bluuebunny/crossref_metadata_2025 huggingface dataset:
Topografisch angepasste torische transepitheliale, gepulste Kollagenvernetzung mit hoher Fluenz, höherer Energie und höherer Riboflavin-Konzentration zur Behandlung des Keratokonus
Authors: Kanellopoulos Anastasios John , Dupps William J. , Seven Ibrahim , Asimellis George
Published: March 2015

Ziel: Bericht über eine neue Anwendungsform der topografisch angepassten torischen transepithelialen Kollagenvernetzung (CXL) zur Herbeiführung refraktiver astigmatischer Veränderungen bei Keratokonus.Methoden: Ein Auge mit progressivem Keratokonus wurde mit einer eigens entwickelten transepithelialen Riboflavin-Formulierung und UVA-Bestrahlung mit hoher Fluenz in einem an die individuelle Topografie angepassten Muster behandelt. Die Sehschärfe, Durchsichtigkeit der Hornhaut, Keratometrie, Topografie und Pachymetrie (mit einer Vielzahl von Modalitäten) sowie endotheliale Zellzählungen wurden über >6 Monate ausgewertet.Ergebnisse: Der unkorrigierte Fernvisus veränderte sich von präoperativ 20/40 auf 20/25 nach 6 Monaten. Außerdem waren 6 Monate nach der Operation eine mittlere Reduktion des Astigmatismus um 0,8 D und eine signifikante Normalisierung der Hornhaut-Oberfläche zu verzeichnen. Bei der epithelialen Verteilung traten geringfügige Veränderungen ein; das behandelte Areal zeigte eine leichte Normalisierung der durchschnittlichen Epitheldicke.Schlussfolgerungen: Wir stellen hier eine neuartige Anwendungsform einer topografisch anpassbaren transepithelialen CXL zur Behandlung des progressiven Keratokonus vor, die auf einen astigmatischen refraktiven Effekt und die Stabilisierung der Ektasie abzielt. Dieses neue Verfahren ist ein nichtablativer und inzisionsfreier Ansatz zur Behandlung von irregulärem Astigmatismus bei Hornhaut-Ektasie mit schneller visueller Rehabilitation.
ß3-Integrin Inhibits Lipopolysaccharide-Induced Autophagy in Cardiomyocytes via the Akt Signaling Pathway
Authors: Zhu Ying , Li Li , Gong Shijin , Yu Yihua , Dai Haiwen , Cai Guolong , Yan Jing
Published: March 2015

Objective: To investigate the role of β3-integrin in lipopolysaccharide (LPS)-induced autophagy in cardiomyocytes and its underlying mechanism. Methods: β3-Integrin expression in cardiomyocytes was up- or downregulated by adenovirus transfection or cyclic arginine-glycine-aspartic acid (cRGD) peptide treatment before LPS stimulation. The expression of autophagy-associated proteins (LC3-II, Beclin-1 and Bcl-2) and the activation of Akt were determined using Western blotting. Autophagosomes and autophagic vacuoles were observed using monodansylcadaverine (MDC) dye and transmission electron microscopy, respectively. Results: Downregulation of β3-integrin with cRGD peptide resulted in enhanced LC3-II and Beclin-1 and decreased Bcl-2 expression. Low Beclin-1 levels were detected after LPS stimulation in adenovirus β3-integrin-transfected cardiomyocytes. There was no significant difference in LC3-II levels between control and adenovirus β3-integrin-transfected cardiomyocytes. Enhanced accumulation of MDC dye and autophagosomes, which were inhibited by β3-integrin overexpression, were detected after LPS treatment. The increased phosphorylation of Akt after LPS stimulation was inhibited by cRGD and enhanced by β3-integrin overexpression. Furthermore, the Akt inhibitor triciribine inhibited the negative effect of β3-integrin on autophagy, as shown by LC3-II and Beclin-1 upregulation. Conclusions: β3-Integrin inhibits LPS-induced autophagy in cardiomyocytes. The inhibition of Akt signaling might be an important mechanism in this process.
Crying Tapir: The Functionality of Errors and Accuracy in Predator Recognition in Two Neotropical High-Canopy Primates
Authors: Mourthé ítalo , Barnett Adrian A.
Published: March 2015

Predation is often considered to be a prime driver in primate evolution, but, as predation is rarely observed in nature, little is known of primate antipredator responses. Time-limited primates should be highly discerning when responding to predators, since time spent in vigilance and avoidance behaviour may supplant other activities. We present data from two independent studies describing and quantifying the frequency, nature and duration of predator-linked behaviours in 2 high-canopy primates, Ateles belzebuth and Cacajao ouakary. We introduce the concept of ‘pseudopredators' (harmless species whose appearance is sufficiently similar to that of predators to elicit antipredator responses) and predict that changes in behaviour should increase with risk posed by a perceived predator. We studied primate group encounters with non-primate vertebrates across 14 (Ateles) and 19 (Cacajao) months in 2 undisturbed Amazonian forests. Although preliminary, data on both primates revealed that they distinguished the potential predation capacities of other species, as predicted. They appeared to differentiate predators from non-predators and distinguished when potential predators were not an immediate threat, although they reacted erroneously to pseudopredators, on average in about 20% of the responses given toward other vertebrates. Reacting to pseudopredators would be interesting since, in predation, one error can be fatal to the prey.
Hospital Cost-Analysis of Complications after Major Abdominal Surgery
Authors: Straatman Jennifer , Cuesta Miguel A. , de Lange-de Klerk Elly S.M. , van der Peet Donald L.
Published: March 2015

Background: Complications after major abdominal surgery (MAS) are associated with increased morbidity and mortality. Rising costs in health care are of increasing interest and a major factor affecting hospital costs are postoperative complications. In this study, the costs associated with complications are assessed. Methods: Retrospective cohort study of 399 consecutive patients that underwent MAS. Analysis of total costs for hospital stay, complications and treatment was performed, including bootstrapping; allowing for subtraction of data with 95% confidence intervals. Results: For a single patient who underwent MAS the average costs, adjusted for ASA-classification and surgery type, adds up to EUR 8,584.81 (95% CI EUR 8,332.51 - EUR 8,860.81) in patients without complications. EUR 15,412.96 (95% CI EUR 14,250.22 - EUR 16,708.82) after minor complications, and EUR 29,198.23 (95% CI EUR 27,187.13 - EUR 31,295.78) after major complications (p < 0.001). Conclusion: The results provide an insight into the scope of hospital costs associated with complications. Major complications occur in 20% of patients undergoing MAS and account for 50% of the total costs of care. Implementation of a protocol aimed at early diagnosis and treatment of complications might lead to a decrease in morbidity and mortality, but also prove to be cost effective.
Differential Protein Expression in White Adipose Tissue from Obesity-Prone and Obesity-Resistant Mice in Response to High Fat Diet and Anti-Obesity Herbal Medicines
Authors: Kim Sang Woo , Park Tae-Jun , Choi Jae Heon , Aseer Kanikkai Raja , Choi Ji-Young , Kim Ye Jin , Choi Myung-Sook , Yun Jong Won
Published: March 2015

Background: One of the most interesting issues in obesity research is why certain humans are obesity-prone (OP) while others are obesity-resistant (OR) upon exposure to a high-calorie diet. However, the pathways responsible for these phenotypic differences are still largely unknown. Methods: In order to discover marker molecules determining susceptibility and/or resistance to obesity in response to high fat diet (HFD) or anti-obesity herbal medicine (TH), we conducted comparative proteomic analysis of white adipose tissue (WAT) from OP, OR, as well as TH-treated mice. Results: OP mice fed HFD gained approximately 33% more body weight than OR mice, and TH significantly reduced body weight gain in HFD-fed mice by 30%. These mice were further subjected to proteomic analysis using two-dimensional electrophoresis (2-DE) combined with matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS). Proteomic data revealed 59 spots that were differentially regulated from a total of 1,045 matched spots, and 57 spots of these were identified as altered WAT proteins between OP and OR mice by peptide mass finger printing. Interestingly, 45 proteins were similarly regulated in OR mice in response to TH treatment. Of these, 10 proteins have already been recognized in the context of obesity; however, other proteins involved in obesity susceptibility or resistance were identified for the first time in the present study. Conclusion: Our results suggest that TH actively contributed to body weight reduction in HFD-fed obese mice by altering protein regulation in WAT, and it was also found that TH-responsive proteins can be used as potent molecules for obesity treatment.
Activation of Extracellular Signal-Regulated Protein Kinases 1 and 2 (ERK1/2) by Free Fatty Acid Receptor 1 (FFAR1/GPR40) Protects from Palmitate-Induced Beta Cell Death, but Plays no Role in Insulin Secretion
Authors: Panse Madhura , Gerst Felicia , Kaiser Gabriele , Teutsch Charlott-Amélie , Dölker Rebecca , Wagner Robert , Häring Hans-Ulrich , Ullrich Susanne
Published: March 2015

Aims: GPR40/FFAR1 mediates palmitate-induced stimulation of insulin secretion but its involvement in lipotoxicity is controversial. Our previous observations suggest that FFAR1/GPR40 agonists protect against lipotoxicity although the underlying mechanism remains elusive. The present study examines the role of ERK1/2 and GPR40/FFAR1 in palmitate-induced stimulation of insulin secretion and beta cell death. Methods: Insulin secretion of INS-1E cells was measured by radioimmunoassay. Protein phosphorylation was examined on Western blots. Apoptosis was assessed by TUNEL staining. Results: Palmitate and the GPR40/FFAR1 agonist TUG-469 increased phosphorylation of ERK1/2 at low (2.8 mmol/L) and high (12 mmol/L) glucose but stimulated insulin secretion only at high glucose. The MEK1 inhibitor PD98059 significantly reduced phosphorylation of ERK1/2 but did not reverse the stimulation of secretion induced by glucose, palmitate or TUG-469. PD98059 rather augmented glucose-induced secretion. Prolonged exposure to palmitate stimulated apoptosis, an effect counteracted by TUG-469. PD98059 accentuated palmitate-induced apoptosis and reversed TUG-469-mediated inhibition of cell death. Conclusions: Activation of ERK1/2 by palmitate and GPR40/FFAR1 agonist correlates neither with stimulation of insulin secretion nor with induction of apoptosis. The results suggest a significant anti-apoptotic role of ERK1/2 under conditions of lipotoxicity.
MicroRNA-223 Displays a Protective Role Against Cardiomyocyte Hypertrophy by Targeting Cardiac Troponin I-Interacting Kinase
Authors: Wang Yao-Sheng , Zhou Jing , Hong Kui , Cheng Xiao-Shu , Li Yi-Gang
Published: March 2015

Background/Aims: MicroRNAs play regulatory role in cardiovascular disease. MicroRNA-223 (miR-223) was found to be expressed abundantly in myocardium. TNNI3K, a novel cardiac troponin I (cTnI)-interacting and cardiac hypertrophy related kinase, is computationally predicted as a potential target of miR-223. This study was designed to investigate the cellular and molecular effects of miR-223 on cardiomyoctye hypertrophy, focusing on the role of TNNI3K. Methods: Neonatal rat cardiomyocytes (CMs) were cultured, and CMs hypertrophy was induced by endothelin-1 (ET-1). In vivo cardiac hypertrophy was induced by transverse aorta constriction (TAC) in rats. Expression of miR-223 in CMs and myocardium was detected by real-time PCR (RT-PCR). MiR-223 and TNNI3K were overexpressed in CMs via chemically modifed sense RNA (miR-223 mimic) transfection or recombinant adenovirus infection, respectively. Cell size was measured by surface area calculation using fluorescence microscopy after anti-α-actinin staining. Expression of hypertrophy-related genes was detected by RT-PCR. The protein expression of TNNI3K and cTnI was determined by Western blots. Luciferase assay was employed to confirm the direct binding of miR-223 to the 3'UTR of TNNI3K mRNA. Intracellular calcium was measured by sensitive fluorescent indicator (Furo-2). Video-based edge detection system was employed to measure cardiomyocyte contractility. Results: MiR-223 was downregulated in ET-1 induced hypertrophic CMs and in hypertrophic myocardium compared with respective controls. MiR-223 overexpression in CMs alleviated ET-1 induced hypertrophy, evidenced by smaller cell surface area and downregulated ANP, α-actinin, Myh6 and Myh7 expression. Luciferase reporter gene assay showed that TNNI3K serves as a direct target gene of miR-223. In miR-223-overexpressed CMs, the protein expression of TNNI3K was significantly downregulated. MiR-223 overexpression also rescued the upregulated TNNI3K expression in hypertrophic CMs. Furthermore, cTnI phosphorylation was downregulated post miR-223 overexpression. Ad.rTNNI3K increased intracellular Ca2+ concentrations and cell shortening in CMs, while miR-223 overexpression significantly rescued these hypertrophic effects. Conclusion: By direct targeting TNNI3K, miR-223 could suppress CMs hypertrophy via downregulating cTnI phosphorylation, reducing intracellular Ca2+ and contractility of CMs. miR-223 / TNNI3K axis may thus be major players of CMs hypertrophy.
NSAID-Induced Small Intestinal Damage - Roles of Various Pathogenic Factors
Authors: Takeuchi Koji , Satoh Hiroshi
Published: March 2015

Background/Aims: NSAID-induced enteropathy has been the focus of recent basic and clinical research subsequent to the development of the capsule endoscope and double-balloon endoscope. We review the possible pathogenic mechanisms underlying NSAID-induced enteropathy and discuss the role of the inhibition of COX-1/COX-2 and the influences of food as well as various prophylactic treatments on these lesions. Methods: Studies were performed in experimental animals. Results: Multiple factors, such as intestinal hypermotility, decreased mucus secretion, enterobacteria, and upregulation of iNOS/NO expression, are involved in the pathogenesis of NSAID-induced enteropathy, in addition to the decreased production of PGs due to the inhibition of COX. Enterobacterial invasion is the most important pathogenic event, and intestinal hypermotility, which was associated with this event, is essential for the development of these lesions. NSAIDs also upregulate the expression of COX-2, and the inhibition of both COX-1 and COX-2 is required for the intestinal ulcerogenic properties of NSAIDs to manifest. NSAID-induced enteropathy is prevented by PGE2, atropine, ampicillin, and aminoguanidine as well as soluble dietary fiber, and exacerbated by antisecretory drugs such as proton pump inhibitors. Conclusion: These findings on the pathogenesis of NSAID-induced enteropathy will be useful for the future development of intestinal-sparing alternatives to standard NSAIDs.
High Impact of Histopathological Remission for Prognosis after Perioperative Chemotherapy with ECF and ECF-Like Regimens for Gastric and Gastroesophageal Adenocarcinoma
Authors: Bichev Dmitry , Treese Christoph , von Winterfeld Moritz , Breithaupt Kirstin , Dogan Yasemin , Schmidt Sven C. , Daum Severin , Thuss-Patience Peter C.
Published: March 2015

Background: Perioperative chemotherapy with epirubicin, cisplatin and 5-fluorouracil (5-FU) (ECF)-like regimens is the European standard for patients with adenocarcinoma of the gastroesophageal junction (GEJ) or gastric body (GaCa) stage UICC II/III (staged according to the Union for International Cancer Control). However, limited data exist on the histopathological response and relevance of prognosis for patients homogeneously treated with ECF(-like) therapies. Methods: All patients with GEJ/GaCa treated from September 2004 to September 2008 by perioperative ECF(-like) chemotherapy were retrospectively analyzed. Cisplatin and 5-FU were substituted with oxaliplatin or capecitabine when indicated. The histopathological response was assessed using the Becker score. Results: Seventy-seven patients were analyzed with a median follow-up of 72.3 months. R0 resection was achieved in 53 of 68 operated patients. Recurrence was observed in 25 (32.5%) of these curatively treated patients, whereas 53/77 patients (68.8%) died, 39 (50.6%) of whom tumor related. The 5-year overall survival (OS) for the intention-to-treat population was 36.3%, and the 5-year tumor-specific survival was 42.2%. Pathological complete response (pCR) was seen in 10 patients (13.0%) and near pCR in 3 patients (3.9%). Patients with pCR had a significantly prolonged 5-year OS of 80.0 versus 29.7% compared to the nonhistopathological complete remission group (p = 0.01). Conclusion: In our retrospective analysis, ECF(-like) pretreatment resulted in a (near) pCR rate of 16.9%. In line with other regimens, our data suggest that histopathological response predicts the OS in patients treated with ECF(-like) regimens.
Application of a 70-Gene Expression Profile to Japanese Breast Cancer Patients
Authors: Shimizu Hideo , Horimoto Yoshiya , Arakawa Atsushi , Sonoue Hiroshi , Kurata Mami , Kosaka Taijiro , Nakai Katsuya , Himuro Takanori , Tokuda Emi , Takahashi Yuka , Taira Fumi , Ito Mayuko , Abe Ikuko , Senuma Koji , Stork-Sloots Lisette , de Snoo Femke , Saito Mitsue
Published: March 2015

Background: As data on using MammaPrint®, a 70-gene expression profile for molecular subtyping of breast cancer, are limited in Japanese patients, we aimed to determine the gene profiles of Japanese patients using MammaPrint and to investigate its possible clinical application for selecting adjuvant treatments. Patients and Methods: 50 women treated surgically at our institution were examined. The MammaPrint results were compared with the St Gallen 2007 and intrinsic subtype risk categorizations. Results: Of 38 cases judged to be at intermediate risk based on the St Gallen 2007 Consensus, 11 (29%) were in the high-risk group based on MammaPrint. 1 of the 30 luminal A-like tumors (3%) was judged as high risk based on MammaPrint results, whereas 7 of the 20 tumors (35%) categorized as luminal B-like or triple negative were in the low-risk group. There have been no recurrences to date in the MammaPrint group, and this is possibly attributable to most of the high-risk patients receiving chemotherapy that had been recommended on the basis of their MammaPrint results. Conclusions: Our results indicate that MammaPrint is applicable to Japanese patients and that it is of potential value in current clinical practice for devising individualized treatments.
Utilisation of Blood Components in Cardiac Surgery: A Single-Centre Retrospective Analysis with Regard to Diagnosis-Related Procedures
Authors: Geissler Raoul Georg , Rotering Heinrich , Buddendick Hubert , Franz Dominik , Bunzemeier Holger , Roeder Norbert , Kwiecien Robert , Sibrowski Walter , Scheld Hans H. , Martens Sven , Schlenke Peter
Published: March 2015

Background: More blood components are required in cardiac surgery than in most other medical disciplines. The overall blood demand may increase as a function of the total number of cardiothoracic and vascular surgical interventions and their level of complexity, and also when considering the demographic ageing. Awareness has grown with respect to adverse events, such as transfusion-related immunomodulation by allogeneic blood supply, which can contribute to morbidity and mortality. Therefore, programmes of patient blood management (PBM) have been implemented to avoid unnecessary blood transfusions and to standardise the indication of blood transfusions more strictly with aim to improve patients' overall outcomes. Methods: A comprehensive retrospective analysis of the utilisation of blood components in the Department of Cardiac Surgery at the University Hospital of Münster (UKM) was performed over a 4-year period. Based on a medical reporting system of all medical disciplines, which was established as part of a PBM initiative, all transfused patients in cardiac surgery and their blood components were identified in a diagnosis- and medical procedure-related system, which allows the precise allocation of blood consumption to interventional procedures in cardiac surgery, such as coronary or valve surgery. Results: This retrospective single centre study included all in-patients in cardiac surgery at the UKM from 2009 to 2012, corresponding to a total of 1,405-1,644 cases per year. A blood supply was provided for 55.6-61.9% of the cardiac surgery patients, whereas approximately 9% of all in-patients at the UKM required blood transfusions. Most of the blood units were applied during cardiac valve surgery and during coronary surgery. Further surgical activities with considerable use of blood components included thoracic surgery, aortic surgery, heart transplantations and the use of artificial hearts. Under the measures of PBM in 2012 a noticeable decrease in the number of transfused cases was observed compared to the period from 2009 to 2011 before implementation of the PBM initiative (red blood cells p < 0.002; fresh frozen plasma p < 0.0006; platelets p < 0.00006). Conclusion: Until now, cardiac surgery comes along with a significant blood supply. By using a case-related data evaluation programme, the consumption of each blood component can be linked to clinical performance groups and, if necessary, to individual patients. Based on the results obtained from this retrospective analysis, prospective studies are underway to begin conducting target / actual performance comparisons to better understand the individual decision-making by the attending physicians with respect to transfusions.
Hypocalcemia Post Denosumab in Patients with Chronic Kidney Disease Stage 4-5
Authors: Dave Vatsa , Chiang Cherie Y. , Booth Jane , Mount Peter F.
Published: March 2015

Background: Denosumab, a RANK-ligand inhibitor, is an effective treatment for osteoporosis in postmenopausal women and men. Unlike the bisphosphonates, it is not excreted by the kidney. Little is known, however, about its efficacy and safety in patients with severe chronic kidney disease (CKD). Methods: A retrospective study was performed in CKD 4-5D patients from a tertiary referral hospital who were treated with denosumab between 1st January 2011 and 31st March 2014. Data collected included information about the following: CKD stage, fracture history, bone mineral density, serum calcium levels pre and post denosumab treatment, episodes of hypocalcemia, relevant medications and adverse events. Results: Eight patients with CKD-5 and 6 patients with CKD-4 were identified (all female, mean age 77.1 ± 9.9). The mean pre-denosumab calcium value was 2.42 ± 0.12 mmol/l, PTH 20.2 ± 14.7 pmol/l and 25-OH vitamin D 69.1 ± 30.1 nmol/l. After denosumab treatment, 6/8 patients with CKD-5/5D, and 2/5 patients with CKD-4 developed severe hypocalcemia. Two patients developed direct adverse complications of hypocalcemia (seizure, laryngospasm, prolonged QTc). Among the patients who developed hypocalcemia, the median time to serum calcium nadir was 21 days and the median time to correction of hypocalcemia was 71 days. Treatment of hypocalcemia required large doses of oral calcium and calcitriol, and increases in dialysate calcium concentration. Conclusions: A high rate of severe hypocalcemia was observed in patients with advanced CKD treated with denosumab. If denosumab is used in patients with severe CKD, close monitoring and aggressive replacement of calcium and calcitriol is required to avoid the development of hypocalcemia.
Elfenbeintürme im Treibsand oder: Was macht es so schwierig, Erkenntnisse aus der Forschung in der therapeutischen Praxis umzusetzen?
Authors: Bohus Martin
Published: March 2015

Auch 20 Jahre nach der Drucklegung von Klaus Grawes Pionierwerk ist es noch ein weiter Weg von der psychotherapeutischen Konfession zur Profession. Wie in den meisten Fachgebieten der Medizin besteht auch in der Psychotherapie ein nicht unerhebliches «science-practice gap», also eine deutliche zeitliche Verzögerung in der Umsetzung von Forschungsergebnissen in die klinische Praxis. Dabei weist die Psychotherapie einige Besonderheiten auf: Seitens der Kliniker besteht erhebliche Skepsis bezüglich der Relevanz von Top-down-Forschungsergebnissen für ihren klinischen Alltag. Dies betrifft die Repräsentativität der Stichproben, die Besonderheit der Forschungsbedingungen und die Komplexität der Programme. Im Gegenzug wird die Forderung nach einer praxisbasierten Evidenz laut, also nach Forschungsansätzen, die die alltägliche therapeutische Arbeit als Forschungsgegenstand in den Blick nehmen sollten. Der Artikel beleuchtet die jeweiligen Argumentationsstränge sowie deren immanente Logik und Relevanz. Er plädiert für moderne strukturierte, zirkulär organisierte Kooperationsmodelle zwischen Forschern und Klinikern.
Point of Care and Factor Concentrate-Based Coagulation Algorithms
Authors: Theusinger Oliver M. , Stein Philipp , Levy Jerrold H.
Published: March 2015

In the last years it has become evident that the use of blood products should be reduced whenever possible. There is increasing evidence regarding serious adverse events, including higher mortality and morbidity, related to transfusions. The use of point of care (POC) devices integrated in algorithms is one of the important mechanisms to limit blood product exposure. Any type of algorithm, especially the POC-based ones, allows goal-directed transfusions of blood products and even better targeted factor concentrate substitutions. Different types of algorithms in different surgical settings (cardiac surgery, trauma, liver surgery etc.) have been established with growing interest in their use as they offer objective therapy for management and reduction of blood product use. The use of POC devices with evidence-based algorithms is important in the bleeding patient independent of its origin (traumatic vs. surgical). The use of factor concentrates compared to the classical blood products can be cost-saving, beneficial for the patient, and in agreement with the WHO-requested standard of care. The empiric and uncontrolled use of blood products such as fresh frozen plasma, red blood cells, and platelets without POC monitoring should no longer be followed with regard to actual evidence in literature. Furthermore, the use of factor concentrates may provide better outcomes and potential for cost saving.
Incidence of Second Primary Malignancies in Patients with Neuroendocrine Tumours
Authors: Clift Ashley K. , Drymousis Panagiotis , Al-Nahhas Adil , Wasan Harpreet , Martin John , Holm Sture , Frilling Andrea
Published: March 2015

Background: An association between neuroendocrine tumours (NET) and increased risk of developing second primary malignancies (SPM) has been recognised. Methods: This was a retrospective review of our institutional prospectively maintained database of NET patients. We identified patients who had been diagnosed with both neuroendocrine and any additional malignancies via examination of patient notes. Results: Clinical data for 169 patients were analysed. After exclusion of patients known to have hereditary tumour predisposition syndromes, 29 SPM were identified in 26 patients (15.38%), the commonest being colorectal (n = 6), breast and renal carcinomas (both n = 5). SPM were classified as previous, synchronous or subsequent relative to NET diagnosis. Rates of SPM in pancreatic and small-bowel NET patients were comparable (15.7 vs. 19.6%, p = 0.78). A person-year methodology was used to compare observed numbers of SPM against expected values generated from age- and sex-specific incidence tables, with standardised incidence ratios (SIR) and 95% confidence intervals (CI) calculated. SPM incidence was significantly elevated in the synchronous subset (SIR 2.732, CI 1.177-5.382) whilst significantly fewer NET patients had a cancer history compared to the general population (SIR 0.4, CI 0.241-0.624). No overall differences were evident between observed and expected incidences of subsequent SPM (SIR 0.36, CI 0.044-1.051). The incidence of synchronous colorectal cancers was markedly elevated (SIR 13.079, CI 4.238-30.474). Conclusions: Our data support the use of colonoscopy in the diagnostic work-up of NET patients in anticipation of a colorectal SPM. The mechanistic underpinnings of this clinical phenomenon require further genetic investigation, and consideration of this knowledge in patient management pathways is warranted.
First systematic monitoring of Batrachochytrium dendrobatidis in collections of captive amphibians in the Czech Republic
Authors: Havlíková Barbora , Havlíková Barbora , Baláž Vojtech , Havlíková Barbora , Baláž Vojtech , Vojar Jiří
Published: March 2015

The popularity of amphibians as pets in the Czech Republic is growing. Private keepers breed mainly exotic species that are available at popular exotic animal fairs and in pet shops. This growing demand for amphibians also brings increasing risk of disease transmission. In our study, we focused on two objectives: detecting the pathogen Batrachochytrium dendrobatidis (Bd) in captive amphibians across the Czech Republic and summarizing the results of itraconazole treatments. We performed a systematic survey, focusing on public institutions, the pet trade and private breeders. Of 610 amphibians tested, we recorded 5.1% to be infected with Bd. The fungus was present mainly as a mild asymptomatic infection, but we also found cases of acute disease, including mortalities. Amphibian breeders, zookeepers and pet sellers should regularly test their animals for the presence of Bd and other pathogens, because captive amphibians can serve as their reservoirs. When Bd infection is present in a captive amphibian, treatment should be appropriate to the infection’s intensity. The trade-off between the risk of disease and the risk of antifungal treatment varies greatly among species, and even itraconazole’s use can cause fatal health complications.
Sexual dimorphism and geographic variation in the morphology of a small southern African tortoise Psammobates oculifer
Authors: Keswick Toby , Keswick Toby , Hofmeyr Margaretha D.
Published: March 2015

We studied morphological traits ofPsammobates oculiferover its range to evaluate patterns in sexual size dimorphism (SSD) and geographic variation. Females were larger than males for 40 of the 44 characters measured and the growth trajectories of female parameters, scaled to body size (ANCOVA and MANCOVA on carapace length), most often followed juvenile patterns. For males, either the slopes or elevations of morphometric parameters were lower than in females. These divergent growth trajectories resulted in shape differences with female shells being higher and wider than the shells of males. Males matured at a smaller age and size, and had wider hind feet and larger shell openings relative to females; the latter being due to a shorter and narrower plastron, a shorter bridge length, and a bigger anal gap and cranial space. These male characteristics possibly enhance mobility for mate searching and combat, as well as courtship and mating behaviour. Small sample sizes for females in two of the three regions restricted geographic evaluations to males, for which shell shape, front foot width and hind leg length of the eastern group differed from the others. We interpreted these variations as the consequence of differences in the substratum and vegetation openness over the range of the species.
Individual performance in socio-cognitive tasks predicts social behaviour in carrion crows
Authors: Wascher Claudia A.F.
Published: March 2015

The social intelligence hypothesis links the evolution of exceptional cognitive skills to the requirements of complex social systems. Empirical evidence of a connection between cognitive skills and social behaviour on an individual level is lacking. I investigated how cognitive performance in carrion crows correlates with social behaviour. Social behaviour was observed and crows were tested in four tasks previously published elsewhere: qualitative exchange, quantity preference, inequity aversion, heterospecific recognition. I describe correlations between an individuals’ involvement in affiliative and aggressive encounters and performance during these different cognitive tasks. For example, individuals performing better in the qualitative exchange task received more approaches and affiliative interactions. There was a correlation between birds choosing higher quantities during testing and their propensity to initiate aggressive and affiliative interactions with others. Overall these results show a link between social behaviour and individual performance in cognitive tasks.
Traditional and Institutional Medicine in Ottoman Damascus
Authors: Rafeq Abdul-Karim
Published: March 2015

Traditional medicine in the first three centuries of Ottoman rule in Damascus was practiced by local doctors who studied medicine, in addition to other Islamic studies, with their fathers or with others. It also included visitations to spiritual healers and shrines. Time-honoured procedures, such as cupping and the use of leeches, were also practiced. Biographical dictionaries, a major source for traditional medicine, mentioned only Muslim doctors, whereas the Islamic court records at the time mentioned Christian doctors. A turning point occurred in the nineteenth century when the state took over the initiative in establishing institutional medicine, as happened under Egyptian rule in Syria in the 1830s when a hospital was built and quarantine was introduced. The peak occurred under Sultan Abdülhamid II who ordered the building of a hospital in Damascus in 1899 and the establishment of a medical school in 1903.
Morphological, morphometric and genetic variation among cryptic and sympatric species of southeastern South American three-striped opossums (Monodelphis: Mammalia: Didelphidae)
Authors: DUDA RAFAELA , COSTA LEONORA PIRES
Published: March 2015

Monodelphis is the most diverse genus of the family Didelphidae, whose systematics and taxonomy have not yet been well established. Two of the included species, Monodelphis americana and M. iheringi, are difficult to distinguish because both present three dorsal black stripes. Furthermore, they show intra- and interspecific variation related to body size and pelage coloration. Because this variation is not well understood, there are problems in correctly identifying these species, which remain poorly collected and thus rare in zoological collections. This study evaluated the morphological and genetic variations in a sample of striped opossums from a single location in southeastern Brazil to understand if the morphological variation observed in individuals from the same location was indicative of the existence of more than one taxon. The comparative analyses of a series from this single locality with museum specimens of other locations revealed variations in the skin and skull qualitative characters that were related to age and sex. Morphological comparisons led to the identification of two morphogroups, which were corroborated by molecular data; the analysis of cytochrome b sequences indicated the existence of two clades, with an average divergence of 14%. Thus, the results support the existence of two taxa in the sample, defined as M. americana and M. iheringi. We confirmed the sympatry of these two species in a location in southeastern Brazil, presented morphological diagnostic characters to distinguish the two species, provided novel phylogenetic information on the group, and also demonstrated the existence of important intra- and interspecific morphological variations related to sexual dimorphism and ontogeny in the group. These results significantly contribute to information on the systematics of the genus.
Eusyllinae and “Incertae sedis” syllids (Annelida: Syllidae) from South America, with a new species from Brazil and a new combination for a Peruvian species
Authors: FUKUDA MARCELO V. , NOGUEIRA JOÃO M. M. , MARTÍN GUILLERMO SAN
Published: March 2015

We herein present the first taxonomic account on the genera Amblyosyllis, Brevicirrosyllis, Eusyllis and Opisthodonta from Brazilian waters, with the description of Eusyllis nonatoi sp. nov. The new species is characterized by having transverse dark stripes on dorsum, unidentate, relatively short falciger blades with inverted dorso-ventral gradation in length, and distally rounded to inconspicuously bifid dorsal simple chaetae. In adittion, the description of Eusyllis liniata comb. nov., from Peru, originally described as belonging to Odontosyllis, is also provided. Finally, we amend the description of Opisthodonta russelli, originally described from anterior fragments only.
Quadrature Methods for the Calculation of Subgrid Microphysics Moments
Authors: Chowdhary K. , Salloum M. , Debusschere B. , Larson V. E.
Published: March 2015

Many cloud microphysical processes occur on a much smaller scale than a typical numerical grid box can resolve. In such cases, a probability density function (PDF) can act as a proxy for subgrid variability in these microphysical processes. This method is known as the assumed PDF method. By placing a density on the microphysical fields, one can use samples from this density to estimate microphysics averages. In the assumed PDF method, the calculation of such microphysical averages has primarily been done using classical Monte Carlo methods and Latin hypercube sampling. Although these techniques are fairly easy to implement and ubiquitous in the literature, they suffer from slow convergence rates as a function of the number of samples. This paper proposes using deterministic quadrature methods instead of traditional random sampling approaches to compute the microphysics statistical moments for the assumed PDF method. For smooth functions, the quadrature-based methods can achieve much greater accuracy with fewer samples by choosing tailored quadrature points and weights instead of random samples. Moreover, these techniques are fairly easy to implement and conceptually similar to Monte Carlo–type methods. As a prototypical microphysical formula, Khairoutdinov and Kogan’s autoconversion and accretion formulas are used to illustrate the benefit of using quadrature instead of Monte Carlo or Latin hypercube sampling.
The Extent and Patterns of Multiple Chronic Conditions in Low-Income Children
Authors: Clark Noreen M. , Lachance Laurie , Benedict M. Beth , Little Roderick , Leo Harvey , Awad Daniel F. , Wilkin Margaret K.
Published: March 2015

Background and objectives. Little is known about the magnitude of multiple chronic conditions (MCC) in children. This study describes the prevalence of and patterns of comorbidities in children receiving Medicaid assistance. Methods. Diagnoses from 5 years of Medicaid claims data were reviewed and identified 128 044 children with chronic conditions. The relationship between comorbidities and significant urgent health care events was analyzed using logistic regression modeling. Results. More than 15 000 children (12%) had claims for more than 1 condition. The most frequent combination was asthma and allergic rhinitis. Significant health care events ranged from 18% to 51% in children, and the odds of having a significant event increased with each additional condition. Those with ≥4 conditions had 4.5 times the odds of a significant event compared with those with 1 condition ( P < .0001). Conclusion. MCC are prevalent in low-income children and are associated with greater risk for urgent health care use.
After-Hours Pediatric Care Compared With Emergency Department Care
Authors: Goodrich Shea , Evans Joseph , Gress Todd , Werthammer Joseph
Published: March 2015

Objective. To compare financial charges between children treated and released from an emergency department (ED) with those evaluated in an after-hours (AH) pediatric clinic. Methods. Medical records were retrospectively reviewed for 200 children <15 years of age treated in a hospital-based ED and compared with 200 children seen in an AH pediatric clinic. Our main outcome was median overall patient charges by clinic setting. We additionally examined charges by the 6 most common disease diagnoses. Results. Median charges for children treated and released from the ED were $457 [interquartile range (IQR) $320-$628] compared with $140 (IQR $140-$140) for those treated in the AH clinic ( P < .01). In addition, median charges were higher for the ED group in the 6 most common disease classes shared between the 2 study groups, both overall and for individual disease class comparison between study groups (all P < .01). We examined the association between charges and clinic setting in multiple quantile regression model while simultaneously adjusting for age, gender, insurance status, and diagnosis. Median costs were $305 (95% CI = $261 to $348; P < .01) more for the ED compared with the AH group. Conclusion. We found that financial charges for pediatric health care delivered in an AH clinic were less than those in an ED. We found significantly higher charges for the ED when like diagnoses were compared. Patients should be encouraged to attend AH clinics for urgent care needs when appropriate, which could result in significant cost savings to the health care system.
Ministry with a Laugh
Authors: Campbell Charles L.
Published: March 2015

Laughter is pervasive in Christian theological and liturgical traditions, breaking up human idolatries and totalities. This gospel laughter gives Christian ministry an essential orientation of “open seriousness.”
Laughter as Ethical and Theological Resistance: Leymah Gbowee, Sarah, and the Hidden Transcript
Authors: Bussie Jacqueline A.
Published: March 2015

Through an analysis of Nobel Peace Prize winner Leymah Gbowee’s memoir, Mighty Be Our Powers, as well as the story of the biblical Sarah, this essay argues that laughter is a liberating means of ethical and theological resistance, a manifestation of the “hidden transcript” constructed by the marginalized to reclaim hope and dignity in the face of oppression’s radical negation and dehumanization. This essay also argues that laughter helps the suffering faithful resist despair, “Pollyannaism,” evil, either/or dichotomous thought, and the spiritual and social paralysis induced by paradox.
Helicopter parents can be a good thing
Authors: Hiltz Julie
Published: March 2015

Helicopter parents get a bad rap. Teachers and administrators should view them as a resource -- not a nuisance. By encouraging open communication, teachers can begin to understand the motivations of these parents and find creative ways to connect them with opportunities to promote their students’ academic success and the school’soverall effectiveness.
Libraries emerging as leaders in parent engagement
Authors: Celano Donna C. , Neuman Susan B.
Published: March 2015

The Every Child Ready to Read program encourages parents to interact with their children using the five practices of early literacy: singing, talking, reading, writing, and playing. The program is reaching children in high-need communities who are likely to enter school less prepared their wealthier peers. Every Child Ready to Read has found that libraries hold a unique advantage in fostering parent education. Nearly every community has a library and their services are free. Finding partnership with other agencies has also helped expand their reach to parents and families who can most benefit from their services.
ESEA at 50
Authors: Jennings Jack
Published: March 2015

The author draws on his extensive experience helping lead Congress’s education efforts and later a highly respected education research concern to propose a new approach to federal education policy that expands and transforms the federal role. This new approach would significantly expand federal aid to schools that is not restricted to particular categories of students but that is contingent on states’ willingness to address the most fundamental issues that impede educational progress. This expanded general aid program could be called the United for Students Act (USA). A new approach is needed because progress has not been sufficient and because the world is changing at such a fast pace that we cannot procrastinate, the author says. If we want improvement, we must let go of resistance to change and sweep aside old excuses to adopting new and better ways.
Multiplying is more than math – it’s also good management
Authors: Foster Elise , Wiseman Liz
Published: March 2015

Studying more than 400 educational leaders, the authors propose a new model for leadership and management rooted in the belief that there is latent intelligence inside schools and educational organizations. Their findings suggest two dramatically different types of leaders, Multipliers and Diminishers. The five disciplines that distinguish Multipliers from Diminishers are explored.
Close early learning gaps with Rigorous DAP
Authors: Brown Christopher P. , Mowry Brian
Published: March 2015

Rigorous DAP (developmentally appropriate practices) is a set of 11 principles of instruction intended to help close early childhood learning gaps. Academically rigorous learning environments create the conditions for children to learn at high levels. While academic rigor focuses on one dimension of education -- academic -- DAP considers the whole landscape of learning -- motivational, cultural, socioemotional as well as cognitive. Combined, Rigorous DAP calls for early childhood educators teach the knowledge and skills they expect all their children to eventually attain and demonstrate on a regular basis.
A collaborative approach can improve world language education
Authors: Burke Brigid M.
Published: March 2015

In the last decade, the American Council on the Teaching of Foreign Languages (ACTFL) has mandated proficiency requirements for teacher candidates at nationally recognized universities and published a position statement recommending teachers use 90% or more of the world language during instruction. The author explains reform is more successful when change is initiated simultaneously from the top and bottom in pursuit of the same goals. Researchers and consultants need to provide teachers with on-site, experiential professional development on proficiency-based methods in order for world language education to improve in a meaningful and viable way.
Washington View
Authors: Ferguson Maria
Published: March 2015

Like many complex social issues, education policies are developed and implemented under the shadow of politics, advocacy, and money. The current testing debate is a casebook example of how these forces can come to bear on schools and families. The biggest policy challenge facing the U.S. is figuring out how to get students out from under the weight of those forces so their concerns trump all.
Backtalk
Authors: Beltran Patricia
Published: March 2015

The author explores feelings of despair and varied human reactions to them. One day a student in the author's class -- not a very good one -- shows kindness and tenderness in response to another person’s despair, leading the author to conclude that there is hope when a person has the courage to act when someone else is in a despairing situation.
Indigenising Christianity: Politics of Conversion among the Sumi Naga
Authors: Zhimo Avitoli G.
Published: March 2015

This article seeks to explore the intricate fusion of Christianity with traditional religion of the Sumi Naga. The manner in which the entire tribe converted, and the friction between the converts and the followers of traditional religion have been examined in the light of politics of identity and power. Having accepted new religion, traditional institutions were compromised, changes incurred; however, some traditional practices were retained in a modified manner. The new converts incorporated traditional aspects to the newly found religion, thus indigenising Christianity. Is this a strategy to maintain their distinct ethnic identity?