growth was observed in all samples. Prefreezing storage of 96 h was associated with a relative loss of colony formation (median 12%). Postthaw, this loss had a median of 49% (24 h samples) to 56% (96 h samples).

Conclusion

The delay of 96 h before UCB processing is possible, without a prohibitive impairment of CD34+ loss in number and functionality.
T‐Cell death, phosphatidylserine exposure and reduced proliferation rate to validate extracorporeal photochemotherapy
Authors: Schmid D. , Grabmer C. , Streif D. , Lener T. , Schallmoser K. , Rohde E.
Published: October 2014

Background and Objectives

Extracorporeal photochemotherapy (ECP) is an established therapy in various diseases, such as cutaneous T‐cell lymphoma and graft‐versus‐host disease. This study was performed to investigate the practicability of a flow cytometric T‐cell evaluation after ECP as a tool to validate the quality of ECP procedures and to enable the comparability of treatments with different ECP devices.

Materials and Methods

Peripheral blood mononuclear cells (PBMNCs) of healthy volunteer blood donors were treated by offline ECP. To quantify the effect of ECP on T cells in vitro, phosphatidylserine exposure and 7‐aminoactinomycin D (7‐AAD) reactivity as well as the proliferative activity of phytohaemagglutinin‐induced, viable CD3+ lymphocytes were analysed by flow cytometry.

Results

The expected T‐cell death after ECP was confirmed by 7‐AAD measurements. Phosphatidylserine exposure gradually increased between 20 and 70 h after ECP. Treatment‐related inhibition of T‐cell proliferation was 92·6 ± 1·4%.

Conclusion

The combination of viability, phosphatidylserine exposure and T‐cell division analyses by flow cytometry in a single‐platform system provides a valuable tool to validate ECP procedures.
Systematic study of trimethyl aluminum infiltration in polyethylene terephthalate and its effect on the mechanical properties of polyethylene terephthalate fibers
Authors: Padbury Richard P. , Jur Jesse S.
Published: October 2014

Hybrid organic–inorganic materials are of increasing interest in the development of novel materials that unite characteristic properties of both organic and inorganic constituents. This work provides a mechanistic understanding of the processing space necessary to utilize hybrid modifications to produce advanced high strength fibrous and textile materials. The infiltration of organometallic precursors into fiber forming polymers and the subsequent formation of a hybrid material interface is detailed. To explore this in more detail, in-situ quartz crystal microgravimetry is employed to investigate the infiltration of trimethyl aluminum (TMA) into polyethylene terephthalate polymer films. Specifically, films with varied crystallinities are explored demonstrating that an increase in crystallinity results in a decrease in mass uptake of trimethyl aluminum. Subsequently, the authors highlight the structure–property relationships between modified and unmodified fibers infiltrated with TMA. For the first time, increases in peak load and elongation is observed by facile exposure to organometallic vapors. The combined peak load and elongation increase is an exciting outcome typically not observed in synthetic fibers.
Realization of suspended silicon-based structures using a smart three-dimensional etching method
Authors: Mazraati Hamid , Gharooni Milad , Darbari Sara , Mohajerzadeh Shams , Salehi Fatemeh
Published: October 2014

The authors report a smart three-dimensional etching method to realize complex floating structures on silicon substrates with a single masking layer. This method is established on two vertical etching processes, a sequential vertical etching process based on SF6, H2, and O2 gases and a novel nonsequential hydrogen-pulsed deep reactive ion etching in a low-density capacitive-coupled RF-reactor. By controlling the flows of gases and plasma parameters, it is possible to achieve desired deep vertical etching with controlled underetching. In addition, the use of tilted chromium deposition as a self-aligned deposition technique and reticular contact configuration to eliminate the parasitic resistance and capacitance between substrate and floating structures, have been exploited. Moreover, in order to investigate the efficacy of this etching method to produce complex features, the authors have designed an interdigital structure suitable for accelerometers and fabricated it by our 3D-etching process.
Quantitative evaluation of atrial radio frequency ablation using intracardiac shear‐wave elastography
Authors: Kwiecinski Wojciech , Provost Jean , Dubois Rémi , Sacher Frédéric , Haïssaguerre Michel , Legros Mathieu , Nguyen‐Dinh An , Dufait Rémi , Tanter Mickaël , Pernot Mathieu
Published: October 2014

Purpose:

Radio frequency catheter ablation (RFCA) is a well‐established clinical procedure for the treatment of atrial fibrillation (AF) but suffers from a low single‐procedure success rate. Recurrence of AF is most likely attributable to discontinuous or nontransmural ablation lesions. Yet, despite this urgent clinical need, there is no clinically available imaging modality that can reliably map the lesion transmural extent in real time. In this study, the authors demonstrated the feasibility of shear‐wave elastography (SWE) to map quantitatively the stiffness of RFCA‐induced thermal lesions in cardiac tissues in vitro and in vivo using an intracardiac transducer array.

Methods:

SWE was first validated in ex vivo porcine ventricular samples (N = 5). Both B‐mode imaging and SWE were performed on normal cardiac tissue before and after RFCA. Areas of the lesions were determined by tissue color change with gross pathology and compared against the SWE stiffness maps. SWE was then performed in vivo in three sheep (N = 3). First, the stiffness of normal atrial tissues was assessed quantitatively as well as its variation during the cardiac cycle. SWE was then performed in atrial tissue after RFCA.

Results:

A large increase in stiffness was observed in ablated ex vivo regions (average shear modulus across samples in normal tissue: 22 ± 5 kPa, average shear‐wave speed (ct): 4.5 ± 0.4 m s−1 and in determined ablated zones: 99 ± 17 kPa, average ct: 9.0 ± 0.5 m s−1 for a mean shear modulus increase ratio of 4.5 ± 0.9). In vivo, a threefold increase of the shear modulus was measured in the ablated regions, and the lesion extension was clearly visible on the stiffness maps.

Conclusions:

By its quantitative and real‐time capabilities, Intracardiac SWE is a promising intraoperative imaging technique for the evaluation of thermal ablation during RFCA.