bluuebunny/crossref_metadata_2025 huggingface dataset:
Design, optimization and validation of genes commonly used in expression studies on DMH/AOM rat colon carcinogenesis model
Authors: Bars-Cortina David , Riera Antoni , Gou Gemma , Piñol-Felis Carme , Motilva Maria-José
Published: July 2018

Colorectal cancer (CRC), also known as colon cancer, is the third most common form of cancer worldwide in men and the second in women and is characterized by several genetic alterations, among them the expression of several genes. 1,2-dimethylhydrazine (DMH) and its metabolite azoxymethane (AOM) are procarcinogens commonly used to induce colon cancer in rats (DMH/AOM rat model). This rat model has been used to study changes in mRNA expression in genes involved in this pathological condition. However, a lack of proper detailed PCR primer design in the literature limits the reproducibility of the published data.

The present study aims to design, optimize and validate the qPCR, in accordance with the MIQE (Minimum Information for Publication of Quantitative Real-Time PCR Experiments) guidelines, for seventeen genes commonly used in the DMH/AOM rat model of CRC (Apc, Aurka, Bax, Bcl2, β-catenin, Ccnd1, Cdnk-1A, Cox2, Gsk3beta, IL-33, iNOs, Nrf2, p53, RelA, Smad4, Tnfa and Vegfa) and two reference genes (Actb or β-actin and B2m). The specificity of all primer pairs was empirically validated on agarose gel, and furthermore, the melting curve inspection was checked as was their efficiency (%) ranging from 90 to 110 with a correlation coefficient of r2 > 0.980. Finally, a pilot study was performed to compare the robustness of two candidate reference genes.
Circadian gene Clock regulates mitochondrial morphology and functions by posttranscriptional way
Authors: Xu Lirong , Cheng Qianyun , Hua Bingxuan , Cai Tingting , Lin Jiaxin , Yuan Gongsheng , Yan Zuoqin , Li Xiaobo , Sun Ning , Lu Chao , Qian Ruizhe
Published: July 2018

Many daily activities are under the control of circadian clock, including nutrition metabolism and energy generation. Mitochondria, as the core factories of oxidizing substrates and producing ATP, undergo changes in quantity and morphology to adapt to the demand for energy. It has been demonstrated that mitochondrial gene expression, dynamics and functions are all affected by circadian clock. Here, we demonstrated that circadian gene Clock affects the number, architecture and function of mitochondria via posttranscriptional regulation of Drp1. ClockΔ19 leads to fragmented mitochondria accompanied with the loss of membrane potential, excessive ROS accumulation and decreased mitochondrial respiration and ATP generation. ClockΔ19 mice exhibit disordered lipid metabolism and evident nonalcoholic fatty liver disease (NAFLD), which are rescued by treatment with the mitochondrial fission inhibitor Mdivi-1. These results suggest a strong relationship between Clock, mitochondrial dynamics and metabolic diseases and provide a new perspective on disordered circadian clock and related diseases.
Effects of passive phospholipid flip-flop and asymmetric external fields on bilayer phase equilibria
Authors: Williamson J. J. , Olmsted P. D.
Published: July 2018

Compositional asymmetry between the leaflets of bilayer membranes is known to couple strongly to their phase behaviour, in addition to having important effects on, e.g., mechanical properties and protein activity. We address how phase behaviour is affected by passive phospholipid flip-flop, such that the compositional asymmetry is not fixed. We predict transitions from “pre flip-flop” behaviour to a restricted set of phase equilibria that can persist in the presence of passive flip-flop. Surprisingly, such states are not necessarily symmetric. We further account for external symmetry-breaking, such as a preferential substrate interaction, and show how this can stabilise strongly asymmetric equilibrium states. Our theory explains several experimental observations of flip-flop mediated changes in phase behaviour, and shows how domain formation and compositional asymmetry can be controlled in concert, by manipulating passive flip-flop rates and applying external fields.
Pharmacologic activation of the G protein-coupled estrogen receptor inhibits pancreatic ductal adenocarcinoma
Authors: Natale Christopher A. , Li Jinyang , Dentchev Tzvete , Capell Brian C. , Seykora John T. , Stanger Ben Z. , Ridky Todd W.
Published: July 2018

Female sex is associated with lower incidence and improved clinical outcomes for many cancer types, including pancreatic ductal adenocarcinoma (PDAC). Although the mechanisms responsible for this sex difference are unknown, recent data suggests nonclassical estrogen signaling through the G Protein-coupled Estrogen Receptor (GPER) is likely involved. Here we used murine syngeneic tumor models and human xenografts to test whether GPER signaling inhibits pancreatic ductal adenocarcinoma (PDAC). Activation of GPER with the specific, small molecule agonist G-1 inhibited PDAC proliferation, depleted c-Myc and programmed death ligand 1 (PD-L1), and increased tumor cell immunogenicity. Systemically delivered G-1 was well tolerated in PDAC bearing mice, significantly prolonged survival, and markedly increased the efficacy of PD-1 targeted immune therapy. We detected GPER protein in a majority of spontaneous human PDAC tumors. These data, coupled with the wide tissue distribution of GPER, and our previous work showing that G-1 inhibits melanoma, suggest that GPER agonists may be useful against many different cancer types.
Proteolytic processing of LRP2 on RPE cells regulates BMP activity to control eye size and refractive error
Authors: Collery Ross F. , Link Brian A.
Published: July 2018

Mutations in LRP2, a transmembrane receptor, cause ocular enlargement and high-myopia. LRP2 is expressed by the RPE and eye ciliary epithelia, binding many extracellular ligands, including Bmp4 and Shh. Signaling mediated by LRP2 is very context-dependent, and how multiple pathways are coordinated is unknown. Transcriptome analyses of ocular tissues revealed that controlled, sustained BMP signaling from the RPE is critical for normal eye growth and emmetropia (proper refraction). Using zebrafish, we demonstrate that BACE sheddase-dependent LRP2 cleavage produces a soluble domain that binds BMP4, inhibiting its signaling. We propose that controlled proteolytic cleavage of LRP2 makes two ligand-binding receptor forms available: a soluble BMP trap, and a membrane-bound RPE signaling facilitator. By modulating LRP2 cleavage, cells can fine-tune and coordinate multiple signaling pathways, as well as growth and turnover of the extracellular matrix, control of which is important to maintain proper eye size. This data supports the concept that LRP2 acts as a homeostasis node that buffers and integrates diverse signaling to regulate emmetropic eye growth.

Author Summary

For proper focusing and normal vision, the axial length of the eye needs to match the refractive power of the lens. This is achieved by fine-tuning multiple signaling pathways to regulate the shape of the eye primarily by remodeling of the sclera, the outermost layer of the eye. This process is termed emmetropization. Emmetropization cues are initiated by visual input, but how signals are transduced from the photoreceptors across the retinal pigment epithelium to the sclera is incompletely understood. Here we show that cleavage of Lrp2, a large receptor expressed on RPE cells in the eye, alters BMP signaling, which contributes to proper eye size control. Dysregulation of BMP signaling by a) absence of Lrp2 in mutant zebrafish or b) overexpression of BMP antagonists from the RPE both cause eye enlargement and myopia. Understanding how regulated cleavage of Lrp2 affects paracrine signaling provides critical insight to emmetropization, raising the possibility for development of therapeutic agents to combat the epidemic incidence of refractive error.
Identifying child victims of the South-East Asia Tsunami in Thailand
Authors: Wright Kirsty , Mundorff Amy , Chaseling Janet , Maguire Christopher , Crane Denis I.
Published: July 2018

Purpose

The purpose of this paper is to reveal difficulties associated with identifying child victims of the 2004 South-East Asia Tsunami at the Thai Tsunami Victim Identification (TTVI) operation in Phuket and explores two strategies that increased child identifications.

Design/methodology/approach

Data allowing comparison of identification proportions between adult and child (defined as ⩽16 years old) victims of six nationalities and the forensic methods used to establish identification were used in this study.

Findings

The first 100 days of the operation revealed that the proportion of adult identifications far outweighed the proportion of child identifications. Moreover, the younger the child, the longer the identification process took (p<0.0001). Children under the age of 1 year took an average of 195 days to identify compared to 130 days for children aged 16. Identification was extended, on average, 4.3 days for each year that victims younger were than 16. Identifying large numbers of child victims requires targeted protocols. Two efforts increased child identifications for the TTVI operation: using body length to distinguish post-mortem (PM) DNA samples potentially belonging to children for targeted testing, and singling out deceased parents of missing children who were previously identified by a modality other than DNA, in order to retrieve and test their PM samples as references for kinship matching. Disaster victim identification operations with similar characteristics may benefit from implementing a strategy targeting child identifications.

Originality/value

The implementation of these two strategies at the TTVI helped to overcome initial complexities, namely, the lack of ante-mortem and PM material, and increased child identifications.
Prioritising solutions for Lean Six Sigma adoption barriers through fuzzy AHP-modified TOPSIS framework
Authors: Yadav Gunjan , Seth Dinesh , Desai Tushar N.
Published: July 2018

Purpose

This paper aims to guide about prioritisation and ranking of the solutions and overcoming barriers to facilitate the adoption of Lean Six Sigma (LSS) by using a hybrid framework.

Design/methodology/approach

It identifies LSS barriers and solutions to facilitate LSS adoption through literature review and by involving subject experts. The study makes use of fuzzy set theory and proposes a fuzzy analytical hierarchy process (AHP)-modified TOPSIS (technique for order preference by similarity to ideal solution) framework. It uses sensitivity analysis to establish framework robustness.

Findings

The key findings of this techno-managerial study are identification and prioritisation of 27 LSS barriers and 22 solutions to overcome adoption challenges, proposition and usage of fuzzy AHP-modified TOPSIS framework, guidance regarding where to focus for facilitating LSS adoption and ensuring robustness using sensitivity analysis, which establishes insignificant deviation in rankings when criteria weights are altered.

Research limitations/implications

Some biasness and subjectivity may exist during pairwise comparisons as human judgements are involved.

Practical implications

Handling a hybrid solution like LSS is never easy. It is expected that the study will help industry professionals to plan their LSS adoption attempts effectively. Guidance regarding LSS barriers will assist in observing necessary precautions to avoid failures. It will open up new research fronts for researchers also.

Originality/value

Literature is full of studies regarding LSS barriers and its rankings. It is very rare to witness a study like ours, which discusses the barriers and links with solutions and its prioritisation. Proposed hybrid framework for a hybrid techno-managerial approach such as LSS is unique and acts as the roadmap for smooth implementation.
Investors overconfidence behaviour at Bombay Stock Exchange
Authors: Mushinada Venkata Narasimha Chary , Veluri Venkata Subrahmanya Sarma
Published: July 2018

Purpose

The purpose of the paper is to empirically test the overconfidence hypothesis at Bombay Stock Exchange (BSE).

Design/methodology/approach

The study applies bivariate vector autoregression to perform the impulse-response analysis and EGARCH models to understand whether there is self-attribution bias and overconfidence behavior among the investors.

Findings

The study shows the empirical evidence in support of overconfidence hypothesis. The results show that the overconfident investors overreact to private information and underreact to the public information. Based on EGARCH specifications, it is observed that self-attribution bias, conditioned by right forecasts, increases investors’ overconfidence and the trading volume. Finally, the analysis of the relation between return volatility and trading volume shows that the excessive trading of overconfident investors makes a contribution to the observed excessive volatility.

Research limitations/implications

The study focused on self-attribution and overconfidence biases using monthly data. Further studies can be encouraged to test the proposed hypotheses on daily data and also other behavioral biases.

Practical implications

Insights from the study suggest that the investors should perform a post-analysis of each investment so that they become aware of past behavioral mistakes and stop continuing the same. This might help investors to minimize the negative impact of self-attribution and overconfidence on their expected utility.

Originality/value

To the best of the authors’ knowledge, this is the first study to examine the investors’ overconfidence behavior at market-level data in BSE, India.
A social exchange perspective for achieving safety culture in healthcare organizations
Authors: Trinchero Elisabetta , Farr-Wharton Ben , Brunetto Yvonne
Published: July 2018

Purpose

Using social exchange theory (SET) and Cooper’s (2000) model, the purpose of this paper is to operationalise a comprehensive model of safety culture and tests whether SET factors (supervisor-employee relationships and engagement) predict safety culture in a causal chain.

Design/methodology/approach

The model was tested using surveys from 648 healthcare staff in an Italian acute care hospital and analysed using structural equation modelling.

Findings

Safety behaviours of clinical staff can be explained by the quality of the supervisor-employee relationship, their engagement, their feelings about safety and the quality of organisational support.

Practical implications

The model provides a roadmap for strategically embedding effective safe behaviours. Management needs to improve healthcare staff’s workplace relationships to enhance engagement and to shape beliefs about safety practices.

Originality/value

The contribution of this paper is that it has empirically developed and tested a comprehensive model of safety culture that identifies a causal chain for healthcare managers to follow so as to embed an effective safety culture.
Antecedents and consequences of intellectual capital
Authors: Allameh Sayyed Mohsen
Published: July 2018

Purpose

The purpose of this paper is to propose and test an integrated model focusing on the drivers and consequences of intellectual capital in the context of the hotel industry.

Design/methodology/approach

A quantitative study was conducted, including 156 hotels located in Iran. Structural equation modeling examines the validity of constructs and path relationships.

Findings

The results of the PLS-SEM analysis provided three findings as follows: the three dimensions of social capital, namely the structural, relational, and cognitive social capital, had positive effects on knowledge sharing; knowledge sharing had positive effects on three components of intellectual capital (human capital, structural capital and relational capital); and intellectual capital dimensions, which in turn, lead to innovation.

Originality/value

The combination of a developing country context and the significance of social capital, knowledge sharing, intellectual capital and innovation in hotel industry enhance the contextual contribution of the paper.
Improving inter-organizational care-cure designs: specialization versus integration
Authors: Pieters Angele , van Oorschot Kim E. , Akkermans Henk A. , Brailsford Sally C.
Published: July 2018

Purpose

The purpose of this paper is to investigate inter-organizational designs for care–cure conditions in which low-risk patients are cared for in specialized care organizations and high-risk patients are cared for in specialized cure organizations. Performance impacts of increasing levels of integration between these organizations are analyzed.

Design/methodology/approach

Mixed methods were used in Dutch perinatal care: analysis of archival data, clinical research and system dynamics simulation modeling.

Findings

Inter-organizational design has an effect on inter-organizational dynamics such as collaboration and trust, and also on the operational aspects such as patient flows through the system. Solutions are found in integrating care and cure organizations. However, not all levels of integrated designs perform better than a design based on organizational separation of care and cure.

Practical implications

A clear split between midwifery practices (care) and obstetric departments (cure) will not work since all pregnant women need both care and cure. Having midwifery practices only works well when there are high levels of collaboration and trust with obstetric departments in hospitals. Integrated care designs are likely to exhibit superior performance. However, these designs will have an adverse effect on organizations that are not part of this integration, since integrating only a subset of organizations will feed distrust, low collaboration and hence low performance.

Originality/value

The originality of this research is derived from its multi-method approach. Archival data and clinical research revealed the dynamic relations between organizations. The caveat of some integrated care models was found through simulation.
Conflict as it happens
Authors: Kykyri Virpi-Liisa , Puutio Risto
Published: July 2018

Purpose

Although emotions are relevant for conflicted interactions, the role of emotions in organizational conflicts has remained understudied. The purpose of this paper is to contribute to this by looking at the role of nonverbal affective elements in conversations.

Design/methodology/approach

Bringing together organizational “becoming” and embodiment approaches, the study focused on a conflict which emerged during a multi-actor consulting conversation. The episode in question was analyzed via a detailed, micro-level discursive method which focused specifically on the participants’ use of prosodic and nonverbal behaviors.

Findings

Changes in prosody were found to have an important role in how the conflict between a consultant and an employee client emerged and was handled. Nonverbal and prosodic means had a central role in creating legitimate space for the employees’ feelings: they helped to validate the feelings and thus led the interlocutors to act in a more constructive manner in their handling of the conflicted situation.

Research limitations/implications

Findings are based on a single case study. Multi-modal analysis proved effective in capturing the relevant interactions in a comprehensive manner.

Practical implications

Conversational “traps” may be observed by becoming alert to interactional patterns involving repeated chains of actions. A nonverbal response, validating the interlocutor as someone who is entitled to her/his feelings, can be sufficient in providing emotional help in consultancy.

Social implications

Nonverbal elements of interactions are important in handling delicate issues in conflicts.

Originality/value

To the authors’ knowledge, no previous organizational research has provided a detailed description of a conflicted interaction “as it happened” between clients and a consultant.
Ambiguous spaces: the charity-NGO nexus in Iceland
Authors: Rice James Gordon , Wojtyńska Anna
Published: July 2018

Purpose

The purpose of this paper is to provide a case study which analyses the ambiguous relationship that Icelandic charities and NGOs have with the formal social welfare services they collaborate with as well as the clients they serve.

Design/methodology/approach

The paper is based upon the combined work of both authors and drawn from a number of projects spanning the years immediately preceding the Icelandic economic crisis of 2008, through to the years of crisis and recovery, and into the present context. This contribution is a combination of a re-analysis of older material combined with new data and emergent issues.

Findings

The contribution argues charities and NGOs in Iceland operate within an ambiguous space, not part of the formal welfare authorities yet in practice in collaboration with them. One danger is that the charitable environment offers no clear legal protections concerning client rights or entitlements to assistance, or grievance redress mechanisms typical of the formal social assistance schemes. Further, the ways in which charities exclude certain segments of the population is troubling, particularly in consideration of the lack of protections and the willingness of governments to download the costs of and responsibilities for services to non-professional and private charities and NGOs.

Social implications

The findings are intended to contribute toward encouraging critical discussion about the appeal of charity as a service alternative in the context of governmental cutbacks and austerity measures.

Originality/value

The findings are based upon limited but original case studies in Iceland.
Green consumption: a network analysis in marketing
Authors: Semprebon Elder , Mantovani Danielle , Demczuk Rafael , Souto Maior Cecilia , Vilasanti Victoria
Published: July 2018

Purpose

Considerable research has been performed to understand green consumption behavior. Given the emergence of this discussion, the purpose of this paper is to apply network analytical techniques to identify the main theoretical relationships regarding green consumption in the most relevant journals between 2000 and 2016.

Design/methodology/approach

This paper applies a fit-for-purpose systematic review using network analysis, which includes a screening of 4,049 articles published in 39 journals in the business and marketing subjects, ranked by the Q1 extract of SCImago Journal & Country Rank, accessed between March and July 2017. From 2000 to 2016, 216 articles were selected in 24 journals. The explored variables formed 21 categories.

Findings

Five network groups emerged according to the background theories used by green consumption studies: “Consumers’ and companies’ characteristics and actions,” “Consumer intentions, perceptions and their cognitive mechanisms,” “Environmental concern effects,” “Attitudes toward green expertise” and “Behavioral control”. The findings showed what variables have a central relevance to the network, being essential to explain green consumption phenomenon, exploring relations and pointing out gaps for future studies.

Practical implications

Based on the strongest connections between the network groups, practical implications are offered for marketers interested in developing actions promoting green consumption.

Originality/value

This paper identifies the main categories related to green consumption in a network analysis, showing its antecedents and consequents grouped in five clusters. These results indicate that there are relationships still awaiting further investigation.
Neighborhood by neighborhood: community policing in a rust belt city
Authors: Cooley Will , Bemiller Michelle , Jefferis Eric , Penix Rose
Published: July 2018

Purpose

The purpose of this paper is to examine citizen satisfaction with police services and perceived safety using survey research in two high crime neighborhoods. Problem-oriented crime deterrence strategies were used in one neighborhood, the other served as a control group.

Design/methodology/approach

Mixed-methods approach was used to measure the effectiveness of problem-oriented approaches in persistent high-crime areas. Pre- and post-intervention surveys were conducted by sampling addresses in both neighborhoods and analyzing results.

Findings

No between-neighborhood differences were reported regarding the satisfaction with police services or improvement in perceived safety.

Originality/value

These findings suggest that this deterrence strategy is a promising approach to reducing crime while not damaging community perceptions. However, departments must vary place-based strategies, and prevention is difficult given historical contexts, the absence of credible community partners and limited resources in a declining city.
Generality of associations between biological richness and the rates of metabolic processes across microbial communities
Authors: Patsch Deborah , van Vliet Simon , Marcantini Lorenzo Garbani , Johnson David R.
Published: July 2018

Biological richness is positively associated with the rates of some metabolic processes performed by microbial communities. It remains unclear, however, whether these positive associations are a general feature of the metabolic processes performed by microbial communities or whether they are specific to certain types of metabolic processes. For example, it was hypothesized that the strength of any particular positive association depends on how many different genotypes within a microbial community perform the metabolic process of interest (i.e. the ‘rarity hypothesis’). We tested the generality of these positive associations by measuring the taxonomic richness, functional gene richness and rate constants for 71 different metabolic processes across 30 independent microbial communities. We found that both taxonomic and functional gene richness do indeed tend to positively associate with the rates of metabolic processes. In addition, we found that positive associations occur across a wide range of different environmental conditions. Counter to the ‘rarity hypothesis’, however, we did not detect a relationship between the strengths of the positive associations and the rarity of each metabolic process. Together, our data provide empirical evidence that positive associations with biological richness may indeed be a general feature of the metabolic processes performed by microbial communities.
Integration of MRI target delineation into rapid workflow cervical cancer brachytherapy: Impact on clinical outcomes
Authors: Dutta Sunil W , Trifiletti Daniel M , Pugh Kelly J , Romano Kara D , Libby Bruce , Showalter Timothy N
Published: July 2018

Introduction

We evaluated the impact of MRI‐based target delineation on toxicity and tumour control after implementation of a protocol to incorporate MRI while minimizing impact on overall procedural time.

Methods

We retrospectively reviewed outcomes for a cohort of 96 consecutive patients who received intracavitary brachytherapy for cervical cancer at our institution during 2012–2016. Starting in October 2014, an outpatient MRI was obtained for patients after Smit sleeve placement and first insertion to assess concurrent chemoradiotherapy tumour response. Then, for subsequent fractions, the MRI was co‐registered by the Smit sleeve to the planning CT for target volume delineation. The primary and secondary outcomes were toxicity and local control, respectively.

Results

Median follow‐up for the pre‐ (n = 50) and post‐MRI‐based (n = 46) planning groups was 24.6 and 14.7 months, respectively. Median treatment duration for patients before and after MRI implementation was 56 and 58 days (P = 0.052), respectively. Cumulative rectal D2 cc was less for those with MRI‐based target delineation (P = 0.005). On multivariable analysis, patients with MRI‐based target delineation experienced fewer severe late (CTCAE grade ≥ 3) toxicities (P = 0.025, hazard ratio = 0.25). Local control was 86% and 91% of the pre‐ and post‐MRI groups, respectively (P = 0.959).

Conclusions

Preliminary findings using this technique, which is applicable to other institutions without in‐room MRI availability, are associated with lower radiation prescription doses, lower rectal doses and favourable toxicity rates while maintaining a rapid workflow. Longer follow‐up is required to confirm equivalent local control.
First record of the subfamily Psallopinae (Heteroptera: Miridae) from Australia and discussion of its systematic position and diagnostic characters
Authors: Namyatova Anna A. , Cassis Gerasimos
Published: July 2018

Psallopinae are the smallest subfamily within the heteropteran family Miridae, including only two extant genera and 18 species. This group is widely distributed in the Old World but previously has never been recorded from Australia. In this work, Psallopinae is recorded for the first time from the Australian continent, with the description of three new species of Psallops Usinger . A comparison of the Australian taxa with extralimital species is provided. The distribution of Psallops in Australia, the morphology of the genus and the systematic position of Psallopinae within Miridae are discussed.
Primary uterine lymphoma: The Yokohama Cooperative Study Group for Hematology (YACHT) study
Authors: Ishii Yoshimi , Fujisawa Shin , Ando Taiki , Suzuki Taisei , Ishiyama Yasufumi , Kishimoto Kumiko , Hattori Yukako , Nakajima Yuki , Miyazaki Takuya , Takasaki Hirotaka , Matsumoto Kenji , Koharazawa Hideyuki , Taguchi Jun , Fujimaki Katsumichi , Sakai Rika , Nakajima Hideaki
Published: July 2018

Aim

Primary malignant lymphomas arising from the female genital tract are very rare, with an incidence rate of 0.5%. Because of its rarity, its clinical characteristics, prognosis and optimal treatment are still unclear. Here, we retrospectively evaluated female patients with uterine lymphoma.

Methods

Between January 2000 and October 2016, 4362 patients were newly diagnosed with malignant lymphoma by the participating institutions of YACHT. Among these 4362 patients, we retrospectively evaluated 14 adult patients with primary uterine lymphoma.

Results

The median follow up time was 41 months. The median age at diagnosis was 68 years. Of 14 patients, 10 (72%) were diagnosed with diffuse large B‐cell lymphoma. Seven patients presented with vaginal bleeding and three with abdominal pain. Eleven patients (79%) had advanced stages at diagnosis. Three patients (21%) had ovarian involvement and 2 (14%) had vaginal involvement. Induction chemotherapy regimens were R‐CHOP in seven patients (50%), CHOP in three (21%) and other regimens in four (29%). Among 14 patients, 12 patients (86%) achieved a complete response and 2 (14%) experienced disease progression. Three patients (21%) showed relapse. Five patients (36%) died because of malignant lymphoma. The 3‐year overall survival rate was 57.9%. Soluble interleukin‐2 receptor levels > 5000 U/mL, anemia, a bulky mass and the presence of > 1 extranodal sites, B symptom at diagnosis were associated with a poor prognosis.

Conclusion

Female genital lymphoma is very rare, and further study of more cases is warranted.
Regression of a metastatic lung mass after receiving whole brain irradiation: Can the abscopal effect cross the blood–brain barrier?
Authors: Chuang Cheng‐Hao , Hsu Jui‐Feng , Shen Yu‐Ting , Yang Chih‐Jen
Published: July 2018

An abscopal effect refers to distant tumor regression after localized irradiation. The mechanism is thought to be via local radiotherapy triggering the immune system which then attacks distant tumor sites. Only several cases of solid tumors with an abscopal effect have been reported in the past few decades, and whether an abscopal effect can cross the blood–brain barrier is still unknown.

Herein, we present a female patient who was admitted due to unsteady gait and dyspnea. Chest X‐ray (CXR) and chest CT showed a huge lung mass with left lung collapse and multiple liver masses. Brain MRI also showed multiple brain metastases. A bronchoscopic biopsy proved metastatic adenocarcinoma from colorectal cancer based on immunohistochemical staining. She therefore received 30 Gy (10 fractions) for the brain metastases; however, she refused to receive any systemic therapy for her lung mass and asked for hospice care. She was therefore transferred to a nursing home and was lost to follow‐up. She returned 2 months later due to right pneumonia with fever and productive cough. Surprisingly, her left lung mass had markedly regressed even though she had not received any additional systemic anticancer therapy. This may be the first case of an abscopal effect after receiving whole brain irradiation for brain metastases.
Gestational diabetes mellitus is associated with increased CD163 expression and iron storage in the placenta
Authors: Barke Theresa L. , Goldstein Jeffery A. , Sundermann Alexandra C. , Reddy Arun P. , Linder Jodell E. , Correa Hernan , Velez‐Edwards Digna R. , Aronoff David M.
Published: July 2018

Problem

GDM has been associated with disturbances in iron homeostasis and exaggerated immune activation. We sought to investigate the extent to which placental iron storage and macrophage accumulations were altered in GDM.

Method of Study

We conducted a retrospective, case‐control study of archived placental tissues obtained from 22 pregnancies complicated by GDM and 22 unaffected controls. Controls were matched to cases based on maternal age, gestational age at birth, and method of delivery. Placental tissues were assessed for altered histology and CD68 and CD163 staining. Tissue iron was assessed using Prussian blue staining.

Results

Maternal hematocrit levels were higher in GDM participants compared to controls (P = 0.02). The presence of meconium‐laden macrophages was significantly greater within the amnion of GDM cases (adjusted odds ratio (OR) 12.51). Although the total abundance of CD68‐expressing macrophages was not significantly different between groups, we detected a significantly greater abundance of CD163 expression within the chorion and decidua of cases. The total area staining positive for iron was 24% (95% confidence intervals of 2%‐46%) greater in GDM placentae versus controls.

Conclusion

GDM is associated with altered placental histology and increases in meconium‐laden macrophages. Greater iron stores within the placentae of women with GDM is consistent with reports that iron excess is associated with an increased risk for GDM. The higher level of expression of CD163 on macrophage‐like cells of the chorion and decidua in GDM suggests an increase in M2‐like macrophages. Overall, our results add to growing evidence that GDM has direct effects on placental structure.
Laparoscopic transabdominal cerclage in pregnancy: A single centre experience
Authors: Ades Alex , Aref‐Adib Mehrnoosh , Parghi Sneha , Hong Phoebe
Published: July 2018

Background

Transabdominal cerclage can reduce the risk of preterm birth in women with cervical insufficiency.

Aims

This study evaluated outcomes following insertion of a laparoscopic transabdominal cerclage in pregnant women.

Materials and methods

A retrospective observational study. Patients: pregnant women who underwent laparoscopic transabdominal cerclage from 2011 to 2017. Eligible women had cervical insufficiency and were not suitable for a transvaginal cerclage. Intervention: the insertion of a laparoscopic transabdominal cerclage in the pregnancy. Measurements: neonatal survival, delivery of an infant at ≥34 weeks gestation and surgical morbidity were evaluated.

Results

Of 19 women who underwent laparoscopic transabdominal cerclage in pregnancy, at 6–11 weeks gestation, the perinatal survival rate was 100%. There were no complications. The average gestational age at delivery was 37.1 weeks. Sixteen women delivered after 34 weeks.

Conclusions

Laparoscopic transabdominal cerclage is a safe and effective procedure in women with poor obstetric histories. It requires the correct skill, expertise and patient selection.
A‐kinase anchor protein 4 precursor (pro‐AKAP4) in human spermatozoa
Authors: Jumeau F. , Sigala J. , Dossou‐Gbete F. , Frimat K. , Barbotin A. L. , Buée L. , Béhal H. , Sergeant N. , Mitchell V.
Published: July 2018

Background

A‐kinase anchor protein 4 (AKAP4) and its precursor pro‐AKAP4 are two major proteins in spermatozoa of rodents and mammals. Although researchers have characterized the AKAP4 expression in various species, the protein's expression in humans has not been described in detail.

Objectives

The objective of this study was to characterize human pro‐AKAP4 more precisely (notably the definition of its localization and expression levels in human spermatozoa and testes).

Materials and Methods

pro‐AKAP4 protein expression levels were assessed by Western blotting. The pro‐AKAP4's localization in spermatozoa and testes was determined using immunofluorescence staining and immunogold electron microscopy. Furthermore, pro‐AKAP4 protein expression levels were assessed in a series of 77 human semen samples, and associations with semen parameters were evaluated.

Results

Western blotting revealed a 100‐kDa band in human sperm protein extracts. The pro‐AKAP4 was immunolocalized in the fibrous sheath of the flagellum of ejaculated spermatozoa and in elongated spermatids in human testes. A Western blot analysis of 77 normozoospermic semen samples evidenced striking differences in pro‐AKAP4 levels from one to another sample (median [interquartile range] integrated optical density = 305 [49–1038]). No correlations were found for pro‐AKAP4 levels on one hand and semen volume, sperm concentration, sperm count, sperm motility, or sperm morphology on the other (p > 0.05 for all). However, pro‐AKAP4 levels were positively correlated with motility after density gradient centrifugation of the semen (r = 0.224, p = 0.049).

Discussion

AKAP4 protein might be activated as an alternative pathway to rescue sperm motility. In human spermatozoa, pro‐AKAP4 might therefore be a ‘reservoir’ of mature AKAP4.

Conclusion

This study generated new knowledge about pro‐AKAP4 in human semen, which may be of interest in the management of male infertility.
“Lambda‐wave” ST‐elevation is associated with severe prognosis in stress (takotsubo) cardiomyopathy
Authors: Tarantino Nicola , Santoro Francesco , Guastafierro Francesca , Di Martino Luigi F. M. , Scarcia Maria , Ieva Riccardo , Ruggiero Antonio , Cuculo Andrea , Mariano Enrica , Di Biase Matteo , Brunetti Natale Daniele
Published: July 2018

Background

Persistent ST‐segment elevation in acute coronary syndrome is associated with both short and long‐term complications. By contrast, there is limited information about ST‐elevation and its evolution during takotsubo (stress) cardiomyopathy (TTC).

Aim

To evaluate whether persistent downsloping ST‐elevation in the early stages of TTC might correlate with short and long‐term clinical events.

Methods

One‐hundred fifty‐eight consecutive subjects with TTC were prospectively enrolled and assessed by electrocardiogram. Patients were classified in two groups according to the presence of downsloping ST‐elevation ≥5 mm lasting at least 24 hr (“lambda‐wave” ST‐elevation group vs. without downsloping ST‐elevation) in at least one/two contiguous leads.

Results

Five (3.2%) patients, all female with a mean left ventricular ejection fraction 32 ± 5%, were included in the lambda‐wave ST‐elevation group. These patients were characterized by a higher prevalence of physical stressor (100% vs. 49%, p = 0.04) and higher admission and peak levels of troponin‐I levels during hospitalization. Peak of ST‐elevation in the lambda‐wave ST‐elevation group was reached 6 hr after admission and gradually decreased after 24 hr. In‐hospital complications were observed in all the patients presenting lambda ST‐elevation (100% vs. 23%, p = 0.03, OR: 29.1, p = 0.04); one patient presented endoventricular thrombosis and two died of cardiogenic shock. At long‐term follow‐up (mean 443 days), adverse events were observed in 80% of patients with lambda‐wave ST‐elevation (RR of adverse events at follow‐up 32, p < 0.01).

Conclusion

Persistent downsloping lambda‐wave ST‐elevation during the acute phase of stress cardiomyopathy may be associated with a higher risk of adverse events at short and long‐term follow‐up.
Peristomal pyoderma gangrenosum: 12‐year experience in a single tertiary referral centre
Authors: Toh James W. T. , Young Christopher J. , Rickard Matthew J. F. X. , Keshava Anil , Stewart Peter , Whiteley Ian
Published: July 2018

Background

Peristomal pyoderma gangrenosum (PPG) is an unusual but potentially devastating condition that is difficult to diagnose and manage.

Methods

This was a single centre, retrospective review of a prospectively collected database. Included were consecutive patients referred to a stoma therapy clinic at a single institution between 2005 and 2016. Main outcomes of interest were management strategies and outcome of patients with PPG including time to healing and recurrence.

Results

Of 1295 consecutive patients who underwent stoma formation, 12 patients with PPG were identified. The mean age at the time of diagnosis of PPG was 43.5 years (range 19–72 years). Five cases (41.7%) were associated with Crohn's disease and five cases (41.7%) with ulcerative colitis. The median duration of days between stoma formation and PPG diagnosis was 101.5 days (mean duration was 670 days (range 14–2641 days)). Nearly all patients (91.7%) were referred to a dermatologist. Majority (66.7%) were managed in an outpatient setting. For those requiring inpatient management, the mean length of stay was 13.5 days (range 3–31 days). Five patients had a biopsy and seven patients were diagnosed with PPG by dermatologist without biopsy. A range of oral and topical steroids, steroid injections, dressings, anti‐inflammatories, antibiotics, tacrolimus and analgesia was used in the management of PPG. All patients achieved complete healing of PPG, with only one patient developing a recurrence of PPG. The mean duration of time to achieve complete healing of PPG was 282 days (range 28–1751 days).

Discussion

Medical management of PPG was effective with complete healing and low recurrence. The average duration to complete healing of PPG was approximately 9 months.
Systematic review with meta‐analysis: anxiety and depression in children and adolescents with inflammatory bowel disease
Authors: Stapersma L. , van den Brink G. , Szigethy E. M. , Escher J. C. , Utens E. M. W. J.
Published: July 2018

Background

The co‐existence of psychological problems and paediatric inflammatory bowel disease (IBD) is receiving increasing attention. Most studies investigated anxiety and depression, with prevalence rates varying from 0% to 50%. A systematic review is necessary to provide clear insight into the prevalence of anxiety and depression in paediatric IBD.

Aim

To systematically evaluate available data on the prevalence of anxiety and depressive symptoms and disorders in paediatric IBD (aged 6‐18 years).

Methods

Comprehensive searches were performed in Embase, Medline Ovid, Web of Science, Cochrane, PubMed, PsychInfo Ovid, and Google scholar for studies published from 1994 to 2017. Pooled prevalence rates were calculated using inverse variance heterogeneity models. Meta‐regression was used to study if disease type, disease activity and gender influence prevalence.

Results

Twenty‐eight studies (N = 8107, mean age: 14.3) were identified. Pooled prevalence estimates were 16.4% (95% confidence interval [CI] 6.8%‐27.3%) for anxiety symptoms and 4.2% (95% CI 3.6%‐4.8%) for anxiety disorders. Pooled prevalence estimates were 15.0% (95% CI 6.4%‐24.8%) for depressive symptoms and 3.4% (95% CI 0%‐9.3%) for depressive disorders. Meta‐regression showed no influence of disease type or gender on these prevalence rates, but studies with a higher percentage of active disease had a higher rate of depressive symptoms.

Conclusions

The described pooled prevalence of anxiety and depressive symptoms is lower than in adult IBD. However, due to varying instruments/cut‐offs for measuring symptoms and few studies investigating disorders, the results should be interpreted with caution. Cross‐cultural use of the same instruments is needed to gain better insight into prevalence rates.
Systematic review with meta‐analysis: the prevalence of coeliac disease in patients with osteoporosis
Authors: Laszkowska M. , Mahadev S. , Sundström J. , Lebwohl B. , Green P. H. R. , Michaelsson K. , Ludvigsson J. F.
Published: July 2018

Background

Earlier studies have produced highly varying risk estimates for the prevalence of coeliac disease (CD) in osteoporosis.

Aims

To investigate the prevalence of CD among individuals with osteoporosis.

Methods

We conducted a systematic review of articles published in PubMed, Medline or EMBASE through May 2017 to identify studies looking at prevalence of CD in patients with osteoporosis. Search terms included “coeliac disease” combined with “fractures”, “bone disease”, “bone density”, “densitometry”, “osteoporos*”, “osteomal*”, “osteodys” or “dexa” or “dxa” or “skelet”. Non‐English papers with English‐language abstracts were included. We used fixed‐effects inverse variance‐weighted models, and tested heterogeneity through subgroup analysis as well as through meta‐regression.

Results

We identified eight relevant studies, comprising data from 3188 individuals with osteoporosis. Of these, 59 individuals (1.9%) had CD. A weighted pooled analysis demonstrated biopsy‐confirmed CD in 1.6% (95% CI = 1.1%‐2.0%) of individuals with osteoporosis. The heterogeneity was moderate (I2 = 40.1%), and influenced by the underlying CD prevalence in the general population. After adding four studies (n = 814) with CD defined as positive tissue transglutaminase or endomysial antibodies, the pooled prevalence was comparable (1.6%; 95% CI = 1.2%‐2.0%).

Conclusions

About 1 in 62 individuals with osteoporosis, or 1.6%, have biopsy‐verified CD. This prevalence is comparable to that in the general population. These findings argue against routinely screening patients with osteoporosis for CD, which is contrary to current guideline recommendations. Additional studies are needed to determine the true utility of such screening programs.
The absent presence: Children's place in narratives of human trafficking
Authors: Blazek Matej , Esson James
Published: July 2018

This paper uses in‐depth qualitative data, obtained as part of research examining human trafficking from Slovakia to the United Kingdom, to explore the place of children in human trafficking processes. Rather than foregrounding cases of children as direct subjects of abuse, the paper focuses on instances where children are used to control, manipulate and exploit relatives embroiled in human trafficking. We study examples when children are moved across national borders and those when they remain in the home country, and show how in both accounts their (absent) presence constitutes a significant means for facilitating, maintaining and intensifying the exploitation of their adult relatives. Through doing so, the paper demonstrates how identifying the distinct spaces and moments within which children appear in narratives of exploitation has the potential to uncover nefarious practices occurring within the human trafficking process, as well as the indirect effects of human trafficking on family dynamics. The paper extends conceptual understandings of agency in human trafficking by illustrating how children are simultaneously subjects of exploitation and emplaced through complex channels within the exploitation of others.