bluuebunny/crossref_metadata_2025 huggingface dataset:
Basic life support skill improvement with newly designed renewal programme: cluster randomised study of small-group-discussion method versus practice-while-watching method
Authors: Na Ji Ung , Lee Tae Rim , Kang Mun Ju , Shin Tae Gun , Sim Min Seob , Jo Ik Joon , Song Keun Jeong , Jeong Yeon Kwon
Published: August 2013

Background

For the basic life support (BLS) renewal course, we have devised a new educational programme entitled a small-group-discussion (SGD) programme using personalised video-based debriefing.

Objective

We compared the efficacy in BLS skill improvement of the SGD programme with the currently used practice-while-watching (PWW) programme, which uses a standardised education video.

Method

This was a prospective, cluster randomised study, conducted in a single centre, over 6 months from May 2009 to October 2009. Training was performed in two groups of participants, each group with a different renewal education programme. The efficacy of the programmes was compared using the modified Cardiff test and skill-reporting manikins.

Results

Results from 2169 participants were analysed: 1061 in the SGD programme group and 1108 in the PWW programme group. There were no differences between groups on the pretest, either in compression or non-compression skills. However, on the post-test, the SGD programme gave better results for both compression skills and non-compression skills.

Conclusions

The new SGD renewal programme is more effective than the PWW programme for improving skills in BLS renewal training.
Operator training requirements and diagnostic accuracy of Fibroscan in routine clinical practice
Authors: Armstrong M J , Corbett C , Hodson J , Marwah N , Parker R , Houlihan D D , Rowe I A , Hazlehurst J M , Brown R , Hübscher S G , Mutimer D
Published: August 2013

Background

Fibroscan is a quick, non-invasive technique used to measure liver stiffness (kPa), which correlates with fibrosis. To achieve a valid liver stiffness evaluation (LSE) the operator must obtain all the following three criteria: (1) ≥10 successful liver stiffness measurements; (2) IQR/median ratio <0.30 and (3) ≥60% measurement success rate.

Objectives

To assess the operator training requirements and the importance of adhering to the LSE validity criteria in routine clinical practice.

Methods

We retrospectively analysed the LSE validity rates of 2311 Fibroscans performed (1 August 2008 to 31 July 2011) in our tertiary liver outpatients department at the University Hospital Birmingham, UK. The diagnostic accuracy of Fibroscan was assessed in 153 patients, by comparing LSE (valid and invalid) with the modified Ishak fibrosis stage on liver biopsy.

Results

Learning curve analysis highlighted that the greatest improvement in validity of LSE rates occurs in the operator's first 10 Fibroscans, reaching 64.7% validity by the 50th Fibroscan. The correlation between LSE and the fibrosis stage on liver biopsy was superior in patients with a valid LSE (n=97) compared with those with an invalid LSE (n=56) (rs 0.577 vs 0.259; p=0.022). Area under receiving operating characteristics for significant fibrosis was greater when LSE was valid (0.83 vs 0.66; p=0.048). Using an LSE cut-off of 8 kPa, the negative predictive value of valid LSE was superior to invalid LSE for the detection of significant (84% vs 71%) and advanced fibrosis (100% vs 93%).

Conclusions

Fibroscan requires minimal operator training (≥10 observed on patients), and when a valid LSE is obtained, it is an accurate tool for excluding advanced liver fibrosis. To ensure the diagnostic accuracy of Fibroscan it is essential that the recommended LSE validity criteria are adhered to in routine clinical practice.
AMP-activated protein kinase mediates myogenin expression and myogenesis via histone deacetylase 5
Authors: Fu Xing , Zhao Jun-Xing , Liang Junfang , Zhu Mei-Jun , Foretz Marc , Viollet Benoit , Du Min
Published: August 2013

There is a global epidemic of obesity, and obesity is known to inhibit AMP-activated protein kinase (AMPK) activity and impairs myogenesis. Myogenin mediates the fusion of myoblasts into myotubes, a critical step in myogenesis. We observed that inhibition of AMPKα1 downregulates myogenin expression and myogenesis, but the underlying mechanisms are unclear. We postulated that AMPK regulates myogenin expression through phosphorlytion of histone deacetylase 5 (HDAC5). In C2C12 cells, HDAC5 knockdown increased while HDAC5 stablization by MC1568 reduced myogenin expression. Consistently, using luciferase assay, we observed that myogenin promoter activity was negatively regulated by HDAC5. Using RNA interference and primary myoblasts prepared from wild-type and AMPKα1 knockout mice, we further demonstrate that AMPKα1 regulates HDAC5 phosphorylation at Ser 259 and 498. Mutation of these two Ser to Ala in HDAC5 abolished the regulatory role of AMPKα1 on myogenin expression, clearly showing the necessity of these phosphorylation sites in mediating myogenin expression. In aggregate, these data show that AMPK inhibition downregulates myogenin transcription and myogenesis through phosphorylation of HDAC5, mediated mainly by AMPKα1. These data demonstrate that AMPK is a key molecular target for promoting myogenesis and muscular regeneration. Because drugs activating AMPK activity, such as metformin, are widely available, our finding has critical clinical implications to ensure proper muscle development and regeneration in obese subjects and under other pathophysiological conditions where AMPK activity is attenuated.
Characterization of the development of renal injury in Type-1 diabetic Dahl salt-sensitive rats
Authors: Slaughter Tiffani N. , Paige Adrienne , Spires Denisha , Kojima Naoki , Kyle Patrick B. , Garrett Michael R. , Roman Richard J. , Williams Jan M.
Published: August 2013

The present study compared the progression of renal injury in Sprague-Dawley (SD) and Dahl salt-sensitive (SS) treated with streptozotocin (STZ). The rats received an injection of STZ (50 mg/kg ip) and an insulin pellet (2 U/day sc) to maintain the blood glucose levels between 400 and 600 mg/dl. Twelve weeks later, arterial pressure (143 ± 6 vs. 107 ± 8 mmHg) and proteinuria (557 ± 85 vs. 81 ± 6 mg/day) were significantly elevated in STZ-SS rats compared with the values observed in STZ-SD rats, respectively. The kidneys from STZ-SS rats exhibited thickening of glomerular basement membrane, mesangial expansion, severe glomerulosclerosis, renal interstitial fibrosis, and occasional glomerular nodule formation. In additional studies, treatment with a therapeutic dose of insulin (4 U/day sc) attenuated the development of proteinuria (212 ± 32 mg/day) and renal injury independent of changes in arterial pressure in STZ-SS rats. Since STZ-SS rats developed severe renal injury, we characterized the time course of changes in renal hemodynamics during the progression of renal injury. Nine weeks after diabetes onset, there was a 42% increase in glomerular filtration rate in STZ-SS rats vs. time-control SS rats with reduced renal blood flow. These results indicate that SS rats treated with STZ develop hyperfiltration and progressive proteinuria and display renal histological lesions characteristic of those seen in patients with diabetic nephropathy. Overall, this model may be useful to study signaling pathways and mechanisms that play a role in the progression of diabetes-induced renal disease and the development of new therapies to slow the progression of diabetic nephropathy.
Focal segmental glomerulosclerosis is associated with aPDSS2haplotype and, independently, with a decreased content of coenzyme Q10
Authors: Gasser David L. , Winkler Cheryl A. , Peng Min , An Ping , McKenzie Louise M. , Kirk Gregory D. , Shi Yuchen , Xie Letian X. , Marbois Beth N. , Clarke Catherine F. , Kopp Jeffrey B.
Published: August 2013

Focal segmental glomerulosclerosis (FSGS) and collapsing glomerulopathy are common causes of nephrotic syndrome. Variants in >20 genes, including genes critical for mitochondrial function, have been associated with these podocyte diseases. One such gene, PDSS2, is required for synthesis of the decaprenyl tail of coenzyme Q10(Q10) in humans. The mouse gene Pdss2 is mutated in the kd/kd mouse model of collapsing glomerulopathy. We examined the hypothesis that human PDSS2 polymorphisms are associated with podocyte diseases. We genotyped 377 patients with primary FSGS or collapsing glomerulopathy, together with 900 controls, for 9 single-nucleotide polymorphisms in the PDSS2 gene in a case-control study. Subjects included 247 African American (AA) and 130 European American (EA) patients and 641 AA and 259 EA controls. Among EAs, a pair of proxy SNPs was significantly associated with podocyte disease, and patients homozygous for one PDSS2 haplotype had a strongly increased risk for podocyte disease. By contrast, the distribution of PDSS2 genotypes and haplotypes was similar in AA patients and controls. Thus a PDSS2 haplotype, which has a frequency of 13% in the EA control population and a homozygote frequency of 1.2%, is associated with a significantly increased risk for FSGS and collapsing glomerulopathy in EAs. Lymphoblastoid cell lines from FSGS patients had significantly less Q10than cell lines from controls; contrary to expectation, this finding was independent of PDSS2 haplotype. These results suggest that FSGS patients have Q10deficiency and that this deficiency is manifested in patient-derived lymphoblastoid cell lines.
Encoding of near-range spatial information by descending interneurons in the stick insect antennal mechanosensory pathway
Authors: Ache Jan M. , Dürr Volker
Published: August 2013

Much like mammals use their whiskers, insects use their antennae for tactile near-range orientation during locomotion. Stick insects rapidly transfer spatial information about antennal touch location to the front legs, allowing for aimed reach-to-grasp movements. This adaptive behavior requires a spatial coordinate transformation from “antennal contact space” to “leg posture space.” Therefore, a neural pathway must convey proprioceptive and tactile information about antennal posture and contact site to thoracic motor networks. Here we analyze proprioceptive encoding properties of descending interneurons (DINs) that convey information about antennal posture and movement to the thoracic ganglia. On the basis of response properties of 110 DINs to imposed movement of the distal antennal joint, we distinguish five functional DIN groups according to their sensitivity to three parameters: movement direction, movement velocity, and antennal joint angle. These groups are simple position-sensitive DINs, which signal the antennal joint angle; dynamic position-sensitive DINs, which signal the joint angle with strong dependence on movement; unspecific movement-sensitive DINs, which signal movement but not the velocity, position, or direction of movement; and ON- and OFF-type velocity-sensitive DINs. The activity of the latter two groups is increased/attenuated during antennal movement, with the spike rate increasing/decreasing linearly with antennal joint angle velocity. Some movement-sensitive DINs convey spikes to the thorax within 11 ms, suggesting a rapid, direct pathway from antennal mechanosensory to thoracic motor networks. We discuss how the population of DINs could provide the neural basis for the intersegmental spatial coordinate transfer between a touch sensor of the head and thoracic motor networks.
Role of synaptic dynamics and heterogeneity in neuronal learning of temporal code
Authors: Rotman Ziv , Klyachko Vitaly A.
Published: August 2013

Temporal codes are believed to play important roles in neuronal representation of information. Neuronal ability to classify and learn temporal spiking patterns is thus essential for successful extraction and processing of information. Understanding neuronal learning of temporal code has been complicated, however, by the intrinsic stochasticity of synaptic transmission. Using a computational model of a learning neuron, the tempotron, we studied the effects of synaptic unreliability and short-term dynamics on the neuron's ability to learn spike timing rules. Our results suggest that such a model neuron can learn to classify spike timing patterns even with unreliable synapses, albeit with a significantly reduced success rate. We explored strategies to improve correct spike timing classification and found that firing clustered spike bursts significantly improves learning performance. Furthermore, rapid activity-dependent modulation of synaptic unreliability, implemented with realistic models of dynamic synapses, further improved classification of different burst properties and spike timing modalities. Neuronal models with only facilitating or only depressing inputs exhibited preference for specific types of spike timing rules, but a mixture of facilitating and depressing synapses permitted much improved learning of multiple rules. We tested applicability of these findings to real neurons by considering neuronal learning models with the naturally distributed input release probabilities found in excitatory hippocampal synapses. Our results suggest that spike bursts comprise several encoding modalities that can be learned effectively with stochastic dynamic synapses, and that distributed release probabilities significantly improve learning performance. Synaptic unreliability and dynamics may thus play important roles in the neuron's ability to learn spike timing rules during decoding.
Energizing the Search to Target LKB1-Mutant Tumors
Authors: Marcus Adam I. , Khuri Fadlo R.
Published: August 2013

Summary: LKB1 is the third most frequently mutated gene in non–small cell lung cancer and serves as a master regulator of cell metabolism and polarity across a variety of model organisms. Recent studies are beginning to identify therapeutics that exploit defects associated with LKB1 loss. The work presented here by Liu and colleagues shows that deoxythymidylate kinase is a new potential target in LKB1-deficient tumors and highlights the possibility of a new therapeutic option for this subset of patients with cancer. Cancer Discov; 3(8); 843–5. ©2013 AACR.

See related article by Liu et al., p. 870
Polarity Index of Psychological Interventions in Maintenance Treatment of Bipolar Disorder
Authors: Popovic Dina , Reinares Maria , Scott Jan , Nivoli Alessandra , Murru Andrea , Pacchiarotti Isabella , Vieta Eduard , Colom Francesc
Published: August 2013

Background: Although several adjunctive psychological interventions are effective in the maintenance of bipolar disorders (BD), no attempt has been made to classify them according to their ability to prevent manic versus depressive episodes. Our study aims to rank the adjunctive psychotherapies for the prophylaxis of BD by means of their polarity index (PI). Methods: Randomized controlled trials comparing the efficacy of a psychological intervention with a comparator in BD maintenance treatment in patients aged over 18 were systematically reviewed. Exclusion criteria were a small sample size, a study sample not exclusively composed of bipolar patients and the absence of a control group. PI is a novel metric indicating the relative antimanic versus antidepressive preventive efficacy of treatments. PI was retrieved by calculating the ratio of the number needed to treat (NNT) for prevention of depression and the NNT for prevention of mania. PI >1.0 indicates a relatively higher antimanic prophylactic efficacy and PI <1.0 a greater antidepressive efficacy. Results: A total of 9 studies were included. PI was 0.33, 0.63 and 0.89 for cognitive-behavioral therapy, 0.42 for family-focused therapy, 0.73 and 0.78 for psychoeducation, 1 for enhanced relapse prevention, 1.78 for caregiver group psychoeducation and 3.36 for brief technique-driven interventions. With regard to the PI for 1 cognitive-behavioral study, enhanced relapse prevention and brief technique-driven interventions may not be reliable since those trials were negative. Conclusions: The PI provides a measure of how much depression-preventive or (hypo) mania-preventive an intervention is and may guide the choice of adjunctive psychotherapy in the context of individualized long-term treatment of BD.
Mindfulness-Oriented Recovery Enhancement Reduces Pain Attentional Bias in Chronic Pain Patients
Authors: Garland Eric L. , Howard Matthew O.
Published: August 2013

Background: Chronic pain involves hypervigilance for pain-related stimuli. Selective attention to pain-related stimuli, known as pain attentional bias (AB), can exacerbate chronic pain, prolong suffering, and undermine quality of life. The aim of this study was to determine if a multimodal mindfulness-oriented intervention could significantly reduce pain AB among chronic pain patients receiving opioid analgesics. Methods: A total of 67 chronic pain patients were randomized to an 8-week Mindfulness-Oriented Recovery Enhancement (MORE) intervention or a social support group intervention and began treatment. A dot probe task was used to measure pain AB. Primary outcomes were pain AB scores for cues presented for 2,000 and 200 ms. Results: Prior to intervention, participants exhibited a significant bias towards pain-related cues presented for 2,000 ms, but no bias for cues presented for 200 ms. A statistically significant time × intervention condition interaction was observed for 2,000 ms pain AB, such that participants in MORE evidenced significantly reduced posttreatment pain AB relative to pretreatment levels, whereas no significant pre-post treatment changes in pain AB were observed for support group participants. Decreases in pain AB were associated with increased perceived control over pain and attenuated reactivity to distressing thoughts and emotions. Conclusion: Study findings provide the first indication that a mindfulness-oriented intervention may reduce pain AB among adults suffering from chronic pain. Given the magnitude of chronic pain in postindustrial societies, coupled with the dramatic escalation in prescription opioid misuse, future studies should evaluate MORE as a nonpharmacological means of addressing factors linked with chronic pain.
Three-Month Treatment with Adaptive Servoventilation Improves Cardiac Function and Physical Activity in Patients with Chronic Heart Failure and Cheyne-Stokes Respiration: A Prospective Randomized Controlled Trial
Authors: Hetland Arild , Haugaa Kristina H. , Olseng Margareth , Gjesdal Ola , Ross Stian , Saberniak Jørg , Jacobsen Morten B. , Edvardsen Thor
Published: August 2013

Background: Cheyne-Stokes respiration frequently occurs in patients with congestive heart failure (CHF). Adaptive servoventilation (ASV) is a novel therapy with potential benefits. This prospective randomized trial investigated the effects of ASV on myocardial function and physical capacity. Methods: Patients with severe CHF, despite optimal cardiac medication and/or left ventricular ejection fraction (LVEF) ≤40% and Cheyne-Stokes breathing for >25% of sleeping time were included. Fifty-one patients, age 57-81 years (4 were women), were randomized to either an ASV or a control group; 30 patients completed the study (15 from each group). The primary end point was any change in LVEF. The secondary end points were alterations in physical capacity according to the 6-min walk test or the New York Heart Association (NYHA) class. Results: In the ASV-treatment group, LVEF improved from baseline (32 ± 11%) to study end (36 ± 13%), p = 0.013. The 6-min walk test improved from 377 ± 115 to 430 ± 123 m (p = 0.014) and the NYHA class from 3.2 (3.0-3.0) to 2.0 (2.0-3.0) (p < 0.001). No changes occurred in the control group. Conclusion: Three months of ASV treatment improved LVEF and physical capacity in CHF patients with Cheyne-Stokes respiration. These results suggest that ASV may be a beneficial supplement to standard medication in these patients.
Lithotrites and Postoperative Fever: Does Lithotrite Type Matter? Results from the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study
Authors: Chu David I. , Lipkin Michael E. , Wang Agnes J. , Ferrandino Michael N. , Preminger Glenn M. , Kijvikai Kittinut , Gupta Narmada P. , Melekos Michael D. , de la Rosette Jean J.M.C.H. ,   on behalf of the CROES Global PCNL study group
Published: August 2013

Objective: To compare the risks of fever from different lithotrites after percutaneous nephrolithotomy (PNL). Materials and Methods: The Clinical Research Office of the Endourological Society (CROES) PNL database is a prospective, multi-institutional, international PNL registry. Of 5,803 total patients, 4,968 received preoperative antibiotics, were supplied with complete information and included in this analysis. The lithotrites assessed included no fragmentation, ultrasonic, laser, pneumatic and combination ultrasonic/pneumatic. Risk of fever was estimated using multivariate logistic regression with adjustment for diabetes, steroid use, a history of positive urine culture, the presence of staghorn calculi or preoperative nephrostomy, stone burden and lithotrite. Results: The overall fever rate was 10%. Pneumatic lithotrites were used in 43% of the cohort, followed by ultrasonic (24%), combination ultrasonic/pneumatic (17.3%), no fragmentation (8.4%) and laser (7.3%). Fever rates were no different between patients who underwent no or any fragmentation (p = 0.117), nor among patients when stratified by lithotrite (p = 0.429). On multivariate analysis, fragmentation was not significantly associated with fever [Odds Ratio (OR) 1.17, p = 0.413], while diabetes (OR 1.32, p = 0.048), positive urine culture (OR 2.08, p < 0.001), staghorn calculi (OR 1.80, p < 0.001) and nephrostomy (OR 1.65, p < 0.001) increased fever risk. Fever risk among lithotrites did not differ (p ≥ 0.128). Conclusions: Risk of post-PNL fever was not significantly different among the various lithotrites used in the CROES PNL study.
Clinical Impact of Endoscopic Devices for Colorectal Endoscopic Submucosal Dissection
Authors: Harada Asuka , Gotoda Takuji , Fukuzawa Masakatsu , Moriyasu Fuminori
Published: August 2013

Background/Aims: Endoscopic submucosal dissection (ESD) allows the en bloc resection of large colorectal tumors. This requires a safe and effective ESD instrument. We compared colorectal ESD outcome using a bipolar or monopolar knife. Methods: We retrospectively studied 122 patients and 125 lesions in consecutive cases treated at our hospital. Patients were divided into a bipolar knife group (BKG; n = 45) and a monopolar knife group (MKG; n = 80). Comparisons were based on age and gender, tumor morphology, size and location, specimen size, procedure time, complications, and en bloc resection and curative resection rates. Results: There were no significant differences in age and gender, tumor morphology, size and location, or specimen size between the 2 groups. The procedure time was significantly shorter in the MKG than in the BKG (p < 0.05). The number of patients for whom the procedure time exceeded 120 min was significantly lower in the MKG than in the BKG (p < 0.05). Conclusions: In this study, the monopolar knife was shown to be effective for colorectal ESD with a shorter procedure time.
Extraperitoneal Fluid Collection due to Chronic Pancreatitis
Authors: Yasuda Takeo , Kamei Keiko , Araki Mariko , Nakata Yasuyuki , Ishikawa Hajime , Yamazaki Mitsuo , Sakamoto Hiroki , Kitano Masayuki , Nakai Takuya , Takeyama Yoshifumi
Published: August 2013

A 39-year-old man was referred to our hospital for the investigation of abdominal fluid collection. He was pointed out to have alcoholic chronic pancreatitis. Laboratory data showed inflammation and slightly elevated serum direct bilirubin and amylase. An abdominal computed tomography demonstrated huge fluid collection, multiple pancreatic pseudocysts and pancreatic calcification. The fluid showed a high level of amylase at 4,490 IU/l. Under the diagnosis of pancreatic ascites, endoscopic pancreatic stent insertion was attempted but was unsuccessful, so surgical treatment (Frey procedure and cystojejunostomy) was performed. During the operation, a huge amount of fluid containing bile acid (amylase at 1,474 IU/l and bilirubin at 13.5 mg/dl) was found to exist in the extraperitoneal space (over the peritoneum), but no ascites was found. His postoperative course was uneventful and he shows no recurrence of the fluid. Pancreatic ascites is thought to result from the disruption of the main pancreatic duct, the rupture of a pancreatic pseudocyst, or possibly leakage from an unknown site. In our extremely rare case, the pancreatic pseudocyst penetrated into the hepatoduodenal ligament with communication to the common bile duct, and the fluid flowed into the round ligament of the liver and next into the extraperitoneal space.
Treatment with the CC chemokine-binding protein Evasin-4 improves post-infarction myocardial injury and survival in mice
Authors: Braunersreuther Vincent , Pelli Graziano , Galan Katia , Proudfoot Amanda E. , Belin Alexandre , Vuilleumier Nicolas , Burger Fabienne , Lenglet Sébastien , Caffa Irene , Soncini Debora , Nencioni Alessio , Vallée Jean-Paul , Mach François , Montecucco Fabrizio
Published: August 2013

summary

Chemokines trigger leukocyte trafficking and are implicated in cardiovascular disease pathophysiology. Chemokine-binding proteins, called “Evasins” have been shown to inhibit both CC and CXC chemokinemediated bioactivities. Here, we investigated whether treatment with Evasin-3 (CXC chemokine inhibitor) and Evasin-4 (CC chemokine inhibitor) could influence post-infarction myocardial injury and remodelling. C57Bl/6 mice were submitted in vivo to left coronary artery permanent ligature and followed up for different times (up to 21 days). After coronary occlusion, three intraperitoneal injections of 10 μg Evasin-3, 1 μg Evasin-4 or equal volume of vehicle (PBS) were performed at 5 minutes, 24 hours (h) and 48 h after ischaemia onset. Both anti-chemokine treatments were associated with the beneficial reduction in infarct size as compared to controls. This effect was accompanied by a decrease in post-infarction myocardial leukocyte infiltration, reactive oxygen species release, and circulating levels of CXCL1 and CCL2. Treatment with Evasin-4 induced a more potent effect, abrogating the inflammation already at one day after ischaemia onset. At days 1 and 21 after ischaemia onset, both anti-chemokine treatments failed to significantly improve cardiac function, remodelling and scar formation. At 21-day follow-up, mouse survival was exclusively improved by Evasin-4 treatment when compared to control vehicle. In conclusion, we showed that the selective inhibition of CC chemokines (i.e. CCL5) with Evasin-4 reduced cardiac injury/inflammation and improved survival. Despite the inhibition of CXC chemokine bioactivities, Evasin-3 did not affect mouse survival. Therefore, early inhibition of CC chemokines might represent a promising therapeutic approach to reduce the development of post-infarction heart failure in mice.
Platelet count and outcome in patients with acute venous thromboembolism
Authors: Di Micco Pierpaolo , Ruiz-Giménez Nuria , Nieto José Antonio , Aujesky Drahomir , Molino Fátima del , Valle Reina , Barrón Manuel , Maestre Ana , Monreal Manuel ,   the RIETE Investigators
Published: August 2013

The relationship between platelet count and outcome in patients with acute venous thromboembolism (VTE) has not been consistently explored. RIETE is an ongoing registry of consecutive patients with acute VTE. We categorised patients as having very low- (<80,000/μl), low- (80,000/μl to 150,000/μl), normal- (150,000/μl to 300,000/μl), high- (300,000/μl to 450,000/μl), or very high (>450,000/μl) platelet count at baseline, and compared their three-month outcome. As of October 2012, 43,078 patients had been enrolled in RIETE: 21,319 presenting with pulmonary embolism and 21,759 with deep-vein thrombosis. In all, 502 patients (1.2%) had very low-; 5,472 (13%) low-; 28,386 (66%) normal-; 7,157 (17%) high-; and 1,561 (3.6%) very high platelet count. During the three-month study period, the recurrence rate was: 2.8%, 2.2%, 1.8%, 2.1% and 2.2%, respectively; the rate of major bleeding: 5.8%, 2.6%, 1.7%, 2.3% and 4.6%, respectively; the rate of fatal bleeding: 2.0%, 0.9%, 0.3%, 0.5% and 1.2%, respectively; and the mortality rate: 29%, 11%, 6.5%, 8.8% and 14%, respectively. On multivariate analysis, patients with very low-, low-, high- or very high platelet count had an increased risk for major bleeding (odds ratio [OR]: 2.70, 95% confidence interval [CI]: 1.85–3.95; 1.43 [1.18–1.72]; 1.23 [1.03–1.47]; and 2.13 [1.65–2.75]) and fatal bleeding (OR: 3.70 [1.92–7.16], 2.10 [1.48–2.97], 1.29 [0.88–1.90] and 2.49 [1.49–4.15]) compared with those with normal count. In conclusion, we found a U-shaped relationship between platelet count and the three-month rate of major bleeding and fatal bleeding in patients with VTE.
Two novel inhibitory anti-human factor XI antibodies prevent cessation of blood flow in a murine venous thrombosis model
Authors: van Montfoort Maurits L. , Veronique Knaup L. , Arnoud Marquart J. , Bakhtiari Kamran , Castellino Francis J. , Erik Hack C. , Meijers Joost C. M.
Published: August 2013

Coagulation factor XI (FXI) is a promising target for anticoagulation, because of its major role in thrombosis and relatively minor role in haemostasis. This implies that inhibition of FXI can prevent thrombosis without causing bleeding. It was our aim to investigate the antithrombotic properties of two novel inhibitory anti-human FXI antibodies (αFXI-175 and αFXI-203). The in vitro properties of both antibodies were analysed using standard clotting assays and calibrated automated thrombography. For the in vivo model we used FXI knockout mice, in which FXI plasma levels were restored with purified human FXI. Thrombosis was induced by applying ferric chloride to the vena cava inferior, after which time to occlusion was analysed. A tail bleeding assay was used to investigate the safety of both antibodies. Using calibrated automated thrombography, both antibodies inhibited thrombin generation initiated via the intrinsic pathway. In contrast, upon tissue factor (TF)-initiated thrombin generation, αFXI-203 did not inhibit thrombin generation, while αFXI-175 inhibited thrombin generation only at low concentrations of TF. In the murine thrombosis model, the vena cava inferior remained patent for 25 minutes (min) in mice treated with αFXI-175 and for 12.5 min in αFXI-203 treated animals, which was significantly longer than in placebo-treated animals (5 min, p<0.05). Neither antibody caused severe blood loss in a tail bleeding assay. In conclusion, the two inhibitory antibodies against FXI prevented cessation of blood flow in a murine thrombosis model without inducing a bleeding tendency.
Progressive Radiation Dose Reduction From Coronary Computed Tomography Angiography in a Statewide Collaborative Quality Improvement Program
Authors: Chinnaiyan Kavitha M. , Boura Judith A. , DePetris Ann , Gentry Ralph , Abidov Aiden , Share David A. , Raff Gilbert L.
Published: August 2013

Background—

A best-practice intervention previously demonstrated significant dose reduction over a period of one year. We sought to evaluate whether this reduction would be incremental and sustained by promoting new scanner technology in the context of an ongoing quality improvement program during a 3-year period in a statewide registry of coronary computed tomography angiography.

Methods and Results—

In this prospective, controlled, nonrandomized study involving 11 901 patients at 15 Michigan centers participating in the Advanced Cardiovascular Imaging Consortium, radiation doses and image quality were compared between the following periods: control (May to June 2008) versus follow-up I (July 2008 to June 2009) and follow-up I versus follow-up II (July 2009 to April 2011). Intervention during these study periods included continuous education, feedback, and mandatory participation in this initiative. The median radiation dose remained unchanged from control to follow-up I: dose-length product of 697 (interquartile range, 407–1163) to 675 (interquartile range, 418–1146) mGy·cm (
P
=0.93). With the introduction of newer technology in follow-up I period, there was incremental 31% decrease during follow-up II to median dose-length product of 468 (interquartile range, 292–811) mGy·cm (
P
<0.0001). No significant change was noted in the percentage of diagnostic quality scans from follow-up I (92%) to follow-up II (92.7%).

Conclusions—

Although ongoing application of a best-practice algorithm was associated with sustaining previously achieved targets, the use of newer scanner technology resulted in incremental radiation dose reduction in a statewide coronary computed tomography angiography registry without image quality degradation.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00640068.
Effects of Visit-to-Visit Variability in Systolic Blood Pressure on Macrovascular and Microvascular Complications in Patients With Type 2 Diabetes Mellitus
Authors: Hata Jun , Arima Hisatomi , Rothwell Peter M. , Woodward Mark , Zoungas Sophia , Anderson Craig , Patel Anushka , Neal Bruce , Glasziou Paul , Hamet Pavel , Mancia Giuseppe , Poulter Neil , Williams Bryan , MacMahon Stephen , Chalmers John
Published: August 2013

Background—

Recent evidence suggests that visit-to-visit variability in systolic blood pressure (SBP) and maximum SBP are predictors of cardiovascular disease. However, it remains uncertain whether these parameters predict the risks of macrovascular and microvascular complications in patients with type 2 diabetes mellitus.

Methods and Results—

The Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) was a factorial randomized controlled trial of blood pressure lowering and blood glucose control in patients with type 2 diabetes mellitus. The present analysis included 8811 patients without major macrovascular and microvascular events or death during the first 24 months after randomization. SBP variability (defined as standard deviation) and maximum SBP were determined during the first 24 months after randomization. During a median 2.4 years of follow-up from the 24-month visit, 407 major macrovascular (myocardial infarction, stroke, or cardiovascular death) and 476 microvascular (new or worsening nephropathy or retinopathy) events were observed. The association of major macrovascular and microvascular events with SBP variability was continuous even after adjustment for mean SBP and other confounding factors (both
P
<0.05 for trend). Hazard ratios (95% confidence intervals) for the highest tenth of SBP variability were 1.54 (0.99–2.39) for macrovascular events and 1.84 (1.19–2.84) for microvascular events in comparison with the lowest tenth. For maximum SBP, hazard ratios (95% confidence intervals) for the highest tenth were 3.64 (1.73–7.66) and 2.18 (1.04–4.58), respectively.

Conclusion—

Visit-to-visit variability in SBP and maximum SBP were independent risk factors for macrovascular and microvascular complications in type 2 diabetes mellitus.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique Identifier: NCT00145925.
Changes in Lipoprotein Particle Number With Ezetimibe/Simvastatin Coadministered With Extended‐Release Niacin in Hyperlipidemic Patients
Authors: Le Ngoc‐Anh , Jin Ran , Tomassini Joanne E. , Tershakovec Andrew M. , Neff David R. , Wilson Peter W.F.
Published: August 2013

Background

Combination therapy with ezetimibe/simvastatin (E/S) and extended‐release niacin (N) has been reported to be safe and efficacious in concomitantly reducing low‐density lipoprotein cholesterol and increasing high‐density lipoprotein cholesterol in hyperlipidemic patients at high risk for atherosclerotic cardiovascular events. This analysis evaluated the effect of E/S coadministered with N on low‐density lipoprotein particle number (
LDL
‐P) and high‐density lipoprotein particle number (
HDL
‐P) as assessed by nuclear magnetic resonance (
NMR
) spectroscopy in patients with type
II
a or
II
b hyperlipidemia.

Methods and Results

This was an analysis of a previously reported 24‐week randomized, double‐blind study in type
II
a/
II
b hyperlipidemic patients randomized to treatment with E/S (10/20 mg/day)+N (titrated to 2 g/day) or N (titrated to 2 g/day) or E/S (10/20 mg/day). Samples from a subset of patients (577 of 1220) were available for post hoc analysis of
LDL
‐P and
HDL
‐P by
NMR
spectroscopy. Increases in
HDL
‐P (+16.2%) and decreases in
LDL
‐P (−47.7%) were significantly greater with E/S+N compared with N (+9.8% for
HDL
‐P and −21.5% for
LDL
‐P) and E/S (+12.8% for
HDL
‐P and −36.8% for
LDL
‐P). In tertile analyses, those with the lowest baseline
HDL
‐P had the greatest percent increase in
HDL
‐P (N, 18.4/7.9/2.1; E/S, 19.3/12.2/5.3; and E/S+N, 26.9/13.8/6.9; all
P
<0.001). Individuals in the highest tertile of
LDL
‐P had the greatest percent reduction in
LDL
‐P (N, 18.3/23.1/24.6; E/S, 29.7/38.3/41.8; and E/S+N, 44.3/49.0/50.5; all
P
<0.001).

Conclusions

These results suggest that E/S+N improves lipoprotein particle number, consistent with its lipid‐modifying benefits in type
II
a or
II
b hyperlipidemia patients and may exert the greatest effect in those with high
LDL
‐P and low
HDL
‐P at baseline.

Clinical Trial Registration

URL: Clinicaltrials.gov Identifier:
NCT00271817
The Historical Roots and Occurrence of Honour-Related Violence in Non-Muslim and Muslim Societies
Authors: Fildis A.T.
Published: August 2013

Abstract

Every year, males across the world murder thousands of female family members. The practice is called “honour killing” and it entails the execution of female family member(s) for the perceived misuse of their sexuality.

The main focus of this paper will be to look at the formative phase of religious-legal ethical codes for disciplining of female sexual conduct, which marks the boundaries of the institution of family in Muslim and Non-Muslim societies. Since most of the incidents reported in the local and global media come from Muslim communities living in the Middle East, Africa, and Asia, it is necessary to question why honour-killing practices are still present in the Muslim societies. How have most other religions and civilizations managed to dispose attitudes, perceptions and practices, which breed the practice of honour killing of women?
Conflicting Paradigms in Theological Education for Public Ministry in the Church of England: Issues for Church and Academy
Authors: Williams John
Published: August 2013

Abstract

Over recent years the Church of England has been introducing university validated programmes for the ministerial education of its clergy. By drawing on the experience of one region in delivering such a programme, this article identifies a number of tensions in the church’s relationship with higher education and explores how critical academic study might be better understood as a resource for ministerial formation. The article also raises issues for the validating universities arising out of their partnership with church institutions, and argues that both church and academy alike could benefit from a reappraisal of their aims and values as public institutions in the light of their shared involvement in theological education for the church’s public ministers.
Oracles, Trauma, and the Limits of Contextualization: Naming the Witch in Contemporary Kenya
Authors: Blunt Robert
Published: August 2013

Abstract

This article revisits Terence Ranger’s call for scholars of the occult in Africa to better historicize, contextualize, and disaggregate the subject. I argue that Ranger’s imperative fails to define what type of object of study the occult is and take seriously the ‘aggregation’ of the occult as an empirical ethnographic fact. I suggest that ‘the occult’ is often experienced as both a proliferating series of oracular institutions for contending with feelings of affliction, and as invisible forces whose origin and nature are compound. I turn to James Siegel’s work on witchcraft to bring attention to the experiential dimension of the occult, and provide an extended ethnographic account of a moment in which the source, nature, and means of redress of an individual’s occult affliction cannot be determined. I argue, in line with Siegel, that historicization and contextualization, while important, risk denaturing the occult and impairing our understanding of its persistence.
Equals before the Law? Public Religion and Queer Activism in the Age of Judicial Politics in South Africa
Authors: Burchardt Marian
Published: August 2013

Abstract

On a global scale, the politics around the recognition of same-sex relationships has turned into legal controversies while opposition to it is often framed in religious terms. This article takes the case of Christian mobilization around the legal recognition of same-sex marriage in South Africa to investigate the intertwinement of religious and sexual rights struggles. Linking the anthropology of law, the sociolegal literature on judicialization, and studies of public religion, it argues that both same-sex activism and religious mobilization should be understood in terms of judicial politics. The article analyses religious responses to lesbian and gay judicial activism and presents a typology that reveals the structured diversity of these responses in terms of public discourse, political strategy, and legal argument. Two dimensions are key to conceptualizing these responses: religious communities’ ontological concepts of the world, including ideas about human agency and God, and their relationships to the world, construed in terms of political habitus.
The Death of Caucasus Philology: Towards a Discipline Beyond Areal Divides
Authors: Gould Rebecca
Published: August 2013

This essay investigates the challenges facing Caucasus philology, by which I mean the institutional capacity to conduct deep research into the literary cultures of Azerbaijan Republic, Georgia, Daghestan, and Chechnya. I argue that the philological approach to the literary cultures of the Caucasus has been a casualty of the rise of areas studies in the North American academy during the Cold War, and that Cold War legacies continue to shape Caucasus Studies to this day. I conclude by offering three proposals for opening exchanges between the humanities and the social sciences within Caucasus Studies. More broadly, this essay argues for a rapprochement between the social sciences and philological inquiry vis-à-vis the Caucasus.
Making Sense of Canada’s Public Image in China
Authors: Zhu Yuchao
Published: August 2013

A country’s image is the product largely of one nation’s socially constructed perception (or misperception) of another nation. A country’s image may seem politically insignificant, but its image and associated identity are often socially meaningful and have an important impact on the overall milieu for narratives and discourses in international relations. This essay intends to make sense of Canada’s image among Chinese. It first defines the concept of “image” and specifically Canada’s image in China. Then, through examination of various aspects of image-making, such as symbolic individual figures, media venues, and popular topics, this article seeks to deconstruct this image. It argues that the Canadian image is important for Sino-Canadian relations because a country’s image and reputation are among the most valuable assets its people possess and a key component of soft power. The political weight of public image, however, is more the product of a country’s importance and less its image. For example, compared to the relatively negative public image of the United States in China, Canada’s more positive public image does not make it more important to China’s government or its people.
French Canada’s Quiet Obsession with China
Authors: Granger Serge
Published: August 2013

Missionaries played a significant role in presenting China to a French Canadian audience. Whatever the “heritage” missionaries in French Canada left before 1960, China was undoubtedly their greatest effort and it did leave a historical legacy. Despite the cultural gap, French Canadian literature focused on China because of the historic Jesuit links, the Sainte-Enfance [Holy Childhood], and missionaries who brought two distant cultures into contact. Even though Québec secularized during the 1960s, the China endeavor maintained avid French Canadian interest in China to the present day.
Revision of the checkered beetle genus Eunatalis Schenkling,
1909 (Coleoptera: Cleridae: Clerinae)
Authors: GERSTMEIER ROLAND , SEITNER MARTIN
Published: August 2013

The genus Eunatalis Schenkling, 1909 is taxonomically revised to include twenty-two species. The following species are described as new: Eunatalis auricoma, Eunatalis flavopilosa, Eunatalis foveata, Eunatalis ninae, Eunatalis pernodulosa, Eunatalis punctata, Eunatalis schopfi, Eunatalis spadicea and Eunatalis villosa. Eunatalis blackburni (Waterhouse, 1894), n. syn. is placed in synonymy with Eunatalis lugubris (Blackburn, 1890), Eunatalis longicollis (Blackburn, 1890), n. syn. is placed in synonymy with Eunatalis hirta (Blackburn, 1890); Eunatalis lata (Waterhouse, 1894), n. syn. and Eunatalis alternicostata (Kuwert, 1893), n. syn. are synonymized with Eunatalis semicostata (Blackburn, 1888). A key to the species, color photographs, genital figures and distribution maps are provided.
On the Control of the Residual Circulation and Stratospheric Temperatures in the Arctic by Planetary Wave Coupling
Authors: Shaw Tiffany A. , Perlwitz Judith
Published: August 2013

It is well established that interannual variability of eddy (meridional) heat flux near the tropopause controls the variability of Arctic lower-stratospheric temperatures during spring via a modification of the strength of the residual circulation. While most studies focus on the role of anomalous heat flux values, here the impact of total (climatology plus anomaly) negative heat flux events on the Arctic stratosphere is investigated. Utilizing the Interim ECMWF Re-Analysis (ERA-Interim) dataset, it is found that total negative heat flux events coincide with a transient reversal of the residual circulation and cooling of the Arctic lower stratosphere. The negative events weaken the seasonally averaged adiabatic warming.

The analysis provides a new interpretation of the winters of 1997 and 2011, which are known to have the lowest March Arctic lower-stratospheric temperatures in the satellite era. While most winters involve positive and negative heat flux extremes, the winters of 1997 and 2011 are unique in that they only involved extreme negative events. This behavior contributed to the weakest adiabatic downwelling in the satellite era and suggests a dynamical contribution to the extremely low temperatures during those winters that could not be accounted for by diabatic processes alone. While it is well established that dynamical processes contribute to the occurrence of stratospheric sudden warming events via extreme positive heat flux events, the results show that dynamical processes also contribute to cold winters with subsequent impact on Arctic ozone loss. The results highlight the importance of interpreting stratospheric temperatures in the Arctic in the context of the dynamical regime with which they are associated.