bluuebunny/crossref_metadata_2025 huggingface dataset:
TrioVis: a visualization approach for filtering genomic variants of parent–child trios
Authors: Sakai Ryo , Sifrim Alejandro , Vande Moere Andrew , Aerts Jan
Published: May 2013

Summary: TrioVis is a visual analytics tool developed for filtering on coverage and variant frequency for genomic variants from exome sequencing of parent–child trios. In TrioVis, the variant data are organized by grouping each variant based on the laws of Mendelian inheritance. Taking three Variant Call Format files as input, TrioVis allows the user to test different coverage thresholds (i.e. different levels of stringency), to find the optimal threshold values tailored to their hypotheses and to gain insights into the global effects of filtering through interaction.

Availability: Executables, source code and sample data are available at https://bitbucket.org/biovizleuven/triovis. Screencast is available at http://vimeo.com/user6757771/triovis.

Contact:  ryo.sakai@esat.kuleuven.be
N‐terminal pro brain natriuretic peptide‐guided management in patients with heart failure and preserved ejection fraction: findings from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME‐CHF)
Authors: Maeder Micha T. , Rickenbacher Peter , Rickli Hans , Abbühl Heidi , Gutmann Marc , Erne Paul , Vuilliomenet André , Peter Martin , Pfisterer Matthias , Brunner‐La Rocca Hans‐Peter ,   for the TIME‐CHF Investigators
Published: May 2013

Aims

To assess the effects of an NT‐proBNP‐guided medical management on 18‐month outcomes in patients with heart failure (HF) and preserved LVEF (HFpEF).

Methods and results

Patients with HFpEF (LVEF >45%; n = 123) and HF with reduced LVEF (HFrEF; LVEF ≤45%; n = 499) with age ≥60 years, NYHA class ≥ II, and elevated NT‐proBNP (>400 ng/L or >800 ng/L depending on age) were randomized to medical therapy titrated only to reduce symptoms to NYHA ≤II (symptom‐guided) or also to reduce NT‐proBNP below the inclusion threshold (NT‐proBNP‐guided) during a 6‐month period. Patients were followed for an additional 12 months. Despite similar treatment escalation, NT‐proBNP reduction and symptom relief were less in HFpEF than in HFrEF. Hospitalization‐free survival at 18 months was worse in HFpEF than in HFrEF (P = 0.02), while survival and HF hospitalization‐free survival did not differ. Among HFpEF patients, NT‐proBNP reduction and symptom relief were similar in the symptom‐guided (n = 59) and NT‐proBNP‐guided (n = 64) group despite more aggressive treatment in the NT‐proBNP‐guided group. In contrast to effects in HFrEF, NT‐proBNP‐guided management tended to worsen 18‐month outcomes in HFpEF, with P‐values for the interactions between LVEF stratum and management strategy of 0.2 for hospitalization‐free survival, 0.03 for survival, and 0.01 for HF hospitalization‐free survival.

Conclusions

Outcomes in HFpEF were not better than in HFrEF, and opposite effects of NT‐proBNP‐guided management were observed in HFpEF compared with HFrEF. These preliminary findings suggest that, in contrast to HFrEF, NT‐proBNP‐guided therapy may not be beneficial in HFpEF.

Trial registration

ISRCTN43596477.
Long‐term Outcomes for Infants With Intestinal Atresia Studied at Children's National Medical Center
Authors: Nusinovich Yevgeniya , Revenis Mary , Torres Clarivet
Published: May 2013

Objectives:

Intestinal atresia is a common cause of intestinal obstruction in neonates. The predominant cause of late complications in these children is prolonged dependence on parenteral nutrition (PN). Our aims were to analyze the outcomes for patients with intestinal atresia at our institution, and to see how these changed with the implementation of an intestinal rehabilitation program (IRP).

Methods:

This is a retrospective cohort study. The patient population is all children with intestinal atresias (118 patients) treated at our institution from July 2000 to June 2010, 20 of whom became PN dependent.

Results:

Survival to hospital discharge was 95% for all patients, and 100% for those who had isolated atresia. Twenty of 118 patients (17%) were PN dependent beyond initial hospital discharge. At discharge, their median intestinal length was 22.5 cm, and they required PN for a mean of 88.5% of energy needs. Of these 20 patients, 2 died, 2 received transplants, and 2 transferred away for transplantation. The remaining 14 joined the IRP. Their mean energy requirement from PN is presently 10%, down from 87% at IRP enrollment, and 10 patients fully weaned off PN. Eleven of the 14 children had hyperbilirubinemia, with mean direct bilirubin of 7.5 mg/dL. All resolved their cholestasis during an average of 12 weeks.

Conclusions:

These results compare favorably with those reported in earlier periods. With programs such as the IRP, patients with short bowel secondary to intestinal atresia can show improvement in liver function and nutritional parameters, and discontinue PN, avoiding the need for transplantation.
Antifungal mechanism of essential oil from Anethum graveolens seeds against Candida albicans
Authors: Chen Yuxin , Zeng Hong , Tian Jun , Ban Xiaoquan , Ma Bingxin , Wang Youwei
Published: May 2013

This work studied the antifungal mechanism of dill seed essential oil (DSEO) against Candida albicans. Flow cytometric analysis and inhibition of ergosterol synthesis were performed to clarify the mechanism of action of DSEO on C. albicans. Upon treatment of cells with DSEO, propidium iodide penetrated C. albicans through a lesion in its plasma membrane. DSEO also significantly reduced the amount of ergosterol. These findings indicate that the plasma membrane of C. albicans was damaged by DSEO. The effect of DSEO on the functions of the mitochondria in C. albicans was also studied. We assayed the mitochondrial membrane potential (mtΔψ) using rhodamine 123 and determined the production of mitochondrial dysfunction-induced reactive oxygen species (ROS) via flow cytometry. The effects of the antioxidant l-cysteine (Cys) on DSEO-induced ROS production and the antifungal effect of DSEO on C. albicans were investigated. Exposure to DSEO increased mtΔψ. Dysfunctions in the mitochondria caused ROS accumulation in C. albicans. This increase in the level of ROS production and DSEO-induced decrease in cell viability were prevented by the addition of Cys, indicating that ROS are an important mediator of the antifungal action of DSEO. These findings indicate that the cytoplasmic membrane and mitochondria are the main anti-Candida targets of DSEO.
Isolated sinusitis sphenoidalis caused by Trichoderma longibrachiatum in an immunocompetent patient with headache
Authors: Molnár-Gábor Etelka , Dóczi Ilona , Hatvani Lóránt , Vágvölgyi Csaba , Kredics László
Published: May 2013

We present a case of isolated sinusitis sphenoidalis caused by Trichoderma longibrachiatum, an emerging causal agent of fungal infections with an often fatal outcome. A Trichoderma strain was isolated from secretion obtained from the sinus sphenoidalis of a rhinosinusitis patient and identified by sequence analysis of two loci as Trichoderma longibrachiatum from the Longibrachiatum Clade of the genus Trichoderma. T. longibrachiatum can trigger a fatal pathomechanism in immunodeficient patients, but only rarely causes disease in healthy people. The case presented is unique because the patient was not immunocompromised.
Grounded theory: an inductive method for supply chain research
Authors: Randall Wesley S. , Mello John E.
Published: May 2013

Purpose

Development of theory remains an essential step in the evolution of supply chain management as an integrative business discipline. Supply chain research often involves phenomena possessing complex behavioral dimensions at both the individual and organizational levels. Such complexity can require the utilization of holistic and inductive approaches in order to more fully understand the behaviors associated with the phenomena. This paper aims to provide a step‐by‐step guide intended to increase researchers' understanding of the use of grounded theory (GT) methodology in supply chain contexts.

Design/methodology/approach

The paper argues for GT as an appropriate method for studying emerging supply chain phenomena using an inductive, holistic approach.

Findings

GT is positioned in a holistic framework of research methodologies. Next a step‐by‐step explanation of the grounded theory process is offered, illustrated by examples from the authors' own research.

Originality/value

This paper links the complex “system of systems” nature characteristic of supply chains to the need for a holistic research approach such as grounded theory. It also provides a guide for researchers, reviewers, and editors to judge sound GT. Moreover, from a practical perspective, the in‐vivo nature of GT provides recognizable solutions to managerial problems.
Dealing with supply chain risks
Authors: Wieland Andreas , Wallenburg Carl Marcus
Published: May 2013

Purpose

The effects of supply chain risk management (SCRM) on the performance of a supply chain remain unexplored. It is assumed that SCRM helps supply chains to cope with vulnerabilities both proactively by supporting robustness and reactively by supporting agility. Both dimensions are assumed to have an influence on the supply chain's customer value and on business performance. The aim of this research is to provide clarity by empirically testing these hypotheses and scrutinizing the findings by the means of case studies.

Design/methodology/approach

The research is empirical. Survey data were collected from 270 manufacturing companies for hypotheses testing via structural equation modeling. Additionally, qualitative data were collected to explore the nature of non‐hypothesized findings.

Findings

It is found that SCRM is important for agility and robustness of a company. Both agility and robustness show to be important in improving performance. While agility has a strong positive effect only on the supply chain's customer value, but not directly on business performance, robustness has a strong positive effect on both performance dimensions. This important finding directs the strategic attention from agility‐centered supply chains to ones that are both robust and agile. The case studies provide insights to the fact that robustness can be considered a basic prerequisite to deal with supplier‐side risks, while agility is necessary to deal with customer‐side risks. The amount of agility and robustness needs to fit to the competitive strategy.

Practical implications

Since volatility has increasingly become a prevalent state of supply chains, companies need to consider robustness to be of primary importance to withstand everyday risks and exceptions.

Originality/value

This is the first study to view the relationship between SCRM, agility/robustness, and performance.
Critical realism in supply chain research
Authors: Adamides Emmanuel D. , Papachristos George , Pomonis Nikolaos
Published: May 2013

Purpose

The purpose of this paper is to show how a critical realist paradigmatic stance and its associated research methodology can contribute to supply‐chain research by providing explanations for specific supply‐chain‐ and logistics‐related dynamic phenomena.

Design/methodology/approach

Initially, the case for a critical realist research paradigm is made, and then a retroductive pluralistic research methodology is used for demonstrating its application. Starting from an observation in the distribution part of a seasonal goods supply chain, ethnographic‐like field research suggested deeper social structures as being responsible for the events observed. The operation of event‐generating mechanisms related to these structures was matched to existing behavioural theories using dynamic modelling and simulation.

Findings

The adoption of the critical realist perspective and its pluralistic research methodology can bring into surface the root causes of, and explain, complex supply chain phenomena. In the particular case presented, it provided an explanation for the inventories observed in a supply chain of perishable seasonal goods as results of two underlying interacting mechanisms: one related to the promotions bias of the manufacturer, and one related to the risk management attitude of resellers.

Research limitations/implications

As far as underpinning philosophy and research methodology are concerned, the research presented is globally significant and valid. Nevertheless, any supply‐chain management policies derived in the demonstrative case as results of the explanation may be significant only to specific industries and geo‐historical contexts.

Practical implications

Results obtained by employing the critical realist perspective may be used in managers' education for developing intellectual frameworks to better understand the causes of complex supply chain phenomena. Of the same importance to practitioners is the methodology and inference process used for explaining real abnormal situations and intervening accordingly.

Originality/value

The paper shows how a critical realist perspective and its associated methodology can be used for extracting/researching deeper mechanisms responsible for observed behaviours in supply chains. Such an approach is in the opposite direction with respect to the hypothetico‐deductive approaches that dominate supply chain research. The paper demonstrates the adoption of the critical realist perspective in supply chain research using a real case.
Quantifying the impact of a supply chain's design parameters on the bullwhip effect using simulation and Taguchi design of experiments
Authors: Hussain Matloub , Drake Paul R. , Myung Lee Dong
Published: May 2013

Purpose

The purpose of this paper is to quantify the effect of design parameters on the bullwhip effect and dynamic responses produced by a multi‐echelon supply chain with information sharing.

Design/methodology/approach

Taguchi design of experiments and system dynamics simulation are used to quantify the impact of a supply chain's design parameters, including degree of information sharing, on its dynamic performance, and the interactions that occur as the parameter values are varied.

Findings

Quantified relationships between supply chain design parameters and dynamic performance, including the bullwhip effect, are presented. Two parameters in particular, time to adjust inventory error and production lead time, are shown to have a particularly strong impact on the order variance compared to other parameters. However, there are several other significant findings.

Research limitations/implications

Batching and capacity constraints are common causes of the bullwhip effect, but they are not included here. Future work should quantify the impact of these.

Practical implications

This paper presents a systematic way for quantifying and understanding the impact of supply chain design parameters on the bullwhip effect and dynamic responses, and their interactions. The experimental results provide practical understanding for supply chain managers.

Originality/value

Previous studies have identified causes of the bullwhip effect but little attention has been given to quantifying their impact and interactions. This paper makes a contribution towards filling this gap, using system dynamics simulation and Taguchi design of experiments.
Starry‐eyed: journal rankings and the future of logistics research
Authors: McKinnon Alan C.
Published: May 2013

Purpose

This is a polemical paper challenging both the principle and practice of journal ranking. In recent years academics and their institutions have become obsessive about the star‐ratings of the journals in which they publish. In the UK this is partly attributed to quinquennial reviews of university research performance though preoccupation with journal ratings has become an international phenomenon. The purpose of this paper is to examine the arguments for and against these ratings and argue that, on balance, they are having a damaging effect on the development of logistics as an academic discipline.

Design/methodology/approach

The arguments advanced in the paper are partly substantiated by references to the literature on the ranking of journals and development of scientific research. A comparison is made of the rating of logistics publications in different journal ranking systems. The views expressed in the paper are also based on informal discussions with numerous academics in logistics and other fields, and long experience as a researcher, reviewer and journal editor.

Findings

The ranking of journals gives university management a convenient method of assessing research performance across disciplines, though has several disadvantages. Among other things, it can skew the choice of research methodology, lengthen publication lead times, cause academics to be disloyal to the specialist journals in their field, favour theory over practical relevance and unfairly discriminate against relatively young disciplines such as logistics. Research evidence suggests that journal ratings are not a good proxy for the value and impact of an article. The paper aims to stimulate a debate on the pros and cons of journal rankings and encourage logistics academics to reflect on the impact of these rankings on their personal research plans and the wider development of the field.

Research limitations/implications

The review of journal ranking systems is confined to three countries, the UK, Germany and Australia. The analysis of journal ranking was also limited to 11 publications with the word logistics or supply chain management. The results of this review and analysis, however, provide sufficient evidence to support the main arguments advanced in the paper.

Practical implications

The paper asserts that the journal ranking system is encouraging a retreat into ivory towers where academics become more interested in impressing each other with their intellectual brilliance than in doing research that is of real value to the outside world.

Originality/value

Many logistics academics are concerned about the situation and trends outlined in this paper, but find it very difficult to challenge the prevailing journal ranking orthodoxy. This paper may give them greater confidence to question the value of the journal ranking systems that are increasing dominating academic life.
Frost hardiness vs. growth performance in trembling aspen: an experimental test of assisted migration
Authors: Schreiber Stefan G. , Ding Chen , Hamann Andreas , Hacke Uwe G. , Thomas Barb R. , Brouard Jean S.
Published: May 2013

According to the range limit hypothesis, the distribution of many temperate species is restricted by a trade‐off between their capacity to survive winter extremes in the north (or high elevation) and their ability to compete with better‐adapted species in the south (or low elevation range limits). This trade‐off has important implications in forestry, particularly in the context of managed seed movement under climate change.

In this study, we aim to quantify trade‐offs among growth, frost hardiness and timing of leaf senescence and bud break in populations of trembling aspen, Populus tremuloides Michx., which were observed in a large reciprocal transplant experiment across five planting sites in western Canada, including additional provenances from Minnesota.

After 10 years, we found pronounced increases in productivity as a result of long‐distance transfers in a north‐west direction. For example, provenances moved 1600 km north‐west from Minnesota to central Alberta (a shift of 7° latitude to the north) produced almost twice the biomass of local sources. Similarly, provenances moved 800 km from central Alberta to north‐east British Columbia (4° latitude north) also produced twice the biomass of local sources.

We further found that increased growth was not associated with lower survival rates. Bud break in provenances transferred north‐west generally occurred slightly later than in local sources, suggesting decreased risk of spring frost injury. Leaf abscission was later in provenances transferred in a north‐west direction, but they appeared to be very frost hardy, well ahead of very rare early fall frost events.

Synthesis and applications. This study demonstrated that assisted migration prescriptions have considerable potential to enhance forest productivity. In the case of aspen, even long‐distance seed transfers in a north‐west direction were successful. We conclude that benefits in productivity outweigh potential risks associated with northward transfer of aspen planting stock under both current and projected future climate conditions.
Convergence and Divergence Dynamics inBritish andFrench Business Schools: How Will the Pressure for Accreditation Influence these Dynamics?
Authors: Thomas Lisa , Billsberry Jon , Ambrosini Véronique , Barton Harry
Published: May 2013

This paper focuses on convergence and divergence dynamics among leadingBritish andFrench business schools and explores how the pressure for accreditation influences these dynamics. We illustrate that despite historical differences in approaches to management education inBritain andFrance, these approaches have converged partly based on the influence of theAmerican model of management education but more recently through the pursuit of accreditation, in particular from theAssociation toAdvanceCollegiateSchools ofBusiness and theEuropeanQualityImprovementStandard. We explore these dynamics through the application of the resource‐based view of the firm and institutional theory and suggest that, whilst achieving accreditation is a necessary precursor for international competition, it is no longer a form of competitive advantage. The pursuit of accreditation has fostered a form of competitive mimicry reducing national distinctiveness. The resource‐based view of the firm suggests that the top schools need a more heterogeneous approach that is not easily replicable if they are to outperform the competitors. Consequently, the convergence of management education inBritain andFrance will become a new impetus for divergence. We assert that future growth and competitive advantage might be better achieved through the reassertion of national, regional and local cultural characteristics.
The Last Bastion of the Social Democratic Golden Age: The Welfare State without its Class Basis
Authors: Crook Max
Published: May 2013

The social democratic golden age is long gone; today its historical legacy is largely maintained by the European welfare state in its various continental, liberal and Nordic forms. But how long can the welfare state maintain its progressive content outside the social democratic era? Through a selection of the contemporary literature on the rise and fall of social democracy and the welfare state, this review article will argue that social democracy and its welfare state heritage are primarily based on the relative strength of the labour movement. Without this fundamental constraint on capital the welfare state's social democratic content has and will continue to come under threat. Due to the centrality of power relations in this analysis of the rise and fall of social democracy and the welfare state, the article will critique the ways in which the literature has portrayed reform as the product of seemingly objective changes within the economy and society external to class relations.
Barack Obama and the Calculus of Presidential Ambiguity
Authors: Foley Michael
Published: May 2013

The 2008 US presidential election brought victory to a largely inexperienced and untested politician who had offered himself as both a symbolic register of social change and an agency of transformative action. President Obama's campaign for re-election in 2012 prompted an intensive period of retrospection and reassessment into what the preceding four years had revealed about both the Obama phenomenon and the complex systemic environment with which he had to engage. Using an array of recently published overviews, the article examines the Obama Presidency from three different categories of analytical and evaluative assessment. It proceeds to review the seminal complaints made against his policies and style from both ends of the political spectrum – as well as Obama's responses to the increasingly fractious nature of the positioning strategies undertaken by his opponents. Finally, observations are made concerning a series of interpretive issues surrounding the 2012 result and its implications for Obama's reputation and legacy.
Impact of smoking on mortality of patients with non‐small cell lung cancer
Authors: Lee Seung Jun , Lee Jinwoo , Park Young Sik , Lee Chang‐Hoon , Lee Sang‐Min , Yim Jae‐Joon , Yoo Chul‐Gyu , Han Sung Koo , Kim Young Whan
Published: May 2013

Background

Cigarette smoking is one of the major causes of lung cancer. However, the correlation between smoking status and the survival of patients with lung cancer is uncertain. The present study aimed to evaluate the impact of smoking status on the mortality of patients with non‐small cell lung cancer (NSCLC).

Methods

The medical records of 313 patients newly diagnosed with NSCLC between January 2005 and January 2006 were reviewed. Eligible patients were divided into ever‐smokers (221 patients) and never‐smokers (92 patients), and the overall survival and clinical characteristics of the two groups were compared. Predictors of survival were analyzed using Cox's proportional hazards regression.

Results

In ever‐smokers, the mean age was higher, and male gender and squamous histology were predominant compared to never‐smokers. The median survival time was longer in never‐smokers (21.1 vs. 41.9 months, ever‐smokers vs. never‐smokers, respectively; P = 0.027). Overall survival estimates at 12, 24, and 60 months were 62.9 versus 82.6%, 43.4 versus 65.2%, and 31.2 versus 42.4%, in each group. Advanced age, advanced disease stage (stages III and IV), and coexistence of interstitial lung disease were analyzed as independent risk factors for shorter survival. Although ever‐smoking was not an independent risk factor, current smoking was a risk factor for higher mortality.

Conclusions

The overall mortality of ever‐smokers was higher than that of never‐smokers in patients with newly diagnosed NSCLC, and current smoking was an independent risk factor for a poorer prognosis.
Menopausal hot flushes do not associate with changes in heart rate variability in controlled testing: a randomized trial on hormone therapy
Authors: Hautamäki Hanna , Mikkola Tomi S. , Sovijärvi Anssi R.A. , Piirilä Päivi , Haapalahti Petri
Published: May 2013

Objective

To compare in controlled cardiovascular autonomic function tests the effects of hormone therapy (HT) on heart rate variability (HRV) responses in postmenopausal women with and without pretreatment hot flushes.

Design

A randomized placebo‐controlled trial.

Setting

Finland, Helsinki University Central Hospital.

Population

A total of 150 recently postmenopausal and healthy women with prospectively evaluated hot flushes.

Methods

Women (72 with and 78 without hot flushes) were randomized to receive estradiol alone or in combination with medroxyprogesterone acetate or placebo for 6 months. Time and frequency domain measures of HRV were assessed at baseline and after HT with short‐term recordings during paced quiet and deep breathing and with active orthostatic tests, both under carefully controlled laboratory conditions to avoid confounding factors present in long‐term ambulatory HRV measurements.

Main outcome measures

Responses of time and frequency domain measures of HRV to HT.

Results

At baseline HRV was similar in women with and without hot flushes. Pretreatment hot flushes did not associate with changes in time domain parameters of HRV during controlled quiet or deep breathing or active orthostatic tests after different types of HT. However, HT reduced HRV in very low frequency power in women with pretreatment hot flushes (from 371 ± 40 to 258 ± 28 ms2, p = 0.018). HT did not have an effect on other frequency domain measures during quiet breathing or active orthostatic tests.

Conclusions

Hormone therapy did not significantly modify the HRV responses in women with or without hot flushes under controlled short‐term measurements of the cardiovascular autonomic nervous system.
Definitions and roles of a skilled birth attendant: a mapping exercise from four South‐Asian countries
Authors: Utz Bettina , Siddiqui Ghazna , Adegoke Adetoro , van den Broek Nynke
Published: May 2013

Objective

To identify which cadres of healthcare providers are considered to be skilled birth attendants in South Asia, which of the signal functions of emergency obstetric care each cadre is reported to provide and whether this is included in their training and legislation.

Design

Cross‐sectional, descriptive study.

Setting

Bangladesh, India, Nepal and Pakistan.

Sample

Thirty‐three key informants involved in training, regulation, recruitment and deployment of healthcare providers.

Methods

Between November 2011 and March 2012, structured questionnaires were sent out to key informants by email followed up by face‐to‐face or telephone interviews.

Main outcome measures

Mapping of definitions and roles of healthcare providers in four South Asian countries to assess which cadres are skilled birth attendants.

Results

Cadres of healthcare providers expected to provide skilled birth attendance differ across countries. Although most identified cadres administer parenteral antibiotics, oxytocics and perform newborn resuscitation; administration of anticonvulsants varies by country. Manual removal of the placenta, removal of retained products of conception and assisted vaginal delivery are not provided by all cadres expected to provide skilled birth attendance.

Conclusion

Key signal functions of emergency obstetric care are often provided by medical doctors only. Provision of such potentially life‐saving interventions by more healthcare provider cadres expected to function as skilled birth attendants can save lives. Ensuring better training and legislation are in place for this is crucial.
Review article: proton pump inhibitor therapy for suspected eosinophilic oesophagitis
Authors: Molina‐Infante J. , Katzka D. A. , Gisbert J. P.
Published: May 2013

Background

Recent advances in eosinophilic oesophagitis (EoE) have confirmed the existence of a new disease phenotype, proton pump inhibitor (PPI)‐responsive oesophageal eosinophilia (PPI‐REE).

Aim

To summarise evidence supporting the use of PPI therapy in patients with suspected EoE (oesophageal dysfunction plus >15 eos/HPF in oesophageal biopsies).

Methods

A literature search was conducted through MEDLINE, using the MeSH search terms ‘eosinophilic oesophagitis’, ‘proton pump inhibitors’ and ‘oesophageal eosinophilia’. Relevant articles and their reference lists were identified through manual review.

Results

Ten articles, including 258 patients with suspected EoE (152 children, 106 adults) undergoing clinico‐histological re‐evaluation after PPI therapy, were identified. In children, clinical response ranged from 78% to 86% and histological remission from 23% to 40%. In adults, symptom response ranged from 25% to 80% and histological remission from 33% to 61%. Among PPI‐REE patients with oesophageal pH‐monitoring, 35 showed pathological and 10 normal studies. PPI‐REE was significantly commoner with documented gastro‐oesophageal reflux disease (GERD) when compared to patients with negative pH monitoring (70% vs. 29%, P < 0.001). Symptom improvement/resolution occurred in 50–85% of patients without histological remission on PPI therapy. Six PPI‐REE patients demonstrated clinico‐histological relapse on PPI therapy.

Conclusions

At least one third of patients with suspected EoE achieve clinico‐histological remission on PPI therapy. Response is more limited in children compared with that in adults. pH monitoring does not accurately predict response to PPI therapy, albeit histological remission is significantly higher, up to 70%, upon documented GERD. Symptom improvement is common with PPI therapy despite persistent eosinophilic infiltration.
The haemocytes of the salpThalia democratica(Tunicata, Thaliacea): an ultrastructural and histochemical study in the oozoid
Authors: Cima Francesca , Caicci Federico , Sordino Paolo
Published: May 2013

In comparative immunology and evolution of the chordate immune system, tunicates hold an important phylogenetic position as sister group of vertebrates. However, knowledge of the tunicate immune system is limited to the class Ascidiacea, in which some species are now considered model organisms. In the class Thaliacea, represented by fragile pelagic species, the few studies on their haemocytes go back to several decades ago and do not consider comparative aspects with ascidian haemocytes. In this study, we identified various haemocyte types and their distribution in the common salpThalia democraticaby comparative observations under light and electron microscopy and by histochemical, histoenzymatic and immunohistochemical techniques. By comparing specialisations with those of ascidian haemocytes, we detected an undifferentiated cell type (lymphocyte‐like cell) and three categories with four cell types, that is, (i) phagocytic line (hyaline amoebocyte and amoebocyte with large vacuoles), (ii) mast cell‐like line (granular cell) and (iii) storage cells (nephrocyte). Both phagocytes and granular cells appear to migrate in the tunic. Phagocytes adhere to the tunic which internally covers the oral siphon, where they probably function as sentinel cells of the pharynx. Results show the variety of haemolymph cells in the salp similar to phlebobranch ascidians.
In‐hospital mortality and failure‐to‐rescue rates after radical cystectomy
Authors: Trinh Vincent Q. , Trinh Quoc‐Dien , Tian Zhe , Hu Jim C. , Shariat Shahrokh F. , Perrotte Paul , Karakiewicz Pierre I. , Sun Maxine
Published: May 2013

Objective

To show the underlying variability in peri‐operative mortality after radical cystectomy (RC) by analysing failure‐to‐rescue (FTR) rates, i.e. deaths after complications.

Materials and Methods

Patients undergoing RC for non‐metastatic bladder cancer (BCa) were identified from the Nationwide Inpatient Sample, 1999–2009, resulting in a weighted estimate of 79 972 patients.

The FTR rates were assessed according to patient and hospital characteristics, as well as complication type.

Generalized linear regression analyses were performed.

Results

Overall, 26 740 patients had a complication, corresponding to a FTR rate of 5.5%. Septicaemia (odds ratio [OR]: 13.41, P < 0.001) and cardiac (OR: 3.97, P < 0.001), wound‐related (OR: 2.12, P < 0.001), genitourinary (OR: 1.62, P = 0.045) and haematological (OR: 1.78, P = 0.008) complications were associated with FTR.

Older age (OR: 1.05, P < 0.001), increasing comorbidities (OR: 1.33, P < 0.001), Medicare (OR: 1.52, P = 0.016), and Medicaid insurance status (OR: 2.10, P = 0.029) were associated with higher odds of FTR. Conversely, increasing hospital volume (OR: 0.992, P = 0.014) reduced the odds of FTR.

Conclusions

Whereas both patient and hospital characteristics were associated with increased odds of FTR, the occurrence of septicaemia and cardiac complications were the most strongly associated with a higher risk of in‐hospital mortality.
Outpatient laser ablation of non‐muscle‐invasive bladder cancer: is it safe, tolerable and cost‐effective?
Authors: Wong Kathie A. , Zisengwe Grace , Athanasiou Thanos , O'Brien Tim , Thomas Kay
Published: May 2013

Objectives

To evaluate the safety, tolerability and effectiveness of outpatient (office‐based) laser ablation (OLA), with local anaesthetic, for non‐muscle‐invasive bladder cancer (NMIBC) in an elderly population with and without photodynamic diagnosis (PDD).

To compare the cost‐effectiveness ofOLAofNMIBCwith that of inpatient cystodiathermy (IC).

Patients and Methods

We conducted a prospective cohort study of patients withNMIBCtreated withOLAby one consultant surgeon betweenMarch 2008 andJuly 2011

A subgroup of patients hadPDDbefore undergoingOLA.

Safety and effectiveness were determined by complications (In the immediate post operative period, at three days and at three months), patient tolerability (visual analogue score) and recurrence rates.

The long‐term costs and cost‐effectiveness ofOLAandICofNMIBCwere evaluated usingMarkov modeling.

Results

A total of 74OLAprocedures (44 white‐light, 30PDD) were carried out in 54 patients. The mean (range) patient age was 77 (52–95) years. More than half of the patients had more than three comorbidities. Previous tumour histology ranged fromG1pTatoT3.

One patient had haematuria for 1 week which settled spontaneously and did not require hospital admission. There were no other complications.

The procedure was well tolerated with pain scores of 0–2/10.

Additional lesions were found in 21% of patients usingPDDthat were not found using white light.

At 3 months, the percentage of patients who had recurrence afterOLAwith white light andOLAwithPDDwere 10.6 and 4.3%, respectively. At 1 year, 65.1% and 46.9% of patients had recurrence.

The cost ofOLAwas found to be much lower than that ofIC(£538 vs £1474), even with the addition ofPDD(£912 vs £1844).

Over the course of a patient's lifetime,OLAwas more clinically effective, measured in quality‐adjusted life‐years (QALY), thanIC(0.147 [sd0.059]) and less costly (£2576.42 [sd£7293.07]).

At a cost‐effectiveness threshold of £30 000/QALY, as set by theNationalInstitute forHealth andCareExcellence, there was an 82% probability thatOLAwas cost‐effective.

Conclusions

This is the first study to demonstrate the long‐term cost‐effectiveness ofOLAofNMIBC.

The results support the use ofOLAfor the treatment ofNMIBC, especially in the elderly.
Need to void and attentional process interrelationships
Authors: Jousse Marylène , Verollet Delphine , Guinet‐Lacoste Amandine , Le Breton Frédérique , Auclair Laurent , Sheikh Ismael Samer , Amarenco Gérard
Published: May 2013

Objectives

To determine whether a strong urge to void could affect a person's attentional performance.

To determine whether an attentional task could decrease a strong urge to void a prospective study was performed.

Subjects and Methods

Healthy adults were asked to perform two neuropsychological tests, the modified Paced Auditory Serial Addition Test (mPASAT) and the Psychology Experiment Building Language Continuous Performance Test (pCPT), under two different conditions: no need to void, and a strong urge to void defined by a score of >70/100 mm on a visual analogue scale.

Results

In all, 21 healthy volunteers were included.

There was no statistical difference between the mPASAT scores from the two sessions (P = 0.57).

The mean total error score of the pCPT increased with the individual's urge to void (P = 0.043).

The mean omission score decreased, but was not statistically different (P = 0.129), the commission error score increased with the urge to void (P = 0.017), with a shorter reaction time for the inter‐stimuli intervals of 1 (P < 0.001) and 2 s (P = 0.036), suggesting a tendency to hurry.

Conclusions

A strong urge to void can alter attentional performance, with a tendency to hurry, in healthy volunteers taking part in a sustained attention test pCPT involving the use of the anterior cingulate cortex.
High levels of CD20 expression predict good prognosis in chronic lymphocytic leukemia
Authors: Fang Cheng , Zhuang Yun , Wang Li , Fan Lei , Wu Yu‐Jie , Zhang Run , Zou Zhi‐Jian , Zhang Li‐Na , Yang Shu , Xu Wei , Li Jian‐Yong
Published: May 2013

Heterogeneity of CD20 expression exists in chronic lymphocytic leukemia (CLL), therefore, we explored the prognostic significance of CD20 expression in Chinese patients with CLL. Multiparameter flow cytometry was used to detect the expression of CD20 in CD5+CD19+ cells. In 172 CLL patients, the median expression percent of CD20 was 97.82% (range, 0–100), and the median mean fluorescence intensity (MFI) of CD20 in CLL cells was 731.45 (range, 0.00–9071.90). The percentage of CD20+ cells in the patient group with mutated variable region of immunoglobulin genes (IGHV) was higher than in the non‐mutant IGHV group (mean, 92.1% vs 80.4%, P < 0.001). There were no differences in the MFI of CD20+ cells in all prognostic factor groups. Representation of the data using a receiver operating characteristic plot reflected separation between the two IGHV groups, with an area under the curve of 0.661 (95% confidence interval, 0.569–0.753). At the cut‐off value of 60.3% for percentage of CD20, the sensitivity and specificity were 90.00% and 38.46%, respectively. Patients whose percentage of CD20 antigen was above 60.3% had longer treatment‐free survival (hazard ratio, 0.452; 95% confidence interval, 0.232–0.884, P = 0.020). Percentage and MFI of CD20 were the variables not associated with treatment‐free survival by multivariate Cox regression analysis (P < 0.05). High level of CD20 expression in de novo CLL appears to be associated with a good prognosis.
Speech, communication and use of augmentative communication in young people with cerebral palsy: The SH&PE population study
Authors: Cockerill H. , Elbourne D. , Allen E. , Scrutton D. , Will E. , McNee A. , Fairhurst C. , Baird G.
Published: May 2013

Background

Communication is frequently impaired in young people (YP) with bilateral cerebral palsy (CP). Important factors include motoric speech problems (dysarthria) and intellectual disability. Augmentative and Alternative Communication (AAC) techniques are often employed. The aim was to describe the speech problems in bilateral CP, factors associated with speech problems, current AAC provision and use, and to explore the views of both the parent/carer and young person about communication.

Methods

A total population of children with bilateral CP (n = 346) from four consecutive years of births (1989–1992 inclusive) with onset of CP before 15 months were reassessed at age 16–18 years. Motor skills and speech were directly assessed and both parent/carer and the young person asked about communication and satisfaction with it.

Results

Sixty had died, eight had other conditions, 243 consented and speech was assessed in 224 of whom 141 (63%) had impaired speech. Fifty‐two (23% of total YP) were mainly intelligible to unfamiliar people, 22 (10%) were mostly unintelligible to unfamiliar people, 67 (30%) were mostly or wholly unintelligible even to familiar adults. However, 89% of parent/carers said that they could communicate 1:1 with their young person. Of the 128 YP who could independently complete the questions, 107 (83.6%) were happy with their communication, nine (7%) neither happy nor unhappy and 12 (9.4%) unhappy. A total of 72 of 224 (32%) were provided with one or more types of AAC but in a significant number (75% of 52 recorded) AAC was not used at home, only in school. Factors associated with speech impairment were severity of physical impairment, as measured by Gross Motor Function Scale level and manipulation in the best hand, intellectual disability and current epilepsy.

Conclusions

In a population representative group of YP, aged 16–18 years, with bilateral CP, 63% had impaired speech of varying severity, most had been provided with AAC but few used it at home for communication.
Flow cytometric assay detecting cytotoxicity against human endogenous retrovirus antigens expressed on cultured multiple sclerosis cells
Authors: Møller-Larsen A , Brudek T , Petersen T , Petersen E L , Aagaard M , Hansen D T , Christensen T
Published: May 2013

Damage of target cells by cytotoxicity, either mediated by specific lymphocytes or via antibody-dependent reactions, may play a decisive role in causing the central nervous system (CNS) lesions seen in multiple sclerosis (MS). Relevant epitopes, antibodies towards these epitopes and a reliable assay are all mandatory parts in detection and evaluation of the pertinence of such cytotoxicity reactions. We have adapted a flow cytometry assay detecting CD107a expression on the surface of cytotoxic effector cells to be applicable for analyses of the effect on target cells from MS patients expressing increased amounts of human endogenous retrovirus antigens. MS patients also have increased antibody levels to these antigens. The target cells are spontaneously growing peripheral blood mononuclear cells (PBMCs) of B cell lineage, expressing human endogenous retrovirus HERV epitopes on their surface. Polyclonal antibodies against defined peptides in the Env- and Gag-regions of the HERVs were raised in rabbits and used in antibody-dependent cell-mediated cytotoxicity (ADCC) -assays. Rituximab® (Roche), a chimeric monoclonal antibody against CD20 expressed primarily on B cells, was used as control antibody. Without antibodies this system is suitable for analyses of natural killer cell activity. In optimization of the assay we have used effector lymphocytes from healthy donors. The most effective effector cells are CD56+ cells. CD8+ T cells also express CD107a in ADCC. Using the adapted assay, we demonstrate significant ADCC activity to target cells expressing HERV epitopes, and additionally a low level of NK activity.
Fungal infections after liver transplantation: outcomes and risk factors revisited in the MELD era
Authors: Saliba Faouzi , Delvart Valérie , Ichaï Philippe , Kassis Najiby , Botterel Françoise , Mihaila Liliana , Azoulay Daniel , Adam René , Castaing Denis , Bretagne Stéphane , Samuel Didier
Published: May 2013

Antifungal prophylaxis is recommended in high‐risk patients, but risk criteria remain unclear and the predictive value of Model of End‐Stage Liver Disease (MELD) score is unknown. In a retrospective, single‐center analysis of 667 liver transplants, potential risk factors for fungal infection were assessed, including MELD score. Antifungal prophylaxis was administered in 198 patients (29.4%). During follow‐up (mean 43.6 ± 29.6 months), 263 patients (39.4%) developed ≥1 episode of fungal infection, and 187 (28.0%) patients developed a probable or proven invasive fungal infection requiring systemic antifungal treatment. Patients receiving antifungal prophylaxis had a lower incidence of fungal infection (29.8% vs. 43.5% without prophylaxis, p < 0.001) and invasive fungal infection (17.7% vs. 32.4%, p < 0.001). One‐yr patient survival was 91%, 85% and 69%, respectively, in patients with no fungal infection, fungal colonization and treated invasive fungal infection (p < 0.001); graft survival was 88%, 85% and 66% (p < 0.001). Multivariate analysis indicated that MELD score of 20–30 or ≥30 was associated with a 2.0‐fold or 4.3‐fold increase in relative risk of fungal infection, respectively, and a 2.1‐fold or 3.1‐fold increase in relative risk of invasive fungal infection. In conclusion, liver transplant patients with a MELD score ≥20, and particularly patients with a score ≥30, are candidates for antifungal prophylaxis.