bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypertrophy of Neurons Within Cardiac Ganglia in Human, Canine, and Rat Heart Failure: The Potential Role of Nerve Growth Factor
Authors: Singh Sanjay , Sayers Scott , Walter James S. , Thomas Donald , Dieter Robert S. , Nee Lisa M. , Wurster Robert D.
Published: August 2013

Background

Autonomic imbalances including parasympathetic withdrawal and sympathetic overactivity are cardinal features of heart failure regardless of etiology; however, mechanisms underlying these imbalances remain unknown. Animal model studies of heart and visceral organ hypertrophy predict that nerve growth factor levels should be elevated in heart failure; whether this is so in human heart failure, though, remains unclear. We tested the hypotheses that neurons in cardiac ganglia are hypertrophied in human, canine, and rat heart failure and that nerve growth factor, which we hypothesize is elevated in the failing heart, contributes to this neuronal hypertrophy.

Methods and Results

Somal morphology of neurons from human (579.54±14.34 versus 327.45±9.17 μm
2
;
P
<0.01) and canine hearts (767.80±18.37 versus 650.23±9.84 μm
2
;
P
<0.01) failing secondary to ischemia and neurons from spontaneously hypertensive rat hearts (327.98±3.15 versus 271.29±2.79 μm
2
;
P
<0.01) failing secondary to hypertension reveal significant hypertrophy of neurons in cardiac ganglia compared with controls. Western blot analysis shows that nerve growth factor levels in the explanted, failing human heart are 250% greater than levels in healthy donor hearts. Neurons from cardiac ganglia cultured with nerve growth factor are significantly larger and have greater dendritic arborization than neurons in control cultures.

Conclusions

Hypertrophied neurons are significantly less excitable than smaller ones; thus, hypertrophy of vagal postganglionic neurons in cardiac ganglia would help to explain the parasympathetic withdrawal that accompanies heart failure. Furthermore, our observations suggest that nerve growth factor, which is elevated in the failing human heart, causes hypertrophy of neurons in cardiac ganglia.
School-Based Accountability and the Distribution of Teacher Quality Across Grades in Elementary School
Authors: Fuller Sarah C. , Ladd Helen F.
Published: August 2013

We use North Carolina data to explore whether the quality of teachers in the lower elementary grades (K–2) falls short of teacher quality in the upper grades (3–5) and to examine the hypothesis that school accountability pressures contribute to such quality shortfalls. Our concern with the early grades arises from recent studies highlighting how children's experiences in those years have lasting effects on their later outcomes. Using two credentials-based measures of teacher quality, we document within-school quality shortfalls in the lower grades, and show that the shortfalls increased with the introduction of No Child Left Behind. Consistent with that pattern, we find that schools responded to accountability pressures by moving their weaker teachers down to the lower grades and stronger teachers up to the higher grades. These findings support the view that accountability pressure induces schools to pursue actions that work to the disadvantage of children in the lower grades.
Incorporating Access to More Effective Teachers into Assessments of Educational Resource Equity
Authors: Bastian Kevin C. , Henry Gary T. , Thompson Charles L.
Published: August 2013

To address gaps in achievement between more- and less-affluent students, states and districts need to ensure that high-poverty students and schools have equitable access to educational resources. Traditionally, assessments of resource equity have focused on per-pupil expenditures and more proximal inputs, such as teacher credentials and class size, despite the inconsistent and/or weak relationships between these measures and student performance. Given the sizable and direct effects of teachers on student achievement, we argue that (1) teachers’ value-added scores should be incorporated into assessments of resource equity and (2) providing schools with greater flexibility for setting salaries or using strategic staffing initiatives may be necessary to achieve an equitable distribution of effective teachers. To illustrate these assertions we incorporate teacher value added into a case study of resource allocation in the public high schools of Wayne County, North Carolina, which have been the target of a complaint by the North Carolina National Association for the Advancement of Colored People.
CHOA Concussion Consensus
Authors: Popoli David Michael , Burns Thomas G. , Meehan William P. , Reisner Andrew
Published: August 2013

Concussion research generally centers on physical challenges, though aspects such as social functioning and returning to school also warrant attention in pediatric populations. Restoring academic performance postconcussion remains a challenge. Here we provide recommendations addressing a uniform policy for pediatric concussion patients in academic institutions. Tools that may minimize difficulty with academic re-entry include independent educational evaluations, individualized educational programs (IEPs), student support teams (SSTs), letters of academic accommodation, time off, and 504 Plans. Recognition and treatment is crucial for symptom relief and prevention of functional disruption, as is specialist referral during the acute window. We recommend early intervention with a letter of academic accommodation and SST and suggest that 504 Plans and IEPs be reserved for protracted or medically complicated cases. Students with concussion should be observed for anxiety and depression because these symptoms can lead to prolonged recovery, decreased quality of life, and other social challenges.
Effects of Quaternary Ammonium Chain Length on Antibacterial Bonding Agents
Authors: Li F. , Weir M.D. , Xu H.H.K.
Published: August 2013

The objectives of this study were to synthesize new quaternary ammonium methacrylates (QAMs) with systematically varied alkyl chain lengths (CL) and to investigate, for the first time, the CL effects on antibacterial efficacy, cytotoxicity, and dentin bond strength of bonding agents. QAMs were synthesized with CL of 3 to 18 and incorporated into Scotchbond Multi-Purpose (SBMP) bonding agent. The cured resins were inoculated with Streptococcus mutans. Bacterial early attachment was investigated at 4 hrs. Biofilm colony-forming units (CFU) were measured after 2 days. With CL increasing from 3 to 16, the minimum inhibitory concentration and minimum bactericidal concentration were decreased by 5 orders of magnitude. Incorporating QAMs into SBMP reduced bacterial early attachment, with the least colonization at CL = 16. Biofilm CFU for CL = 16 was 4 log lower than SBMP control ( p < .05). All groups had similar dentin bond strengths ( p > .1). The new antibacterial materials had fibroblast/odontoblast viability similar to that of commercial controls. In conclusion, increasing the chain length of new QAMs in bonding agents greatly increased the antibacterial efficacy. A reduction in Streptococcus mutans biofilm CFU by 4 log could be achieved, without compromising bond strength and cytotoxicity. New QAM-containing bonding agents are promising for a wide range of restorations to inhibit biofilms.
The Educational Achievement of Brazilian Adolescents
Authors: Marteleto Leticia , Andrade Fernando
Published: August 2013

Most studies find a positive correlation between family cultural capital and educational achievement. As compelling as the evidence on the advantages of family cultural capital for educational achievement is, most studies have focused on countries characterized by having a large middle class and high levels of income, not addressing societies with high levels of social inequality. Importantly, few studies have examined whether schools interact with families in determining the relationship between cultural capital and educational achievement. The goal of this article is to examine how cultural capital is associated with achievement in Brazil, one of the most unequal countries in the world. Using data from the 2006 Program for International Student Assessment (PISA), results from multilevel models show that the science and reading achievement gaps associated with cultural capital are magnified in Brazilian schools, an important finding given that the country is an already highly stratified society.
What Makes Firms Leave the Neighbourhood?
Authors: Weterings Anet
Published: August 2013

Limited attention has been paid to neighbourhood conditions as a driver of firm relocation choices. Using a panel dataset (1999–2006) of actual firm relocations in the Netherlands, the effect of different neighbourhood conditions on firms’ propensity to relocate was estimated. Results show that, besides firm and regional characteristics, neighbourhood conditions also affect firms’ relocation choices, but which conditions matter depends on the firm’s industrial activity and size. The relocation decision of consumer services in particular is affected by neighbourhood conditions, while the choice of manufacturing, wholesale and business services firms is affected more by increases in population density. Nevertheless, a higher number of shops, cafes and restaurants and a more attractive physical environment do lower the probability that business services leave the neighbourhood, while manufacturing and wholesale firms are more inclined to leave neighbourhoods when a higher share of consumer services is not in use.
Transnational Transitions: The Diffusion and Integration of Mechanical Cooling
Authors: Shove Elizabeth , Walker Gordon , Brown Sam
Published: August 2013

In less than a generation, air conditioning has spread around the world, increasing energy consumption and producing demand where none existed before. How has this come about? This article asks whether transition theories (and the multilevel perspective as an exemplar) are of value in addressing this question and what other approaches might be developed. It is concluded that what seems to be the transnational diffusion of mechanical cooling is best understood as an outcome of multisited processes in which air conditioning is integrated into practices like those of office work, nursing, taking a luxury break or simply living at home. Rather than mapping diffusion across a stable terrain, this perspective argues for a more sophisticated interpretation of how mechanical cooling remakes practices and the places in which they are reproduced. This conclusion has implications for efforts to stem air conditioning and the energy demand associated with it.
The interplay of perceived stress, self-determination and school engagement in adolescence
Authors: Raufelder Diana , Kittler Frieder , Braun Sarah R. , Lätsch Alexander , Wilkinson R. Poppy , Hoferichter Frances
Published: August 2013

Currently, many societies are placing a greater onus on academic achievement–resulting in higher levels of stress being observed among adolescent students. Stress can have detrimental repercussions on adolescents’ health and is also associated with anxiety and depression. However, since less is known about how high stress levels affect school engagement, this study examined the interplay of perceived stress and school engagement in a large sample of seventh and eighth grade students ( N = 1088; MAge = 13.7) in secondary schools in Brandenburg, Germany. Based on self-determination theory (SDT), this study also examined if perceived autonomy, relatedness, and competence mediated the association between stress and school engagement in order to identify possible strategies for intervention and prevention. Latent structural equation modeling (SEM) was used to test for the associations between stress, self-determination, and school engagement. Results showed that self-determination acted as a full mediator in the negative association between stress and school engagement. These results suggest that supporting students’ basic psychological needs for autonomy, relatedness, and competence could be an effective starting point for prevention and intervention of stress and its negative association with school engagement. Consequently, SDT has strong implications for both school psychologists as well as teachers.
Trajectories and personality correlates of change in perceptions of physical and mental health across adulthood and old age
Authors: Morack Jennifer , Infurna Frank J. , Ram Nilam , Gerstorf Denis
Published: August 2013

Subjective health is known to predict later outcomes, including survival. However, less is known about subjective health changes across adulthood, how personality moderates those changes, and whether such associations differ with age. We applied growth models to 10 waves of data from the Household, Income and Labour Dynamics in Australia Survey (HILDA, N = 7,172; median ages 20–93) to examine age-related differences in trajectories of subjective physical and mental health. On average, perceptions of physical health declined with increasing steepness in old age, whereas self-rated mental health remained relatively stable across all ages. Higher neuroticism and lower extraversion and conscientiousness were each related to less successful aging. The health implications of personality did not differ by age for physical health, but were weaker for mental health in old age. We discuss implications of our results for accelerated longitudinal designs and consider avenues for future more mechanism-oriented research.
The sources of mass partisanship in newer democracies: Social identities or performance evaluations? Southern Europe in comparative perspective
Authors: Lisi Marco
Published: August 2013

This study seeks to improve the current conceptualisation of partisanship and to provide empirical evidence about the nature of partisan identities in new democracies. Conventional theories suggest that partisan loyalties are grounded in social and group contexts, while ‘revisionist’ theories have emphasised the importance of the performance evaluations of political actors. This study argues that the nature of partisanship in newer democracies is more strongly influenced by the latter. By focusing on new Southern European democracies, this research confirms the importance of performance and retrospective evaluations as the basis of partisan loyalties. The impact of age and education is very weak, while ideological extremism displays a constant and significant effect. However, the nature of partisanship varies according to different party types, as voters of more ideological parties are less sensitive to short-term judgements.
Teachers’ transformation as learning: Teaching Cantonese opera in Hong Kong schools with a teacher–artist partnership
Authors: Leung Bo Wah
Published: August 2013

The Hong Kong Government has advocated teaching Cantonese opera in the school music curriculum to promote Chinese culture education. This longitudinal study aims to examine how and why teachers transform within 3 years in learning and teaching Cantonese opera with a teacher-artist partnership approach in schools. Five primary and two secondary teachers collaborated with a Cantonese opera artist to teach the genre for 8 weeks in 2008. With reference to the Transformative Learning Theory, two rounds of interviews with teachers in 2008 and 2011 were carried out to investigate the extent they had transformed in relation to teaching Cantonese opera. Informational learning from the partnership and self reflection in sufficient time are the main attributes in teachers’ transformation. It is implied that music teachers may reinterpret their old experience of learning the Chinese music with the assistance of relevant experts in order to make new meaning of their perception on music education.
Cultural Techniques: Preliminary Remarks
Authors: Winthrop-Young Geoffrey
Published: August 2013

These introductory remarks outline the German concept of Kulturtechniken (cultural techniques) by tracing its various overlapping meanings from the late 19th century to today and linking it to developments in recent German theory. Originally related to the agricultural domain, the notion of cultural techniques was later employed to describe the interactions between humans and media, and, most recently, to account for basic operations and differentiations that give rise to an array of conceptual and ontological entities which are said to constitute culture. In the second part of the essay, cultural techniques are analyzed as a concept that allows theorists to overcome certain biases and impasses characteristic of that domain of German media theory associated with the work of the late Friedrich Kittler.
Concussion Symptoms and Neurocognitive Performance of High School and College Athletes Who Incur Multiple Concussions
Authors: Covassin Tracey , Moran Ryan , Wilhelm Kristyn
Published: August 2013

Background:

Multiple concussions have been associated with prolonged symptoms, recovery time, and risk for future concussions. However, very few studies have examined the effect of multiple concussions on neurocognitive performance and the recently revised symptom clusters using a large database.

Purpose:

To examine concussed athletes with a history of 0, 1, 2, or ≥3 concussions on neurocognitive performance and the recently revised symptom clusters.

Study Design:

Cohort study (prognosis); Level of evidence, 2.

Methods:

The independent variables were concussion group (0, 1, 2, and ≥3 concussions) and time (baseline, 3 days, and 8 days). The dependent variables were neurocognitive test scores as measured by the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) neurocognitive test battery (verbal and visual memory, processing speed, and reaction time) and 4 concussion symptom clusters (migraine-cognitive-fatigue, affective, somatic, and sleep). All concussed athletes (n = 596) were administered the ImPACT test at a mean 2.67 ± 1.98 and 7.95 ± 4.46 days after injury. A series of 4 (concussion group) × 3 (time) repeated-measures analyses of covariance (age = covariate) were performed on ImPACT composite scores and symptom clusters.

Results:

Concussed athletes with ≥3 concussions were still impaired 8 days after a concussion compared with baseline scores on verbal memory ( P < .001), reaction time ( P < .001), and migraine-cognitive-fatigue symptoms ( P < .001). There were no significant findings on the remaining dependent variables.

Conclusion:

Concussed athletes with a history of ≥3 concussions take longer to recover than athletes with 1 or no previous concussion. Future research should concentrate on validating the new symptom clusters on multiple concussed athletes, examining longer recovery times (ie, >8 days) among athletes with multiple concussions.
Q222R polymorphism in DNAse I gene is a risk factor for nephritis in South Indian SLE patients
Authors: Panneer D , Antony PT , Negi VS
Published: August 2013

Objective

Systemic lupus erythematosus (SLE) is a multisystem disorder in which defective apoptotic clearance is considered to be an important factor in pathogenesis. DNAse I is associated with disposal of apoptotic nuclear debris. The defective enzyme production due to +2373  A to G ( Q222R) in exon 8 is reported to be a genetic risk factor for SLE. SLE in Indians is reported to be severe. There are no genetic studies reported from India which have explored this aspect of DNAseI gene. This study aimed to analyze whether Q222R is a susceptibility factor for SLE and to study its influence on clinical manifestations and autoantibody production in South Indian Tamils.

Method

Three hundred SLE cases (based on ACR 1982 criteria) and 530 age, sex similar and ethnicity matched controls were recruited. All the cases and controls were genotyped for DNAse I Q222R polymorphism using PCR-RFLP method.

Results

DNAse I Q222R polymorphism is prevalent in our population. We observed higher frequency of Q/R in patients compared with controls (60% vs. 53%). This was found to be a genetic risk for SLE susceptibility ( p = 0.04, odds ratio 1.5, 95% confidence interval 1–2.1). It also conferred a significant risk for development of nephritis ( p = 0.007, odds ratio 1.93, 95% confidence interval 1.2–3.2).

Conclusion

DNAse I Q222R polymorphism is a potential genetic risk factor for SLE in South Indian Tamils. In addition, the mutant allele confers a significant risk for lupus nephritis.
Impaired sexual function in women with systemic lupus erythematosus: a cross-sectional study
Authors: Morales M García , Rubio JL Callejas , Peralta-Ramírez MI , Romero LJ Henares , Fernández R Ríos , García MT Camps , Navarrete N Navarrete , Centeno N Ortego
Published: August 2013

Objective

The objectives of this paper are to compare sexual function and distress in women with systemic lupus erythematosus (SLE) and in healthy controls; to determine the association between disease characteristics, quality of life, psychopathology and sexual function; and to compare sexual function and distress of women according to age (reproductive and nonreproductive-age women).

Methods

We conducted a cross-sectional study of 120 participants; 65 women had SLE (aged 18–65), and 55 were healthy, age-matched controls. The assessment included the Female Sexual Function Index (FSFI), Symptom Checklist-90-Revised (SCL-90-R), Short Form 36 health survey (SF-36), socio-demographic characteristics and the Systemic Lupus International Collaborating Clinics (SLICC) and SLE Disease Activity Index (SLEDAI) in SLE patients only.

Results

Of 65 eligible patients with SLE, 61 (94%) responded; of 55 control subjects, 53 (96%) responded. The FSFI total score and subscale scores for desire, arousal, lubrication, orgasm and pain were significantly lower in patients with SLE. More somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid ideation, psychoticism, the Positive Symptom Total (PST), Positive Score Discomfort Index (PSDI), the use of psychotropic drugs, general health, vitality, social function, emotional role and mental health were significantly associated with changes in the patient group’s sexuality. Multivariate analysis indicated that depression, PSDI and vitality were the variables significantly associated with low sexual function in patients with SLE.

Conclusions

Women with SLE reported significantly impaired sexual function compared with healthy controls. Impaired sexual function was associated with somatization, obsessive-compulsive behavior, interpersonal sensitivity, depression, hostility, paranoid ideation, psychoticism, PST, higher scores in the PSDI subscale, vitality, social functioning and mental health. These results indicate that, in daily practice, inquiring about sexuality and quality of life and screening for psychopathology are important for every patient with SLE, irrespective of their clinical characteristics.
Expert–novice differences in mental models of viruses, vaccines, and the causes of infectious disease
Authors: Jee Benjamin D. , Uttal David H. , Spiegel Amy , Diamond Judy
Published: August 2013

Humans are exposed to viruses everywhere they live, play, and work. Yet people’s beliefs about viruses may be confused or inaccurate, potentially impairing their understanding of scientific information. This study used semi-structured interviews to examine people’s beliefs about viruses, vaccines, and the causes of infectious disease. We compared people at different levels of science expertise: middle school students, teachers, and professional virologists. The virologists described more entities involved in microbiological processes, how these entities behaved, and why. Quantitative and qualitative analyses revealed distinctions in the cognitive organization of several concepts, including infection and vaccination. For example, some students and teachers described viral replication in terms of cell division, independent of a host. Interestingly, most students held a mental model for vaccination in which the vaccine directly attacks a virus that is present in the body. Our findings have immediate implications for how to communicate about infectious disease to young people.
Changing the ideological roots of prejudice: Longitudinal effects of ethnic intergroup contact on social dominance orientation
Authors: Dhont Kristof , Van Hiel Alain , Hewstone Miles
Published: August 2013

Social dominance orientation (SDO) has been reported to be strongly related to a multitude of intergroup phenomena, but little is known about situational experiences that may influence SDO. Drawing from research on intergroup contact theory, we argue that positive intergroup contact is able to reduce SDO-levels. The results of an intergroup contact intervention study among high school students (Study 1, N = 71) demonstrated that SDO levels were indeed attenuated after the intervention. Furthermore, this intervention effect on SDO was especially pronounced among students reporting a higher quality of contact. A cross-lagged longitudinal survey among adults (Study 2, N = 363) extended these findings by demonstrating that positive intergroup contact is able to decrease SDO over time. Moreover, we did not obtain evidence for the idea that people high in SDO would engage less in intergroup contact. These findings indicate that intergroup contact erodes one of the important socio-ideological bases of generalized prejudice and discrimination.
Guidelines for Physical Activity During Pregnancy
Authors: Evenson Kelly R. , Barakat Ruben , Brown Wendy J. , Dargent-Molina Patricia , Haruna Megumi , Mikkelsen Ellen M. , Mottola Michelle F. , Owe Katrine M. , Rousham Emily K. , Yeo SeonAe
Published: August 2013

Introduction. Women attain numerous benefits from physical activity during pregnancy. However, because of physical changes that occur during pregnancy, special precautions are also needed. This review summarizes current guidelines for physical activity among pregnant women worldwide. Methods. We searched PubMed (MedLINE) for country-specific governmental and clinical guidelines on physical activity during pregnancy through the year 2012. We cross-referenced with articles referring to guidelines, with only the most recent included. An abstraction form was used to extract key details and summarize. Results. In total, 11 guidelines were identified from 9 countries (Australia, Canada, Denmark, France, Japan, Norway, Spain, United Kingdom, United States). Most guidelines supported moderate-intensity physical activity during pregnancy (10/11) and indicated specific frequency (9/11) and duration/time (9/11) recommendations. Most guidelines provided advice on initiating an exercise program during pregnancy (10/11). Six guidelines included absolute and relative contraindications to exercise. All guidelines generally ruled-out sports with risks of falls, trauma, or collisions. Six guidelines included indications for stopping exercise during pregnancy. Conclusion. This review contrasted pregnancy-related physical activity guidelines from around the world, and can help inform new guidelines as they are created or updated and facilitate the development of a worldwide guideline.
The number of spanning trees of a graph
Authors: Das Kinkar C , Cevik Ahmet S , Cangul Ismail N
Published: August 2013

Let G be a simple connected graph of order n, m edges, maximum degree

Δ
1

and minimum degree δ. Li et al. (Appl. Math. Lett. 23:286-290, 2010) gave an upper bound on number of spanning trees of a graph in terms of n, m,

Δ
1

and δ:

t
(
G
)
≤
δ

(

2
m
−

Δ
1

−
δ
−
1

n
−
3

)

n
−
3

.

The equality holds if and only if

G
≅

K

1
,
n
−
1

,

G
≅

K
n

,

G
≅

K
1

∨
(

K
1

∪

K

n
−
2

)

or

G
≅

K
n

−
e

, where e is any edge of

K
n

. Unfortunately, this upper bound is erroneous. In particular, we show that this upper bound is not true for complete graph

K
n

.

In this paper we obtain some upper bounds on the number of spanning trees of graph G in terms of its structural parameters such as the number of vertices (n), the number of edges (m), maximum degree (

Δ
1

), second maximum degree (

Δ
2

), minimum degree (δ), independence number (α), clique number (ω). Moreover, we give the Nordhaus-Gaddum-type result for number of spanning trees.

MSC:05C50, 15A18.
Long term healthcare costs of infants who survived neonatal necrotizing enterocolitis: a retrospective longitudinal study among infants enrolled in Texas Medicaid
Authors: Ganapathy Vaidyanathan , Hay Joel W , Kim Jae H , Lee Martin L , Rechtman David J
Published: August 2013

Background

Infants who survive advanced necrotizing enterocolitis (NEC) at the time of birth are at increased risk of having poor long term physiological and neurodevelopmental growth. The economic implications of the long term morbidity in these children have not been studied to date. This paper compares the long term healthcare costs beyond the initial hospitalization period incurred by medical and surgical NEC survivors with that of matched controls without a diagnosis of NEC during birth hospitalization.

Methods

The longitudinal healthcare utilization claim files of infants born between January 2002 and December 2003 and enrolled in the Texas Medicaid fee-for-service program were used for this research. Propensity scoring was used to match infants diagnosed with NEC during birth hospitalization to infants without a diagnosis of NEC on the basis of gender, race, prematurity, extremely low birth weight status and presence of any major birth defects. The Medicaid paid all-inclusive healthcare costs for the period from 6 months to 3 years of age among children in the medical NEC, surgical NEC and matched control groups were evaluated descriptively, and in a generalized linear regression framework in order to model the impact of NEC over time and by birth weight.

Results

Two hundred fifty NEC survivors (73 with surgical NEC) and 2,909 matched controls were available for follow-up. Medical NEC infants incurred significantly higher healthcare costs than matched controls between 6–12 months of age (mean incremental cost = US$ 5,112 per infant). No significant difference in healthcare costs between medical NEC infants and matched controls was seen after 12 months. Surgical NEC survivors incurred healthcare costs that were consistently higher than that of matched controls through 36 months of age. The mean incremental healthcare costs of surgical NEC infants compared to matched controls between 6–12, 12–24 and 24–36 months of age were US$ 18,274, 14,067 (p < 0.01) and 8,501 (p = 0.06) per infant per six month period, respectively. These incremental costs were found to vary between sub-groups of infants born with birth weight < 1,000g versus ≥ 1,000g (p < 0.05).

Conclusions

The all-inclusive healthcare costs of surgical NEC survivors continued to be substantially higher than that of matched controls through the early childhood development period. These results can have important treatment and policy implications. Further research in this topic is needed.
Prevalence and patterns of multimorbidity among tuberculosis patients in Brazil: a cross-sectional study
Authors: Reis-Santos Bárbara , Gomes Teresa , Macedo Laylla R , Horta Bernardo L , Riley Lee W , Maciel Ethel L
Published: August 2013

Introduction

The number of subjects with tuberculosis (TB) presenting with co-occurrence of multiple chronic medical conditions, or multimorbidity (MM) is increasing in Brazil. This manuscript aimed to characterize subjects with TB, according to their MM status and to analyse factors associated with TB treatment outcomes.

Methods

This is a cross-sectional study that included 39,881 TB subjects reported in Brazil, in 2011. MM were defined as any (two or more) occurrence of chronic medical conditions in a TB patient (TB–MM). Data analysis was performed by hierarchical logistic regression models comparing TBMM with those with only TB.

Results

Of the reported TB cases in 2011, 454 (1.14%) had MM. The subjects in the age group 40–59 years (OR: 17.89; 95% CI, 5.71-56.03) and those ≥ 60 years (OR: 44.11; 95% CI, 14.09-138.06) were more likely to develop TB–MM. The TB–MM subjects were less likely to be male (OR: 0.63; 95% CI, 0.52-0.76), institutionalized (OR: 0.59; 95% CI, 0.23-0.80) and live in rural areas (OR: 0.63; 95% CI, 0.42-0.95). Death from causes other than TB was higher among TB–MM subjects (OR: 1.76; 95% CI, 1.36-2.28). Of 454 TB–MM subjects 302 (66.5%) were cured and 152 (33.5%) were not cured. The odds of not being cured was 1.55 (95% CI, 1.04-2.32) among males, 2.85 (95% CI, 1.12-7.28) among institutionalized subjects, and 3.93 (IC 95%, 1.86-8.30) among those who were infected with HIV. TB retreatment after previous abandonment (OR: 7.53; 95% CI, 2.58-21.97) and transfer from a treatment site (OR: 2.76; 95% CI, 1.20-6.38) were higher for subjects not cured compared to those who were cured.

Conclusions

While TB is well recognized to be a disease engendered by social inequity, we found that even among TB patients, those who have MM have greater inequity in terms of socioeconomic status and adverse clinical outcomes. Addressing the problem of TB and TB–MM requires a multisectorial approach that includes health and social service organizations.
Strong convergence theorems for fixed point problems of infinite family of asymptotically quasi-ϕ-nonexpansive mappings and a system of equilibrium problems
Authors: Wang Xin , Hu Changsong , Guan Jinlin
Published: August 2013

In this paper, we introduce a general iterative algorithm for finding a common element of the set of common fixed points of infinite family of asymptotically quasi-ϕ-nonexpansive mappings and of the set of solutions for finite equilibrium problems in a real Banach space. Our results are the generalization of the results (Shehu in Comput. Math. Appl. 63:1089-1103, 2012; Kim in Fixed Point Theory Appl., 2011, doi:10.1186/1687-1812-2011-10) and (Kim and Buong in Fixed Point Theory Appl., 2011, doi:10.1155/2011/780764), and improvement of the result (Yang et al. in Appl. Math. Comput. 218:6072-6082, 2012).

MSC:47H09, 47H10, 47H17.
Kamenev-type oscillation criteria for higher-order nonlinear dynamic equations on time scales
Authors: Wu Xin , Sun Taixiang , Xi Hongjian , Chen Changhong
Published: August 2013

In this paper, we investigate the oscillation of the following higher-order dynamic equation:

{

r
n

(
t
)

[

(

r

n
−
1

(
t
)

(
⋯

(

r
1

(
t
)

x
△

(
t
)
)

△

⋯
)

△

)

△

]

γ

}

△

+
F

(
t
,
x

(
τ
(
t
)
)

)

=
0

on an arbitrary time scale T, where

n
≥
2

,

1

r
k

(
t
)

(

1
≤
k
≤
n

) are positive rd-continuous functions on T, and γ is the quotient of two odd positive integers,

τ
:
T
→
T

with

τ
(
t
)
>
t

and

F
∈
C
(
T
×
R
,
R
)

. We give sufficient conditions under which every solution of this equation is either oscillatory or tends to zero.

MSC:34K11, 39A10, 39A99.
The combination of arsenic, interferon-alpha, and zidovudine restores an “immunocompetent-like” cytokine expression profile in patients with adult T-cell leukemia lymphoma
Authors: Kchour Ghada , Rezaee SA Rahim , Farid Reza , Ghantous Akram , Rafatpanah Houshang , Tarhini Mahdi , Kooshyar Mohamad-Mehdi , El Hajj Hiba , Berry Fadwa , Mortada Mohamad , Nasser Roudaina , Shirdel Abbas , Dassouki Zeina , Ezzedine Mohamad , Rahimi Hossein , Ghavamzadeh Ardeshir , de Thé Hugues , Hermine Olivier , Mahmoudi Mahmoud , Bazarbachi Ali
Published: August 2013

Background

HTLV-I associated adult T-cell leukemia/lymphoma (ATL) carries a dismal prognosis due to chemo-resistance and immuno-compromised micro-environment. The combination of zidovudine and interferon-alpha (IFN) significantly improved survival in ATL. Promising results were reported by adding arsenic trioxide to zidovudine and IFN.

Results

Here we assessed Th1/Th2/Treg cytokine gene expression profiles in 16 ATL patients before and 30 days after treatment with arsenic/IFN/zidovudine, in comparison with HTLV-I healthy carriers and sero-negative blood donors. ATL patients at diagnosis displayed a Treg/Th2 cytokine profile with significantly elevated transcript levels of Foxp3, interleukin-10 (IL-10), and IL-4 and had a reduced Th1 profile evidenced by decreased transcript levels of interferon-γ (IFN-γ) and IL-2. Most patients (15/16) responded, with CD4+CD25+ cells significantly decreasing after therapy, paralleled by decreases in Foxp3 transcript. Importantly, arsenic/IFN/zidovudine therapy sharply diminished IL-10 transcript and serum levels concomittant with decrease in IL-4 and increases in IFN-γ and IL-2 mRNA, whether or not values were adjusted to the percentage of CD4+CD25+ cells. Finally, IL-10 transcript level negatively correlated with clinical response at Day 30.

Conclusions

The observed shift from a Treg/Th2 phenotype before treatment toward a Th1 phenotype after treatment with arsenic/IFN/zidovudine may play an important role in restoring an immuno-competent micro-environment, which enhances the eradication of ATL cells and the prevention of opportunistic infections.
Short–term effects of neoadjuvant chemoradiation therapy on anorectal function in rectal cancer patients: a pilot study
Authors: Kye Bong-Hyeon , Kim Hyung-Jin , Kim Jun-Gi , Kim Sung-Hwan , Shim Byoung-Yong , Lee Nan-Sook , Cho Hyeon-Min
Published: August 2013

Background

Neoadjuvant chemoradiation therapy followed by curative surgery has gained acceptance as the therapy of choice in locally advanced rectal cancer. However, deterioration of anorectal function after long-course neoadjuvant chemoradiation therapy combined with surgery for rectal cancer is poorly defined. The aim of this study was to evaluate the physiological and clinical change of anorectal function after neoadjuvant chemoradiation therapy for rectal cancer.

Methods

We analyzed 30 patients on whom preoperative anorectal manometry data were available both before and after chemoradiation from October 2010 to September 2011. All patients underwent long-course neoadjuvant chemoradiation therapy. We compared manometric parameters between before and after neoadjuvant chemoradiation therapy.

Results

Of 30 patients, 20 were males and 10 females. The mean age was 64.9 ± 9.9 years (range, 48-82). Before nCRT, the rectal compliance was higher in patients with ulceroinfiltrative type (P = 0.035) and greater involvement of luminal circumference (P = 0.017). However, there was the tendency of increased rectal sensory threshold for desire to defecate when the patient had decreased circumferential ratio of the tumor (P = 0.099), down-graded T stage (P = 0.016), or reduced tumor volume (P = 0.063) after neoadjuvant chemoradiation.

Conclusions

Neoadjuvant chemoradiation therapy did not significantly impair overall sphincter function before radical operation. The relationship between tumor response of chemoradiation and sensory threshold for desire to defecate may suggest that neoadjuvant chemoradiation may be helpful for defecatory function as well as local disease control, at least in the short-term period after the radiation in locally advanced rectal cancer patients.
Core modular blood and brain biomarkers in social defeat mouse model for post traumatic stress disorder
Authors: Yang Ruoting , Daigle Jr Bernie J , Muhie Seid Y , Hammamieh Rasha , Jett Marti , Petzold Linda , Doyle Francis J
Published: August 2013

Background

Post-traumatic stress disorder (PTSD) is a severe anxiety disorder that affects a substantial portion of combat veterans and poses serious consequences to long-term health. Consequently, the identification of diagnostic and prognostic blood biomarkers for PTSD is of great interest. Previously, we assessed genome-wide gene expression of seven brain regions and whole blood in a social defeat mouse model subjected to various stress conditions.

Results

To extract biological insights from these data, we have applied a new computational framework for identifying gene modules that are activated in common across blood and various brain regions. Our results, in the form of modular gene networks that highlight spatial and temporal biological functions, provide a systems-level molecular description of response to social stress. Specifically, the common modules discovered between the brain and blood emphasizes molecular transporters in the blood-brain barrier, and the associated genes have significant overlaps with known blood signatures for PTSD, major depression, and bipolar disease. Similarly, the common modules specific to the brain highlight the components of the social defeat stress response (e.g., fear conditioning pathways) in each brain sub-region.

Conclusions

Many of the brain-specific genes discovered are consistent with previous independent studies of PTSD or other mental illnesses. The results from this study further our understanding of the mechanism of stress response and contribute to a growing list of diagnostic biomarkers for PTSD.
Systemic sclerosis sera affect fibrillin-1 deposition by dermal blood microvascular endothelial cells: therapeutic implications of cyclophosphamide
Authors: Villano Marilisa , Borghini Annalisa , Manetti Mirko , Gabbrielli Erica , Rossi Antonella , Sestini Piersante , Milia Anna Franca , Nacci Francesca , Guiducci Serena , Matucci-Cerinic Marco , Ibba-Manneschi Lidia , Weber Elisabetta
Published: August 2013

Introduction

Systemic sclerosis (SSc) is a connective tissue disorder characterized by endothelial cell injury, autoimmunity and fibrosis. The following three fibrillin-1 alterations have been reported in SSc. (1) Fibrillin-1 microfibrils are disorganized in SSc dermis. (2) Fibrillin-1 microfibrils produced by SSc fibroblasts are unstable. (3) Mutations in the FBN1 gene and anti-fibrillin-1 autoantibodies have been reported in SSc. Fibrillin-1 microfibrils, which are abundantly produced by blood and lymphatic microvascular endothelial cells (B-MVECs and Ly-MVECs, respectively), sequester in the extracellular matrix the latent form of the potent profibrotic cytokine transforming growth factor β (TGF-β). In the present study, we evaluated the effects of SSc sera on the deposition of fibrillin-1 and microfibril-associated glycoprotein 1 (MAGP-1) and the expression of focal adhesion molecules by dermal B-MVECs and Ly-MVECs.

Methods

Dermal B-MVECs and Ly-MVECs were challenged with sera from SSc patients who were treatment-naïve or under cyclophosphamide (CYC) treatment and with sera from healthy controls. Fibrillin-1/MAGP-1 synthesis and deposition and the expression of αvβ3 integrin/phosphorylated focal adhesion kinase and vinculin/actin were evaluated by immunofluorescence and quantified by morphometric analysis.

Results

Fibrillin-1 and MAGP-1 colocalized in all experimental conditions, forming a honeycomb pattern in B-MVECs and a dense mesh of short segments in Ly-MVECs. In B-MVECs, fibrillin-1/MAGP-1 production and αvβ3 integrin expression significantly decreased upon challenge with sera from naïve SSc patients compared with healthy controls. Upon challenge of B-MVECs with sera from CYC-treated SSc patients, fibrillin-1/MAGP-1 and αvβ3 integrin levels were comparable to those of cells treated with healthy sera. Ly-MVECs challenged with SSc sera did not differ from those treated with healthy control sera in the expression of any of the molecules assayed.

Conclusions

Because of the critical role of fibrillin-1 in sequestering the latent form of TGF-β in the extracellular matrix, its decreased deposition by B-MVECs challenged with SSc sera might contribute to dermal fibrosis. In SSc, CYC treatment might limit fibrosis through the maintenance of physiologic fibrillin-1 synthesis and deposition by B-MVECs.
Rituximab Maintenance Compared With Observation After Brief First-Line R-FND Chemoimmunotherapy With Rituximab Consolidation in Patients Age Older Than 60 Years With Advanced Follicular Lymphoma: A Phase III Randomized Study by the Fondazione Italiana Linfomi
Authors: Vitolo Umberto , Ladetto Marco , Boccomini Carola , Baldini Luca , De Angelis Federico , Tucci Alessandra , Botto Barbara , Chiappella Annalisa , Chiarenza Annalisa , Pinto Antonello , De Renzo Amalia , Zaja Francesco , Castellino Claudia , Bari Alessia , Alvarez De Celis Isabel , Evangelista Andrea , Parvis Guido , Gamba Enrica , Lobetti-Bodoni Chiara , Ciccone Giovannino , Rossi Giuseppe
Published: August 2013

Purpose

To evaluate the efficacy of rituximab maintenance in 60- to 75-year-old patients with advanced follicular lymphoma responding to brief first-line chemoimmunotherapy followed by rituximab consolidation.

Patients and Methods

A total of 234 treatment-naive 60- to 75-year-old patients began chemoimmunotherapy with four monthly courses of rituximab, fludarabine, mitoxantrone, and dexamethasone (R-FND) followed by four weekly cycles of rituximab consolidation. Of these, 210 patients completed the planned treatment, and 202 responders were randomly assigned to rituximab maintenance (arm A) for 8 months, once every 2 months for a total of four doses, or to observation (arm B).

Results

Median ages in arms A and B were 66 and 65 years, respectively. After induction and consolidation therapy, the overall response rate was 86%, with 69% complete remissions (CR). After a 42-month median follow-up from diagnosis, 3-year progression-free survival (PFS; the primary end point) and overall survival (OS) were 66% (95% CI, 59% to 72%) and 89% (95% CI, 85% to 93%), respectively. After randomization, 2-year PFS was 81% for rituximab maintenance versus 69% for observation, with a hazard ratio of 0.74 (95% CI, 0.45 to 1.21; P = .226), although this was not statistically significant. No differences between the two arms were detected for OS. Overall, the regimen was well-tolerated. The most frequent grade 3 to 4 toxicity was neutropenia (25% of treatment courses), with 13 infections. Two toxic deaths (0.8%) occurred during induction treatment.

Conclusion

A brief R-FND induction plus rituximab consolidation achieved excellent results with high CR and PFS rates, supporting the feasibility of this regimen in patients older than 60 years. A short rituximab maintenance did not achieve a statistically significant PFS improvement over observation.
Vertebral Compression Fracture After Spine Stereotactic Body Radiotherapy: A Multi-Institutional Analysis With a Focus on Radiation Dose and the Spinal Instability Neoplastic Score
Authors: Sahgal Arjun , Atenafu Eshetu G. , Chao Sam , Al-Omair Ameen , Boehling Nicholas , Balagamwala Ehsan H. , Cunha Marcelo , Thibault Isabelle , Angelov Lilyana , Brown Paul , Suh John , Rhines Laurence D. , Fehlings Michael G. , Chang Eric
Published: August 2013

Purpose

Vertebral compression fracture (VCF) is increasingly recognized as an adverse event after spine stereotactic body radiotherapy (SBRT). We report a multi-institutional study aimed at clarifying the risk and predictive factors associated with VCF.

Patients and Methods

A total of 252 patients with 410 spinal segments treated with SBRT were included. The primary outcome was the development of VCF (a new VCF or progression of a baseline VCF). In addition to various patient-, treatment-, and tumor-specific factors, the Spinal Instability Neoplastic Scoring (SINS) system was applied to determine predictive value.

Results

The median follow-up was 11.5 months (range, 0.03 to 113 months). The median and mean overall survival rates were 16 and 26 months, respectively. We observed 57 fractures (57 of 410, 14%), with 47% (27 of 57) new fractures and 53% (30 of 57) fracture progression. The median time to VCF was 2.46 months (range, 0.03 to 43.01 months), and 65% occurred within the first 4 months. The 1- and 2-year cumulative incidences of fracture were 12.35% and 13.49%, respectively. Multivariable analysis identified dose per fraction (greatest risk for ≥ 24 Gy v 20 to 23 Gy v ≤ 19 Gy), in addition to three of the six original SINS criteria: baseline VCF, lytic tumor, and spinal deformity, as significant predictors of VCF.

Conclusion

Caution must be observed when treating with ≥ 20 Gy/fraction, in particular, for patients with lytic tumor, spinal misalignment, and a baseline VCF. Frequent short-term follow-up is required, as nearly two thirds of all VCF occurred within the first 4 months. We also conclude that SINS may have utility in predicting patients at high risk of SBRT-induced VCF.