bluuebunny/crossref_metadata_2025 huggingface dataset:
Fatal Streptococcus anginosus‐associated pneumonia in a captive Sumatran orangutan (Pongo abelii)
Authors: Ihms E.A. , Daniels J.B. , Koivisto C.S. , Barrie M.T. , Russell D.S.
Published: October 2013

Background

Bacterial infections commonly affect the lungs and air sacs of orangutans; culture and identification is rarely performed and may have clinical relevance.

Methods

Necropsy, histopathology and bacterial culture were performend on a captive adult male Sumatran orangutan with chronic air sacculitis. Bacterial speciation was confirmed by sequencing of the 16s–23s ribosomal DNA spacer region.

Results

Necropsy revealed severe suppurative pneumonia. Moderate growth of Streptoccocus anginosus was recovered from the lungs.

Conclusions

This is the first report of S. anginosus as a cause of fatal suppurative pneumonia in a non‐human primate.
A lipid neurochemist's siren: docosahexaenoic acid and its elusive function in the central nervous system
Authors: Murphy Eric J.
Published: October 2013

Read the full article ‘Unesterified docosahexaenoic acid is protective in neuroinflammation’ on doi: 10.1111/jnc.12392.
Celastrol prevents cadmium‐induced neuronal cell death via targeting JNK and PTEN‐Akt/mTOR network
Authors: Chen Sujuan , Gu Chenjian , Xu Chong , Zhang Jinfei , Xu Yijiao , Ren Qian , Guo Min , Huang Shile , Chen Long
Published: October 2013

Cadmium (Cd), a toxic environmental contaminant, induces neurodegenerative diseases. Celastrol, a plant‐derived triterpene, has shown neuroprotective effects in various disease models. However, little is known regarding the effect of celastrol on Cd‐induced neurotoxicity. Here, we show that celastrol protected against Cd‐induced apoptotic cell death in neuronal cells. This is supported by the findings that celastrol strikingly attenuated Cd‐induced viability reduction, morphological change, nuclear fragmentation, and condensation, as well as activation of caspase‐3 in neuronal cells. Concurrently, celastrol remarkably blocked Cd‐induced phosphorylation of c‐Jun N‐terminal kinase (JNK), but not extracellular signal‐regulated kinases 1/2 and p38, in neuronal cells. Inhibition of JNK by SP600125 or over‐expression of dominant negative c‐Jun potentiated celastrol protection against Cd‐induced cell death. Furthermore, pre‐treatment with celastrol prevented Cd down‐regulation of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and activation of phosphoinositide 3′‐kinase/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling in neuronal cells. Over‐expression of wild‐type PTEN enhanced celastrol inhibition of Cd‐activated Akt/mTOR signaling and cell death in neuronal cells. The findings indicate that celastrol prevents Cd‐induced neuronal cell death via targeting JNK and PTEN‐Akt/mTOR network. Our results strongly suggest that celastrol may be exploited for the prevention of Cd‐induced neurodegenerative disorders.

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Celastrol, a plant‐derived triterpene, has shown neuroprotective effects. However, little is known regarding the effect of celastrol on cadmium (Cd) neurotoxicity. This study underscores that celastrol prevents Cd‐induced neuronal apoptosis via inhibiting activation of JNK (c‐Jun N‐terminal kinase) and Akt/mTOR network. Celastrol suppresses Cd‐activated Akt/mTOR pathway by elevating PTEN (phosphatase and tensin homolog). The findings suggest that celastrol may be exploited for the prevention of Cd‐induced neurodegenerative disorders.
Murine dopaminergic Müller cells restore motor function in a model of Parkinson's disease
Authors: Stutz Bernardo , da Conceição Fabio Silva Lima , Santos Luís Eduardo , Cadilhe Daniel Veloso , Fleming Renata L. , Acquarone Mariana , Gardino Patrícia F. , de Melo Reis Ricardo A. , Dickson Phillip W. , Dunkley Peter R. , Rehen Stevens , Houzel Jean‐Christophe , de Mello Fernando G.
Published: October 2013

Müller cells constitute the main glial cell type in the retina where it interacts with virtually all cells displaying relevant functions to retinal physiology. Under appropriate stimuli, Müller cells may undergo dedifferentiation, being able to generate other neural cell types. Here, we show that purified mouse Müller cells in culture express a group of proteins related to the dopaminergic phenotype, including the nuclear receptor‐related 1 protein, required for dopaminergic differentiation, as well the enzyme tyrosine hydroxylase. These dopaminergic components are active, since Müller cells are able to synthesize and release dopamine to the extracellular medium. Moreover, Müller‐derived tyrosine hydroxylase can be regulated, increasing its activity because of phosphorylation of serine residues in response to agents that increase intracellular cAMP levels. These observations were extended to glial cells obtained from adult monkey retinas with essentially the same results. To address the potential use of dopaminergic Müller cells as a source of dopamine in cell therapy procedures, we used a mouse model of Parkinson's disease, in which mouse Müller cells with the dopaminergic phenotype were transplanted into the striatum of hemi‐parkinsonian mice generated by unilateral injection of 6‐hydroxydopamine. These cells fully decreased the apomorphine‐induced rotational behavior and restored motor functions in these animals, as measured by the rotarod and the forelimb‐use asymmetry (cylinder) tests. The data indicate local restoration of dopaminergic signaling in hemi‐parkinsonian mice confirmed by measurement of striatal dopamine after Müller cell grafting.

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Müller cells are the main glial cells in the retina. When these cells are cultured in the absence of neurons, they spontaneously express proteins of the dopaminergic phenotype, including the enzymes tyrosine hydroxylase (TH), L‐DOPA‐decarboxylase (DDC) and the dopamine transport system (DAT). In this study, we show this phenomenon is observed with Müller cells obtained from different species, including primates, and address the therapeutic potential of these cells, using a mouse model of Parkinson's disease (PD). ‘Dopaminergic Müller cells’ synthesize dopamine and release most of this neurotransmitter to the extracellular space, constituting a natural dopaminergic ‘pump’. When transplanted to the striatum of PD mice, Müller cells decreased their apomorphine‐induced rotational behavior and restored their overall motor functions, measured by rotarod and forelimb use asymmetry tests. Local restoration of dopaminergic signaling was also observed in grafted PD mice, by measuring striatum dopamine and its metabolite (DOPAC) levels (SB: 20µm).
KIBRA (KIdney/BRAin protein) regulates learning and memory and stabilizes Protein kinase Mζ
Authors: Vogt‐Eisele Angela , Krüger Carola , Duning Kerstin , Weber Daniela , Spoelgen Robert , Pitzer Claudia , Plaas Christian , Eisenhardt Gisela , Meyer Annette , Vogt Gerhard , Krieger Markus , Handwerker Eva , Wennmann Dirk Oliver , Weide Thomas , Skryabin Boris V. , Klugmann Matthias , Pavenstädt Hermann , Huentelmann Matthew J. , Kremerskothen Joachim , Schneider Armin
Published: October 2013

The WWC1 gene has been genetically associated with human episodic memory performance, and its product KIdney/BRAin protein (KIBRA) has been shown to interact with the atypical protein kinase protein kinase M ζ (PKMζ). Although recently challenged, PKMζ remains a candidate postsynaptic regulator of memory maintenance. Here, we show that PKMζ is subject to rapid proteasomal degradation and that KIBRA is both necessary and sufficient to counteract this process, thus stabilizing the kinase and maintaining its function for a prolonged time. We define the binding sequence on KIBRA, a short amino acid motif near the C‐terminus. Both hippocampal knock‐down of KIBRA in rats and KIBRA knock‐out in mice result in decreased learning and memory performance in spatial memory tasks supporting the notion that KIBRA is a player in episodic memory. Interestingly, decreased memory performance is accompanied by decreased PKMζ protein levels. We speculate that the stabilization of synaptic PKMζ protein levels by KIBRA may be one mechanism by which KIBRA acts in memory maintenance.

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KIBRA/WWC1 has been genetically associated with human episodic memory. KIBRA has been shown to be post‐synaptically localized, but its function remained obscure. Here, we show that KIBRA shields PKMζ, a kinase previously linked to memory maintenance, from proteasomal degradation via direct interaction. KIBRA levels in the rodent hippocampus correlate closely both to spatial memory performance in rodents and to PKMζ levels. Our findings support a role for KIBRA in memory, and unveil a novel function for this protein.
Non‐motor parkinsonian pathology in aging A53T α‐Synuclein mice is associated with progressive synucleinopathy and altered enzymatic function
Authors: Farrell Kaitlin F. , Krishnamachari Sesha , Villanueva Ernesto , Lou Haiyan , Alerte Tshianda N. M. , Peet Eloise , Drolet Robert E. , Perez Ruth G.
Published: October 2013

Aging, the main risk factor for Parkinson's disease (PD), is associated with increased α–synuclein levels in substantia nigra pars compacta (SNc). Excess α‐synuclein spurs Lewy‐like pathology and dysregulates the activity of protein phosphatase 2A (PP2A). PP2A dephosphorylates many neuroproteins, including the catecholamine rate‐limiting enzyme, tyrosine hydroxylase (TH). A loss of nigral dopaminergic neurons induces PD movement problems, but before those abnormalities occur, behaviors such as olfactory loss, anxiety, and constipation often manifest. Identifying mouse models with early PD behavioral changes could provide a model in which to test emerging therapeutic compounds. To this end, we evaluated mice expressing A53T mutant human (A53T) α–synuclein for behavior and α–synuclein pathology in olfactory bulb, adrenal gland, and gut. Aging A53T mice exhibited olfactory loss and anxiety that paralleled olfactory and adrenal α‐synuclein aggregation. PP2A activity was also diminished in olfactory and adrenal tissues harboring insoluble α‐synuclein. Low adrenal PP2A activity co‐occurred with TH hyperactivity, making this the first study to link adrenal synucleinopathy to anxiety and catecholamine dysregulation. Aggregated A53T α–synuclein recombinant protein also had impaired stimulatory effects on soluble recombinant PP2A. Collectively, the data identify an excellent model in which to screen compounds for their ability to block the spread of α‐synuclein pathology associated with pre‐motor stages of PD.

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Aging A53T α‐synuclein mice develop behaviors common to premotor Parkinson's disease (PD) with synucleinopathy occuring in adrenal gland, olfactory bulb, and intestine. Insoluble aggregated A53T α‐synuclein loses PP2A‐stimulatory‐effects, which normally down regulate dopamine synthesis. This is the first study to link adrenal synucleinopathy to catecholamine dysregulation and anxiety. The mice are an excellent model for testing emerging neuroprotective therapies for PD.
Lentivirus‐Mediated α‐Melanocyte‐Stimulating Hormone Overexpression in the Hypothalamus Decreases Diet Induced Obesity in Mice
Authors: Eerola K. , Nordlund W. , Virtanen S. , Dickens A. M. , Mattila M. , Ruohonen S. T. , Chua S. C. , Wardlaw S. L. , Savontaus M. , Savontaus E.
Published: October 2013

Melanocyte stimulating hormone (MSH) derived from the pro‐hormone pro‐opiomelanocortin (POMC) has potent effects on metabolism and feeding that lead to reduced body weight in the long‐term. To determine the individual roles of POMC derived peptides and their sites of action, we created a method for the delivery of single MSH peptides using lentiviral vectors and studied the long‐term anti‐obesity effects of hypothalamic α‐MSH overexpression in mice. An α‐MSH lentivirus (LVi‐α‐MSH‐EGFP) vector carrying the N‘‐terminal part of POMC and the α‐MSH sequence was generated and shown to produce bioactive peptide in an in vitro melanin synthesis assay. Stereotaxis was used to deliver the LVi‐α‐MSH‐EGFP or control LVi‐EGFP vector to the arcuate nucleus (ARC) of the hypothalamus of male C57Bl/6N mice fed on a high‐fat diet. The effects of 6‐week‐treatment on body weight, food intake, glucose tolerance and organ weights were determined. Additionally, a 14‐day pairfeeding study was conducted to assess whether the weight decreasing effect of the LVi‐α‐MSH‐EGFP treatment is dependent on decreased food intake. The 6‐week LVi‐α‐MSH‐EGFP treatment reduced weight gain (8.4 ± 0.4 g versus 12.3 ± 0.6 g; P < 0.05), which was statistically significant starting from 1 week after the injections. The weight of mesenteric fat was decreased and glucose tolerance was improved compared to LVi‐EGFP treated mice. Food intake was decreased during the first week in the LVi‐α‐MSH‐EGFP treated mice but subsequently increased to the level of LVi‐EGFP treated mice. The LVi‐EGFP injected control mice gained more weight even when pairfed to the level of food intake by LVi‐α‐MSH‐EGFP treated mice. We demonstrate that gene transfer of α‐MSH, a single peptide product of POMC, into the ARC of the hypothalamus, reduces obesity and improves glucose tolerance, and that factors other than decreased food intake also influence the weight decreasing effects of α‐MSH overexpression in the ARC. Furthermore, viral MSH vectors delivered stereotaxically provide a novel tool for further exploration of chronic site‐specific effects of POMC peptides.
Building an open academic environment – a new approach to empowering students in their learning of anatomy through ‘Shadow Modules’
Authors: Scott Jonathan L. , Moxham Bernard J. , Rutherford Stephen M.
Published: October 2013

Teaching and learning in anatomy is undertaken by a variety of methodologies, yet all of these pedagogies benefit from students discussing and reflecting upon their learning activities. An approach of particular potency is peer‐mediated learning, through either peer‐teaching or collaborative peer‐learning. Collaborative, peer‐mediated, learning activities help promote deep learning approaches and foster communities of practice in learning. Students generally flourish in collaborative learning settings but there are limitations to the benefits of collaborative learning undertaken solely within the confines of modular curricula. We describe the development of peer‐mediated learning through student‐focused and student‐led study groups we have termed ‘Shadow Modules’. The ‘Shadow Module’ takes place parallel to the formal academically taught module and facilitates collaboration between students to support their learning for that module. In ‘Shadow Module’ activities, students collaborate towards curating existing online open resources as well as developing learning resources of their own to support their study. Through the use of communication technologies and Web 2.0 tools these resources are able to be shared with their peers, thus enhancing the learning experience of all students following the module. The Shadow Module activities have the potential to lead to participants feeling a greater sense of engagement with the subject material, as well as improving their study and group‐working skills and developing digital literacy. The outputs from Shadow Module collaborative work are open‐source and may be utilised by subsequent student cohorts, thus building up a repository of learning resources designed by and for students. Shadow Module activities would benefit all pedagogies in the study of anatomy, and support students moving from being passive consumers to active participants in learning.
Origin of the unique morphology of the shoulder girdle in turtles
Authors: Nagashima Hiroshi , Hirasawa Tatsuya , Sugahara Fumiaki , Takechi Masaki , Usuda Ryo , Sato Noboru , Kuratani Shigeru
Published: October 2013

The shoulder girdle of turtles has a triradiate morphology. Although its dorsal process represents the scapular blade, the skeletal identities of the two ventral processes remain uncertain. To elucidate the question, developmental patterns of the girdles were compared between Chinese soft‐shelled turtles, chickens, and mice. Despite the morphological diversity of adults, the initial primordia of the shoulder girdles showed similar morphological patterns. The ventral two processes developed from the anlagen comparable to those of the acromion and the coracoid in other amniotes. The developmental pattern of the acromion is very similar among embryos, whereas that of the coracoid in mammals differs from that in non‐mammals, implying that coracoids are not homologous between non‐mammals and mammals. Therefore, amniotes have retained the ancestral pattern of the girdle anlage, and the shoulder girdle of turtles has been achieved through a transformation of the pattern in the late ontogenic period.
The complex ontogenetic trajectory of mandibular shape in a laboratory mouse
Authors: Swiderski Donald L. , Zelditch Miriam L.
Published: October 2013

The mouse mandible is a popular model system that continues to be the focus of studies in evo‐devo and other fields. Yet, little attention has been given to the role of postnatal growth in producing the adult form. Using cleared and stained specimens, we describe the timing of tooth and jaw development and changes in jaw size and shape from postnatal day 1 (p1) through weaning to adulthood. We found that tooth development is relatively advanced at birth, and that the functional adult dentition is in place by p15 (just before the start of weaning). Shape analysis showed that the trajectory of mandible shape changes direction at least twice between birth and adulthood, at p7 and p15. At each stage there are changes in shape to all tooth‐ and muscle‐bearing regions and, at each change of direction, all of these regions change their pattern of growth. The timing of the changes in direction in Mus suggests there are signals that redirect growth patterns independently of changes in function and loading associated with weaning and jaw muscle growth. A better understanding of these signals and how they produce a functionally integrated mandible may help explain the mechanisms guiding evolutionary trends and patterns of plasticity and may also provide valuable clues to therapeutic manipulation of growth to alleviate the consequences of trauma or disease.
Gender differences in sagittal standing alignment before pubertal peak growth: the importance of subclassification and implications for spinopelvic loading
Authors: Dolphens Mieke , Cagnie Barbara , Vleeming Andry , Vanderstraeten Guy , Danneels Lieven
Published: October 2013

The aim of this study was to analyze gender differences in sagittal standing alignment at pre‐peak height velocity age thereby applying a scientifically sound and practically oriented classification scheme for overall standing balance. The study population consisted of healthy boys (n = 639) and girls (n = 557) before pubertal peak growth. During subjects' habitual standing, sagittal plane measures of the spine, pelvis and lower limbs were collected using a clinical screening protocol. With each subject classified as one of three postural types (neutral, sway‐back, or leaning‐forward), differences in sagittal plane alignment were analyzed between sexes. The results revealed clear differences between genders in each of the postural types. Within the neutral and sway‐back postural subgroups, boys presented more forward inclination of the trunk, more thoracic kyphosis and more pelvis backtilt compared with girls. Within the leaning‐forward category, girls displayed more forward trunk lean, less thoracic kyphosis and more pelvic anteversion. A state of lumbar segmental hyperextension appeared to exist in female leaning‐forward subjects. Our results reveal for the first time that sagittal standing alignment is different between prepubescent boys and girls when subjects are appropriately subclassified, and conversely represent a ‘wash‐out effect’ when pooled. When the classification system is applied, gender‐specificity in gravity line position is suggested, implying gender‐related differences in lever arms and thus load. Present findings may add to our understanding of gender‐specific biomechanical challenges posed by habitual posture, and may shed new light on sagittal standing alignment as a possible contributory factor in developmental spinal‐pelvic disorders.
A belief in the soul may contribute to the stress experienced in the dissecting room
Authors: Martyn Helen , Barrett Anthony , Nicholson Helen D.
Published: October 2013

The aim of this research was to explore whether medical students believe in a soul and how this may affect their dissecting experience. Three questionnaires were delivered electronically to the 2011 cohort of second‐year medical students over a 2‐year period. At the University of Otago, students enter medicine via three categories: Health Sciences First Year (following 1 year of university); postgraduate (following a Bachelors or higher degree); and ‘other’ category entry (Allied Health Professional or 3 years after a Bachelors degree). The entry category, age, ethnicity and gender of the students were collected; 51.6% of the students believed in the concept of a soul. On a scale of 1–5, students ranked the importance of religion/spirituality as 2.69. Those who believed in a soul were more likely to have a religious/spiritual component to their life and be males or ‘other’ category entrants. However, there were many students who believed in the soul who did not have a religious/spiritual association, suggesting that this belief extends beyond religion. Those who believed in a soul had significantly higher anticipatory stress and experienced higher levels of stress during dissection. A higher proportion of students in the ‘other’ category entrants believed in the concept of the soul and also had significantly higher levels of stress during dissection. Our data suggest that a belief in a soul may affect students' experiences in dissecting. Incorporating the teaching of humanities with anatomy may help medical students as they assimilate both the biomedical and philosophical aspects of dissection.
Materialism and Life Satisfaction: The Role of Stress and Religiosity
Authors: BAKER ANDREW M. , MOSCHIS GEORGE P. , ONG FON SIM , PATTANAPANYASAT RA‐PEE
Published: October 2013

Materialism has been a topic of interest to consumer researchers for decades. This article explores the effect of materialism on individuals' life satisfaction using a large sample from Malaysia, a country with cultural diversity within a collectivist mainstream culture. The results suggest that the effects of materialism on life satisfaction could be indirect, mediated by stress and moderated by religiosity. The study helps to explain the mechanisms that account for the negative relationship between materialism and life satisfaction reported in previous studies conducted in many countries; it provides a blueprint and directions for further research.
Prices Paid in Grocery Markets: Searching Across Stores and Brands
Authors: BINKLEY JAMES
Published: October 2013

Using a large sample of prices paid for 21 homogeneous grocery products available in several brands in each of 16 markets, we simulate the search behavior of a consumer following different shopping strategies using as many as four supermarkets. We find that price search can lead to substantial savings. Brand switching can generate savings at least as large as visiting multiple stores to find the lowest price for a single brand. Buying a private label is usually a better way to save than any amount of search for low prices on national brands. A case study in a small metropolitan area grocery market yields results substantially the same as the simulation results.
Safety incidents involving confused and forgetful older patients in a specialised care setting – analysis of the safety incidents reported to the HaiPro reporting system
Authors: Kinnunen‐Luovi Kaisa , Saarnio Reetta , Isola Arja
Published: October 2013

Aims and objectives

To describe the safety incidents involving confused and forgetful older patients in a specialised care setting entered in the HaiPro reporting system.

Background

About 10% of patients experience a safety incident during hospitalisation, which causes or could cause them harm. The possibility of a safety incident during hospitalisation increases significantly with age. A mild or moderate memory disorder and acute confusion are often present in the safety incidents originating with an older patient.

Design

The design of the study was action research with this study using findings from one of the first‐phase studies, which included qualitative and quantitative analysed data.

Methods

Data were collected from the reporting system for safety incidents (HaiPro) in a university hospital in Finland. There were 672 reported safety incidents from four acute medical wards during the years 2009–2011, which were scrutinised. Seventy‐five of them were linked to a confused patient and were analysed.

Results

The majority of the safety incidents analysed involved patient‐related accidents. In addition to challenging behaviour, contributing factors included ward routines, shortage of nursing staff, environmental factors and staff knowledge and skills. Nurses tried to secure the patient safety in many different ways, but the modes of actions were insufficient.

Conclusion and relevance to clinical practice

Nursing staff need evidence‐based information on how to assess the cognitive status of a confused patient and how to encounter such patients. The number of nursing staff and ward routines should be examined critically and put in proportion to the care intensity demands caused by the patient's confused state. The findings can be used as a starting point in the prevention of safety incidents and in improving the care of older patients.
Are Analysts’ Recommendations Informative? Intraday Evidence on the Impact of Time Stamp Delays
Authors: BRADLEY DANIEL , CLARKE JONATHAN , LEE SUZANNE , ORNTHANALAI CHAYAWAT
Published: October 2013

We demonstrate that time stamps reported in I/B/E/S for analysts’ recommendations released during trading hours are systematically delayed. Using newswire‐reported time stamps, we find 30‐minute returns of 1.83% (−2.10%) for upgrades (downgrades), but for this subset of recommendations we find corresponding returns of −0.07% (−0.09%) using I/B/E/S‐reported time stamps. We also examine the information content of recommendations relative to management guidance and earnings announcements. Our evidence suggests that analysts’ recommendations are the most important information disclosure channel examined.
Surgical outcomes and quality of life post‐synthetic mesh‐augmented repair for pelvic organ prolapse in the Chinese population
Authors: Sun Xiuli , Zhang Xiaowei , Wang Jianliu
Published: October 2013

Aim

To investigate the surgical outcomes, urinary incontinence and quality of life (QOL) of patients with pelvic organ prolapse after synthetic mesh‐augmented repair in the Chinese population.

Method

This is a retrospective study of women who underwent synthetic mesh‐augmented repair. Surgical outcomes were investigated by recurrence rate of prolapse and Organ Prolapse Quantification, and QOL by Pelvic Floor Impact Questionnaire‐7 (PFIQ‐7) and Pelvic Floor Distress Inventory‐20 (PFDI‐20). The sex life quality was evaluated by Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire‐31 (PISQ‐31).

Results

Eighty‐three patients completed the entire study. Anatomical success was 90.36%. Of patients with preoperative stress urinary incontinence, 91.89% claimed that the incontinence symptoms were completely relieved. The 6‐month PFDI‐20 and PFIQ‐7 scores were significantly decreased, indicating that improved QOL occurs. However, the PISQ‐31 showed no significant difference between preoperative and postoperative data in sex life quality.

Conclusion

The synthetic polypropylene mesh is effective in treating POP and may improve QOL with no significant difference in the sexual life postoperatively. De novo stress urinary incontinence may occur after synthetic mesh‐augmented repair.
Thrombus just beneath a retrievable inferior vena cava filter in a pregnant woman with deep vein thrombosis: Its removal requiring catheter thrombus fragmentation with fibrinolysis
Authors: Horie Kenji , Suzuki Hirotada , Ohkuchi Akihide , Matsubara Shigeki , Ikemoto Tomokazu , Suzuki Mitsuaki
Published: October 2013

Recently, transient inferior vena cava (IVC) filters have been employed to protect against pulmonary embolism (PE) in pregnant women with deep vein thrombosis. A 34‐year‐old primiparous Japanese woman with a history of myomectomy was diagnosed with deep vein thrombosis by ultrasound at 27 weeks of gestation. Unfractionated heparin was administered, which soon ameliorated swelling in the right thigh. A transient IVC filter was implanted just before cesarean section. An enhanced computed tomography scan 2 days after cesarean section revealed a wide thrombus just distal to the filter. We performed catheter thrombus fragmentation with fibrinolysis just before the removal of the IVC filter, resulting in re‐canalization of blood flow. No significant PE occurred. Although a transient IVC filter may work well for the prophylaxis of PE during labor and delivery, catheter fragmentation with fibrinolysis may become necessary at removal of the filter.
Developmental competence of human embryos derived from in vitro maturation of immature oocytes retrieved during cesarean section
Authors: Pongsuthirak Pallop , Vutyavanich Teraporn
Published: October 2013

Aim

To investigate the developmental competence of human embryos that originated from in vitro matured oocytes retrieved during cesarean section.

Methods

Immature oocytes were collected from 95 pregnant women, who underwent cesarean section at Buddhachinaraj Hospital Medical School and consented to participate in the study. Retrieved oocytes were cultured in blastocyst medium supplemented with 75 IU/L of human menopausal gonadotropin. Oocyte maturation was assessed at 30 and 48 h after culture. In vitro matured oocytes were inseminated by intracytoplasmic sperm injection and cultured up to 144 h. The fertilization, cleavage and blastocyst formation rates were observed.

Results

Maturation rate of oocytes after 30 h of culture was 67.9% compared with 13.1% at 48 h (P < 0.0001). Insemination of oocytes in both groups resulted in similar fertilization, cleavage and blastocyst formation rates.

Conclusion

A large proportion of oocytes retrieved at the time of cesarean section exhibited the capacity to undergo maturation in vitro. They can be fertilized and developed into good‐quality blastocyst stage.
Predictive factors for failure of salpingostomy in ectopic pregnancy
Authors: Kayatas Semra , Demirci Oya , Kumru Pinar , Mahmutoglu Didar , Saribrahim Bahar , Arinkan Sevcan Arzu
Published: October 2013

Aim

The objective of this study was to review our experience with ectopic pregnancy management and to evaluate major predictive factors for failure of conservative linear salpingostomy.

Methods

Seven hundred and ninety‐seven cases that were treated for ectopic pregnancy in our clinic between October 2005 and September 2011 were analyzed retrospectively for incidence and treatment options. We defined failure as rising or plateauing postoperative serum β‐hCG levels that required additional medical or surgical treatment after initial removal of the ectopic pregnancy by laparoscopy or by laparotomy. We examined the risk factors consisting of preoperative β‐hCG, size and location of ectopic lesions, the presence of fetal heart beat and tubal condition that can influence the failure or success of conservative salpingostomy.

Results

In total, 403 patients were treated conservatively. These conservative managements consist of 334 salpingostomies performed by laparoscopy and 69 by laparotomy. Because of persistent ectopic pregnancy, 16 patients underwent medical treatment. In total, 387 patients were treated successfully with conservative management and 16 patients were treated unsuccessfully with conservative management. When variables of P < 0.05 were subjected to multivariate analysis, size of the ectopic pregnancy of 33.5 mm or greater and fimbrial and isthmic region ectopic pregnancies were significantly associated with the failure rate.

Conclusions

The size of the ectopic pregnancy and fimbrial and isthmic region ectopic pregnancies were determinant of failure of conservative surgery. Our success rate in the ruptured group is not an underestimated value to dissuade patients wishing to maintain fertility by undergoing salpingectomy. So, the conservative approach to ectopic pregnancy should be undertaken after careful patient evaluation.
Factors that predict poor clinical course among patients hospitalized with pelvic inflammatory disease
Authors: Terao Miyoko , Koga Kaori , Fujimoto Akihisa , Wada‐Hiraike Osamu , Osuga Yutaka , Yano Tetsu , Kozuma Shiro
Published: October 2013

Aim

The aim of this study was to identify factors that can predict clinical course among patients hospitalized with pelvic inflammatory disease (PID).

Methods

Ninety‐three patients who needed hospitalization with a diagnosis of PID were retrospectively studied. Patients who were discharged within 7 days by conservative treatment were defined as favorable course cases (n = 44). Patients who needed more than 7 days of hospitalization and/or surgery were defined as poor course cases (n = 49). Twenty variables were evaluated by univariate and logistic regression analysis: age, history of pregnancy/delivery, gynecological open/laparoscopic surgery, PID, oral contraceptives/intrauterine device use and intrauterine operation before onset, body temperature, signs of peritoneal irritation, vomiting/diarrhea, abnormal vaginal discharge, endometriosis/fibroid/adenomyosis/any cystic lesion detected by ultrasonography, white blood cell counts/C‐reactive protein (CRP) levels . The cut‐off value was calculated by receiver–operator curve (ROC) analysis.

Results

Factors associated with poor clinical course were advanced age (P < 0.01), history of gynecological open surgery (P < 0.05), any cystic lesion detected by ultrasonography (P < 0.05) and high CRP levels (P < 0.05). High CRP levels and intrauterine operation before onset were independently associated with poor clinical course. The cut‐off value for CRP was 4.4 mg/dL.

Conclusion

This study identified variables that can predict poor clinical course of PID. These results can assist gynecologists with identifying patients at risk and optimizing the choice of management.
An Audit of Outcomes After Same‐Day Discharge Post‐PCI in Acute Coronary Syndrome and Elective Patients
Authors: HODKINSON EMILY C. , RAMSEWAK ADESH , MURPHY JOHN CONLETH , SHAND JAMES A. , MCCLELLAND ANTHONY J. , MENOWN IAN B. A. , HANRATTY COLM G. , SPENCE MARK S. , WALSH SIMON J.
Published: October 2013

Objectives

To investigate the outcomes of a cohort of acute and elective percutaneous coronary intervention (PCI) patients who were discharged home 6 hours postprocedure.

Background

Contemporary PCI is safe with a low rate of acute complications. It is well established as a day procedure in elective cases; however, data are lacking in acute cases.

Methods

We describe a prospective observational audit of routine clinical practice in the 3 PCI centers in Northern Ireland. Patients were selected for same‐day discharge after 6 hours of post‐PCI observation. Both elective and acute coronary syndrome (ACS) cases were included. Criteria for same‐day discharge were based on the technical result of the procedure rather than lesion complexity or clinical presentation. Radial access was preferred but not mandatory. Patients were contacted directly to assess for 30‐day major adverse cardiovascular events (MACE). Reported events were corroborated with the general practitioner or hospital notes.

Results

A total of 1,059 patients were selected for same‐day discharge with 30‐day follow‐up available for all cases. Of these, 766 (72.3%) were elective and 293 (27.7%) were ACS patients. Radial access was almost universal (98%). A total of 1,224 lesions were stented, of which 432 (40.8%) were high risk (highest risk lesion in each case by AHA/ACC classification). MACE rate at 30 days was 0.85% with a sub‐acute stent thrombosis rate of 0.4%. There were no MACE events from discharge to 24 hours.

Conclusions

Selected acute and elective patients with a range of lesion complexity and risk can be discharged safely home early after PCI.
The large‐scale placebo‐controlled beta‐blocker studies in systolic heart failure revisited: results from CIBIS‐II, COPERNICUS and SENIORS‐SHF compared with stratified subsets from MERIT‐HF
Authors: Wikstrand J. , Wedel H. , Castagno D. , McMurray J. J. V.
Published: October 2013

Aims

The four pivotal beta‐blocker trials in heart failure (HF) had different inclusion criteria, making comparison difficult without patient stratifying. The aim of this study was to compare, in similar patients, the effects of bisoprolol, metoprolol controlled release/extended release (CR/XL), carvedilol and nebivolol on (i) total mortality, (ii) all‐cause mortality or hospitalization due to cardiovascular causes (time to first event), (iii) all‐cause mortality or hospitalization because of HF and (iv) tolerability, defined as discontinuation of randomized treatment.

Methods

We compared stratified (s) subsets in MERIT‐HF with patients in CIBIS‐II [New York Heart Association (NYHA) class III/IV and ejection fraction (EF) ≤35%] and COPERNICUS (NYHA III/IV and EF <25%) and in patients with systolic HF in SENIORS‐SHF (age ≥70 years and EF ≤35%).

Results

The annual mortality rates in the placebo and beta‐blocker arms were: (i) CIBIS‐II (n = 2647), 13.2% vs. 8.8% (relative risk reduction 34%, 95% CI: 19–46, P < 0.0001) and MERIT‐HFs (n = 2002), 14.8% vs. 8.6% (relative risk reduction 42%, 95% CI: 24–56, P < 0.0001); (ii) COPERNICUS (n = 2289), 19.7% vs. 12.8% (relative risk reduction 35%, 95% CI: 19–48, P = 0.0014) and MERIT‐HFs (n = 795), 19.1% vs. 11.7% (relative risk reduction 39%; 95% CI: 11–58, P = 0.0086); (iii) SENIORS‐SHF (n = 1359), 11.3% vs. 9.7% (relative risk reduction 16%, NS) and MERIT‐HFs (n = 985), 14.8% vs. 10.1% (relative risk reduction 32%, 95% CI: 2–53, P = 0.038). The effects on the other outcomes assessed were similar. Analyses indicated fewer discontinuations from randomized treatment on beta‐blockers compared with placebo in COPERNICUS and the MERIT‐HFs subsets.

Conclusion

The efficacy and tolerability of bisoprolol, carvedilol and metoprolol CR/XL are similar in patients with systolic HF, irrespective of NYHA class or ejection fraction. Nebivolol is less effective and not better tolerated.
The effect of financial incentives on performance: A quantitative review of individual and team‐based financial incentives
Authors: Garbers Yvonne , Konradt Udo
Published: October 2013

We meta‐analysed 146 studies (n = 31,861) to examine the effects of individual and team‐based financial incentives on peoples' performance and to explore potential moderators. The overall effect size of the individual incentives (116 studies) was positive (g = 0.32). Moderator analyses revealed effect sizes to be larger for field studies (g = 0.34) than for laboratory studies (g = 0.29), larger for qualitative (g = 0.39) than quantitative performance measures (g = 0.28), and smaller for less complex tasks (g = 0.19). Results on team‐based incentives (30 studies) indicated a positive effect regarding team‐based rewards on performance (g = 0.45), with equitably distributed rewards resulting in higher performance than equally distributed rewards. This relationship was larger in field studies and smaller for less complex tasks. In addition, our results show that the effect of team‐based rewards depends on team size and gender composition. Implications for organizational rewards and suggestions for future research are discussed.

Practitioner points

Our study demonstrates the importance of rewarding employees as teams to motivate them to a greater extent.

The results show that equitably distributed rewards lead to higher performance than equally distributed rewards.

Managers should design their appraisal and feedback process for individual team members and the team as a whole.

Our results provide useful information regarding the creation of appropriate reward systems.

Differences in reward characteristics, team composition, and distribution rules offer practical implications for factors on organizational (i.e., personnel selection, frequency, and amount of rewards), team (i.e., team characteristics, type of performance measurement), and individual level (i.e., importance of rewards, personality).
Association between underweight and taste sensitivity in middle‐ to old‐aged nursing home residents in Sri Lanka: a cross‐sectional study
Authors: Fuchida S. , Yamamoto T. , Takiguchi T. , Kandaudahewa G. , Yuyama N. , Hirata Y.
Published: October 2013

Low taste sensitivity may be one factor related to undernutrition, which is a major problem in developing countries. The purpose of this cross‐sectional study was to examine the association between underweight, one indicator of undernutrition, and taste sensitivity in middle‐ to old‐aged Sri Lankan nursing home residents. Participants were 946 residents with BMI of <25·0 from 25 nursing homes. Data were obtained on height, weight, taste sensitivity, subjective taste ability, sex, age, ethnicity, number of years in nursing homes, activities of daily living (ADL), frequency of exercise, bowel movements, smoking status, drinking status, current number of chronic diseases, number and kinds of medications used, self‐reporting questionnaire 20 (SRQ20), subjective smell ability, number of teeth present, Eichner index and flow rate of saliva. Low sensitivity to bitter taste, being male, old age, low ADL, smoking experience, drinking experience, fewer medications used and no use of medication for hypertension and diabetes were each associated with underweight (P < 0·05). In a multilevel Poisson regression model adjusted for sex, age, ADL, smoking status, drinking status, number of medications used, use of medication for hypertension and diabetes and flow rate of saliva, subjects with low sensitivity (>0·003% quinine hydrochloride dihydrate) to bitter taste had a significant 1·70 times higher prevalence ratio (95% confident interval 1·04–2·80) for underweight compared with those with high sensitivity (0·0001% quinine hydrochloride dihydrate). These results suggest that low taste sensitivity to bitter taste may be one factor related to underweight.
Oral candidosis in relation to oral immunity
Authors: Feller L. , Khammissa R. A. G. , Chandran R. , Altini M. , Lemmer J.
Published: October 2013

Symptomatic oral infection with Candida albicans is characterized by invasion of the oral epithelium by virulent hyphae that cause tissue damage releasing the inflammatory mediators that initiate and sustain local inflammation. Candida albicans triggers pattern‐recognition receptors of keratinocytes, macrophages, monocytes and dendritic cells, stimulating the production of IL‐1β, IL‐6 and IL‐23. These cytokines induce the differentiation of Th17 cells and the generation of IL‐17‐ and/or IL‐22‐mediated antifungal protective immuno‐inflammatory responses in infected mucosa. Some immune cells including NKT cells, γδ T cells and lymphoid cells that are innate to the oral mucosa have the capacity to produce large quantities of IL‐17 in response to C. albicans, sufficient to mediate effective protective immunity against C. albicans. On the other hand, molecular structures of commensal C. albicans blastoconidia, although detected by pattern‐recognition receptors, are avirulent, do not invade the oral epithelium, do not elicit inflammatory responses in a healthy host, but induce regulatory immune responses that maintain tissue tolerance to the commensal fungi. The type, specificity and sensitivity of the protective immune response towards C. albicans is determined by the outcome of the integrated interactions between the intracellular signalling pathways of specific combinations of activated pattern‐recognition receptors (TLR2, TLR4, Dectin‐1 and Dectin‐2). IL‐17‐mediated protective immune response is essential for oral mucosal immunity to C. albicans infection.
Transition from Failing Dentition to Full‐Arch Fixed Implant‐Supported Prosthesis with a Staged Approach Using Removable Partial Dentures: A Case Series
Authors: Cortes Arthur Rodriguez Gonzalez , Cortes Djalma Nogueira , No‐Cortes Juliana , Arita Emiko Saito
Published: October 2013

The present retrospective case series is aimed at evaluating a staged approach using a removable partial denture (RPD) as an interim prosthesis in treatment to correct a failing dentition until such time as a full‐arch fixed implant‐supported prosthesis may be inserted. Eight patients, who had undergone maxillary full‐arch rehabilitation with dental implants due to poor prognosis of their dentitions, were analyzed. All treatment included initial periodontal therapy and a strategic order of extraction of hopeless teeth. An RPD supported by selected teeth rehabilitated the compromised arch during implant osseointegration. These remaining teeth were extracted prior to definitive prosthesis delivery. Advantages and drawbacks of this technique were also recorded for the cases presented. Among the advantages provided by the staged approach are simplicity of fabrication, low cost, and ease of insertion. Additionally, RPD tooth support prevented contact between the interim prosthesis and healing abutments, promoting implant osseointegration. The main drawbacks were interference with speech and limited esthetic results. Implant survival rate was 100% within a follow‐up of at least 1 year. The use of RPDs as interim prostheses allowed for the accomplishment of the analyzed rehabilitation treatments. It is a simple treatment alternative for patients with a low smile line.
Peer Status Among Incarcerated Female Offenders: Associations With Social Behavior and Adjustment
Authors: Goldweber Asha , Cauffman Elizabeth , Cillessen Antonius H. N.
Published: October 2013

Peers are a powerful socializing force, especially during adolescence. Whether peer status holds the same meaning, correlates, and consequences for female offenders remains unknown. Using a peer nomination technique in a sample of incarcerated females (N = 86, age 15–24 years), our study is the first to examine the association between peer status and psychopathology in a correctional facility. Results indicated that a key indicator of likeability was prosocial behavior; popularity was related to leadership; and social impact was associated with aggression. Popularity might serve as a buffer against, and social impact as a risk factor for, psychosocial problems. Findings shed light on peer status as a mechanism underpinning female offenders' problem behaviors and an entry point for targeted interventions.
Dräger VN500's oscillatory performance has a frequency‐dependent threshold
Authors: John Jubal , Harcourt Edward R , Davis Peter G , Tingay David G
Published: October 2013

Aim

The aim of this study is to compare the high‐frequency pressure amplitude (oscillatory change in pressure (ΔP)) and tidal volume (high‐frequency tidal volume at the airway opening (VTHF)) delivered by the Dräger VN500 (Drägerwerk Ag & Co., Lübeck, Germany) and the Sensormedics 3100 (SM3100; CareFusion, San Diego, CA, USA) through a range of oscillatory frequencies.

Methods

In this benchtop study, high‐frequency oscillations were applied to an infant test lung at unrestricted set amplitudes. Pressure and flow were measured as a function of frequency, incremented by 1 Hz from 5 to 15 Hz. Measurements were repeated for a range of ventilator settings, and lung resistive and compliance states.

Results

The VN500, but not the SM3100, demonstrated an exponential decrease in airway opening ΔP as frequency increased. The difference between the SM3100‐ and VN500‐delivered VTHF became greater with each frequency increment. At 15 Hz, VN500 VTHF was 49% of SM3100 VTHF.

Conclusions

The VN500 demonstrates a frequency‐related reduction in ΔP not observed in the SM3100. Clinicians need to be aware of these differences in performance characteristics.