bluuebunny/crossref_metadata_2025 huggingface dataset:
AMPA receptor subunits expression and phosphorylation in cingulate cortex in rats following esophageal acid exposure
Authors: Banerjee B. , Medda B. K. , Pochiraju S. , Kannampalli P. , Lang I. M. , Sengupta J. N. , Shaker R.
Published: October 2013

Background

We recently reported an increase in N‐methyl‐d‐aspartate (NMDA) receptor subunit expression and CaMKII‐dependent phosphorylation of NR2B in the rostral cingulate cortical (rCC) neurons following esophageal acid exposure in rats. As α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazole propionic acid (AMPA) receptors mediate the fast excitatory transmission and play a critical role in synaptic plasticity, in this study, we investigated the effect of esophageal acid exposure in rats on the expression of AMPA receptor subunits and the involvement of these molecular alterations in acid‐induced sensitization of neurons in the anterior cingulate (ACC) and midcingulate (MCC) cortices.

Methods

In molecular study, we examined GluA1 and GluA2 expression and phosphorylation in membrane preparations and in the isolated postsynaptic densities (PSDs) from rats receiving acute esophageal exposure of either saline (control group) or 0.1 N HCl (experimental group). In electrophysiological study, the effect of selective AMPA receptor (Ca2+ permeable) antagonist IEM‐1460 and CaMKII inhibitor KN‐93 was tested on responses of cortical neurons during acid infusion to address the underlying molecular mechanism of acid‐induced sensitization.

Key Results

The acid exposure significantly increased expression of GluA1, pGluA1Ser831, and phosphorylated CaMKIIThr286, in the cortical membrane preparations. In isolated PSDs, a significant increase in pGluA1Ser831 was observed in acid‐treated rats compared with controls. Microinjection of IEM‐1460 or KN‐93 near the recording site significantly attenuated acid‐induced sensitization of cortical neurons.

Conclusions & Inferences

The underlying mechanism of acid‐induced cortical sensitization involves upregulation and CaMKII‐mediated phosphorylation of GluA1. These molecular changes of AMPA receptors subunit GluA1 in the cortical neurons might play an important role in acid‐induced esophageal hypersensitivity.
Prevalence of colonic motor or evacuation disorders in patients presenting with chronic nausea and vomiting evaluated by a single gastroenterologist in a tertiary referral practice
Authors: Kolar G. J. , Camilleri M. , Burton D. , Nadeau A. , Zinsmeister A. R.
Published: October 2013

Background

Nausea and vomiting are thought to result from upper gastrointestinal dysfunctions. Our clinical observations led to the hypothesis that colonic motor dysfunction is associated with nausea and vomiting.

Methods

We reviewed electronic medical records (EMR) of 149 patients presenting with complaints of nausea and/or vomiting in a tertiary gastroenterology practice to investigate the association with disorders of colonic motor or evacuation disorders. We extracted demographics, gastric emptying (GE in 149) and colonic transit (CT in 138) of solids, ascending colon emptying half‐time (AC t1/2), rectal evacuation by anorectal manometry (ARM) in 91 and balloon expulsion test (BE) in 55 patients. We estimated the proportions with delayed GE or CT, based on the 5th percentile of GE (in 319) and CT in 220 healthy volunteers using same method.

Key Results

Among 11 patients with nausea and/or vomiting with only GE measured, five had delayed and six normal GE. Among the 149 patients, 77 (52%) patients had evacuation disorders, confirmed by objective tests in 68 patients, and clinical examination in nine patients. In the 138 patients with both GE and CT measured, 106 (76%) had both normal GE and CT, 11 (8%) only delayed GE, 16 (11%) normal GE with delayed CT, and five (3%) delayed GE and CT. Among 21 patients (15%) with delayed CT, nine had slow AC t1/2 and 12 evacuation disorder.

Conclusions & Inferences

In patients with chronic nausea and/or vomiting in gastroenterology practice, evaluation of colonic motility and rectal evacuation should be considered, since about half the patients have abnormal functions that conceivably contribute to the presenting nausea and/or vomiting.
Rhizosphere stoichiometry: are C : N : P ratios of plants, soils, and enzymes conserved at the plant species‐level?
Authors: Bell Colin , Carrillo Yolima , Boot Claudia M. , Rocca Jennifer D. , Pendall Elise , Wallenstein Matthew D.
Published: October 2013

As a consequence of the tight linkages among soils, plants and microbes inhabiting the rhizosphere, we hypothesized that soil nutrient and microbial stoichiometry would differ among plant species and be correlated within plant rhizospheres.

We assessed plant tissue carbon (C) : nitrogen (N) : phosphorus (P) ratios for eight species representing four different plant functional groups in a semiarid grassland during near‐peak biomass. Using intact plant species‐specific rhizospheres, we examined soil C : N : P, microbial biomass C : N, and soil enzyme C : N : P nutrient acquisition activities.

We found that few of the plant species' rhizospheres demonstrated distinct stoichiometric properties from other plant species and unvegetated soil. Plant tissue nutrient ratios and components of below‐ground rhizosphere stoichiometry predominantly differed between the C4plant speciesBuchloe dactyloidesand the legumeAstragalus laxmannii. The rhizospheres under the C4grassB. dactyloidesexhibited relatively higher microbial C and lower soil N, indicative of distinct soil organic matter (SOM) decomposition and nutrient mineralization activities.

Assessing the ecological stoichiometry among plant species' rhizospheres is a high‐resolution tool useful for linking plant community composition to below‐ground soil microbial and nutrient characteristics. By identifying how rhizospheres differ among plant species, we can better assess how plant–microbial interactions associated with ecosystem‐level processes may be influenced by plant community shifts.
Meta‐analysis of deep‐sequenced fungal communities indicates limited taxon sharing between studies and the presence of biogeographic patterns
Authors: Meiser Anjuli , Bálint Miklós , Schmitt Imke
Published: October 2013

High‐throughput amplicon sequencing gives new insights into fungal community ecology. Massively generated molecular data lead to the discovery of vast fungal diversity. However, it is unclear to what extent operational taxonomic units (OTUs) overlap among independent studies, because no comparative studies exist.

We compared fungal diversity based on the internal transcribed spacer (ITS1) region among 10 published studies. Starting from the raw 454 pyrosequencing data, we used a uniform pipeline to prune the reads. We investigated fungal richness and taxonomic composition among phyllosphere and soil fungal communities, as well as biogeographic signals in the data.

We did not find globally distributed OTUs, even when comparing fungal communities from similar habitats (phyllosphere or soil). This suggests that high local fungal diversity scales up to high global diversity. The most OTU‐rich classes in the phyllosphere were Dothideomycetes (21%) and Sordariomycetes (14%), and in the soil were Sordariomycetes (13%) and Agaricomycetes (12%). The richness estimates suggest the presence of undiscovered fungal diversity even in deeply sequenced study systems.

The small number of OTUs shared among studies indicates that globally distributed taxa and habitat generalists may be rare. Latitudinal diversity decline and distance decay relationships suggest the presence of biogeographic patterns similar to those in plants and animals.
AtSIA1 AND AtOSA1: two Abc1 proteins involved in oxidative stress responses and iron distribution within chloroplasts
Authors: Manara Anna , DalCorso Giovanni , Leister Dario , Jahns Peter , Baldan Barbara , Furini Antonella
Published: October 2013

The Abc1 protein kinases are a large family of functionally diverse proteins with multiple roles in the regulation of respiration and oxidative stress tolerance.

A functional characterization was carried out for AtSIA1, an Arabidopsis thaliana Abc1‐like protein, focusing on its potential redundancy with its homolog AtOSA1. Both proteins are located within chloroplasts, even if a different subplastidial localization seems probable. The comparison of atsia1 and atosa1 mutants, atsia1/atosa1 double mutant and wild‐type plants revealed a reduction in plastidial iron‐containing proteins of the Cytb6f complex in the mutants. Iron uptake from soil is not hampered in mutant lines, suggesting that AtSIA1 and AtOSA1 affect iron distribution within the chloroplast.

Mutants accumulated more ferritin and superoxide, and showed reduced tolerance to reactive oxygen species (ROS), potentially indicating a basal role in oxidative stress. The mutants produced higher concentrations of plastochromanol and plastoquinones than wild‐type plants, but only atsia1 plants developed larger plastoglobules and contained higher concentrations of α‐ and γ‐tocopherol and VTE1.

Taken together, these data suggest that AtSIA1 and AtOSA1 probably act in signaling pathways that influence responses to ROS production and oxidative stress.
Myo‐inositol oxygenase is important for the removal of excess myo‐inositol from syncytia induced by Heterodera schachtii in Arabidopsis roots
Authors: Siddique Shahid , Endres Stefanie , Sobczak Miroslaw , Radakovic Zoran S. , Fragner Lena , Grundler Florian M. W. , Weckwerth Wolfram , Tenhaken Raimund , Bohlmann Holger
Published: October 2013

The enzyme myo‐inositol oxygenase is the key enzyme of a pathway leading from myo‐inositol to UDP‐glucuronic acid. In Arabidopsis, myo‐inositol oxygenase is encoded by four genes. All genes are strongly expressed in syncytia induced by the beet cyst nematode Heterodera schachtii in Arabidopsis roots. Here, we studied the effect of a quadruple myo‐inositol oxygenase mutant on nematode development.

We performed metabolite profiling of syncytia induced in roots of the myo‐inositol oxygenase quadruple mutant. The role of galactinol in syncytia was studied using Arabidopsis lines with elevated galactinol levels and by supplying galactinol to wild‐type seedlings.

The quadruple myo‐inositol oxygenase mutant showed a significant reduction in susceptibility to H. schachtii, and syncytia had elevated myo‐inositol and galactinol levels and an elevated expression level of the antimicrobial thionin gene Thi2.1. This reduction in susceptibility could also be achieved by exogenous application of galactinol to wild‐type seedlings.

The primary function of myo‐inositol oxygenase for syncytium development is probably not the production of UDP‐glucuronic acid as a precursor for cell wall polysaccharides, but the reduction of myo‐inositol levels and thereby a reduction in the galactinol level to avoid the induction of defence‐related genes.
Biological nitrogen fixation and biomass accumulation within poplar clones as a result of inoculations with diazotrophic endophyte consortia
Authors: Knoth Jenny L. , Kim Soo‐Hyung , Ettl Gregory J. , Doty Sharon L.
Published: October 2013

Sustainable production of biomass for bioenergy relies on low‐input crop production. Inoculation of bioenergy crops with plant growth‐promoting endophytes has the potential to reduce fertilizer inputs through the enhancement of biological nitrogen fixation (BNF).

Endophytes isolated from native poplar growing in nutrient‐poor conditions were selected for a series of glasshouse and field trials designed to test the overall hypothesis that naturally occurring diazotrophic endophytes impart growth promotion of the host plants.

Endophyte inoculations contributed to increased biomass over uninoculated control plants. This growth promotion was more pronounced with multi‐strain consortia than with single‐strain inocula. Biological nitrogen fixation was estimated through 15N isotope dilution to be 65% nitrogen derived from air (Ndfa).

Phenotypic plasticity in biomass allocation and branch production observed as a result of endophyte inoculations may be useful in bioenergy crop breeding and engineering programs.
Long noncoding RNAs responsive to Fusarium oxysporum infection in Arabidopsis thaliana
Authors: Zhu Qian‐Hao , Stephen Stuart , Taylor Jennifer , Helliwell Chris A. , Wang Ming‐Bo
Published: October 2013

Short noncoding RNAs have been demonstrated to play important roles in regulation of gene expression and stress responses, but the repertoire and functions of long noncoding RNAs (lncRNAs) remain largely unexplored, particularly in plants.

To explore the role of lncRNAs in disease resistance, we used a strand‐specific RNA‐sequencing approach to identify lncRNAs responsive to Fusarium oxysporum infection in Arabidopsis thaliana.

Antisense transcription was found in c. 20% of the annotated A. thaliana genes. Several noncoding natural antisense transcripts responsive to F. oxysporum infection were found in genes implicated in disease defense. While the majority of the novel transcriptionally active regions (TARs) were adjacent to annotated genes and could be an extension of the annotated transcripts, 159 novel intergenic TARs, including 20 F. oxysporum‐responsive lncTARs, were identified. Ten F. oxysporum‐induced lncTARs were functionally characterized using T‐DNA insertion or RNA‐interference knockdown lines, and five were demonstrated to be related to disease development. Promoter analysis suggests that some of the F. oxysporum‐induced lncTARs are direct targets of transcription factor(s) responsive to pathogen attack.

Our results demonstrated that strand‐specific RNA sequencing is a powerful tool for uncovering hidden levels of transcriptome and that IncRNAs are important components of the antifungal networks in A. thaliana.
Determining place and process: functional traits of ectomycorrhizal fungi that affect both community structure and ecosystem function
Authors: Koide Roger T. , Fernandez Christopher , Malcolm Glenna
Published: October 2013

There is a growing interest amongst community ecologists in functional traits. Response traits determine membership in communities. Effect traits influence ecosystem function. One goal of community ecology is to predict the effect of environmental change on ecosystem function. Environmental change can directly and indirectly affect ecosystem function. Indirect effects are mediated through shifts in community structure. It is difficult to predict how environmental change will affect ecosystem function via the indirect route when the change in effect trait distribution is not predictable from the change in response trait distribution. When response traits function as effect traits, however, it becomes possible to predict the indirect effect of environmental change on ecosystem function. Here we illustrate four examples in which key attributes of ectomycorrhizal fungi function as both response and effect traits. While plant ecologists have discussed response and effect traits in the context of community structuring and ecosystem function, this approach has not been applied to ectomycorrhizal fungi. This is unfortunate because of the large effects of ectomycorrhizal fungi on ecosystem function. We hope to stimulate further research in this area in the hope of better predicting the ecosystem‐ and landscape‐level effects of the fungi as influenced by changing environmental conditions.
Does a decade of elevated [CO2] affect a desert perennial plant community?
Authors: Newingham Beth A. , Vanier Cheryl H. , Kelly Lauren J. , Charlet Therese N. , Smith Stanley D.
Published: October 2013

Understanding the effects of elevated [CO2] on plant community structure is crucial to predicting ecosystem responses to global change. Early predictions suggested that productivity in deserts would increase via enhanced water‐use efficiency under elevated [CO2], but the response of intact arid plant communities to elevated [CO2] is largely unknown.

We measured changes in perennial plant community characteristics (cover, species richness and diversity) after 10 yr of elevated [CO2] exposure in an intact Mojave Desert community at the Nevada Desert Free‐Air CO2 Enrichment (FACE) Facility.

Contrary to expectations, total cover, species richness, and diversity were not affected by elevated [CO2]. Over the course of the experiment, elevated [CO2] had no effect on changes in cover of the evergreen C3 shrub, Larrea tridentata; alleviated decreases in cover of the C4 bunchgrass, Pleuraphis rigida; and slightly reduced the cover of C3 drought‐deciduous shrubs.

Thus, we generally found no effect of elevated [CO2] on plant communities in this arid ecosystem. Extended drought, slow plant growth rates, and highly episodic germination and recruitment of new individuals explain the lack of strong perennial plant community shifts after a decade of elevated [CO2].
Mapping modalities of self‐awareness in mindfulness practice: a potential mechanism for clarifying habits of mind
Authors: Vago David R.
Published: October 2013

To better understand the neurobiological mechanisms by which mindfulness‐based practices function in a psychotherapeutic context, this article details the definition, techniques, and purposes ascribed to mindfulness training as described by its Buddhist tradition of origin and by contemporary neurocognitive models. Included is theory of how maladaptive mental processes become habitual and automatic, both from the Buddhist and Western psychological perspective. Specific noting and labeling techniques in open monitoring meditation, described in the Theravada and Western contemporary traditions, are highlighted as providing unique access to multiple modalities of awareness. Potential explicit and implicit mechanisms are discussed by which such techniques can contribute to transforming maladaptive habits of mind and perceptual and cognitive biases, improving efficiency, facilitating integration, and providing the flexibility to switch between systems of self‐processing. Finally, a model is provided to describe the timing by which noting and labeling practices have the potential to influence different stages of low‐ and high‐level neural processing. Hypotheses are proposed concerning both levels of processing in relation to the extent of practice. Implications for the nature of subjective experience and self‐processing as it relates to one's habits of mind, behavior, and relation to the external world, are also described.
Systemic control of brown fat thermogenesis: integration of peripheral and central signals
Authors: Schulz Tim J. , Tseng Yu‐Hua
Published: October 2013

Brown adipose tissue (BAT) is of great scientific interest as a potential target to treat obesity. The development of novel strategies to quantify brown fat thermogenesis in adult humans now enables minimally invasive assessment of novel pharmacotherapeutics. Input from the central nervous system via sympathetic efferents is widely regarded as the key controller of BAT‐mediated thermogenesis in response to changes in body temperature or nutrient availability. More recently, however, it has become clear that locally secreted signals and endocrine factors originating from multiple organs can control the recruitment of brown adipocytes and, more importantly, induce thermogenesis in brown fat. Thus, they provide an attractive strategy to fine‐tune brown fat thermogenesis independent of classical temperature sensing. Here, we summarize recent findings on bone morphogenetic protein signaling as an example of secreted factors in the regulation of brown adipocyte formation and systemic control of energy metabolism. We further highlight endocrine communication routes between the different types of brown adipocytes and other organs that contribute to regulation of thermogenesis. Thus, emerging evidence suggests that the classical mechanisms of central temperature sensing and sympathetic nervous system–driven thermogenesis are complemented by local and endocrine signals to determine systemic energy homeostasis.
Does obesity affect knee cartilage? A systematic review of magnetic resonance imaging data
Authors: Mezhov V. , Ciccutini F. M. , Hanna F. S , Brennan S. L. , Wang Y. Y. , Urquhart D. M. , Wluka A. E.
Published: October 2013

There is increasing evidence for the effect of obesity on knee osteoarthritis (OA), although the association between obesity, particularly body composition, and knee osteoarthritis, using magnetic resonance imaging (MRI) to examine knee structure, has not been examined. We systematically evaluated the evidence for the relationship between obesity and knee cartilage assessed by MRI. We performed an electronic search of MEDLINE and EMBASE up to December 2012. Included studies investigated the association between obesity and the development and/or progression of knee cartilage changes using MRI. The studies were ranked according to their methodological score and best‐evidence synthesis was performed to summarize the results Twenty‐two studies were identified for inclusion, of which 7 were cross‐sectional, 13 were longitudinal and 2 had both cross‐sectional and longitudinal components. Seven cross‐sectional and eight longitudinal studies were of high quality. Best‐evidence synthesis showed consistent, yet limited evidence for a detrimental effect of body mass index (BMI) and fat mass on knee cartilage. This review identified a consistent detrimental effect of obesity, particularly related to elevated BMI and fat mass on cartilage defects. The strength of evidence was limited by the paucity of high‐quality cohort studies examining this question. By further examining the mechanisms for these different effects, new strategies can be developed to prevent and treat knee OA.
Which type of sedentary behaviour intervention is more effective at reducing body mass index in children? A meta‐analytic review
Authors: Liao Y. , Liao J. , Durand C. P. , Dunton G. F.
Published: October 2013

Sedentary behaviour is emerging as an independent risk factor for paediatric obesity. Some evidence suggests that limiting sedentary behaviour alone could be effective in reducing body mass index (BMI) in children. However, whether adding physical activity and diet‐focused components to sedentary behaviour reduction interventions could lead to an additive effect is unclear. This meta‐analysis aims to assess the overall effect size of sedentary behaviour interventions on BMI reduction and to compare whether interventions that have multiple components (sedentary behaviour, physical activity and diet) have a higher mean effect size than interventions with single (sedentary behaviour) component. Included studies (n = 25) were randomized controlled trials of children (<18 years) with intervention components aimed to reduce sedentary behaviour and measured BMI at pre‐ and post‐intervention. Effect size was calculated as the mean difference in BMI change between children in an intervention group and a control group. Results indicated that sedentary behaviour interventions had a significant effect on BMI reduction. The pooled effect sizes of multi‐component interventions (g = −0.060∼−0.089) did not differ from the single‐component interventions (g = −0.154), and neither of them had a significant effect size on its own. Future paediatric obesity interventions may consider focusing on developing strategies to decrease multiple screen‐related sedentary behaviours.
Polymorphisms of genes encoding P2X7R, IL‐1B, OPG and RANK in orthodontic‐induced apical root resorption
Authors: Pereira S , Lavado N , Nogueira L , Lopez M , Abreu J , Silva H
Published: October 2013

Objective

Orthodontic‐induced external apical root resorption (EARR) is a complex phenotype determined by poorly defined mechanical and patient intrinsic factors. The aim of this work was to construct a multifactorial integrative model, including clinical and genetic susceptibility factors, to analyze the risk of developing this common orthodontic complication.

Materials and Methods

This retrospective study included 195 orthodontic patients. Using a multiple‐linear regression model, where the dependent variable was the maximum% of root resorption (%EARRmax) for each patient, we assessed the contribution of nine clinical variables and four polymorphisms of genes involved in bone and tooth root remodeling (rs1718119 from P2RX7, rs1143634 from IL1B, rs3102735 from TNFRSF11B, encoding OPG, and rs1805034 from TNFRSF11A, encoding RANK).

Results

Clinical and genetic variables explained 30% of%EARRmax variability. The variables with the most significant unique contribution to the model were: gender (P < 0.05), treatment duration (P < 0.001), premolar extractions (P < 0.01), Hyrax appliance (P < 0.001) and GG genotype of rs1718119 from P2RX7 gene (P < 0.01). Age, overjet, tongue thrust, skeletal class II and the other polymorphisms made minor contributions.

Conclusion

This study highlights the P2RX7 gene as a possible factor of susceptibility to EARR. A more extensive genetic profile may improve this model.
Localization and function of the accessory protein Mfa3 in Porphyromonas gingivalis Mfa1 fimbriae
Authors: Hasegawa Y. , Nagano K. , Ikai R. , Izumigawa M. , Yoshida Y. , Kitai N. , Lamont R.J. , Murakami Y. , Yoshimura F.
Published: October 2013

The fimbriae of Porphyromonas gingivalis, the causative agent of periodontitis, have been implicated in various aspects of pathogenicity, such as colonization, adhesion and aggregation. Porphyromonas gingivalis ATCC 33277 has two adhesins comprised of the FimA and Mfa1 fimbriae. We characterized the PGN0289 (Mfa3) protein, which is one of the three accessory proteins of Mfa1 fimbriae in P. gingivalis. The Mfa3 protein was present in two different sizes, 40 and 43 kDa, in the cell. The 43‐kDa and 40‐kDa Mfa3 were detected largely in the inner membrane and the outer membrane, respectively. Purified Mfa1 fimbriae contained the 40‐kDa Mfa3 alone. Furthermore, the 40‐kDa Mfa3 started with the Ala44 residue of the deduced amino acid sequence, indicating that the N‐terminal region of the nascent protein expressed from the mfa3 gene is processed in the transport step from the inner membrane into fimbriae. Immuno‐electron microscopy revealed that Mfa3 localized at the tip of the fimbrial shaft. Interestingly, deletion of the mfa3 gene resulted in the absence of other accessory proteins, PGN0290 and PGN0291, in the purified Mfa1 fimbriae, suggesting that Mfa3 is required for integration of PGN0290 and PGN0291 into fimbriae. A double mutant of mfa3 and fimA genes (phenotype Mfa1 plus, FimA minus) showed increased auto‐aggregation and biofilm formation similar to a double mutant of mfa1 and fimA genes (phenotype Mfa1–, FimA–). These findings suggest that the tip protein Mfa3 of the Mfa1 fimbriae may function in the integration of accessory proteins and in the colonization of P. gingivalis.
Quality of Life and Functional Capacity after Long‐Term Right Ventricular Pacing in Pediatrics and Young Adults with Congenital Atrioventricular Block
Authors: DA SILVA KÁTIA REGINA , COSTA ROBERTO , DE OLIVEIRA ROBERTO MÁRCIO , LACERDA MARIANNA SOBRAL , UN HUANG ADRIANA I , ROSSI MARINA BERTELLI , CREVELARI ELIZABETH SARTORI , TAMAKI WAGNER TETSUJI , FILHO MARTINO MARTINELLI , PIETROBON RICARDO
Published: October 2013

Background

Although several studies have demonstrated deleterious consequences of chronic right ventricular (RV) pacing on ventricular function and synchronicity, its effects on health‐related quality of life (HRQoL) and functional exercise capacity remain uncertain. We aimed to evaluate the effect of RV pacing on HRQoL and functional capacity of children and young adults with congenital complete atrioventricular block (CCAVB).

Methods

We included 66 consecutive subjects with RV cardiac pacemaker due to CCAVB and under clinical follow‐up for more than 1 year. Multidimensional HRQoL scores were evaluated by Short Form‐36 Health Survey (SF‐36) and Child Health Questionnaire‐Parent Form 50 (CHQ‐PF50). Functional capacity was tested by a 6‐minute walk distance test (6MWDT). Association analysis was performed to examine if any demographic and clinical characteristics were associated with lower HRQoL scores and shorter distances at the 6MWDT.

Results

Domains presenting lower HRQoL scores were vitality (64.0 ± 17.3), mental health (67.3 ± 8.0), role emotional (69.7 ± 35.8) in the SF‐36 questionnaire; general health perceptions (61.3 ± 8.3), general behavior (61.9 ± 15.6), parental impact—emotional (67.7 ± 28.7) in the CHQ‐PF50. Female gender (P = 0.009), left ventricular ejection fraction lower than 55% (P = 0.013), cardiovascular drugs (P = 0.003) were significantly associated with lower HRQoL scores. Average distance traveled during the 6MWDT was 539.8 ± 82.9 m. The 6MWDT showed significant association with age (P = 0.006) and cardiovascular drugs (P = 0.024).

Conclusions

Chronic RV pacing did not affect the HRQoL and physical capacity of pediatrics and young subjects. Female gender, ventricular function, and cardiovascular drugs were associated with lower HRQoL scores. Older subjects walked shorter distances in the 6MWDT, as well as subjects who were taking cardiovascular drugs.
Atrial Flutter or Fibrillation is the Most Frequent and Life‐Threatening Arrhythmia in Myotonic Dystrophy
Authors: BREMBILLA‐PERROT BÉATRICE , SCHWARTZ JÉRÔME , HUTTIN OLIVIER , FRIKHA ZIED , SELLAL JEAN MARC , SADOUL NICHOLAS , BLANGY HUGUES , OLIVIER ARNAUD , LOUIS SARAH , KAMINSKY PIERRE
Published: October 2013

Background

Several arrhythmias were reported in myotonic dystrophy (MD).

Objectives

To evaluate the prevalence of atrial fibrillation (AF) and atrial flutter (AFL) in MD and the clinical consequences.

Methods

One hundred sixty‐one patients, mean age 41 ± 14 years, were referred for a type 1 MD. All patients were asymptomatic except four patients and followed during 5 ± 4 years. Electrocardiogram (ECG), echocardiography assessing left ventricular ejection fraction, and Holter monitoring were obtained and repeated.

Results

Twenty‐seven patients (17%) presented sustained (>1 hour) AF (n = 15) or AFL (n = 12); two of them presented syncope‐related 1/1 AFL. In one of them, 16 years of age, cardiac defibrillator was implanted for a diagnosis of ventricular tachycardia, but the true diagnosis was established after inappropriate shocks. AFL ablation was performed in five patients, but four developed AF. The other seven patients with AFL developed AF. During the follow‐up, 22 patients died (14%) from cardiac and respiratory failure; eight patients with AF/AFL died (30%) while only 14 without AF/AFL died (10%; P < 0.01). Univariate analysis indicated that age >40 years (death: 48 ± 14 vs 40 ± 8 in alive patients), abnormal ECG, and occurrence of AF/AFL were significant factors of death. At multivariate analysis, AF at ECG (odds ratio: 3.12) and age >40 (odds ratio: 3.14) were the sole independent variables predicting death.

Conclusions

AF and AFL were frequent in MD and increased mortality. AFL could present as 1/1 AFL with a poor tolerance and a risk of misdiagnosis despite frequent conduction disturbances. This arrhythmia could explain wide QRS tachycardia occurring in MD and interpreted as VT.
INSTITUTIONAL LAYERING IN GOVERNING HEALTHCARE QUALITY
Authors: VAN DE BOVENKAMP HESTER M. , DE MUL MARLEEN , QUARTZ JULIA G.U. , J.W.M. WEGGELAAR‐JANSEN ANNE MARIE , BAL ROLAND
Published: October 2013

Since the 1980s, regulated markets and New Public Management have been introduced in the public sector across the world. How they have affected existing governance mechanisms such as self‐regulation and state regulation has remained largely unexplored, however. This article examines the origins and consequences of institutional layering in governing healthcare quality. Dutch health care, where a market‐based system has been introduced, is used as a case study. The results show that this market‐based system did not replace but modified existing institutional arrangements. As a result, hospitals have to deal with the fragmentation of quality demands. Using the concept of institutional layering, this study shows how different arrangements interact. As a consequence, the introduction of a certain policy reform will work out differently in different countries and policy sectors. Our ‘archaeological’ study in this layering can be seen as an example of how such incremental change can be studied in detail.
Evaluation of closed‐loop anesthesia delivery for propofol anesthesia in pediatric cardiac surgery
Authors: Biswas Indranil , Mathew Preethy J. , Singh Rana S. , Puri Goverdhan D.
Published: October 2013

Objective

The objective of this study was to compare the feasibility of closed‐loop anesthesia delivery with manual control of propofol in pediatric patients during cardiac surgery.

Methods

Forty ASA II‐III children, undergoing elective cardiac surgery under cardiopulmonary bypass (CPB) in a tertiary care hospital, were randomized to receive propofol either through a closed‐loop anesthesia delivery system (CL group) or through traditional manual control (manual group) to achieve a target BIS of 50. Patients were induced and subsequently maintained with a propofol infusion. The propofol usage and the efficacy of closed‐loop system in controlling BIS within ±10 of the target were compared with that of manual control.

Results

The maintenance of BIS within ±10 of target and intraoperative hemodynamic stability were similar between the two groups. However, induction dose of propofol was less in the CL group (2.06 ± 0.79 mg·kg−1) than the manual group (2.95 ± 1.03 mg·kg−1) (P = 0.006) with less overshoot of BIS during induction in the closed‐loop group (P = 0.007). Total propofol used in the off‐CPB period was less in the CL group (6.29 ± 2.48 mg·kg−1 h−1 vs 7.82 ± 2.1 mg·kg−1 h−1) (P = 0.037). Phenylephrine use in the pre‐CPB period was more in the manual group (16.92 ± 10.92 μg·kg−1 vs 5.79 ± 5.98 μg·kg−1) (P = 0.014). Manual group required a median of 18 (range 8–29) dose adjustments per hour, while the CL group required none.

Conclusion

This study demonstrated the feasibility of closed‐loop controlled propofol anesthesia in children, even in challenging procedures such as cardiac surgery. Closed‐loop system needs further and larger evaluation to establish its safety and efficacy.
Laryngeal view and temperature measurements while using the perilaryngeal airway (Cobra‐PLUS™) in children
Authors: Tan Gee Mei , Galinkin Jeffrey L. , Pan Zhaoxing , Polaner David M.
Published: October 2013

Introduction

The Cobra‐PLUS™ perilaryngeal airway (CP) is a modification of the Cobra perilaryngeal airway. It has a distal curve for easier placement and a thermistor on the pharyngeal cuff. We assessed the orientation of the larynx to the CP and compared temperatures measured using CP to temporal arterial (TA) and infrared tympanic (T) thermometers.

Methodology

American Society of Anesthesiologists (ASA) physical status 1 and 2 children 0–18 years old undergoing general anesthesia using CP were grouped into different weight cohorts. A fiberoptic scope was inserted through the CP, and laryngeal views were recorded and graded off line. Temperatures were measured from the CP, TA, and T at 15‐min intervals for four readings or until the end of surgery. The CP was removed, while the patient was deeply anesthetized.

Results

Eighty subjects were analyzed. 87.5% (cohort range 75–95%) had an unobstructed view of the larynx. No serious adverse effects noted. Three hundred and sixteen temperature data points were recorded for each measured site. CP temperatures were consistently lower than TA and T with a bias of 0.9 and 0.6°C, respectively. Using temperatures measured at time 0 and 15 min, CP was associated with a larger intraclass correlation coefficient and smaller repeatability coefficient when compared to TA or T (ICC 0.65, 0.46. 0.44 and RC 0.78, 1, 1.36, respectively), indicating it had a better measure and remeasure reliability.

Conclusion

The CP has a better orientation to the larynx compared with its previous version. It may be used to reliably trend intraoperative temperatures.
Intranasal sufentanil/ketamine analgesia in children
Authors: Nielsen Bettina N. , Friis Susanne M. , Rømsing Janne , Schmiegelow Kjeld , Anderson Brian J. , Ferreirós Nerea , Labocha Sandra , Henneberg Steen W.
Published: October 2013

Background

The management of procedural pain in children ranges from physical restraint to pharmacological interventions. Pediatric formulations that permit accurate dosing, are accepted by children and a have a rapid onset of analgesia are lacking.

Objectives

To investigate a pediatric formulation of intranasal sufentanil 0.5 mcg·kg−1 and ketamine 0.5 mg·kg−1 for procedural pain and to characterize the pharmacokinetic (PK) profile.

Methods

Fifty children (≥10 kg) scheduled for a painful procedure were included in this prospective nonrandomized open‐label clinical trial. Thirteen of these children had central venous access for drug assay sampling; enabling a compartmental PK analysis using nonlinear mixed‐effects models. Pain intensity before and during the procedure was measured using age‐appropriate pain scales. Heart rate, oxygen saturation and sedation were recorded.

Results

Children had a mean age of 8.8 (sd 4.9) years and weight 35.2 (sd 20.1) kg. Sufentanil/ketamine nasal spray was effective (procedural pain intensity scores ≤5 (0–10)) in 78% of the painful procedures. The spray was well accepted by 94% of the children. Oxygen saturation and heart rate remained stable, and sedation was minimal. The bioavailability of sufentanil and ketamine was 24.6% and 35.8%, respectively. Maximum plasma concentration (Cmax) of sufentanil was 0.042 mcg·l−1 (coefficient of variation (CV) 12.9%) at 13.8 min (CV 12.4%) (Tmax). Cmax for ketamine was 0.102 mg·l−1 (CV 10.8%), and Tmax was 8.5 min (CV 17.3%).

Conclusion

Sufentanil/ketamine nasal spray provided rapid onset of analgesia for a variety of painful procedures with few adverse effects and has promising features for use in pediatric procedural pain management.
Changes in Pain Modulation Occur Soon After Whiplash Trauma but are not Related to Altered Perception of Distorted Visual Feedback
Authors: Daenen Liesbeth , Nijs Jo , Cras Patrick , Wouters Kristien , Roussel Nathalie
Published: October 2013

Objectives

Widespread sensory hypersensitivity has been observed in acute whiplash associated disorders (WAD). Changes in descending pain modulation take part in central sensitization. However, endogenous pain modulation has never been investigated in acuteWAD. Altered perception of distorted visual feedback has been observed inWAD. Both mechanisms (ie, pain modulation and perception of distorted visual feedback) may be different components of one integrated system orchestrated by the brain. This study evaluated conditioned pain modulation (CPM) in acuteWAD. Secondly, we investigated whether changes inCPMare associated with altered perception of distorted visual feedback.

Methods

Thirty patients with acuteWAD, 35 patients with chronicWADand 31 controls were subjected to an experiment evaluatingCPMand a coordination task inducing visual mediated changes between sensory feedback and motor output.

Results

A significantCPMeffect was observed in acuteWAD(P = 0.012 andP = 0.006), which was significantly lower compared to controls (P = 0.004 andP = 0.020). No obvious differences inCPMwere found between acute and chronicWAD(P = 0.098 andP = 0.041). Changes inCPMwere unrelated to altered perception of distorted visual feedback (P > 0.01).

Conclusion

Changes inCPMwere observed in acuteWAD, suggesting less efficient pain modulation. The results suggest that central pain and sensorimotor processing underlie distinctive mechanisms.
Valencene synthase from the heartwood of Nootka cypress (Callitropsis nootkatensis) for biotechnological production of valencene
Authors: Beekwilder Jules , van Houwelingen Adèle , Cankar Katarina , van Dijk Aalt D.J. , de Jong René M. , Stoopen Geert , Bouwmeester Harro , Achkar Jihane , Sonke Theo , Bosch Dirk
Published: October 2013

Nootkatone is one of the major terpenes in the heartwood of the Nootka cypress Callitropsis nootkatensis. It is an oxidized sesquiterpene, which has been postulated to be derived from valencene. Both valencene and nootkatone are used for flavouring citrus beverages and are considered among the most valuable terpenes used at commercial scale. Functional evaluation of putative terpene synthase genes sourced by large‐scale EST sequencing from Nootka cypress wood revealed a valencene synthase gene (CnVS). CnVS expression in different tissues from the tree correlates well with nootkatone content, suggesting that CnVS represents the first dedicated gene in the nootkatone biosynthetic pathway in C. nootkatensis The gene belongs to the gymnosperm‐specific TPS‐d subfamily of terpenes synthases and its protein sequence has low similarity to known citrus valencene synthases. In vitro, CnVS displays high robustness under different pH and temperature regimes, potentially beneficial properties for application in different host and physiological conditions. Biotechnological production of sesquiterpenes has been shown to be feasible, but productivity of microbial strains expressing valencene synthase from Citrus is low, indicating that optimization of valencene synthase activity is needed. Indeed, expression of CnVS in Saccharomyces cerevisiae indicated potential for higher yields. In an optimized Rhodobacter sphaeroides strain, expression of CnVS increased valencene yields 14‐fold to 352 mg/L, bringing production to levels with industrial potential.
Population structure and linkage disequilibrium in diploid and tetraploid potato revealed by genome‐wide high‐density genotyping using the SolCAP SNP array
Authors: Stich Benjamin , Urbany Claude , Hoffmann Per , Gebhardt Christiane
Published: October 2013

Genome‐wide association (GWA) mapping in potato requires high‐density genotyping. With the Illumina SolCAP potato single‐nucleotide polymorphism (SNP) array, a first tool for GWA mapping in potato became available. Thirty‐six tetraploid varieties and eight diploid breeding clones were genotyped for 8303 SNPs using this array. The objectives of our study were to examine in this set of germplasm: (i) the degree of polymorphism of the SolCAP SNPs in European germplasm, (ii) the population structure, (iii) temporal trends of genetic diversity and (iv) the genome‐wide extent of linkage disequilibrium (LD). Three‐quarters of the SNPs were polymorphic. In the principal coordinate analysis, a clear separation of tetraploid from diploid genotypes was observed, whereas no distinct subgroups among the tetraploid varieties were detected. The nonlinear trendline of the LD measure vs. the physical map distance decayed within 275 bp to an value of 0.10, indicating that theoretically, about 3 million equally distributed SNPs are required for GWA mapping in this diverse set of germplasm. As the LD decay changes with the population selected for GWA mapping, the number of required markers might be different in other germplasm.
The alternative respiratory pathway mediates carboxylate synthesis in white lupin cluster roots under phosphorus deprivation
Authors: FLOREZ‐SARASA IGOR , LAMBERS HANS , WANG XING , FINNEGAN PATRICK M. , RIBAS‐CARBO MIQUEL
Published: October 2013

Plant adaptations associated with a high efficiency of phosphorus (P) acquisition can be used to increase productivity and sustainability in a world with a growing population and decreasing rock phosphate reserves. White lupin (Lupinus albus) produces cluster roots that release carboxylates to efficiently mobilize P from P‐sorbing soils. It has been hypothesized that an increase in the activity of the alternative oxidase (AOX) would allow for the mitochondrial oxidation of NAD(P)H produced during citrate synthesis in cluster roots at a developmental stage when there is a low demand for ATP. We used the oxygen‐isotope fractionation technique to study the in vivo respiratory activities of the cytochrome oxidase pathway (COP) and the alternative oxidase pathway (AOP) in different root sections of white lupins grown hydroponically with and without P. In parallel, AOX protein levels and internal carboxylate concentrations were determined in cluster and non‐cluster roots. Higher in vivo AOP activity was measured in cluster roots when malate and citrate concentrations were also high, thus confirming our hypothesis. AOX protein levels were not always correlated with in vivo AOP activity, suggesting post‐translational regulation of AOX.
Role of Rho/ROCKsignaling in the interaction of melanoma cells with the blood–brain barrier
Authors: Wilhelm Imola , Fazakas Csilla , Molnár Judit , Haskó János , Végh Attila G. , Cervenak László , Nagyőszi Péter , Nyúl‐Tóth Ádám , Farkas Attila E. , Bauer Hannelore , Guillemin Gilles J. , Bauer Hans‐Christian , Váró György , Krizbai István A.
Published: October 2013

We have investigated the role of theRho/ROCKsignaling pathway in the interaction of metastatic melanoma cells with the brain endothelium.ROCKinhibition induced a shift of melanoma cells to the mesenchymal phenotype, increased the number of melanoma cells attached to the brain endothelium, and strengthened the adhesion force between melanoma and endothelial cells. Inhibition ofROCKraised the number of melanoma cells migrating through the brain endothelial monolayer and promoted the formation of parenchymal brain metastases in vivo. We have shown that inhibition of the Rho/ROCKpathway in melanoma, but not in brain endothelial cells, is responsible for this phenomenon. Our results indicate that the mesenchymal type of tumor cell movement is primordial in the transmigration of melanoma cells through the blood–brain barrier.
Levels of Interleukin‐18 and Endothelin‐1 in Children with Henoch‐Schönlein Purpura: A Study from Northern India
Authors: Mahajan Nitin , Kapoor Divya , Bisht Dinesh , Singh Surjit , Minz Ranjana W. , Dhawan Veena
Published: October 2013

Henoch‐Schönlein purpura (HSP) is an acute systemic vasculitis with unknown etiology, although several studies have found HSP to be related to cytokines such as tumor necrosis factor α, interleukin (IL)‐1, and adhesion molecules. In the present study we determined the levels of cytokines such as IL‐18 and endothelin‐1 (ET‐1) in children with HSP. Subjects were divided into three groups (group 1, 20 subjects with HSP; group 2, 10 subjects belonging to group 1 during their follow‐up 4 to 6 months later; and group 3, 16 controls who were healthy siblings of the subjects). IL‐18 and ET‐1 levels were determined using enzyme immunoassay and expressed as mean ± standard deviation. We observed higher IL‐18 levels in children with HSP (767.6 ± 145.1 pg/mL) than in controls (614.6 ± 66.54 pg/mL, p > 0.05), but IL‐18 levels were found to be significantly lower in subjects with HSP in remission (502.7 ± 60.81 pg/mL) than in those who were in an active phase (1,050 ± 244.5 pg/mL, p < 0.05, n = 10). ET‐1 levels were found to be significantly higher in subjects with HSP (1.93 ± 0.19 pg/mL) than in controls (1.10 ± 0.13 pg/mL, p < 0.05), although no significant difference was observed in ET‐1 levels between subjects in group 1 (1.88 ± 0.30 pg/mL) and group 2 (1.91 ± 0.120, p > 0.05, n = 10). A positive correlation was observed between IL‐18 and ET‐1 levels in subjects with HSP (correlation coefficient [r] = 0.5254, p < 0.01). These results suggest that levels of IL‐18 and ET‐1 are worth monitoring during the clinical course of the disease, but caution must be exercised in extrapolating data based on small study samples.