bluuebunny/crossref_metadata_2025 huggingface dataset:
Demographic and clinical correlates of autism symptom domains and autism spectrum diagnosis
Authors: Frazier Thomas W , Youngstrom Eric A , Embacher Rebecca , Hardan Antonio Y , Constantino John N , Law Paul , Findling Robert L , Eng Charis
Published: October 2013

Demographic and clinical factors may influence assessment of autism symptoms. This study evaluated these correlates and also examined whether social communication and interaction and restricted/repetitive behavior provided unique prediction of autism spectrum disorder diagnosis. We analyzed data from 7352 siblings included in the Interactive Autism Network registry. Social communication and interaction and restricted/repetitive behavior symptoms were obtained using caregiver-reports on the Social Responsiveness Scale. Demographic and clinical correlates were covariates in regression models predicting social communication and interaction and restricted/repetitive behavior symptoms. Logistic regression and receiver operating characteristic curve analyses evaluated the incremental validity of social communication and interaction and restricted/repetitive behavior domains over and above global autism symptoms. Autism spectrum disorder diagnosis was the strongest correlate of caregiver-reported social communication and interaction and restricted/repetitive behavior symptoms. The presence of comorbid diagnoses also increased symptom levels. Social communication and interaction and restricted/repetitive behavior symptoms provided significant, but modest, incremental validity in predicting diagnosis beyond global autism symptoms. These findings suggest that autism spectrum disorder diagnosis is by far the largest determinant of quantitatively measured autism symptoms. Externalizing (attention deficit hyperactivity disorder) and internalizing (anxiety) behavior, low cognitive ability, and demographic factors may confound caregiver-report of autism symptoms, potentially necessitating a continuous norming approach to the revision of symptom measures. Social communication and interaction and restricted/repetitive behavior symptoms may provide incremental validity in the diagnosis of autism spectrum disorder.
Video game access, parental rules, and problem behavior: A study of boys with autism spectrum disorder
Authors: Engelhardt Christopher R , Mazurek Micah O
Published: October 2013

Environmental correlates of problem behavior among individuals with autism spectrum disorder remain relatively understudied. The current study examined the contribution of in-room (i.e. bedroom) access to a video game console as one potential correlate of problem behavior among a sample of 169 boys with autism spectrum disorder (ranging from 8 to 18 years of age). Parents of these children reported on (1) whether they had specific rules regulating their child’s video game use, (2) whether their child had in-room access to a variety of screen-based media devices (television, computer, and video game console), and (3) their child’s oppositional behaviors. Multivariate regression models showed that in-room access to a video game console predicted oppositional behavior while controlling for in-room access to other media devices (computer and television) and relevant variables (e.g. average number of video game hours played per day). Additionally, the association between in-room access to a video game console and oppositional behavior was particularly large when parents reported no rules on their child’s video game use. The current findings indicate that both access and parental rules regarding video games warrant future experimental and longitudinal research as they relate to problem behavior in boys with autism spectrum disorder.
The association between parental interaction style and children’s joint engagement in families with toddlers with autism
Authors: Patterson Stephanie Y , Elder Lauren , Gulsrud Amanda , Kasari Connie
Published: October 2013

Purpose:

This study examines the relationship between parental interaction style (responsive vs directive) and child-initiated joint engagement within caregiver–child interactions with toddlers diagnosed with autism spectrum disorders.

Method:

Videotaped interactions of 85 toddler–caregiver dyads were coded for child engagement and both parental responsiveness and directiveness.

Results:

Altogether, children spent less than one-third of the interaction jointly engaged. After controlling for child characteristics, parental style was associated with the initiator (child or parent) of joint engagement. Specifically, responsiveness predicted total time in child-initiated joint engagement, while directiveness predicted total time in parent-initiated joint engagement. Children’s social behaviours were associated with child-initiated joint engagement.

Discussion:

Social initiations are a key target for children with autism spectrum disorders. Results demonstrate that child initiations and global social behaviour ratings are associated with parental responsivity. Responsivity may be a critical factor to facilitate children’s initiations.
Temporalities of the Formative Period Taraco Peninsula, Bolivia
Authors: Roddick Andrew P.
Published: October 2013

Within the last 15 years archaeologists have developed a ‘dwelling’ perspective in studies of prehistoric landscapes. This research takes a critical approach to time, highlighting the temporality of practices in both daily life and longer-term processes. In this article I investigate temporalities of the Middle (800–200 BC) and Late Formative (200 BC–AD 500) periods on the Taraco Peninsula (Bolivia), drawing on data produced by the Taraco Archaeological Project. Particular attention is paid to long-term landscape tempos, place-making and the intertwined rhythms of technical practice. I end with a brief discussion of the temporal changes that correspond with the urbanization processes seen at the Middle Horizon (AD 500–950) center of Tiwanaku.
Tapu and the invention of the “death taboo”: An analysis of the transformation of a Polynesian cultural concept
Authors: Gilmore Helen , Schafer Cyril , Halcrow Siân
Published: October 2013

Is death “taboo” or “ tapu”? Why do these two versions of the same word evoke such different cultural responses to issues of death and the dead? In this paper, we explore Western anthropological interpretations of the “death taboo”, its relationship to Māori understanding of tapu, and how the transformation of tapu into “taboo” influences engagement with human remains. We maintain that such an anthropological approach—incorporating historical, archaeological and biological anthropological perspectives—can further contribute to a number of cross-cultural, cross-disciplinary debates. We further argue that this will expand and elucidate cross-cultural understandings of responses to death by siting them within specific historical-cultural contexts and locations.
The relation of outdoor lighting characteristics to sky glow from distant cities
Authors: Duriscoe DM , Luginbuhl CB , Elvidge CD
Published: October 2013

Five cities in the southwest United States were selected for an analysis of the impact of outdoor lighting practices on nighttime sky glow as observed from distances of 8–67 km. Data from the Suomi National Polar-orbiting Partnership (NPP) satellite visible infrared imaging radiometer suite day/night band were used to identify light sources for input to an atmospheric sky glow model. Total lumens of outdoor lighting were estimated by matching modelled to observed anthropogenic sky luminance at ground locations. The results of two conservative treatments were then modelled for each city: all outdoor luminaires fully shielded with the current lumen amount, and fully shielded luminaires with a lumen amount scaled to 2075 lm capita−1, matching Flagstaff, Arizona. The results indicate 42–88% reductions in average all-sky glow utilizing these ‘best practices’ for environmental conservation.
A Novel Herbal Formula Induces Cell Cycle Arrest and Apoptosis in Association With Suppressing the PI3K/AKT Pathway in Human Lung Cancer A549 Cells
Authors: Xiong Fei , Jiang Miao , Huang Zhenzhou , Chen Meijuan , Chen Kejun , Zhou Jing , Yin Lian , Tang Yuping , Wang Mingyan , Ye Lihong , Zhan Zhen , Duan Jinao , Fu Haian , Zhang Xu
Published: October 2013

Aim of the study. In recent years, the incidence of lung cancer, as well as the mortality rate from this disease, has increased. Moreover, because of acquired drug resistance and adverse side effects, the effectiveness of current therapeutics used for the treatment of lung cancer has decreased significantly. Chinese medicine has been shown to have significant antitumor effects and is increasingly being used for the treatment of cancer. However, as the mechanisms of action for many Chinese medicines are undefined, the application of Chinese medicine for the treatment of cancer is limited. The formula tested has been used clinically by the China National Traditional Chinese Medicine Master, Professor Zhonging Zhou for treatment of cancer. In this article, we examine the efficacy of Ke formula in the treatment of non–small cell lung cancer and elucidate its mechanism of action. Methods. A Balb/c nude mouse xenograft model using A549 cells was previously established. The mice were randomly divided into normal, mock, Ke, cisplatin (DDP), and co-formulated (Ke + DDP) groups. After 15 days of drug administration, the animals were sacrificed, body weight and tumor volume were recorded, and the tumor-inhibiting rate was calculated. A cancer pathway finder polymerase chain reaction array was used to monitor the expression of 88 genes in tumor tissue samples. The potential antiproliferation mechanism was also investigated by Western blot analysis. Results. Ke formula minimized chemotherapy-related weight loss in tumor-bearing mice without exhibiting distinct toxicity. Ke formula also inhibited tumor growth, which was associated with the downregulation of genes in the PI3K/AKT, MAPK, and WNT/β-catenin pathways. The results from Western blot analyses further indicated that Ke blocked the cell cycle progression at the G1/S phase and induced apoptosis mainly via the PI3K/AKT pathway. Conclusion. Ke formula inhibits tumor growth in an A549 xenograft mouse model with no obvious side effects. Moreover, Ke exhibits synergistic antitumor effects when combined with DDP. The mechanism of action of Ke is to induce cell cycle arrest and apoptosis by suppressing the PI3K/AKT pathway. Further research will be required to determine the mechanism of action behind the synergistic effect of Ke and DDP.
A Pilot Study of a Home-Based Motivational Exercise Program for African American Breast Cancer Survivors
Authors: Spector Denise , Deal Allison M. , Amos Keith D. , Yang Hojin , Battaglini Claudio L.
Published: October 2013

Introduction. African American breast cancer survivors engage in less physical activity compared with their Caucasian counterparts. There is a need for exercise intervention research that focuses on improving the overall health and long-term survivorship of African American breast cancer survivors, especially because they often have worse outcomes than Caucasian survivors. Study objectives were to determine whether African American participants increase physical activity and explore whether exercise had a positive impact on fitness and health. Methods. African American breast cancer survivors, stage 0 to IIIA, within 2 years of completing primary cancer treatments were recruited for a 16-week home-based aerobic and resistance training exercise pilot study. Outcome measures assessed at baseline and postintervention included physical activity questionnaires and accelerometry, cardiopulmonary function (VO2peak) with gas exchange, muscle strength, Selective Functional Movement Assessment, and dual energy X-ray absorptiometry scans for body composition analysis. Assessments for fatigue and quality of life (QOL) were also completed at baseline and postintervention. Motivational interviewing was utilized to determine goals and explore exercise facilitators/barriers. Participants completed weekly exercise logs and received weekly phone calls. Wilcoxon signed rank tests were used to detect significant changes in physical activity and also changes in fitness/health parameters, fatigue, and QOL. Spearman correlation coefficients were used to examine relationships between physical activity and health measures. Results. A total of 17 women enrolled; 13 completed the intervention (76%). Mean age of the participants was 51 years. There was a significant increase in total minutes of weekly physical activity postintervention ( M = 271 minutes, SD = 151; P = .001). Significant improvements were found in cardiopulmonary fitness as measured by VO2peak with a mean increase of 2.03 mL/kg/min ( P = .01). Several strength measures significantly increased and also functional movement ( P = .005). Positive correlations existed between physical activity and several physical measures, with significant relationships between functional movement and some strength measures (eg, left arm extension: rs = 0.61, P = .002). Total QOL and fatigue scores improved, but neither was significant. Conclusions. The intervention led to increased physical activity. As a result of increased levels of physical activity, improvements on several fitness/health parameters occurred.
Effect of Botanical Immunomodulators on Human CYP3A4 Inhibition
Authors: Patil Dada , Gautam Manish , Gairola Sunil , Jadhav Suresh , Patwardhan Bhushan
Published: October 2013

Purpose. Many botanical immunomodulators are used as adjuvants along with cancer chemotherapy. However, information on the impact of concurrent administration of such botanicals on pharmacokinetics of chemotherapy agents is inadequate. This study investigates inhibitory activities of 3 popular botanical adjuvants: Asparagus racemosus (root aqueous extract; ARE), Withania somnifera (root aqueous extract; WSE), and Tinospora cordifolia (stem aqueous extract, TCE) on human CYP3A4 isoenzyme, responsible for metabolism of several chemotherapy agents. Experimental design. Testosterone 6-β hydroxylation was monitored using high-performance liquid chromatography as an indicator of CYP3A4 catalytic activities. Ketoconazole (positive control) and extracts were studied at their in vivo–relevant concentrations. Results. TCE showed mild inhibition while no significant inhibitory activities were observed in WSE and ARE. TCE was further fractionated to obtain polar and nonpolar fractions. The nonpolar fraction showed significant CYP3A4 inhibition with IC50 13.06 ± 1.38 µg/mL. Major constituents of nonpolar fraction were identified using HPLC-DAD-MS profiling as berberine, jatrorrhizine, and palmatine, which showed IC50 values as 6.25 ± 0.30, 15.18 ± 1.59, and 15.53 ± 1.89 µg/mL, respectively. Conclusion. Our findings suggest that constituents of TCE extract especially protoberberine alkaloids have the potential to interact with cancer chemotherapy agents that are metabolized by CYP3A4 in vivo.
Helping people to live well with dementia
Authors: Tang Eugene Yee Hing , Robinson Louise
Published: October 2013

An estimated 800 000 people in England live with dementia, with around 670 000 family and friends acting as primary carers. The number of people with dementia is expected to double in the next 30 years. According to a report from the Alzheimer’s Society, the current financial cost to the NHS, local authorities and families is £23 billion a year; this is likely to rise to £27 billion by 2018. The 2011 Prime Minister’s Challenge on Dementia set out a number of key commitments in order to combat this growing problem. These include: improving current health and social care; creating dementia-friendly communities that understand how to help people live well with dementia; and focusing on more and better quality, research into dementia. GPs have a key role in helping patients with a diagnosis of dementia to live well and in their own homes for as long as possible. Furthermore, the National Institute for Health and Care Excellence has recently published commissioning guidelines to assist GPs to improve the quality of care for people with dementia.
The Repeatability of Gait Speed and Physiological Cost Index Measurements in Working Adults
Authors: Raj Rishi , Mojazi Amiri Hoda , Wang Helen , Nugent Kenneth M.
Published: October 2013

Objectives: To determine the performance characteristics of gait speed measurements and the physiological cost index (PCI; heart rate change/gait speed) in working adults. Methods: Gait speeds, heart rate changes, andnon–steady state PCIs were calculated in 61 volunteers who worked in our health sciences center. These subjects completed 9 separate 100-foot walk tests in 3 separate sessions. Results: The mean heart rate change after a 100-foot walk was 16.6 ± 8.1 beats per minute. The mean gait speed was 76.1 ± 9.6 meters per minute, and the mean PCI was 0.22 ± 0.11 beats per meter. There were highly significant correlations among all measurements on the 9 separate tests (correlation coefficients 0.41-0.95); gait speed measurements had the highest correlations (0.91-0.95). In a multivariable model hypertension and arthritis were associated with reduced gait speeds. Conclusion: Gait speed, heart rate changes, and non–steady state PCIs have good repeatability when measured over short walks. This information provides a rapid physiological assessment and a method for measuring changes in functional status in healthy subjects and most patients.
Functional Outcomes After Arthroscopic Scapulothoracic Bursectomy and Partial Superomedial Angle Scapulectomy
Authors: Tashjian Robert Z. , Granger Erin K. , Barney Jacob K. , Partridge Deveree R.
Published: October 2013

Background:

Arthroscopic scapulothoracic bursectomy with partial superomedial angle scapulectomy has been described as a treatment for persistent scapulothoracic bursitis with varying results.

Purpose:

To evaluate patients after arthroscopic scapulothoracic bursectomy utilizing validated functional outcome instruments.

Study Design:

Case series.

Methods:

Fifteen patients underwent arthroscopic scapulothoracic bursectomy and partial superomedial angle scapulectomy. Thirteen patients were available for review at a mean 27-month follow-up (range, 13-65 months). Patients were evaluated preoperatively with a history, physical examination evaluating medial scapula border tenderness and crepitus, pain visual analog scale (VAS) score, and the simple shoulder test (SST). Postoperatively, patients were evaluated with all preoperative questionnaires as well as a satisfaction survey and the American Shoulder and Elbow Surgeons (ASES) score.

Results:

SST scores improved significantly from a mean 7.7 ± 3.1 preoperatively to 10.3 ± 2.3 postoperatively ( P = .03). VAS pain scores reduced significantly from 6.5 ± 2.2 preoperatively to 2.3 ± 2.4 postoperatively ( P < .001). Ninety-two percent (12/13) of patients were satisfied, and 92% (12/13) stated they would have the surgical procedure performed again. The mean ASES postoperative score was 80.1 (range, 38-100). The 2 clinical failures (ASES scores <50) had either a workers’ compensation claim with persistent medial border tenderness or ongoing rotator cuff disease. Despite lower ASES scores, these patients were still satisfied with the procedure and would undergo it again.

Conclusion:

Arthroscopic scapulothoracic bursectomy with partial superomedial angle scapulectomy provides significant improvements in pain and functional outcomes. Even in patients at risk for poorer clinical outcomes, patient satisfaction and willingness to undergo the surgical procedure again was still high.
Preparation and characterization of polystyrene/starch blends for packaging applications
Authors: Berruezo M , Ludueña LN , Rodriguez E , Alvarez VA
Published: October 2013

Polystyrene/thermoplastic starch blends from 90/10 to 50/50 (w/w) were prepared by melt blending. Blends were characterized by scanning electron microscopy (morphology); thermogravimetric analysis (thermal stability and weight content of each component); Fourier transform infrared spectroscopy (identification of functional groups); differential scanning calorimetry (thermal properties); tensile tests (strength, modulus, elongation at break and tenacity) and biodegradation in soil (biodegradability). The biodegradation process was also followed by thermogravimetric analysis calculating the loss of each component after removing the samples from soil at different time intervals. Scanning electron microscopy results showed good starch dispersion in the blend. The Fourier transform infrared spectroscopy analysis suggested that only physical interaction took place between the polystyrene and the thermoplastic starch. The tensile tests revealed a considerable decrease in the mechanical properties of the polystyrene-thermoplastic starch blends as a function of the thermoplastic starch content. The 50/50 blend showed decreases of 48% in the Young’s modulus, 62% in the tensile strength and increases of 62% in the elongation at break, in comparison to neat polystyrene. The biodegradability tests showed that the greater the thermoplastic starch concentration in the blend, the faster the mass loss, which was also confirmed by the thermogravimetric analysis and Fourier transform infrared spectroscopy analysis.
Glycoengineered CD20 antibody obinutuzumab activates neutrophils and mediates phagocytosis through CD16B more efficiently than rituximab
Authors: Golay Josée , Da Roit Fabio , Bologna Luca , Ferrara Claudia , Leusen Jeanette H. , Rambaldi Alessandro , Klein Christian , Introna Martino
Published: October 2013

Key Points

Phagocytosis of CLL targets by neutrophils is a novel mechanism of action of the glycoengineered anti-CD20 antibody obinutuzumab. This mechanism takes place in physiological conditions and requires CD16B and CD32A.
Genetic diversities of cytochrome B in Xinjiang Uyghur unveiled its origin and migration history
Authors: Ablimit Abdurahman , Qin Wenbei , Shan Wenjuan , Wu Weiwei , Ling Fengjun , Ling Kaitelynn H , Zhao Changjie , Zhang Fuchun , Ma Zhenghai , Zheng Xiufen
Published: October 2013

Background

Uyghurs are one of the many populations of Central Eurasia that is considered to be genetically related to Eastern and Western Eurasian populations. However, there are some different opinions on the relative importance of the degree of Eastern and Western Eurasian genetic influence. In addition, the genetic diversity of the Uyghur in different geographic locations has not been clearly studied.

Results

In this study, we are the first to report on the DNA polymorphism of cytochrome B in the Uyghur population located in Xinjiang in northwest China. We observed a total of 102 mutant sites in the 240 samples that were studied. The average number of mutated nucleotides in the samples was 5.126. A total of 93 different haplotypes were observed. The gene diversity and discrimination power were 0.9480 and 0.9440, respectively. There were founder and bottleneck haplotypes observed in Xinjiang Uyghurs. Xinjiang Uyghurs are more genetically related to Chinese population in genetics than to Caucasians. Moreover, there was genetic diversity between Uyghurs from the southern and northern regions. There was significance in genetic distance between the southern Xinjiang Uyghurs and Chinese population, but not between the northern Xinjiang Uyghurs and Chinese. The European vs. East Asian contribution to the ten regional Uyghur groups varies among the groups and the European contribution to the Uyghur increases from north to south geographically.

Conclusion

This study is the first report on DNA polymorphisms of cytochrome B in the Uyghur population. The study also further confirms that there are significant genetic differences among the Uyghurs in different geographical locations.
Distribution of erythrocyte binding antigen 175 (EBA-175) gene dimorphic alleles in Plasmodium falciparumfield isolates from Sudan
Authors: Adam Ahmed AM , Amine Ahmed AA , Hassan Dina A , Omer Waleed H , Nour Bakri Y , Jebakumar Arulanantham Zechariah , Ibrahim Muntaser E , Abdulhadi Nasreldin H , Mohamed Hiba S
Published: October 2013

Background

The Erythrocyte Binding Antigen (EBA) 175 has been considered as one of the most important Plasmodium falciparum (P. falciparum) merozoite ligands that mediate invasion of the erythrocytes through their sialated receptor: Glycophorin A (GPA). The effect of the EBA 175 dimorphic alleles (F and C) on the severity of the disease is not yet fully understood. Therefore this study was designed to assess the distribution of the divergent dimorphic alleles of P. falciparum EBA-175 (F and C) in three different geographical areas in Sudan and the possible association of this dimorphism with the severity of the disease.

Methods

A sum of 339 field isolates of P. falciparum obtained from patients in three different geographical areas in Sudan were screened for the dimorphic alleles (F, C) of the EBA-175 using nested PCR.

Results

The percentage of F, C, and mixed F/C alleles were; 41%, 51%, and 8% respectively. F and C alleles showed significantly different distributions in the various geographic areas (p = 0.00). There was no significant association between malaria clinical manifestation and P. falciparum EBA-175 F and C alleles frequencies.

Conclusions

This study showed a significant differential distribution of F and C alleles in different geographical malaria endemic areas. No significant association was observed between F and C alleles and different malaria phenotypes.
Detection of malingering: psychometric evaluation of the Chinese version of the structured interview of reported symptoms-2
Authors: Liu Chang , Liu Zhening , Chiu Helen FK , Carl Tam Wai-Cheong , Zhang Huiran , Wang Peng , Wu Guowei , Mwansisya Tumbewene E , Cao Longlong , Hu Aimin , Wang Yu , Xue Zhimin
Published: October 2013

Background

Malingering detection has emerged as an important issue in clinical and forensic settings. The Structured Interview of Reported Symptoms-2 (SIRS-2) was designed to assess the feigned symptoms in both clinical and non-clinical subjects. The aim of the study was to examine the reliability and validity of the Chinese version of this scale.

Methods

Two studies were conducted to evaluate the reliability and validity of the Chinese Version of SIRS-2. In Study one, with a simulation design, the subjects included a. 40 students asked to simulate symptoms of mental illness; b. 40 general psychiatric inpatients and c. 40 students asked to reply to questions honestly. Scales scores for feigning symptoms among three groups were carried out for discriminant validity of the Chinese Version of SIRS-2. Minnesota Multiphasic Personality Inventory-2(MMPI-2) was administered in 80 undergraduate students. In Study two, with a known-groups comparison design, scales scores for feigning symptoms were compared between 20 suspected malingerers and 80 psychiatric outpatients from two forensic centers using the Chinese Version of SIRS-2.

Results

The Chinese Version of SIRS-2 demonstrated satisfactory internal consistency in both study one and two. In study one, criterion validity of this scale was supported by its significantly positive correlation with the MMPI-2 (r = 0.282 ~ 0.481 for Infrequency), and by its significantly negative correlation with the MMPI-2 (r = -0.255 ~ -0.519 for Lie and -0.205 ~ 0.391 for Correction). Scores of 10 out of 13 subscales of the Chinese Version of SIRS-2 for simulators were significantly higher than scores of honest students and general psychiatric patients. In study two, the mean scores of the Chinese Version of 13 subscales for suspected malingerers were significantly higher than those of psychiatric outpatients. For discriminant validity, it yielded a large effect size (d = 1.80) for the comparison of the participant groups in study one and two. Moreover, the sensitivity (proportion of malingerers accurately identified by the measure) and specificity (proportion of people accurately classified as responding honestly) of the Chinese version of SIRS-2 in the detection of malingering in these two studies are acceptable.

Conclusions

The Chinese version of the SIRS-2 has good psychometric properties and is a valid and reliable tool for detection of malingering in Chinese populations.
Pituitary and adrenal involvement in diffuse large B-cell lymphoma, with recovery of their function after chemotherapy
Authors: Nakashima Yasuhiro , Shiratsuchi Motoaki , Abe Ichiro , Matsuda Yayoi , Miyata Noriyuki , Ohno Hirofumi , Ikeda Motohiko , Matsushima Takamitsu , Nomura Masatoshi , Takayanagi Ryoichi
Published: October 2013

Background

Diffuse large B-cell lymphoma sometimes involves the endocrine organs, but involvement of both the pituitary and adrenal glands is extremely rare. Involvement of these structures can lead to hypopituitarism and adrenal insufficiency, and subsequent recovery of their function is rarely seen. The present report describes an extremely rare case of pituitary and adrenal diffuse large B-cell lymphoma presenting with hypopituitarism and adrenal insufficiency with subsequent recovery of pituitary and adrenal function after successful treatment of the lymphoma.

Case presentation

A 63-year-old Japanese man was referred to our hospital due to miosis, ptosis, hypohidrosis of his left face, polydipsia and polyuria.18F-fluorodeoxy glucose positron emission tomography / computed tomography revealed hotspots in the pituitary gland, bilateral adrenal glands and the apex of his left lung. Surgical biopsy from the pituitary lesion confirmed the diagnosis of diffuse large B-cell lymphoma, with lymphoma cells replacing normal pituitary tissue. Endocrine function tests revealed adrenal insufficiency and panhypopituitarism, including a possible affection of the posterior pituitary. Hormone replacement therapy with desmopressin and hydrocortisone was started. Chemotherapy consisted of six courses of R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin and prednisolone) and two courses of high-dose methotrexate followed by autologous hematopoietic stem cell transplantation. Subsequently, his pituitary and bilateral adrenal lesions resolved, and serial endocrine function tests showed gradual improvement in pituitary and adrenal function.

Conclusions

The present report describes an extremely rare case of diffuse large B-cell lymphoma with involvement of both the pituitary and bilateral adrenal glands. R-CHOP and high-dose methotrexate therapy followed by autologous hematopoietic stem cell transplantation was quite effective, and panhypopituitarism and adrenal insufficiency improved to almost normal values after successful treatment of the lymphoma with chemotherapy.
Patterns of engagement with the health care system and risk of subsequent hospitalization amongst patients with diabetes
Authors: Ronksley Paul E , Ravani Pietro , Sanmartin Claudia , Quan Hude , Manns Braden , Tonelli Marcello , Hemmelgarn Brenda R
Published: October 2013

Background

Re-hospitalization is common among patients with diabetes, and may be related to aspects of health care use. We sought to determine the association between patterns of health care engagement and risk of subsequent hospitalization within one year of discharge for patients with diabetes.

Methods

We identified adults with incident diabetes in Alberta, Canada, who had at least one hospitalization following their diabetes diagnosis between January 1, 2004 and March 31, 2011. We used Cox regression to estimate the association between factors related to health care engagement (prior emergency department use, primary care visits, and discharge disposition (i.e. whether the patient left against medical advice)) and the risk of subsequent all-cause hospitalization within one year.

Results

Of the 33811 adults with diabetes and at least one hospitalization, 11095 (32.8%) experienced a subsequent all-cause hospitalization within a mean (standard deviation) follow-up time of 0.68 (0.3) years. Compared to patients with no emergency department visits, there was a 4 percent increased risk of a subsequent hospitalization for every emergency department visit occurring prior to the index hospitalization (adjusted Hazard Ratio [HR]: 1.04; 95% CI: 1.03–1.05). Limited and increased use of primary care was also associated with increased risk of a subsequent hospitalization. Compared to patients with 1–4 visits, patients with no visits to a primary care physician (adjusted HR: 1.11; 95% CI: 0.99–1.25) and those with 5–9 visits (adjusted HR: 1.06; 95% CI: 1.00–1.12) were more likely to experience a subsequent hospitalization. Finally, compared to patients discharged home, those leaving against medical advice were more likely to have a subsequent hospitalization (adjusted HR: 1.74; 95% CI: 1.50–2.02) and almost 3 times more likely to have a diabetes-specific subsequent event (adjusted HR: 2.86; 95% CI: 1.82–4.49).

Conclusions

Patterns of health care use and the circumstances surrounding hospital discharge are associated with an increased risk of subsequent hospitalization among patients with diabetes. Whether these patterns are related to the health care systems ability to manage complex patients within a primary care setting, or to access to primary care services, remains to be determined.
Relationships between the intention to use guidelines, behaviour of insurance physicians and their determinants
Authors: Schellart Antonius JM , Zwerver Feico , Anema Johannes R , van der Beek Allard J
Published: October 2013

Background

We studied the intention of a group of insurance physicians to use the guidelines for depression, and their behaviour in disability assessments. We considered attitude, social norm and self-efficacy, knowledge/skills and stimuli, based on the Attitude - Social norm - self-Efficacy model (ASE model) as possible determinants of both intention and behaviour.

The aim of this study was to understand the determinants of insurance physicians’ behaviour when they are expected to use guidelines in daily practice.

Method

A representative sample of 42 insurance physicians participated in this study. Cross-sectional data were collected by means of a questionnaire based on the ASE model. We developed the questionnaire on the basis of literature and ascertained the content validity of it. Behaviour was made to comprise both “use of the guidelines” and “change in disability assessment behaviour” by the insurance physicians. Reliability analyses were performed to form additive scales of the ASE constructs. These scales were analysed with structural equations modelling (LISREL), by modifying a start model into a final model with a good fit, within theoretical constraints. In these analyses special attention was paid to the fact that the sample size was small.

Results

The most important determinants of the intention and the self-reported use of the guidelines, were: the influence of colleagues, the self-efficacy of the insurance physicians in their use of the guidelines, and the way the guidelines were implemented. The intention to use the guidelines for depression was not associated with the self-reported use of these guidelines, but there proved to be a faint, positive association with the self-reported change in assessment behaviour.

Conclusions

Almost all the insurance physicians in this study intended to use at least elements of the guidelines. Their intention, self reported use of the guidelines and self-reported change in assessment behaviour were explored with help of the ASE model. The model suggested relationships between intention, self reported use of the guidelines and self-reported change in assessment behaviour on the on the one hand and various determinants on the other hand. Be that as it may, we see opportunities to improve insurance physicians’ guideline adherence by offering them a multifaceted training in which they learn to apply the guidelines for depression.
BMP4 is increased in the aortas of diabetic ApoE knockout mice and enhances uptake of oxidized low density lipoprotein into peritoneal macrophages
Authors: Koga Mitsuhisa , Yamauchi Atsushi , Kanaoka Yuki , Jige Ryusuke , Tsukamoto Anna , Teshima Nao , Nishioku Tsuyoshi , Kataoka Yasufumi
Published: October 2013

Background

BMP4, a member of the transforming growth factor-beta superfamily, is upregulated in the aortas of diabetic db/db mice. However, little is known about its role in diabetic atherosclerosis. Therefore, we examined the roles of BMP4 in the formation of diabetic atherosclerosis in apolipoprotein E knockout (ApoE KO) mice and in the uptake of oxidized low density lipoprotein (oxLDL) in peritoneal macrophages of wild-type mice.

Methods

To induce diabetes, ApoE KO mice were intraperitoneally injected with streptozotocin. Diabetic and non-diabetic ApoE KO mice were then fed a high-fat diet for 4 weeks. Next, to investigate a role of BMP4 in the peritoneal macrophages, we examined the uptake of oxLDL in BMP4-treated macrophages.

Results

Diabetic ApoE KO mice showed accelerated progression of aortic plaques accompanied by increased luminal plaque area. Western blot analysis showed that BMP4 expression in the whole aorta was greatly increased in diabetic ApoE KO mice, than non-diabetic mice. Western blot analysis showed that the BMP4/SMAD1/5/8 signaling pathway was strongly activated in the aorta from diabetic ApoE KO mice, compared with control ApoE KO mice. Double immunofluorescence staining showed that BMP4 was expressed in MOMA2-labeled macrophage in the aortic lesions of ApoE KO mice. BMP4 significantly increased the uptake of oxLDL into peritoneal macrophages in vitro.

Conclusion

We show that in the aorta of diabetic ApoE KO mice, BMP4 is increased and activates SMAD1/5/8. Our in vitro findings indicate that BMP4 enhances oxLDL uptake in mouse peritoneal macrophages, suggesting BMP4 may be involved in aortic plaque formation in diabetic ApoE KO mice. Targeting BMP4 may offer a new strategy for inhibition of plaque progression and stabilization of atherosclerotic lesions.
Identification of exon 19 and 21 mutations of EGFR gene in Chinese patients with esophageal squamous cell carcinoma
Authors: Cui Yong , Chang Dong , Liu Mingliang , Lin Changjin , Zhao Baojian , Zhang Xu , Gong Min
Published: October 2013

Background

Although epidermal growth factor receptor (EGFR) inhibitor treatment showed modest response in several clinical trials in esophageal squamous cell carcinoma (ESCC) patients, it has been reported that the frequency of EGFR mutations varied largely. The aim of this study was to investigate the existence of EGFR mutations in Chinese esophageal squamous cell carcinomas.

Methods

Formalin-fixed paraffin-embedded surgically resected tumor samples were obtained from 127 randomly selected Chinese patients with ESCC. The most common EGFR mutations, including in-frame deletions in exon 19 and base substitutions in exon 21, were detected by denaturing high performance liquid chromatography (DHPLC) and direct sequencing simultaneously. K-RAS mutations in codons 12 and 13 were detected by direct sequencing.

Results

In this study, L858R missense mutations of the EGFR gene were found in 8 out of 127 patients (6.3%) by DHPLC but no mutation was observed by direct sequencing. In addition, K-RAS mutation was detected in 2 out of 127 (1.6%) patients by direct sequencing.

Conclusions

The incidence of EGFR mutations was relatively high using DHPLC method but no mutation with direct sequencing in Chinese ESCC patients.
TaO
x
-based resistive switching memories: prospective and challenges
Authors: Prakash Amit , Jana Debanjan , Maikap Siddheswar
Published: October 2013

Resistive switching memories (RRAMs) are attractive for replacement of conventional flash in the future. Although different switching materials have been reported; however, low-current operated devices (<100 μA) are necessary for productive RRAM applications. Therefore, TaO
x
is one of the prospective switching materials because of two stable phases of TaO2 and Ta2O5, which can also control the stable low- and high-resistance states. Long program/erase endurance and data retention at high temperature under low-current operation are also reported in published literature. So far, bilayered TaO
x
with inert electrodes (Pt and/or Ir) or single layer TaO
x
with semi-reactive electrodes (W and Ti/W or Ta/Pt) is proposed for real RRAM applications. It is found that the memory characteristics at current compliance (CC) of 80 μA is acceptable for real application; however, data are becoming worst at CC of 10 μA. Therefore, it is very challenging to reduce the operation current (few microampere) of the RRAM devices. This study investigates the switching mode, mechanism, and performance of low-current operated TaO
x
-based devices as compared to other RRAM devices. This topical review will not only help for application of TaO
x
-based nanoscale RRAM devices but also encourage researcher to overcome the challenges in the future production.
Cardiorespiratory and antinociceptive effects of two different doses of lidocaine administered to horses during a constant intravenous infusion of xylazine and ketamine
Authors: Nóbrega Neto Pedro I , Luna Stelio PL , Queiroz-Williams Patricia , Mama Khursheed R , Steffey Eugene P , Carregaro Adriano B
Published: October 2013

Background

This study investigated the antinociceptive effects of a constant rate infusion (CRI) of lidocaine during xylazine and ketamine anesthesia in horses and aimed to correlate these effects with cardiorespiratory variables, bispectral index (BIS) and plasma lidocaine concentrations. Six adult crossbred mares weighing 320–400 kg were anesthetized on three different occasions. Sedation was performed with xylazine (0.75 mg/kg IV) and anesthetic induction with guaifenesin (75 mg/kg IV) and ketamine (2 mg/kg IV). Anesthesia was maintained with 37.5 μg/kg/min of xylazine and 87.5 μg/kg/min of ketamine both administered intravenously for 75 min. The three treatments consisted of: lidocaine (loading dose: 5 mg/kg, CRI: 100 μg/kg/min; THL); lidocaine (loading dose: 2.5 mg/kg; CRI: 50 μg/kg/min: TLL); and saline (TS); all given 15 min after induction and maintained for 1 h. Antinociception was measured by response to electrical stimulation and bispectral index (BIS) was recorded during anesthesia. Parametric and non-parametric data were compared using ANOVA followed by Student-Newman-Keuls and Friedman tests, respectively.

Results

Plasma lidocaine concentrations peaked at the end of lidocaine loading dose and was greater in THL (9.61 ± 2.75 μg/mL) vs TLL (4.50 ± 3.34 μg/mL). Electrical noxious stimulation caused purposeful movement in all horses from TS, but no response in THL. The BIS was decreased in THL only and was less when compared to the other treatments throughout anesthesia. Blood pressure, PaO2and PaCO2increased and heart rate (HR), respiratory rate (RR), pH, total plasma protein and temperature decreased during anesthesia in all treatments. PaCO2and HR were greater and RR and pH less in THL compared to TLL and TS at 30 min during anesthesia. All recoveries were considered excellent. Time to standing was longer after THL (60 ± 20 min) than following TLL and TS (32 ± 17 and 30 ± 15 min, respectively).

Conclusions

At the highest dose administered (THL) lidocaine CRI during xylazine/ketamine anesthesia decreased BIS and motor response to noxious stimulation, and prolonged recovery time without significant added cardiorespiratory depression.
Sorghum mutant RGdisplays antithetic leaf shoot lignin accumulation resulting in improved stem saccharification properties
Authors: Petti Carloalberto , Harman-Ware Anne E , Tateno Mizuki , Kushwaha Rekha , Shearer Andrew , Downie A Bruce , Crocker Mark , DeBolt Seth
Published: October 2013

Background

Improving saccharification efficiency in bioenergy crop species remains an important challenge. Here, we report the characterization of a Sorghum (Sorghum bicolor L.) mutant, named REDforGREEN (RG), as a bioenergy feedstock.

Results

It was found that RG displayed increased accumulation of lignin in leaves and depletion in the stems, antithetic to the trend observed in wild type. Consistent with these measurements, the RG leaf tissue displayed reduced saccharification efficiency whereas the stem saccharification efficiency increased relative to wild type. Reduced lignin was linked to improved saccharification in RG stems, but a chemical shift to greater S:G ratios in RG stem lignin was also observed. Similarities in cellulose content and structure by XRD-analysis support the correlation between increased saccharification properties and reduced lignin instead of changes in the cellulose composition and/or structure.

Conclusion

Antithetic lignin accumulation was observed in the RG mutant leaf-and stem-tissue, which resulted in greater saccharification efficiency in the RG stem and differential thermochemical product yield in high lignin leaves. Thus, the red leaf coloration of the RG mutant represents a potential marker for improved conversion of stem cellulose to fermentable sugars in the C4 grass Sorghum.
Can a multisensory teaching approach impart the necessary knowledge, skills, and confidence in final year medical students to manage epistaxis?
Authors: Kurien George , Biron Vincent L , Campbell Chase , Cote David WJ , Ansari Kal
Published: October 2013

Objective

The purpose of this study is to evaluate the efficacy of a multisensory teaching approach in imparting the knowledge, skills, and confidence to manage epistaxis in a cohort of fourth year medical students.

Methods

One hundred and thirty four fourth year medical students were recruited into the study from Aug 2011 to February 2012 in four groups. Students listened to an audio presentation ( PODcast) about epistaxis and viewed a video presentation on the technical skills ( VODcast). Following this, students completed a 5-minute Individual Readiness Assessment Test (IRAT) to test knowledge accrued from the PODcast and VODcast. Next, students observed a 10-minute expert demonstration of the technical skills on a human cadaver and spent half an hour practicing these techniques on cadaver simulators with expert guidance. The students’ confidence was assessed with Confidence Level Questionnaires ( CLQs) before and after their laboratory session. The skill level of a subset of students was also assessed with a pre- and post-laboratory Objective Structured Assessment of Technical Skills ( OSATS).

Results

Eighty two percent of the participants achieved a score of at least 80% on the IRAT. The CLQ instrument was validated in the study. There was a statistically significant improvement between the pre- and post-laboratory CLQ scores ( p< 0. 01) and also between pre- and post-laboratory OSATS scores ( p< 0. 01). Qualitative feedback suggested a student preference for this teaching approach.

Conclusions

This study provides further evidence that a multisensory teaching intervention effectively imparts the necessary knowledge, skill and confidence in fourth year medical students to manage epistaxis.
Fixation of CO2 in Clostridium cellulovorans analyzed by 13C-isotopomer-based target metabolomics
Authors: Shinohara Masahiro , Sakuragi Hiroshi , Morisaka Hironobu , Miyake Hideo , Tamaru Yutaka , Fukusaki Eiichiro , Kuroda Kouichi , Ueda Mitsuyoshi
Published: October 2013

Clostridium cellulovorans has been one of promising microorganisms to use biomass efficiently; however the basic metabolic pathways have not been completely known. We carried out 13C-isotopomer-based target metabolome analysis, or carbohydrate conversion process analysis, for more profound understanding of metabolic pathways of the bacterium. Our findings that pyruvate + oxaloacetate, fumarate, and malate inside and outside cells exhibited 13C incorporation suggest that C. cellulovorans exactly fixed CO2 and partly operated the TCA cycle in a reductive manner. Accompanied with CO2 fixation, the microorganism was also found to produce and secrete lactate. Overall, our study demonstrates that a part of C. cellulovorans metabolic pathways related to glycolysis and the TCA cycle are involved in CO2 fixation.