bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost‐effectiveness of zoledronic acid and strontium‐89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate‐refractory prostate cancer: results from theTRAPEZEtrial (ISRCTN12808747)
Authors: Andronis Lazaros , Goranitis Ilias , Pirrie Sarah , Pope Ann , Barton Darren , Collins Stuart , Daunton Adam , McLaren Duncan , O'Sullivan Joe M. , Parker Chris , Porfiri Emilio , Staffurth John , Stanley Andrew , Wylie James , Beesley Sharon , Birtle Alison , Brown Janet E. , Chakraborti Prabir , Hussain Syed A. , Russell J. Martin , Billingham Lucinda J. , James Nicholas D.
Published: June 2016

Objective

To evaluate the cost‐effectiveness of adding zoledronic acid or strontium‐89 to standard docetaxel chemotherapy for patients with castrate‐refractory prostate cancer (CRPC).

Patients and methods

Data on resource use and quality of life for 707 patients collected prospectively in theTRAPEZE2 × 2 factorial randomised trial (ISRCTN12808747) were used to assess the cost‐effectiveness of i) zoledronic acid versus no zoledronic acid (ZA vs. no ZA), and ii) strontium‐89 versus no strontium‐89 (Sr89 vs. no Sr89). Costs were estimated from the perspective of the National Health Service in theUKand included expenditures for trial treatments, concomitant medications, and use of related hospital and primary care services. Quality‐adjusted life‐years (QALYs) were calculated according to patients' responses to the generic EuroQolEQ‐5D‐3L instrument, which evaluates health status. Results are expressed as incremental cost‐effectiveness ratios (ICERs) and cost‐effectiveness acceptability curves.

Results

The per‐patient cost forZAwas £12 667, £251 higher than the equivalent cost in the noZAgroup. Patients in theZAgroup had on average 0.03QALYs more than their counterparts in noZAgroup. TheICERfor this comparison was £8 005. Sr89 was associated with a cost of £13 230, £1365 higher than no Sr89, and a gain of 0.08QALYs compared to no Sr89. TheICERfor Sr89 was £16 884. The probabilities ofZAand Sr89 being cost‐effective were 0.64 and 0.60, respectively.

Conclusions

The addition of bone‐targeting treatments to standard chemotherapy led to a small improvement inQALYs for a modest increase in cost (or cost‐savings).ZAand Sr89 resulted inICERs below conventional willingness‐to‐pay perQALYthresholds, suggesting that their addition to chemotherapy may represent a cost‐effective use of resources.
GCK gene mutations are a common cause of childhood‐onset MODY (maturity‐onset diabetes of the young) in Turkey
Authors: Haliloglu Belma , Hysenaj Gerald , Atay Zeynep , Guran Tulay , Abalı Saygın , Turan Serap , Bereket Abdullah , Ellard Sian
Published: June 2016

Objective

Inactivating heterozygous mutations in the GCK gene are a common cause of MODY and result in mild fasting hyperglycaemia, which does not require treatment. We aimed to identify the frequency, clinical and molecular features of GCK mutations in a Turkish paediatric cohort.

Design and Patients

Fifty‐four unrelated probands were selected based on the following criteria: age of diagnosis ≤17 years, family history of diabetes in at least two generations, anti‐GAD/ICA negative, BMI<95.p and follow‐up with diet, oral antidiabetic drug or low‐dose insulin treatment (≤0·5U/kg/d). A MODY probability score (www.diabetesgenes.org) was calculated and 21 patients with a score ≥75%, HbA1c levels ≤7·5% (58·5 mmol/mol) and fasting blood glucose (FBG) levels 99–145 mg/dl (5·5–8·0 mmol/l) were selected for Sanger sequencing of the GCK gene. Targeted next‐generation sequencing for all known monogenic diabetes genes was undertaken for any patient without a GCK gene mutation.

Results

GCK gene mutations (pathogenic or likely pathogenic variants) and a novel intronic variant of uncertain significance (c.208 + 3A>T) were identified in 13/54 probands (24%). Twelve of these patients had a MODY probability score ≥75%. FBG level and 2‐h glucose level in OGTT were 123 ± 14 mg/dl (6·8 ± 0·7 mmol/l) (107–157 mg/dl) and 181 ± 30 mg/dl (10·1 ± 1·6 mmol/l) (136–247 mg/dl), respectively. Average of glucose increment in OGTT was 58 ± 27 mg/dl (3·2 ± 1·5 mmol/l) (19–120 mg/dl), and mean HbA1c level was 6·5 ± 0·5% (47·5 ± 5·5 mmol/mol) (5·9–7·6%). Five novel missense mutations were identified (p.F123S, p.L58P, p.G246A, p.F419C, and p.S151C). Two patients treated with low‐dose insulin before the molecular analysis were able to stop treatment.

Conclusions

Approximately 1 in 4 MODY cases in this Turkish paediatric cohort have a GCK mutation. Selection of patients for GCK gene analysis using the MODY probability score was an effective way of identifying most (11/12) patients with a GCK mutation.
Comparative proteomic analysis of tear fluid in Graves' disease with and without orbitopathy
Authors: Aass C. , Norheim I. , Eriksen E. F. , Børnick E. C. , Thorsby P. M. , Pepaj M.
Published: June 2016

Background

Graves' orbitopathy (GO) is a severe organ‐specific autoimmune inflammatory ocular complication most often associated with Graves' disease (GD). Besides the cosmetic problems these patients develop,GOmay also cause severe, sight‐threatening complications. Additionally,GOcomplicates the treatment of patients withGD, making the identification of Graves patients at risk for eye disease before they develop symptoms a critical step in the clinical management and quality of life of these patients. The high concentration of proteins in tear fluid makes it an important source for studying potential protein biomarkers forGO.

Patients and methods

The aim of this study was to quantitatively compare tear fluid fromGDpatients with moderate/severeGO(GO) and patients withGDwithoutGO(controls) using untargeted quantitative proteomics based on dimethyl labelling in combination with two‐dimensional liquid chromatography–mass spectrometry.

Results

Among the 1212 proteins identified, 16 showed significant alterations in abundance between the two groups. Thus, in this study, we reveal a number of novel dysregulated proteins inGOwhich may contribute to a better understanding of the disease. In particular, upregulation of lacrimal gland proteins such as lysozyme C, lacritin, antileukoproteinase and zinc‐alpha‐2‐glycoprotein 1 suggests involvement of the lacrimal gland in the pathogenesis ofGO.

Conclusions

It remains to be elucidated whether some of these proteins can be used as markers for patients at risk for developingGOas well as useful indicators for disease activity.
Analysis of gene copy number changes in head and neck cancer
Authors: Baltaci E. , Karaman E. , Dalay N. , Buyru N.
Published: June 2016

Objective

Chromosomal alterations and copy number changes are frequent events in tumours, leading to amplification of focal regions containing several oncogenes. Gains and losses of several regions have been reported in head and neck cancer (HNC), but the copy number changes of the individual genes located in these regions have not been analysed so far. In this study, we aimed to analyse the copy number variations in patients with HNC.

Design

Prospective study.

Setting

University hospital.

Participants

Fifty patients with squamous cell carcinoma of the head and neck.

Methods

Copy number changes and amplifications of 22 genes in tumours and matched tissue were analysed by multiplex ligation‐dependent probe amplification (MLPA) which allows simultaneous analysis of gene copy numbers in multiple genetic regions.

Results

Amplifications were observed in 52%, and losses were detected in 20% of the samples. Chromosome 8 was found to harbour the most frequent copy number alterations. The most frequently amplified genes were CCND1 and the MED1 genes followed by the MTDH and MYC genes on the long arm and ZNF703 on the short arm of chromosome 8. Amplification of the ZNF703, PRDM14 and MYC genes was highly correlated suggesting that the genes displaying high copy number changes on chromosome 8 collaborate during carcinogenesis.

Conclusions

The alterations found in our study support the contribution of gene amplifications and indicate cooperation between certain oncogenes in the pathogenesis of HNSCC. Correlations between amplification of less familiar genes and known oncogenes warrant further investigation.
Morphological features that can predictBRAFV600E‐mutated carcinoma in paediatric thyroid cytology
Authors: Rossi E. D. , Bizzarro T. , Martini M. , Capodimonti S. , Cenci T. , Fadda G. , Schmitt F. , Larocca L. M.
Published: June 2016

Objective

BRAFV600Erepresents the most common diagnostic marker in papillary thyroid carcinoma (PTC). A few papers have demonstrated the correlation betweenBRAFV600Eand specific morphological findings onPTCs in the adult population. This is the first reported series investigating cytological morphological parameters in paediatric thyroid carcinoma.

Methods

One hundred and nineteen paediatric samples (56 male and 63 female patients), diagnosed in the period between April 2013 and July 2015, were enrolled in the study. Fifteen patients with inadequate results were excluded. Cytological cases were processed with liquid‐based cytology (LBC).BRAFV600Eand immunocytochemistry for theVE1 antibody were performed onLBC.

Results

The diagnostic series included 10 mutated and 94 wild‐type (WT) cases. Twenty two percent surgical samples showed 96% cytohistological concordance. The morphological analysis revealed plump cells (abundant eosinophilic cytoplasm andPTCnuclei) in all 10 mutated cases with only four cases showing a focal (less than 20% of the cells) plump component. None of theWTshowed plump cells. A sickle nuclear shape was seen only in the mutated cases.VE1 yielded 100% positivity on mutated cases with three cytohistological discrepancies.

Conclusions

TheBRAFV600Emutation is also seen in paediatric cytology and the morphological features showed a high accuracy as both predictive mutational parameters and a helpful aid in management mainly of the aggressiveBRAFV600Emutated carcinomas.
Adaptive specialization in position encoding while learning to read
Authors: Tóth Dénes , Csépe Valéria
Published: June 2016

The present experiments focused on how orthographic processing develops during reading acquisition. Specifically, a large, cross‐sectional sample of children from grade 2 to grade 4 was exposed to pairs of words, pseudowords, digit strings, and pseudo‐letter (Armenian) strings while their sensitivity to transpositions (T) and substitutions (S) of internal characters was investigated in a perceptual matching task. The results showed that the development of identity and position decoding diverged between the four stimulus categories. Most importantly, sensitivity improved with longer exposure to formal education and higher reading level to both S and T pairs for digit strings, but only to S pairs for words and pseudowords. The results were successfully reproduced in two small independent samples. We propose a general framework, the Adaptive Specialization Hypothesis, to accommodate the results. According to this hypothesis, the transposed‐letter effect is not a hard‐wired feature of the orthographic processing system but an adaptive response of the developing orthographic system to the constraints of lexical access in several orthographies.
ANIMAL SPIRITS, HETEROGENEOUS EXPECTATIONS, AND THE AMPLIFICATION AND DURATION OF CRISES
Authors: Assenza Tiziana , Brock William A. , Hommes Cars H.
Published: June 2016

We introduce a simple equilibrium model of a market for loans, where households lend to firms based on heterogeneous expectations about their loan default probability. Agents select endogenously among heterogeneous expectation rules, based upon their relative performance. Due to strong nonlinearities, a small fraction of pessimistic traders already has a large aggregate effect, leading to a crisis characterized by high interest rates for loans and low output. Our stylized model illustrates how animal spirits and heterogeneous expectations and, in particular, how coordination on pessimistic expectations amplifies crises and slows down recovery. (JELE32, D83, D84)
On the domain‐specificity of the visual and non‐visual face‐selective regions
Authors: Axelrod Vadim
Published: June 2016

What happens in our brains when we see a face? The neural mechanisms of face processing – namely, the face‐selective regions – have been extensively explored. Research has traditionally focused on visual cortex face‐regions; more recently, the role of face‐regions outside the visual cortex (i.e., non‐visual‐cortex face‐regions) has been acknowledged as well. The major quest today is to reveal the functional role of each this region in face processing. To make progress in this direction, it is essential to understand the extent to which the face‐regions, and particularly the non‐visual‐cortex face‐regions, process only faces (i.e., face‐specific, domain‐specific processing) or rather are involved in a more domain‐general cognitive processing. In the current functional MRI study, we systematically examined the activity of the whole face‐network during face‐unrelated reading task (i.e., written meaningful sentences with content unrelated to faces/people and non‐words). We found that the non‐visual‐cortex (i.e., right lateral prefrontal cortex and posterior superior temporal sulcus), but not the visual cortex face‐regions, responded significantly stronger to sentences than to non‐words. In general, some degree of sentence selectivity was found in all non‐visual‐cortex cortex. Present result highlights the possibility that the processing in the non‐visual‐cortex face‐selective regions might not be exclusively face‐specific, but rather more or even fully domain‐general. In this paper, we illustrate how the knowledge about domain‐general processing in face‐regions can help to advance our general understanding of face processing mechanisms. Our results therefore suggest that the problem of face processing should be approached in the broader scope of cognition in general.
Endogenous Credit Spreads and Optimal Debt Financing Structure in the Presence of Liquidity Risk
Authors: Lütkebohmert Eva , Oeltz Daniel , Xiao Yajun
Published: June 2016

We present a structural model that allows a firm to effectively manage its exposure to both insolvency and illiquidity risk inherent in its financing structure. Besides insolvency risk, the firm is exposed to rollover risk through possible runs by short‐term creditors. Moreover, asset price volatilities are subject to macroeconomic shocks and influence creditors' risk attitudes and margin requirements. Credit spreads are derived endogenously depending on the firm's total default risk. Equity holders have to bear the rollover losses. An optimal debt structure that maximises the firm's equity value is determined by trading off lower financing costs and higher rollover risk.
Exploring the Geographies of Privileged Childhoods
Authors: Sparks Hayley
Published: June 2016

Children are widely recognised as active agents in the world, whose perspectives, experiences, and identities are worthy of attention. From this consciousness, it is also noted that childhoods are situated within, and shaped by the broader social, economic, and cultural context. An extensive body of literature has considered the experiences and identities of children in the Global North and other privileged groups. However, there has been limited engagement to explicitly acknowledge and explore what privilege means within the context of childhood. Unpacking the conceptual dimensions of privilege, rather than seeing it as a taken for granted factor shaping young people's experiences is critical. A geographical approach, which acknowledges the mutually constitutive relationship between society and space, has the potential to enable a greater understanding of privileged childhoods, both in terms of the implications for young people's lived realities, but also extending conceptualisations of privilege. Thus, this paper calls for more direct research examining socially consequential discourses that affect privileged childhoods. Potential research agendas for further geographical research exploring privileged childhoods are proposed, including examination of spatialised elements of children's everyday lives including the home, mobilities, and consumption practices.
Clinical characteristics of atrial fibrillation‐related cardioembolic stroke in patients aged 80 years or older
Authors: Tanaka Koji , Yamada Takeshi , Torii Takako , Matsumoto Shoji , Yoshimura Takeo , Takase Kei‐ichiro , Wakata Yoshifumi , Nakashima Naoki , Kira Jun‐ichi , Murai Hiroyuki
Published: June 2016

Aim

Atrial fibrillation (AF)‐related cardioembolic stroke is a serious problem in the aging society. The present study examined the clinical characteristics and outcomes of AF‐related cardioembolic stroke in patients aged ≥80 years.

Methods

Between September 2011 and April 2014, consecutive patients with ischemic stroke and AF were retrospectively extracted from the multicenter database. Clinical characteristics were compared between patients aged ≥80 years and <80 years. Multivariate cox proportional hazard models were used to estimate hazard ratios and 95% confidential intervals on 90‐day mortality for age of ≥80 years.

Results

A total of 253 patients aged ≥80 years (87 men, 86.4 ± 5.0 years) and 196 patients aged <80 years (134 men, 70.4 ± 7.1 years) were included. Patients aged ≥80 years were more frequently female, and more likely to have higher premorbid modified Rankin Scale score (mRS), lower body mass index, previous history of stroke, prior antiplatelet therapy, congestive heart failure, and persistent AF. Patients aged ≥80 years had higher initial National Institutes of Health Stroke Scale score and were more likely to have occlusion of the cervicocephalic arteries, but less likely to receive thrombolysis. Patients aged ≥80 years had a higher mRS and mortality after 3 months. Age of ≥80 years was a significant predictor of 90‐day mortality after adjustment for sex (hazard ratio 2.20, 95% confidential interval 1.25–4.09), but was no longer significant after further adjustment for other clinical characteristics and stroke severity.

Conclusions

In AF‐related cardioembolic stroke, patients aged ≥80 years had different clinical characteristics and poorer outcome compared with patients aged <80 years. Geriatr Gerontol Int 2017; 17: 708–713.
A Cross‐Sectional Clinic‐Based Study in Patients With Side‐Locked Unilateral Headache and Facial Pain
Authors: Prakash Sanjay , Rathore Chaturbhuj , Makwana Prayag , Dave Ankit
Published: June 2016

Objective

To undertake the epidemiological evaluation of the patients presenting with side‐locked headache and facial pain in a tertiary neurology outpatient clinic.

Background

Side‐locked unilateral headache and facial pain include a large number of primary and secondary headaches and cranial neuropathies. A diagnostic approach for the patients presenting with strictly unilateral headaches is important as many of these headache disorders respond to a highly selective drug. Epidemiological data may guide us to formulate a proper approach for such patients. However, the literature is sparse on strictly unilateral headache and facial pain.

Methods

We prospectively recruited 307 consecutive adult patients (>18 years) with side‐locked headache and facial pain presenting to a neurology outpatient clinic between July 2014 and December 2015. All patients were subjected to MRI brain and other investigations to find out the different secondary causes. The diagnosis was carried out by at least two headache specialists together. All patients were classified according to the International Classification of Headache Disorder‐third edition (ICHD‐3β).

Results

The mean age at the time of examination was 42.4 ± 13.6 years (range 18‐80 years). Forty‐eight percent of patients were male. Strictly unilateral headaches accounted for 19.2% of the total headaches seen in the clinic. Headaches were classified as primary in 58%, secondary in 18%, and cranial neuropathies and other facial pain in 16% patients. Five percent of patients could not be classified. Three percent of patients were classified as per the Appendix section of ICHD‐3β. The prevalence of secondary headaches and painful cranial neuropathies increased with age. A total of 36 different diagnoses were made. Only two diseases (migraine and cluster headache) had a prevalence of more than 10%. The prevalence of 13 diseases varied between 6 and 9%. The prevalence of other 14 groups was ≤1%.

Migraine was the most common diagnosis (15%). Cervicogenic headache was the most common secondary headache. Classical trigeminal neuralgias and persistent idiopathic facial pain were two most common diagnoses in the painful cranial neuropathies and other facial pain groups. Sixty‐one percent fulfilled the definition of chronic daily headaches, and hemicrania continua and cervicogenic headache were the two most common diagnoses in this group.

Conclusions

A large number of primary and secondary headaches and cranial neuropathies may present as side‐locked headache and facial pain syndromes. Therefore, a sound knowledge of diagnostic approach is required for the optimal management of side locked headaches and facial pain.
Effect of in utero exposure to the atypical anti‐psychotic risperidone on histopathological features of the rat placenta
Authors: Singh K.P. , Singh Manoj K. , Gautam Shrikant
Published: June 2016

For clinical management of different forms of psychosis, both classical and atypical anti‐psychotic drugs (APDs) are available. These drugs are widely prescribed, even during pregnancy considering their minimal extra‐pyramidal side effects and teratogenic potential compared to classical APDs. Among AAPDs, risperidone (RIS) is a first‐line drug of choice by physicians. The molecular weight of RIS is 410.49 g/mol; hence, it can easily cross the placental barrier and enter the foetal bloodstream. It is not known whether or not AAPDs like RIS may affect the developing placenta and foetus adversely. Reports on this issue are limited and sketchy. Therefore, this study has evaluated the effects of maternal exposure to equivalent therapeutic doses of RIS on placental growth, histopathological and cytoarchitectural changes, and to establish a relationship between placental dysfunction and foetal outcomes. Pregnant rats (n = 24) were exposed to selected doses (0.8, 1.0 and 2.0 mg/kg) of RIS from gestation days 6–21. These dams were sacrificed; their placentas and foetuses were collected, morphometrically examined and further processed for histopathological examination. This study revealed that in utero exposure to equivalent therapeutic doses of RIS during organogenesis‐induced placental dystrophy (size and weight), disturbed cytoarchitectural organization (thickness of different placental layers), histopathological lesions (necrosis in trophoblast with disruption of trophoblastic septa and rupturing of maternal‐foetal interface) and intrauterine growth restriction of the foetuses. It may be concluded that multifactorial mechanisms might be involved in the dysregulation of structure and function of the placenta and of poor foetal growth and development.
Human papillomavirus and anal carcinoma knowledge in men who have sex with men in Belgrade, Serbia
Authors: Bjekic Milan , Sipetic‐Grujicic Sandra , Dunic Ivana , Salemovic Dubravka , Vlajinac Hristina
Published: June 2016

Background

To evaluate the level of knowledge among men who have sex with men regarding human papillomavirus (HPV), anal cancer screening, and HPV vaccine.

Methods

A cross‐sectional study was conducted in 2013 in Belgrade, Serbia, comprising 142 HIV‐positive and 128 HIV‐negative persons.

Results

Of all participants, 34.8% had never heard of HPV infection; 43.3% of participants were informed that HPV infection might be asymptomatic, while 30.4% knew that HPV is not transmitted by towels/cloth. Furthermore, 45.9% answered that HPV is a cause of genital warts, while 28.9%, 14.4%, and 17.4%, respectively, answered that it can cause anal, penile, and oral cancers. Only one‐fourth of participants knew that anal cancer is more frequent in homosexual men. More than 50% had not heard of anal Papanicolaou (Pap) smears, and less than 3% had ever had it. Almost 90% of participants did not know which physicians provide anal Pap smears. Less than one‐third knew that regular anal Pap smears might prevent consequences of anal HPV infection. The majority of participants did not know that there is a vaccine against HPV and anal cancer. Less than 50% reported willingness to receive HPV vaccine. Knowledge was slightly better in HIV‐positive men in comparison with HIV‐negative ones.

Conclusions

Results point out the need for community efforts to promote knowledge about HPV, anal carcinoma, and anal Pap screening among men who have sex with men and their healthcare providers, and to increase the acceptance of HPV vaccine by the population.
EPQ for an unreliable production system with endogenous reliability and product deterioration
Authors: Huang Hongfu , He Yong , Li Dong
Published: June 2016

In this paper, we study an economic production quantity problem for a production line subject to random shift from the in‐control state (with high production rate) to out‐of‐control state (with low production rate). Different from previous research, we model the expected shift time as a controllable variable, based on the fact that, by investment in resources, the reliability of the production line can be improved. In the mathematical model, we consider three possible scenarios: no shift, shift without demand shortage, and shift with demand shortage, which are determined by the values of actual shift time and shifted production rate. Combining the three possible scenarios, the goal is to minimize the expected total cost per unit time by finding the optimal production time, as well as the optimal expected shift time. In addition, we extend the model to deterioration products and study the influence of product deterioration to the optimal decisions. Numerical examples are presented to illustrate the optimal solutions, followed by the sensitive analysis on important parameters. Comparing the optimal solutions under no reliability investment, reliability investment can help companies save more cost. Some other managerial insights are also proposed based on the numerical tests.
Lithium Diffusion in Lithium Niobate Crystals with Different Initial Li2O Content at High Temperature
Authors: Li Qinglian , Sun Jun , Yang Jinfeng , Shang Jifang , Zhang Ling , Xu Jingjun
Published: June 2016

Lithium diffusion in lithium niobate crystals with different initial Li2O content (Cinitial) was investigated under Li‐rich environment at 1100°C. Lithium niobate crystals with widely varying diffusion‐limited Li2O content profiles were prepared through the vapor transport equilibration (VTE) technique using congruent lithium niobate crystals with different Cinitial, and the profiles were measured through Curie temperature by a thermal analyzer. A Boltzmann‐Matano analysis was employed to those profiles to estimate the Li+ diffusivity as a function of Li2O content in lithium niobate crystals. A trigonometric function method was applied to those profiles to correlate diffusion time and Li2O content. The results show that at the same composition of lithium niobate crystals after diffusing treatment, the less the Cinitial, the larger the Li+ diffusivity. The relation between diffusion time and Li2O content of the samples which have different Cinitial and thickness was derived. Based upon the Boltzmann‐Matano result, diffusion time can be estimated easily from the relation. It is concluded that increasing Cinitial contributes to shorten the diffusion time for preparing near‐stoichiometric lithium niobate crystals through the VTE technique, especially for thick crystal wafers.
Histopathological Study of Left and Right Atria in Isolated Rheumatic Mitral Stenosis With and Without Atrial Fibrillation
Authors: SHENTHAR JAYAPRAKASH , KALPANA SALIGRAMA RAMEGOWDA , PRABHU MUKUND A. , RAI MANEESH K. , NAGASHETTY RAVIKUMAR KALYANI , KAMLAPURKAR GIRIDHAR
Published: June 2016

Histopathological Study of Atria in Rheumatic Mitral Stenosis With Respect to Rhythm

Background

Mitral stenosis (MS) has the highest incidence of atrial fibrillation (AF) in chronic rheumatic valvular disease. There are very few studies in isolated MS comparing histopathological changes in patients with sinus rhythm (SR) and AF.

Objectives

To analyze the histological changes associated with isolated MS and compare between changes in AF and SR.

Methods

This was a prospective study in patients undergoing valve replacement surgery for symptomatic isolated MS who were divided into 2 groups, Group I AF (n = 13) and Group II SR (n = 10). Intra‐operative biopsies performed from 5 different sites from both atria were analyzed for 10 histopathologic changes commonly associated with AF.

Results

On multivariate analysis, myocytolysis (odds ratio [OR]: 1.48, P = 0.05) was found to be associated with AF, whereas myocyte hypertrophy (OR: 0.21, P = 0.003), and glycogen deposition (OR: 0.43, P = 0.002) was associated with SR. Interstitial fibrosis the commonest change was uniformly distributed across both atria irrespective of the rhythm.

Conclusion

In rheumatic MS, SR is associated with myocyte hypertrophy whereas AF is associated with myocytolysis. Endocardial inflammation is more common in left atrial appendage irrespective of rhythm. Interstitial fibrosis is seen in >90% of patients distributed in both the atria and is independent of the rhythm. Amyloid and Aschoff bodies are uncommon and the rest of the changes are uniformly distributed across both the atria.
Helium‐based cold atmospheric plasma‐induced reactive oxygen species‐mediated apoptotic pathway attenuated by platinum nanoparticles
Authors: Jawaid Paras , Rehman Mati Ur , Zhao Qing Li , Takeda Keigo , Ishikawa Kenji , Hori Masaru , Shimizu Tadamichi , Kondo Takashi
Published: June 2016

Plasma is generated by ionizing gas molecules. Helium (He)‐based cold atmospheric plasma (CAP) was generated using a high‐voltage power supply with low‐frequency excitation (60 Hz at 7 kV) and He flow at 2 l/min. Platinum nanoparticles (Pt‐NPs) are potent antioxidants due to their unique ability to scavenge superoxides and peroxides. These features make them useful for the protection against oxidative stress‐associated pathologies. Here, the effects of Pt‐NPs on He‐CAP‐induced apoptosis and the underlying mechanism were examined in human lymphoma U937 cells. Apoptosis was measured after cells were exposed to He‐CAP in the presence or absence of Pt‐NPs. The effects of combined treatment were determined by observing the changes in intracellular reactive oxygen species (ROS) and both mitochondrial and Fas dependent pathway. The results indicate that Pt‐NPs substantially scavenge He‐CAP‐induced superoxides and peroxides and inhibit all the pathways involved in apoptosis execution. This might be because of the SOD/catalase mimetic effects of Pt‐NPs. These results showed that the Pt‐NPs can induce He‐CAP desensitization in human lymphoma U937 cells.
Spatial and temporal variability in the otolith chemistry of the Brazilian snapper Lutjanus alexandrei from estuarine and coastal environments
Authors: Aschenbrenner A. , Ferreira B. P. , Rooker J. R.
Published: June 2016

Otolith chemistry of juvenile and adult individuals of the Brazilian snapper Lutjanus alexandrei was measured to assess the utility of natural markers for investigating individual movements. Individuals were collected over a 3‐year period (2010–2012) along the north‐eastern coast of Brazil from both estuarine (juvenile to sub‐adult stages) and coastal (sub‐adult to adult stages) areas. Six elements (7Li, 24Mg, 55Mn, 59Co, 88Sr and 137Ba) were measured in sectioned otoliths of L. alexandrei using laser ablation inductively coupled plasma mass spectrometry (LA‐ICPMS). Edge composition analysis indicated that element:Ca ratios in the otoliths of juvenile and sub‐adult L. alexandrei from estuaries were not significantly different among the three consecutive years (2010, 2011 and 2012), suggesting that physicochemical conditions within the nursery area investigated were temporally stable. Similarly, apart from two elements (Ba and Co), element:Ca ratios for larger L. alexandrei inhabiting coastal waters were also similar. In contrast, otolith chemistry of similar sized L. alexandrei from estuarine and coastal areas was significantly different (based on recently accreted material). Otolith Mn:Ca and Ba:Ca were both significantly higher for L. alexandrei collected in estuaries compared to fish from adjacent coastal reefs, while the opposite trend was observed for Sr:Ca. Given the pronounced differences in otolith chemistry between estuarine and coastal areas, element:Ca transects were constructed from the core to margin of the otoliths for adults (age 7+ years) collected on reefs to determine the timing of movement (ontogenetic migration) from estuarine to coastal areas. Based on observed patterns of decline for both Mn:Ca and Ba:Ca, it appears that L. alexandrei begin the move to more coastal habitats (i.e. lower element:Ca ratios) after age 2 years. The patterns observed for this species highlight the importance of conserving connectivity between coastal habitats to maintain sustainable fish stocks exploited by artisanal fisheries.
Factors affecting surgery decision‐making in patients with a chronic neurovascular condition
Authors: Klest Bridget , Mutschler Christina , Tamaian Andreea
Published: June 2016

Aims and objectives

To explore the factors that affect patient decision‐making for an elective surgery.

Background

Cerebral cavernous malformations are lesions found in the brain and spinal cord comprised of abnormal blood vessels, which bleed sporadically causing serious neurological deficits. Course of treatment for cerebral cavernous malformation is often ultimately left up to the patient, and can include symptom management or surgery. Decision‐making for surgery in life‐threatening conditions has been well documented in the literature. Less extensive research has focused on elective surgeries, where patients have a choice. There has been no research on the factors that affect decision‐making for cavernous malformation patients.

Design

Correlational self‐report survey.

Methods

In part of a larger online study, participants were asked to rate the importance of six factors on their decision‐making about surgery for cavernous malformation.

Results

Factors that were rated most important for individuals' decision‐making included doctor's opinion regarding surgery, presence of disabling symptoms, fear of symptoms getting worse or developing new symptoms, and availability of an expert surgeon. Results indicated that these were rated as more important than having social support during recovery or having the means to pay for surgery. Additionally, having social support during recovery was rated as significantly more important than having the means to pay for surgery.

Conclusions

Factors that affect decision‐making for patients diagnosed with cavernous malformation were similar to those found with other medical conditions requiring elective surgery. This study will assist healthcare workers in understanding the decision‐making process of individuals who may choose an elective surgery for potentially disabling conditions with uncertain outcomes.

Relevance to clinical practice

Understanding the complex factors that affect decision‐making in cavernous malformation will assist healthcare professionals to better communicate and support patients in their elective surgery decision‐making.
Expectations of relatives of Syrian patients in intensive care units in a state hospital in Turkey
Authors: Sevinç Sibel , Ajghif Mohammad , Uzun Özge , Gülbil Uğur
Published: June 2016

Aims and objectives

The purpose of the study was to describe the personal experiences of relatives of Syrian patients in the intensive care unit in one hospital in Turkey.

Background

The concept of the intensive care unit can be particularly frightening for family members. Current recommendations for training Intensive care unit nurses should support a holistic approach to patient (and family) care, including explanations at a level that families can easily understand and allowing family members to see the patient at regular intervals.

Design

This qualitative study was conducted between June and August 2014 and included a study sample of 30 Syrian family members related to patients receiving treatment at a state hospital intensive care unit in Turkey.

Methods

Data were collected by semi‐structured interviews. We used percentages to represent descriptive data and conducted qualitative content analysis.

Results

Following data analysis, six themes arose: (1) communication‐related difficulties, (2) difficulties receiving information regarding the patient's condition, (3) difficulties meeting personal needs, (4) difficulties communicating with other family members, (5) difficulties receiving support from other family members, and (6) unmet expectations from nurses and hospital administration.

Conclusions

Syrian patient's relatives receiving treatment in an intensive care unit in Turkey experienced communication difficulties in terms of receiving information from health care personnel, informing other family members, receiving social support from other family members, and having various unmet expectations from nurses and hospital administration.

Relevance to clinical practice

The results of this study can be used to develop guidelines and predictions for scenarios that are likely to arise for patients' relatives from foreign countries who arrive to support patients who receive healthcare services in our increasingly global world.
Positive impact on heat loss and patient experience of preheated skin disinfection: a randomised controlled trial
Authors: Wistrand Camilla , Söderquist Bo , Nilsson Ulrica
Published: June 2016

Aims and objectives

The aim of this study was to compare the effect of preheated (36 °C) and room‐temperature (20 °C) skin disinfectant solution on skin temperature and patients’ experience of the skin disinfection process.

Background

To prevent surgical site infections, it is important to disinfect skin prior to invasive surgery. In clinical practice, conscious patients often comment on the coldness of the preoperative skin disinfection solution. Evidence is lacking, as to whether preheated skin disinfectant has any positive effects during preoperative skin disinfection.

Design

Randomised controlled trial.

Methods

A total of 220 patients undergoing pacemaker, implantable cardioverter‐defibrillator, or cardiac resynchronisation therapy under local anaesthesia were included and randomly allocated to preheated or room‐temperature skin disinfection. Skin temperature was assessed before and after skin disinfection at the planned incision site; in addition, three study‐specific questions were used to assess how patients experienced the temperature.

Results

Patients experienced the skin disinfection process with preheated disinfectant as significantly more pleasant. They felt less cold and reported increased satisfaction with the temperature of the solution compared to patients who were disinfected with room‐temperature solution. Skin disinfection with preheated solution also yielded a significantly higher mean skin temperature compared to room‐temperature solution.

Conclusions

Preoperative skin disinfection with preheated disinfectant may prevent heat loss and contributes to a more pleasant experience for patients.

Relevance to clinical practice

Skin disinfection with preheated skin disinfectant is an easy and inexpensive nursing intervention that has a positive impact on heat loss and on patients’ experience of the disinfection process.
Alcoholic liver disease patients’ perspective of a coping and physical activity‐oriented rehabilitation intervention after hepatic encephalopathy
Authors: Mikkelsen Maria Rudkjær , Hendriksen Carsten , Schiødt Frank Vinholt , Rydahl‐Hansen Susan
Published: June 2016

Aim and objective

To identify and describe the impact of a coping and physical activity‐oriented rehabilitation intervention on alcoholic liver disease patients after hepatic encephalopathy in terms of their interaction with professionals and relatives.

Background

Patients who have experienced alcohol‐induced hepatic encephalopathy have reduced quality of life, multiple complications, and social problems, and rehabilitation opportunities for these patients are limited.

Design

A grounded theory study and an evaluation study of a controlled intervention study.

Methods

Semi‐structured interviews were conducted with 10 alcoholic liver disease patients who were diagnosed with hepatic encephalopathy and participated in a coping and physical activity‐oriented rehabilitation intervention. Richard S. Lazarus's theory of stress and coping inspired the interview guide.

Results

The significance of a coping and physical activity‐oriented rehabilitation intervention on alcoholic liver disease patients’ ability to cope with problems after surviving alcohol‐induced hepatic encephalopathy in terms of their interaction with professionals and relatives was characterised by the core category ‘regain control over the diseased body’. This is subdivided into three separate categories: ‘the experience of being physically strong’, ‘togetherness’ and ‘self‐control’, and they impact each other and are mutually interdependent.

Conclusion

Alcoholic liver disease patients described the strength of the rehabilitation as regaining control over the diseased body. Professionals and relatives of patients with alcoholic liver disease may need to focus on strengthening and preserving patients’ control of their diseased body by facilitating the experience of togetherness, self‐control and physical strength when interacting with and supporting patients with alcoholic liver disease.

Relevance to clinical practice

A coping and physical activity‐oriented rehabilitation intervention may help alcoholic liver disease patients to regain control over their diseased body and give patients the experience of togetherness, self‐control and physical strength. Professionals should be aware of giving the patients the experience of togetherness in their interactions, help them perceive self‐control and gain physical strength during their rehabilitation.
Using a Visible Light‐Polymerized Resin to Fabricate an Interim Partial Removable Dental Prosthesis
Authors: Segal Aaron , Yu Hui Wen , Elkassaby Heba
Published: June 2016

An interim partial removable dental prosthesis (RDP) is any dental prosthesis that replaces some teeth in a partially dentate arch designed to enhance esthetics, stabilization, and/or function for a limited period of time, after which it is to be replaced by a definitive dental prosthesis. This article describes a technique that uses a visible light‐polymerized (VLP) resin as the base material for an interim partial RDP. This technique can be easily accomplished in a dental office or laboratory and results in a predictable dental prosthesis. This technique eliminates the need for laboratory processing.
How Activists Respond to Social Structure in Offline and Online Contexts
Authors: Hartley Lisa K. , Lala Girish , Donaghue Ngaire , McGarty Craig
Published: June 2016

The social identity model of collective action (SIMCA) proposes that collective action flows from identity, perceived injustice, and efficacy beliefs but do these drivers apply for activists in all situations? Intuitively, the social structure that confronts activists should influence when and how they act. In two studies, we consider how activists incorporate the opinions of other people, groups, and institutions as part of their own reality or social structure. In Study 1, quantitative data from 248 activists campaigning for reconciliation between Indigenous and other Australians showed less support for SIMCA when activists faced a divided social movement. In Study 2, qualitative data from 40 online activists suggested that interactions involved identity presentation, used to sharpen and present views of the world and an idealized social structure. Together, findings highlight the practical importance for activists to have a consensual position about social structure, and of activists’ efforts to reach that consensus.
Sleep duration and blood pressure: a longitudinal analysis from early to late adolescence
Authors: Paciência Inês , Araújo Joana , Ramos Elisabete
Published: June 2016

The aim of this study was to evaluate the association between sleep duration and blood pressure using a cross‐sectional and longitudinal approach. As part of a population‐based cohort, 1403 adolescents were evaluated at 13 and 17 years old. Sleep duration was estimated by the difference between self‐reported usual bedtime and wake‐up time. Blood pressure was measured using the auscultatory method. Regression coefficients (β) and respective 95% confidence intervals were computed to evaluate the association between sleep duration and blood pressure, using linear regression models adjusted for practice of sports and body mass index at 17 years old. The mean (standard deviation) sleep duration at 13 years old was 9.0 (0.76) h per day, and on average it decreased by 46 min up to 17 years old. The median (25th–75th) systolic blood pressure at 17 years old was 110.0 (103.5–119.0) mmHg in females and 114.0 (106.0–122.0)mmHg in males (P < 0.001); for diastolic blood pressure the values were 66.0 (60.0–71.0) and 69.0 (62.0–75.0) mmHg, respectively (P < 0.001). In cross‐sectional analysis, at 17 years old, after adjustment, a positive association was found between sleep duration and blood pressure, significant only for systolic blood pressure among females [β = 0.730 (0.005; 1.455)]. In girls, no significant association was found between sleep duration at 13 years old and blood pressure at 17 years old, but in males an inverse association was found between sleep duration at 13 years old and blood pressure at 17 years old significant only for systolic blood pressure [β = −1.938 (−3.229; −0.647)]. This study found no association between sleep duration at 13 years old and blood pressure at 17 years old in girls, but among males an inverse association was found.
The Formulation Design of Elderly Special Diets
Authors: Funami Takahiro
Published: June 2016

Texture is important not only for food palatability but also for the safety of eating in recent aged society. For the elderlies, particularly those with reduced capability of eating, textural properties of food products should be modified from rheological, colloidal and tribological aspects to make the products friendly to these people. Formulation design for the texture of elderly special diets is now one of the most important tasks in Japanese food industry, and actually Japan is leading the product development by its diversity and quality. In this article, recent research progress on the formulation design of elderly special diets is presented mainly from industrial point of view by focusing on food texture.

Practical Applications

This article can enlighten food industry on usefulness of polysaccharides as a texture modifier in elderly special diets. For the elderlies, safe consumption should be a prerequisite for eating pleasure, and thus texture deign using polysaccharides can lead to improved quality of life. To understand associated working criteria is important for the industry not only from technical but also commercial aspects. In total, this article can contribute to the enhancement of motivation for product development of elderly special diets.