bluuebunny/crossref_metadata_2025 huggingface dataset:
2‐Phenyl‐2‐propanol in Urin [Biomonitoring Methods in German language, 2012]
Authors: Knecht U.
Published: October 2014

Veröffentlicht in der Reihe
Analytische Methoden zur Prüfung gesundheitsschädlicher Arbeitsstoffe: Analysen in biologischem Material
, 20. Lieferung, Ausgabe 2012

Der Artikel enthält folgende Kapitel:

Grundlage des Verfahrens

Geräte, Chemikalien und Lösungen

Geräte

Chemikalien

Lösungen

Vergleichsstandards

Probenahme und Probenaufbereitung

Instrumentelle Arbeitsbedingungen

Analytische Bestimmung

Kalibrierung

Berechnung der Analysenergebnisse

Standardisierung der Messergebnisse und Qualitätssicherung

Beurteilung des Verfahrens

Präzision

Richtigkeit

Nachweis‐ und Bestimmungsgrenze

Störeinflüsse

Diskussion der Methode
Cutaneous Ulceration in Dermatomyositis: Association With Anti–Melanoma Differentiation–Associated Gene 5 Antibodies and Interstitial Lung Disease
Authors: Narang Neera S. , Casciola‐Rosen Livia , Li Shufeng , Chung Lorinda , Fiorentino David F.
Published: October 2014

Objective

To identify clinical and serologic correlates of cutaneous ulcers in dermatomyositis (DM).

Methods

We retrospectively examined a cohort of 152 DM patients. We compared the features of patients with ulcers to those without ulcers using chi‐square or Fisher's exact tests and used univariate and multivariate logistic regression models to assess the association between ulcers and clinical features such as malignancy, interstitial lung disease (ILD), and amyopathic disease.

Results

Forty‐three patients (28%) had cutaneous ulcers. Nearly half the patients had ulcers present in more than 1 location: 24 (56%) had ulcers over the extensor surfaces of joints, 18 (42%) at the digital pulp or periungual areas, and 25 (58%) had ulcers located elsewhere. In univariate analysis ulcers were associated with Asian race, but not with other clinical and demographic features, including malignancy or ILD. In multivariate analysis ulcers were significantly associated with anti–melanoma differentiation gene 5 (anti‐MDA5) antibodies (odds ratio 10.14, 95% confidence interval 1.95–52.78; P = 0.0059) and this was greatest for ulcers located at the digital pulp. In patients with cutaneous ulcers, ILD risk was specifically increased only in patients with anti‐MDA5‐positive antibodies.

Conclusion

We confirmed the strong association between anti‐MDA5 antibodies and cutaneous ulcers, with the novel finding that the association of cutaneous ulcers with ILD depends upon the presence of anti‐MDA5 antibodies. DM patients who display this cutaneous phenotype should undergo appropriate evaluation for ILD.
A Population‐Based Study of Infection‐Related Hospital Mortality in Patients With Dermatomyositis/Polymyositis
Authors: Murray Sara G. , Schmajuk Gabriela , Trupin Laura , Lawson Erica , Cascino Matthew , Barton Jennifer , Margaretten Mary , Katz Patricia P. , Yelin Edward H. , Yazdany Jinoos
Published: October 2014

Objective

Dermatomyositis (DM) and polymyositis (PM) are debilitating inflammatory myopathies associated with significant mortality. We evaluated the relative contribution of infection to hospital mortality in a large population‐based study of individuals with PM/DM.

Methods

Data derive from the 2007 to 2011 Healthcare Cost and Utilization Project National Inpatient Samples and include all hospital discharges that met a validated administrative definition of PM/DM. The primary outcome was hospital mortality. Variables for infections and comorbidities were generated from discharge diagnoses using validated administrative definitions. Logistic regression was used to investigate the relationship between infection and mortality in individuals with PM/DM, adjusting for sociodemographics, utilization variables, and comorbidities. Relative risks (RRs) were calculated to compare the overall prevalence of specific infections and associated mortality in PM/DM hospitalizations with those seen in the general hospitalized population.

Results

A total of 15,407 hospitalizations with PM/DM met inclusion criteria for this study and inpatient mortality was 4.5% (700 deaths). In adjusted logistic regression analyses, infection (odds ratio [OR] 3.4, 95% confidence interval [95% CI] 2.9–4.0) was the strongest predictor of hospital mortality among individuals with PM/DM. Bacterial infection (OR 3.5, 95% CI 3.0–4.1), comprised primarily of pneumonia and bacteremia, and opportunistic fungal infections (OR 2.5, 95% CI 1.5–4.0) were independently associated with hospital mortality. The overall burden of infection in hospitalizations with PM/DM was significantly increased in comparison with the general hospitalized population (RR 1.5, 95% CI 1.4–1.6).

Conclusion

Among hospitalized individuals with PM/DM, infection is the leading cause of mortality. Strategies to mitigate infection risk in both the clinic and hospital settings should be evaluated to improve disease outcomes.
Fully distributed tracking control for non‐identical multi‐agent systems with matching uncertainty
Authors: Zhao Y. , Duan Z. S. , Wen G. H. , Li Z. K. , Chen G. R.
Published: October 2014

This article addresses the fully distributed consensus tracking control problem of linear multi‐agent systems with parameter uncertainties. First, a new class of distributed protocol, based on the relative states of neighbors, is proposed. Theoretical analysis indicates that the considered problem can be solved if the control gain constant of the protocol is larger than the norm bound of the leader's nonlinear inputs. Furthermore, a distributed adaptive control protocol is proposed for the case without available global information. The distributed consensus tracking control problem of uncertain linear multi‐agent systems is solved based only on local information under the proposed adaptive protocol. Finally, an application in low‐Earth‐orbit satellite formation flying is provided to illustrate the theoretical results. Copyright © 2014 John Wiley & Sons, Ltd.
Multi‐Site Functionalization of Protein Scaffolds for Bimetallic Nanoparticle Templating
Authors: Huggins Kelly N. L. , Schoen Alia P. , Arunagirinathan Manickam Adhimoolam , Heilshorn Sarah C.
Published: October 2014

The use of biological scaffolds to template inorganic material offers a strategy to synthesize precise composite nanostructures of different sizes and shapes. Proteins are unique biological scaffolds that consist of multiple binding regions or epitope sites that site‐specifically associate with conserved amino acid sequences within protein‐binding partners. These binding regions can be exploited as synthesis sites for multiple inorganic species within the same protein scaffold, resulting in bimetallic inorganic nanostructures. This strategy is demonstrated with the scaffold protein clathrin, which self‐assembles into spherical cages. Specifically, tether peptides that noncovalently associate with distinct clathrin epitope sites, while initiating simultaneous synthesis of two inorganic species within the assembled clathrin protein cage, are designed. The flexibility and diversity of this unique biotemplating strategy is demonstrated by synthesizing two types of composite structures (silver–gold mixed bimetallic and silver–gold core–shell nanostructures) from a single clathrin template. This noncovalent, Template Engineering Through Epitope Recognition, or TEThER, strategy can be readily applied to any protein system with known epitope sites to template a variety of bimetallic structures without the need for chemical or genetic mutations.
Enhanced Optical Property with Tunable Band Gap of Cross‐linked PEDOT Copolymers via Oxidative Chemical Vapor Deposition
Authors: Lee Sunghwan , Gleason Karen K.
Published: October 2014

Highoptical transmittance conjugated‐polymers with electrical conductivity are garnering much attention for the applications in organic optoelectronic devices including organic field‐effect‐transistors and solar cells. Polymers based on PEDOT are particularly promising candidates with high conductivity, uniform surface planarity and excellent ductility. In this work, homopolymer PEDOT deposited using oxidative chemical‐vapor‐deposition(oCVD) show the maximum conductivity of ≈3500 S/cm. However, their utility is limited due to the relatively low transmittance and abrupt decrease near the red edge in the visible regime. Here, the significantly improved optical properties achieved via tuning the bandgap of cross‐linked PEDOT copolymers using oCVD, offering a single‐step process for the synthesis and deposition of copolymer films, is reported. The cross‐linking monomers of biphenyl or anthracene are simultaneously evaporated with EDOT monomer and an oxidant(FeCl3) during the deposition. Poly(anthracene‐co‐EDOT)[p(ANTH‐co‐EDOT)] shows the superior transmittance (≈93%) to homopolymer PEDOT (≈80%) and poly(biphenyl‐co‐EDOT)[p(BPH‐co‐EDOT)] (≈88%). Additionally, copolymers show no transmission decay in the red edge regime unlike homopolymer PEDOT that presents an abrupt transmission falloff. An improvement in optical transmittance is in agreement with an increase in bandgap of materials (p(ANTH‐co‐EDOT), ≈2.3eV vs PEDOT, ≈1.8 eV). oCVD‐processed bandgap‐tunable PEDOT copolymers with enhanced transmittance may, therefore, have applications in organic optoelectronic devices that require high optical transparency.
Parallel models for arborescent polyisobutylene synthesized in batch reactor
Authors: Zhao Yutian R. , McAuley Kimberley B. , Puskas Judit E.
Published: October 2014

A mathematical model is developed for estimating kinetic parameters that influence the production of arborescent polyisobutylene via carbocationic copolymerization of inimer (IM) and isobutylene. Six different propagation rate constants arise due to the two types of vinyl groups and three types of carbocations. These six parameters are estimated using parallel simulation systems in PREDICI that track (1) functional groups, (2) internal and dangling segments in the polymer, and (3) concentrations of IM and polymer molecules. Parameter estimates obtained using the proposed model result in a better fit to literature data than was obtained using a previous model that neglected two types of propagations reactions. Predictions from the proposed model are consistent with Monte Carlo simulations for molecular weight distribution of the internal and dangling segments. © 2014 American Institute of Chemical Engineers AIChE J, 61: 253–265, 2015
Relative leg length is associated with type 2 diabetes differently according to pubertal timing: The Brazilian longitudinal study of adult health
Authors: Mueller Noel T. , Duncan Bruce B. , Barreto Sandhi M. , Chor Dora , Vigo Alvaro , Aquino Estela M.L. , Demerath Ellen W. , Schmidt Maria Inês
Published: October 2014

Objectives

Studies from developed societies have shown that individuals with short legs relative to height have higher risk of type 2 diabetes. This has been much less explored in less developed populations where influences on relative leg length and diabetes may differ. The Brazilian Longitudinal Study of Adult Health (in Portuguese, ELSA‐Brasil) allows us to test, in a cohort born (1934–1975) and raised when undernutrition was common, whether short legs relative to height is positively associated with diabetes, independent of early‐life factors, including birth weight, age at menarche, and young‐adult BMI.

Methods

We used baseline, cross‐sectional data from 15,105 participants aged 35–74 years participating in ELSA‐Brasil. We created age‐and‐sex‐specific Z scores for leg length index (leg length/height × 100) according to an external reference. Diabetes was defined by self‐reported physician diagnosis, medication use, fasting and 2‐h post‐75‐g‐load glucose, and A1C.

Results

A one‐unit decrement in leg‐length‐index Z score was associated with 12% (8–17%) higher prevalence of diabetes in Brazilian adults, after adjustment through Poisson regression for confounders, including race, maternal education, and birth weight. This association persisted after further adjustment for menarche age, BMI (at age 20), buttocks circumference, and waist circumference. It was stronger among women with early menarche (P interaction = 0.02). Leg length index was also inversely associated with fasting glucose, fasting insulin, 2‐h glucose, and A1C (P < 0.05).

Conclusions

In contemporary Brazilian adults, short legs relative to height is positively associated with diabetes independent of measures of intrauterine growth, pubertal timing, and young‐adult adiposity. This association is stronger in women with early menarche. Am. J. Hum. Biol. 27:219–225, 2015. © 2014 The Authors American Journal of Human Biology Published by Wiley Periodicals, Inc.
Workers' compensation: Poor quality health care and the growing disability problem in the United States
Authors: Franklin Gary M. , Wickizer Thomas M. , Coe Norma B. , Fulton‐Kehoe Deborah
Published: October 2014

The proportion of working age citizens permanently removed from the workforce has dramatically increased over the past 30 years, straining both Federal and State disability systems designed as a safety net to protect them. Almost one‐third of these rapidly emerging disabilities are related to musculoskeletal disorders, and three of the top five diagnoses associated with the longest Years Lived with Disability are back, neck and other musculoskeletal disorders. The failure of Federal and state workers' compensation systems to provide effective health care to treat non‐catastrophic injuries has been largely overlooked as a principal source of permanent disablement and corresponding reduced labor force participation. Innovations in workers' compensation health care delivery, and in use of evidence‐based coverage methods such as prospective utilization review, are effective secondary prevention efforts that, if more widely adopted, could substantially prevent avoidable disability and provide more financial stability for disability safety net programs. Am. J. Ind. Med. 58:245–251, 2015. © 2014 Wiley Periodicals, Inc.
First description of a patient with Vici syndrome due to a mutation affecting the penultimate exon of EPG5 and review of the literature
Authors: Ehmke Nadja , Parvaneh Nima , Krawitz Peter , Ashrafi Mahmoud‐Reza , Karimi Parviz , Mehdizadeh Mehrzad , Krüger Ulrike , Hecht Jochen , Mundlos Stefan , Robinson Peter N.
Published: October 2014

Vici syndrome is a rare autosomal recessively inherited multisystem disorder characterized by agenesis of the corpus callosum, cataracts, cardiomyopathy, combined immunodeficiency, psychomotor delay, and hypopigmentation. Cullup et al. recently identified mutations in the gene EPG5 as the cause of Vici syndrome. EPG5 is involved in autophagy, an evolutionarily conserved lysosomal degradation process that is essential for cell homeostasis. Following the first description in 1988 by Vici et al., 24 other cases of Vici syndrome have been published with variable expression of the defining features. Here, we report on a further case of Vici syndrome with a homozygous truncating mutation of EPG5, identified by whole‐exome sequencing. The mutation in our patient is the first reported affecting the penultimate exon of EPG5 and presenting with typical clinical manifestations of Vici syndrome. Additionally, we present a detailed clinical analysis of Vici syndrome comprising all cases previously described in the literature. © 2014 Wiley Periodicals, Inc.
Neuropsychological profiles of patients with 2q37.3 deletion associated with developmental dyspraxia
Authors: Ogura Kaeko , Takeshita Kenzo , Arakawa Chikako , Shimojima Keiko , Yamamoto Toshiyuki
Published: October 2014

Patients with 2q37 deletions manifest brachydactyly mental retardation syndrome (BDMR). Recent advances in human molecular research have revealed that alterations in the histone deacetylase 4 gene (HDAC4) are responsible for the clinical manifestations of BDMR. Here, we report two male patients with 2q37.3 deletions. One of the patients showed a typical BDMR phenotype, and HDAC4 was included in the deletion region. HDAC4 was preserved in the other patient, and he showed a normal intelligence level with the delayed learning of complex motor skills. Detailed neuropsychological examinations revealed similar neuropsychological profiles in these two patients (visuo‐spatial dyspraxia) that suggested developmental dyspraxia. These observations suggested that some other candidate genes for neuronal development exist in the telomeric region of HDAC4. © 2014 Wiley Periodicals, Inc.
What rhinologists and allergists should know about the medico‐legal implications of antibiotic use: a review of the literature
Authors: Poetker David M. , Smith Timothy L.
Published: October 2014

Background

Antibiotics are commonly used in the management of both acute rhinosinusitis and acute exacerbations of chronic rhinosinusitis. With their common use, they have become the leading medication for litigation. It is crucial for the provider to be familiar with potential complications and the medico‐legal ramifications of their use. The objectives of this review were to outline the existing data of the medico‐legal implications of prescribing oral antibiotics.

Methods

An OVID search of the following terms was performed: antibiotics or antibacterial agents AND medico‐legal, malpractice, jurisprudence, or informed consent. This search was then narrowed to English language articles and the titles and abstracts were searched for relevance.

Results

An OVID search identified 272 articles. This search was then narrowed, resulting in 13 articles that were relevant and included in the current review. Five articles involved database reviews of litigation associated with medications. Antibiotics were the most common medication associated with litigation. Allergic reaction was the single most common reason for litigation.

Conclusion

Lawsuits associated with medications are disproportionately costly and antibiotics are the most common type of medication to result in litigation. Although the use of electronic medical records (EMRs) may decrease the frequency of these lawsuits, it is up to the physician to be familiar with the agents prescribed, their risks, and be vigilant regarding possible reactions.
A simple predictive formula for the blood requirement in patients with high‐energy blunt injuries transferred within one hour post‐trauma
Authors: Akasaki Yukio , Sugimori Hiroshi , Momii Kenta , Akahoshi Tomohiko , Matsuura Suguru , Iwamoto Yukihide , Maehara Yoshihiko , Hashizume Makoto
Published: October 2014

Aims

To recognize patients who require massive transfusion at the early stage of blunt trauma, we retrospectively investigated patients with high‐energy blunt injuries transferred within 1 h post‐trauma.

Methods

Between August 2007 and July 2011, 233 trauma patients were: (i) injured by a high‐energy blunt mechanism with Injury Severity Score ≥9; (ii) not dead on arrival; (iii) older than 9 years; and (iv) at our center within 1 h after injury. The findings for 113 of those patients were analyzed, including those produced by ultrasonography, computed tomography, and arterial blood gas analyses.

Results

Of 113 patients, 33 underwent massive transfusion (≥6 units) within 8 h of arrival. A logistic regression analysis revealed that an arterial lactate level ≥28 mg/dL (P < 0.001; odds ratio, 105.11; 95% confidence interval, 12.58–2,718.84) and a flat ratio of the inferior vena cava on computed tomography ≥3 (P < 0.001; odds ratio, 32.50; 95% confidence interval, 4.44–714.44) were significant independent predictors for a massive transfusion within 8 h. In a receiver operating curve analysis, the area under the curve of the need for massive transfusion was 0.956, with a sensitivity of 0.94 and a specificity of 0.90. A linear predictive formula for the probability (P) of receiving a massive transfusion was generated as P = 2 × lactate (mg/dL) + 15 × the flat ratio of inferior vena cava − 103. Using another 52 trauma patients, the formula was validated.

Conclusions

An elevated level of arterial lactate and the flat ratio of inferior vena cava were significant predictors for identifying the patients who would require a massive transfusion in the early stage after high‐energy blunt trauma.
Comparison of the conventional Macintosh laryngoscope, the Pentax Airwayscope, and the McGrath MAC video laryngoscope under restricted cervical motion: a manikin study
Authors: Kotera Atsushi , Irie Hiroki , Iwashita Shinsuke , Taniguchi Junichi , Kasaoka Shunji , Kinoshita Yoshihiro
Published: October 2014

Aim

We compared the utility of the conventional Macintosh laryngoscope, the Pentax Airway Scope, and the McGrath MAC video laryngoscope under restricted cervical motion using a manikin.

Methods

We recruited 36 participants into the simulation study. The manikin's cervical motion was restricted with a cervical collar and a head immobilizer, as occurs in trauma cases. We recorded the time to intubation and the success rate of the intubations.

Results

Data are medians and ranges. The time to intubation under normal and restricted cervical motion were 22.5 (10–78) and 23 (9–119) s with the Macintosh laryngoscope, 13.5 (5–50) and 14 (7–119) s with the Airway Scope, and 13 (6–32) and 18 (7–80) s with the McGrath MAC video laryngoscope. The differences in the time to intubation between normal and restricted cervical motion were significant only with the McGrath MAC (P = 0.0008). With restricted cervical motion, the times to intubation in the Airway Scope attempts were significantly shorter than those in the Macintosh laryngoscope (P = 0.0005) and McGrath MAC (P = 0.0282) attempts. The success rates under normal and restricted cervical motion were 100% and 80.6% with the Macintosh laryngoscope (P = 0.0054), 100% and 100% with the Airway Scope, and 100% and 97.2% with the McGrath MAC, respectively.

Conclusion

In the present study, the Airway Scope was the best among the three devices. However, the differences between the Airway Scope and the McGrath MAC video laryngoscope may not be serious in a clinical situation. Data were gathered using a manikin, and further studies will be necessary.
Thermal stability and kinetics analysis of epoxy composites modified with reactive polyol diluent and multiwalled carbon nanotubes
Authors: Islam Md Ekramul , Rahman Muhammad M. , Hosur Mahesh , Jeelani Shaik
Published: October 2014

The effect of polyether polyol and amino‐functionalized multiwalled carbon nanotubes (NH2‐MWCNTs) on the thermal stability of three‐phase (epoxy/polyol/NH2‐MWCNTs) epoxy composites was investigated. Thermal stability and degradation characteristics of polyol/MWCNTs modified epoxy composites was evaluated using thermogravimetric analysis. The kinetics of thermal degradation was assessed from data scanned at 5, 10, and 20°C/min. Activation energy for degradation of epoxy nanocomposites was calculated using different differential and integral methods, that is, Kissinger's, Flynn–Wall–Ozawa, Coats–Redfern, and Horowitz–Metzger methods. In addition, the integral procedure decomposition temperature was determined to evaluate the inherent thermal stability of the modified composite system. Rate of thermal degradation in MWCNT/Polyol samples was found to be reduced significantly while activation energy of degradation was increased compared to unmodified epoxy composite. © 2014 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2015, 132, 41558.
Conductive imidazolium side chain liquid crystal polyacrylates prepared from postpolymerization functionalization
Authors: Wang Caihong , Wu Yong , Tan Shuai , Liang Ting , Yang Xiaohui
Published: October 2014

Hydroxide and tetrafluoroborate salts of imidazolium polyacrylates have been prepared from postpolymerization functionalization of a brominated precursor containing mesogenic side chains followed by anion exchange. The ionic polyacrylates possessed molecular weights in the range 1.1–1.3 × 104 g·mol−1. Differential scanning calorimetry measurements and polarizing optical microscope observation indicated that the resultant ionic polyacrylates exhibited smectic C and A liquid crystal phases over a temperature range of about 60°C. Electrochemical impedance spectroscopy measurements show that ionic conductivities of the hydroxide salt were much higher than those of the tetrafluoroborate salt for the imidazolium polyacrylates at the same temperature. The maximum ionic conductivity of the random hydroxide salt of imidazolium polyacrylate in the smectic A phase reached 4.45 × 10−2 S·cm−1. The ionic polyacrylates were successfully aligned by mechanical shearing in the smectic A phase. Ionic conductivities of the sheared samples were more than 1 order of magnitude higher than those of the random samples in the solid state. © 2014 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2015, 132, 41564.
Brief Report: Ankylosing Spondylitis or Diffuse Idiopathic Skeletal Hyperostosis in Royal Egyptian Mummies of the 18th–20th Dynasties? Computed Tomography and Archaeology Studies
Authors: Saleem Sahar N. , Hawass Zahi
Published: October 2014

Objective

To study the computed tomography (CT) images of royal Ancient Egyptian mummies dated to the 18th to early 20th Dynasties for the claimed diagnoses of ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) and to correlate the findings with the archaeology literature.

Methods

We studied the CT images of 13 royal Ancient Egyptian mummies (1492–1153 BC) for evidence of AS and DISH and correlated our findings with the archaeology literature.

Results

The findings of the CT scans excluded the diagnosis of AS, based on the absence of sacroiliac joint erosions or fusion of the facet joints. Four mummies fulfilled the diagnostic criteria for DISH: Amenhotep III (18th Dynasty), Ramesses II, his son Merenptah, and Ramesses III (19th to early 20th Dynasties). The diagnosis of DISH, a commonly asymptomatic disease of old age, in the 4 pharaohs is in concordance with their longevity and active lifestyles.

Conclusion

CT findings excluded the diagnosis of AS in the studied royal Ancient Egyptian mummies and brought into question the antiquity of the disease. The CT features of DISH during this ancient period were similar to those commonly seen in modern populations, and it is likely that they will also be similar in the future. The affection of Ramesses II and his son Merenptah supports familial clustering of DISH. The process of mummification may induce changes in the spine that should be considered during investigations of disease in ancient mummies.
Risk of Incident Diabetes in Patients With Gout: A Cohort Study
Authors: Kim Seoyoung C. , Liu Jun , Solomon Daniel H.
Published: October 2014

Objective

Patients with hyperuricemia or gout often have metabolic syndrome. Few prospective studies have examined the risk of incident diabetes mellitus (DM) in patients with gout, and there are no data to indicate whether the risk of DM in gout differs by sex. Therefore, this cohort study was undertaken to examine the overall and sex‐specific incidence rates of DM in patients with gout.

Methods

Using data from a US commercial insurance plan (2003–2012), the overall and sex‐specific incidence rates of DM in patients with gout (ages ≥40 years) were compared to those in patients with osteoarthritis (OA). Incident DM was defined as a diagnosis of DM and at least one dispensing of an antidiabetic drug. The sex‐specific effect of gout on DM risk was also examined.

Results

The primary study cohorts consisted of 54,075 patients with gout and 162,225 patients with OA, matched for age, sex, and index date. In both cohorts, the mean age of the patients was 56.2 years, and 84.8% were men. Over a mean followup of 1.9 years, the incidence rate of DM was 1.91 per 100 person‐years in patients with gout and 1.12 per 100 person‐years in patients with OA. Multivariable Cox models adjusted for age, comorbidities, medications, and health care utilization factors revealed that gout was associated with an increased risk of DM (hazard ratio 1.45, 95% confidence interval [95% CI] 1.37–1.54) in both sexes. The impact of gout on the risk of incident DM was greater in women (hazard ratio 1.78, 95% CI 1.51–2.09) than in men (hazard ratio 1.41, 95% CI 1.33–1.50), with a significant interaction between gout and sex in relation to the risk of incident DM (P= 0.0009).

Conclusion

Gout was associated with an increased risk of developing DM compared to that in patients with OA after adjustment for potential confounders. In addition, the risk of incident DM associated with gout was higher among women than among men.
Brief Report: Relationship of Age and Body Mass Index to Skin Temperature and Skin Perfusion in Primary Raynaud's Phenomenon
Authors: Giurgea Georgiana‐Aura , Mlekusch Wolfgang , Charwat‐Resl Silvia , Mueller Markus , Hammer Alexandra , Gschwandtner Michael E. , Koppensteiner Renate , Schlager Oliver
Published: October 2014

Objective

To assess the relationship of age and body mass index (BMI) to skin temperature and perfusion in patients with primary Raynaud's phenomenon (RP) compared with controls.

Methods

Patients with RP as well as age‐ and sex‐matched controls underwent external cold provocation by exposure to 20°C water for 1 minute. Before and after cold provocation, skin temperature and skin perfusion were measured.

Results

Twenty‐six patients with RP (20 women and 6 men; median age 41.9 years) and 22 controls (17 women and 5 men; median age 42.9 years) were studied. In RP patients, cold exposure led to a median change in skin temperature of −7% (interquartile range [IQR] −13.1, −4.1) and to a median change in skin perfusion of −26.4% (IQR −36.2, 2.9). In controls, skin temperature changed by −15.7% (IQR −18.3, −11.6) and skin perfusion by −33% (IQR −53.3, −1.1) upon cold exposure. In patients with RP, age and BMI were related to skin temperature (for age, r = 0.683, P < 0.0001; for BMI r = 0.657, P < 0.0001) and skin perfusion (for age, r = 0.595, P = 0.002; for BMI, r = 0.653, P < 0.0001), while no association was found in controls. The cold‐induced decrease in skin temperature was inversely related to age (r = −0.518, P = 0.003) and BMI (r = −0.662, P < 0.0001) in patients with RP; correlations were not observed in controls. The cold‐induced change in skin perfusion was not related to age or BMI in either group.

Conclusion

The cold‐induced decrease in skin temperature is related to age and BMI in patients with RP but not in controls. Further studies are needed to clarify the pathophysiology of digital ischemia in primary RP.
Ras Guanine Nucleotide–Releasing Protein 4 Is Aberrantly Expressed in the Fibroblast‐like Synoviocytes of Patients With Rheumatoid Arthritis and Controls Their Proliferation
Authors: Kono Michihito , Yasuda Shinsuke , Stevens Richard L. , Koide Hideyuki , Kurita Takashi , Shimizu Yuka , Kanetsuka Yusaku , Oku Kenji , Bohgaki Toshiyuki , Amengual Olga , Horita Tetsuya , Shimizu Tomohiro , Majima Tokifumi , Koike Takao , Atsumi Tatsuya
Published: October 2014

Objective

Ras guanine nucleotide–releasing protein 4 (RasGRP‐4) is a calcium‐regulated guanine nucleotide exchange factor and diacylglycerol/phorbol ester receptor not normally expressed in fibroblasts. While RasGRP‐4–null mice are resistant to arthritis induced by anti–glucose‐6‐phosphate isomerase autoantibodies, the relevance of these findings to humans is unknown. We undertook this study to evaluate the importance of RasGRP‐4 in the pathogenesis of human and rat arthritis.

Methods

Synovial tissue from patients with rheumatoid arthritis (RA) and osteoarthritis (OA) were evaluated immunohistochemically for the presence of RasGRP‐4 protein. Fibroblast‐like synoviocytes (FLS) were isolated from synovial samples, and expression of RasGRP‐4 was evaluated by real‐time quantitative reverse transcription–polymerase chain reaction analyses. The proliferation potency of FLS was evaluated by exposing the cells to a RasGRP‐4–specific small interfering RNA (siRNA). Finally, the ability of RasGRP‐4–specific siRNAs to hinder type II collagen–induced arthritis in rats was evaluated to confirm the importance of the signaling protein in the disease.

Results

Unexpectedly, RasGRP‐4 protein was detected in the synovial hyperplastic lining, where proliferating FLS preferentially reside. FLS isolated from tissues obtained from a subpopulation of RA patients expressed much more RasGRP‐4 than did FLS from examined OA patients. Moreover, the level of RasGRP‐4 transcript was correlated with the FLS proliferation rate. The ability of cultured FLS to divide was diminished when they were treated with RasGRP‐4–specific siRNAs. The intraarticular injection of RasGRP‐4–specific siRNAs also dampened experimental arthritis in rats.

Conclusion

RasGRP‐4 is aberrantly expressed in FLS and helps regulate their growth. This intracellular signaling protein is therefore a candidate target for dampening proliferative synovitis and joint destruction.
The shades of gray of the chromatin fiber
Authors: Ausió Juan
Published: October 2014

The chromatin fiber consists of a string of nucleosomes connected by linker DNA regions. The hierarchy of folding of this fiber within the cell has long been controversial, and the existence of an originally described 30 nm fiber has been debated and reviewed extensively. This review contextualizes two recent papers on this topic that suggest the 30 nm fiber to be an over‐simplification. The idealized model from the first study provides good insight into the constraints and histone participation in the maintenance of the fiber structure. The second paper provides a theoretical description of a more realistic view of the highly heterogeneous and dynamic chromatin organization in the in vivo setting. It is now time to abandon the highly regular “one start” solenoidal 30 nm structure and replace it with a more realistic highly dynamic, polymorphic fiber.
Multicentre study of the learning curve and surgical performance of cytoreductive surgery with intraperitoneal chemotherapy for pseudomyxoma peritonei
Authors: Kusamura S , Moran B J , Sugarbaker P H , Levine E A , Elias D , Baratti D , Morris D L , Sardi A , Glehen O , Deraco M , Gilly F N , Barrios P , Quenet F , Loggie B W , Gómez Portilla A , de Hingh I H J T , Ceelen W P , Pelz J O W , Piso P , González-Moreno S , Van Der Speeten K , Chua T C , Yan T D , Liauw W
Published: October 2014

Background

The learning curves for cytoreductive surgery with intraperitoneal chemotherapy for treatment of pseudomyxoma peritonei (PMP) were explored between international centres/surgeons to identify institutional or other factors that might affect performance.

Methods

Data from patients with PMP treated with the combined procedure across 33 international centres between 1993 and 2012 were analysed retrospectively. A risk-adjusted sequential probability ratio test was conducted after defining the target outcome as early oncological failure (disease progression within 2 years of treatment), an acceptable risk for the target outcome (odds ratio) of 2, and type I/II error rates of 5 per cent. The risk prediction model was elaborated and patients were evaluated sequentially for each centre/surgeon. The learning curve was considered to be overcome and proficiency achieved when the odds ratio for early oncological failure became smaller than 2.

Results

Rates of optimal cytoreduction, severe postoperative morbidity and early oncological failure were 84·4, 25·7 and 29·0 per cent respectively. The median annual centre volume was 17 (range 6–66) peritoneal malignancies. Only eight of the 33 centres and six of 47 surgeons achieved proficiency after a median of 100 (range 78–284) and 96 (86–284) procedures respectively. The most important institutional factor affecting surgical performance was centre volume.

Conclusion

The learning curve is extremely long, so centralization and/or networking of centres is necessary to assure quality of services. One centre for every 10–15 million inhabitants would be ideal.
The Legal Aspects of Conditional Release in the Criminal and Civil Court System
Authors: Weinstein Naomi M.
Published: October 2014

This article considers the legal implications of conditional release in both the civil and criminal parts of the law. In the criminal context, conditional release takes the form of probation and parole. It also involves persons who are found to be incompetent to stand trial or not guilty by reason of insanity. In the civil context, conditional release exists for persons with mental illness and sex offenders who face mandatory outpatient treatment.

The public policy behind conditional release is to allow certain persons the least restrictive alternative with proper oversight that will prevent the person from recidivating or being re‐hospitalized. Conditional release is also used as a cost‐saving mechanism in response to the overwhelming costs of incarceration and hospitalization.

This article explores the issues of professional liability, third party liability, and individual rights in relation to conditional release. This article also addresses public policy concerns with conditional release and examines conditional release from a therapeutic jurisprudence perspective. Copyright © 2014 John Wiley & Sons, Ltd.
Shaken Baby Syndrome Prevention Programme: A Pilot Study in Turkey
Authors: Taşar Medine Ayşin , Dallar Bilge Y𝚤ld𝚤z , Şahin Figen , Çamurdan Aysu , Beyazova Ufuk , Polat Selda , İlhan Mustafa N.
Published: October 2014

The purpose of this study is to evaluate the effectiveness of the training materials of a shaken baby syndrome (SBS) prevention programme produced in Western Sydney, Australia, when used with parents in Turkey, and to evaluate the best timing for this training. In this intervention study, a total of 545 mothers, 39.8 per cent of whom were in the first 48 hours after birth (group 1), 43.1 per cent three to seven days after birth (group 2) and 17.1 per cent pregnant (group 3), were tested before and after watching the educational film, for evaluation of their perception, and knowledge of and attitudes towards SBS. The total points measuring the levels of knowledge of shaking hazards changed from an average of 5.0 ± 2.2 pre‐intervention to 6.4 ± 1.7 post‐intervention (p = 0.001). There was no statistically significant difference between the groups in the pre‐test score, whereas in the post‐test score group one was significantly lower than the other groups (p = 0.001). In conclusion, training using the SBS Prevention Program was useful for mothers; their level of knowledge about the dangers of shaking increased. Education given prior to the birth and three to seven days after the birth was found to be more useful than during the immediate postnatal period. Copyright © 2014 John Wiley & Sons, Ltd.

KEY PRACTITIONER MESSAGES

Training in the SBS Prevention Program was useful for mothers.

Their level of knowledge about the dangers of shaking increased.

Education given before birth and in the postnatal three to seven days was found to be more useful compared to that given in the immediate postnatal period.
Predictors of Group Treatment Outcomes for Child Sexual Abuse: An Investigation of the Role of Demographic and Abuse Characteristics
Authors: Hiller Atara , Springer Craig , Misurell Justin , Kranzler Amy , Rizvi Shireen
Published: October 2014

Research has begun to identify factors that may moderate the effects of interventions for symptomatology associated with child sexual abuse (CSA). However, there is disagreement about which factors may be important for different populations. The present investigation examined predictors of treatment outcomes among 166 predominantly economically disadvantaged and culturally diverse CSA survivors between the ages of six and ten, who were treated using game‐based cognitive‐behavioural therapy (GB‐CBT). Predictor variables included demographic characteristics (i.e. age, gender, ethnicity, household income) and abuse‐related risk factors (i.e. degree of invasiveness of abuse, frequency of instances of CSA and type of relationship to the perpetrator). Treatment outcomes included internalising and externalising symptoms, sexually inappropriate behaviours, knowledge of abuse and personal safety skills. Results indicate that participants' responsiveness to treatment was not impacted by demographic or abuse‐related risk factors. Thus, group treatment appears to be effective for treating a wide range of problems following CSA, irrespective of clients' varied demographic background and abuse characteristics. Copyright © 2014 John Wiley & Sons, Ltd.

‘166 predominantly economically disadvantaged and culturally diverse CSA survivors between the ages of six and ten’

Key Practitioner Messages:

GB‐CBT is an integrative treatment approach for survivors of CSA, combining features of trauma‐focused cognitive‐behavioural therapy (TF‐CBT), play therapy and group therapy.

It is important to investigate whether demographic and abuse characteristics impact treatment outcomes for CSA to determine whether children respond differently to treatment based on pre‐existing characteristics.

GB‐CBT participants experienced improvements in internalising and externalising symptoms, sexually inappropriate behaviours and personal safety skills, irrespective of their demographic backgrounds and varied abuse histories.

‘GB‐CBT is an integrative treatment approach for survivors of CSA’
Synthesis by Ring‐Closing Alkyne Metathesis with Selective Hydrogenation, and Olfactory Comparison of (7E)‐ and (7Z)‐Cyclohexadec‐7‐enone (Aurelione®)
Authors: Mathys Marion , Kraft Philip
Published: October 2014

Both CC‐bond isomers of cyclohexadec‐7‐enone (6, Aurelione®) were selectively synthesized via cyclohexadec‐7‐ynol (16) by ring‐closing alkyne metathesis of icosa‐2,18‐diyn‐9‐ol (15), employing an in situ‐formed catalyst from Mo(CO)6 and 4‐(trifluoromethyl)phenol. Pyridinium chlorochromate (PCC) oxidation and subsequent Lindlar hydrogenation afforded the (7Z)‐configured isomer (7Z)‐6, while hydrosilylation of the intermediate cyclohexadec‐7‐ynone (17), followed by desilylation, provided the (7E)‐configured cyclohexadec‐7‐enone ((7E)‐6). The substrate for the alkyne metathesis was prepared from cycloheptanone (7) by cycloaddition of chloromethylcarbene to its trimethylsilyl enol ether 8, and subsequent ring enlargement of the adduct 9 under rearrangement to 2‐methylcyclooct‐2‐enone (10), which was subjected to WeitzScheffer epoxidation and EschenmoserOhloff fragmentation to non‐7‐ynal (12). Its reaction with the Grignard reagent of 11‐bromoundec‐2‐yne (14), prepared from the corresponding alcohol 13 by AppelLee bromination, furnished the icosa‐2,18‐diyn‐9‐ol (15). While both isomers of cyclohexadec‐7‐enone (6) possess warm and powdery musk odors with tobacco‐type ambery accents, (7Z)‐6 is more animalic and waxy, whereas (7E)‐6 was found to be more floral, sweet, and hay‐like in tonality. Interestingly, however, with odor detection thresholds of 2.0 ng/l air and 2.3 ng/l air, respectively, both (7Z)‐6 and (7E)‐6 were found to be almost identical in their odor strength, with the (7Z)‐6 being only very slightly more powerful.
Direct Enantioseparation of Nitrogen‐Heterocyclic Pesticides on Cellulose‐Based Chiral Column by High‐Performance Liquid Chromatography
Authors: Chai Tingting , Yang Wenwen , Qiu Jing , Hou Shicong
Published: October 2014

The enantiomeric separation of eight pesticides including bitertanol (1), diclobutrazol (2), fenbuconazole (3), triticonazole (4), imazalil (5), triapenthenol (6), ancymidol (7), and carfentrazone‐ethyl (8) was achieved, using normal‐phase high‐performance liquid chromatography on two cellulosed‐based chiral columns. The effects of isopropanol composition from 2% to 30% in the mobile phase and column temperature from 5 to 40 °C were investigated. Satisfactory resolutions were obtained for bitertanol (1), triticonazole (4), imazalil (5) with the (+)‐enantiomer eluted first and fenbuconazole (3) with the (—)‐enantiomer eluted first on Lux Cellulose‐2 and Lux Cellulose‐3. (+)‐Enantiomers of diclobutrazol (2) and triapenthenol (6) were first eluted on Lux Cellulose‐2. (—)‐Carfentrazone‐ethyl (8) were eluted first on Lux Cellulose‐2 and Lux Cellulose‐3 with incomplete separation. Reversed elution orders were obtained for ancymidol (7). (+)‐Ancymidol was first eluted on Lux Cellulose‐2 while on Lux Cellulose‐3 (—)‐ancymidol was first eluted. The results of the elution order at different column temperatures suggested that column temperature did not affect the optical signals of the enantiomers. These results will be helpful to prepare and analyze individual enantiomers of chiral pesticides. Chirality 27:32–38, 2015. © 2014 Wiley Periodicals, Inc.
Adjuvant chemotherapy use and outcomes of patients with high‐risk versus low‐risk stage II colon cancer
Authors: Kumar Aalok , Kennecke Hagen F. , Renouf Daniel J. , Lim Howard J. , Gill Sharlene , Woods Ryan , Speers Caroline , Cheung Winson Y.
Published: October 2014

BACKGROUND

Adjuvant chemotherapy (AC) is frequently considered in patients with stage II colon cancer who are considered to be at high risk. However, to the authors' knowledge, the survival benefits associated with AC in these patients remain largely unproven. In the current study, the authors sought to examine the use of AC in patients with AJCC stage II colon cancer and to compare the impact of AC on outcomes in patients with high‐risk versus low‐risk disease in a population‐based setting.

METHODS

Patients with stage II colon cancer who were evaluated at 1 of 5 regional cancer centers in British Columbia from 1999 to 2008 were analyzed. Kaplan‐Meier and Cox regression methods were used to correlate high‐risk versus low‐risk status and receipt of AC with recurrence‐free survival (RFS), disease‐specific survival (DSS), and overall survival (OS).

RESULTS

A total of 1697 patients were identified: 1286 (76%) with high‐risk and 411 (24%) with low‐risk disease, among whom 373 (29%) and 51 (12%),respectively, received AC. Individuals with high‐risk disease treated with AC were younger (median age, 62 years vs 72 years; P<.001) and had better Eastern Cooperative Oncology Group performance status (0/1: 47% vs 33%; P = .001). For high‐risk patients, AC was associated with improved OS (hazard ratio [HR], 0.65; 95% confidence interval [95% CI], 0.50‐0.83 [P = .001]). However, no significant benefits with regard to RFS or DSS were observed. Subgroup analyses revealed that AC in patients with T4 disease was associated with significantly improved RFS (HR, 0.63; 95% CI, 0.42‐0.95 [P = .03]), DSS (HR, 0.59; 95% CI, 0.37‐0.93 [P = .02]), and OS (HR, 0.50; 95% CI, 0.33‐0.77 [P = .002]). For patients with low‐risk disease, AC was associated with inferior RFS (HR, 2.18; 95% CI, 1.00‐4.79 [P = .05]) and DSS (HR, 3.01; 95% CI, 1.10‐8.23 [P = .03]).

CONCLUSIONS

In this population‐based analysis, AC was associated with an OS advantage in high‐risk patients, most likely due to patient selection. RFS, DSS, and OS benefits were mainly observed in patients with T4 disease, suggesting a limited role for AC in patients deemed to be high risk by non‐T4 features. Cancer 2015;121:527–534. © 2014 American Cancer Society.