bluuebunny/crossref_metadata_2025 huggingface dataset:
Student and supervisor productivity change during nutrition and dietetic practice placements: A cohort study
Authors: Ash Susan , Martin Elizabeth K. , Rodger Sylvia , Clark Michele , Graves Nick
Published: November 2013

Aim

This study aimed to demonstrate how supervisors and students use their time during the three domains of nutrition and dietetic clinical placement and to what extent patient‐care and non‐patient activities change during placement compared with pre‐ and post‐placement.

Methods

A cohort survey design was used with students from two Queensland universities, and their supervisors in 2010. Participants recorded their time use in either a paper‐based or an electronic survey. Supervisors' and students' time use was calculated as independent daily means according to time‐use categories reported over the length of the placement. Mean daily number of occasions of service, length of occasions of service, project activities and other time use in minutes was reported as productivity output indicators and the data imputed. A linear mixed modelling approach was used to describe the relationship between the stage of placement and time use in minutes.

Results

Combined students' (n = 21) and supervisors' (n = 29) time use as occasions of service or length of occasions of service in patient‐care activities were significantly different pre, during and post placement. On project‐based placements in food‐service management and community public health nutrition, supervisors' project activity time significantly decreased during placements with students undertaking more time in project activities.

Conclusions

This study showed students do not reduce occasions of service in patient care, and they enhance project activities in food service and community public health nutrition while on placement. A larger study is required to confirm these results.
Does the Mini Nutrition Assessment—Short Form predict clinical outcomes at six months in older rehabilitation patients?
Authors: Slattery Andrew , Wegener Lorinda , James Sarah , Satanek Megan E. , Miller Michelle D.
Published: November 2013

Aims

This study aimed to determine if nutritional status as assessed by the revised Mini Nutritional Assessment—Short Form is predictive of relevant clinical outcomes within six months in older rehabilitation patients, and to investigate the relationship between admission diagnosis and nutritional status.

Methods

A consecutive retrospective case note audit of 181 patients ≥ 65 years admitted to rehabilitation between May and November 2010 at the Repatriation General Hospital was performed. Nutritional status was assessed using the revised Mini Nutritional Assessment—Short Form. Outcomes measured included length of stay in rehabilitation, complications during admission, participation in rehabilitation activities and change in function during admission. Acute readmissions and mortality were assessed at six months post discharge from rehabilitation.

Results

Thirty‐nine (22%) patients had normal nutritional status, 98 (54%) were at risk of malnutrition and 43 (24%) were malnourished. Patients at risk of malnutrition/malnourished had a longer length of stay (P = 0.008) and were more likely to be poor participators in rehabilitation activities (P = 0.006). Malnourished patients had poor function on admission to rehabilitation (P < 0.001) and had the greatest improvement in function during the rehabilitation admission (P = 0.012).

Conclusions

Over three‐quarters of older rehabilitation patients were identified as malnourished or at risk of malnutrition, and this was associated with poorer function on admission, increased length of stay and poorer participation in rehabilitation activities. Thus, the issue of malnutrition is a concern as it impacts on clinical outcomes of rehabilitation and therefore, further investigation and attention to nutritional status during admission is required.
Physiological and genetic basis for self‐aggregation of a thermophilic hydrogenotrophic methanogen, Methanothermobacter strain CaT2
Authors: Kosaka Tomoyuki , Toh Hidehiro , Fujiyama Asao , Sakaki Yoshiyuki , Watanabe Keiji , Meng Xian‐Ying , Hanada Satoshi , Toyoda Atsushi
Published: November 2013

Several thermophilic hydrogenotrophic methanogens naturally aggregate in their habitats in association with hydrogen‐producing bacteria for efficient transfer of the methane fermentation intermediates to produce methane. However, physiology of aggregation and the identity of aggregation‐specific genes remain to be elucidated. Here, we isolated and characterized a hydrogen and formate‐utilizing Methanothermobacter sp. CaT2 that is capable of self‐aggregation and utilizing formate. CaT2 produced methane from propionate oxidation in association with a syntrophic propionate‐oxidizing bacterium faster than other methanogens, including Methanothermobacter thermautotrophicus ΔH and Methanothermobacter thermautotrophicus Z‐245. CaT2 also aggregated throughout the culture period and was coated with polysaccharides, which was not found on the ΔH and Z‐245 cells. Sugar content (particularly of rhamnose and mannose) was also higher in the CaT2 cells than the ΔH and Z‐245 cells. Comparative genomic analysis of CaT2 indicated that four candidate genes, all of which encode glycosyltransferase, were involved in aggregation of CaT2. Transcriptional analysis showed that one glycosyltransferase gene was expressed at relatively high levels under normal growth conditions. The polysaccharide layer on the CaT2 cell surface, which is probably assembled by these glycosyltransferases, may be involved in cell aggregation.
Ethanol Plus the Jo2 Fas Agonistic Antibody‐Induced Liver Injury is Attenuated in Mice with Partial Ablation of Argininosuccinate Synthase
Authors: Lu Yongke , Ward Stephen C. , Nieto Natalia
Published: November 2013

Background

Argininosuccinate synthase (ASS) is an enzyme shared by the urea cycle and the l‐citrulline/nitric oxide (NO·) cycle. ASS is the rate‐limiting enzyme in the urea cycle and along with nitric oxide synthase 2 (NOS2), it endows cells with the l‐citrulline/NO· salvage pathway to continuously supply l‐arginine from l‐citrulline for sustained NO· generation. Thus, ASS conditions NO· synthesis by NOS2. Because of the relevance of NOS2 activation for liver injury, we examined the contribution of ASS to NO· generation and how it impacts liver injury.

Methods

Wild‐type (WT) mice and Ass+/− mice (Ass−/− mice are lethal) were intraperitoneally injected with ethanol (EtOH) at a dose of 2.5 g/kg of body weight twice a day for 3 days. Two hours after the last dose of EtOH, mice were administered the agonistic Jo2 anti‐mouse Fas monoclonal antibody (Ab) at a dose of 0.2 μg/g of body weight. Mice were sacrificed 8 hours after the Jo2 Ab injection. Markers of nitrosative and oxidative stress as well as liver damage were analyzed.

Results

EtOH plus Jo2 injection induced liver injury as shown by serum alanine aminotransferase and aspartate aminotransferase activity, liver pathology, TUNEL, and cleaved caspase‐3 were lower in Ass+/− mice compared with WT mice, suggesting that ASS contributes to EtOH plus Jo2‐mediated liver injury. CYP2E1 induction, glutathione depletion, and elevated thiobarbituric acid reactive substances were comparable in both groups of mice, suggesting that CYP2E1‐mediated oxidative stress is not linked to ASS‐induced liver injury. In contrast, NOS2 induction, 3‐nitrotyrosine adducts formation and elevated nitrites, nitrates, and S‐nitrosothiols were higher in livers from WT mice than from Ass+/− mice.

Conclusion

Decreased nitrosative stress causes lower EtOH plus Jo2‐induced liver injury in Ass+/− mice.
S‐Adenosylhomocysteine Inhibits NF‐κB‐Mediated Gene Expression in Hepatocytes and Confers Sensitivity to TNF Cytotoxicity
Authors: Watson Walter H. , Burke Tom J. , Doll Mark A. , McClain Craig J.
Published: November 2013

Background

Chronic alcohol exposure results in liver injury that is driven in part by inflammatory cytokines such as tumor necrosis factor‐α (TNF). Hepatocytes are normally resistant to the cytotoxic effects of TNF, but they become sensitized to TNF by chronic alcohol exposure. Recently, we reported that the decrease in the ratio of S‐adenosylmethionine (SAM) to S‐adenosylhomocysteine (SAH) that occurs with alcoholic liver injury renders hepatocytes sensitive to TNF cytotoxicity. The purpose of this study was to determine whether inhibition of the transcription factor nuclear factor‐kappaB (NF‐κB) contributed to TNF‐induced cell death in hepatocytes with high levels of SAH.

Methods

Primary human hepatocytes or HepG2 cells were pre‐incubated with a combination of adenosine plus homocysteine to increase SAH levels. Following exposure to TNF, viability was determined by the MTT assay, and activation of the NF‐κB pathway was assessed by measuring degradation of cytosolic IκB‐α, phosphorylation and translocation of NF‐κB to the nucleus, and expression of NF‐κB‐dependent genes. TNF‐induced apoptotic signaling pathways were assessed by monitoring levels of the anti‐apoptotic protein, A20, and cleavage products of the caspase‐8 substrate, RIP1.

Results

NF‐κB‐mediated gene expression was inhibited in cells with high SAH, despite the fact that TNF‐induced degradation of the cytoplasmic inhibitor IκB‐α and accumulation of NF‐κB in the nucleus persisted for much longer. In contrast to control cells, the NF‐κB that accumulated in the nucleus of cells with high SAH levels was not phosphorylated at serine 536, a modification associated with activation of the transactivation potential of this transcription factor. The inhibition of transactivation by NF‐κB resulted in lower mRNA and protein levels of the anti‐apoptotic protein A20 and increased cleavage of RIP1.

Conclusions

High SAH levels inhibited NF‐κB‐mediated gene expression and sensitized primary hepatocytes and HepG2 cells to the cytotoxic effects of TNF. It is likely that crosstalk with other transcription factors is perturbed under these conditions, resulting in still other changes in gene expression.
Centrifugal Blood Pump for Temporary Ventricular Assist Devices With Low Priming and Ceramic Bearings
Authors: Leme Juliana , da Silva Cibele , Fonseca Jeison , da Silva Bruno Utiyama , Uebelhart Beatriz , Biscegli José F. , Andrade Aron
Published: November 2013

A new model of centrifugal blood pump for temporary ventricular assist devices has been developed and evaluated. The design of the device is based on centrifugal pumping principles and the usage of ceramic bearings, resulting in a pump with reduced priming (35 ± 2 mL) that can be applied for up to 30 days. Computational fluid dynamic (CFD) analysis is an efficient tool to optimize flow path geometry, maximize hydraulic performance, and minimize shear stress, consequently decreasing hemolysis. Initial studies were conducted by analyzing flow behavior with different impellers, aiming to determine the best impeller design. AfterCFDstudies, rapid prototyping technology was used for production of pump prototypes with three different impellers. In vitro experiments were performed with those prototypes, using a mock loop system composed ofTygon tubes, oxygenator, digital flow meter, pressure monitor, electronic driver, and adjustable clamp for flow control, filled with a solution (1/3 water, 1/3 glycerin, 1/3 alcohol) simulating blood viscosity and density. Flow‐versus‐pressure curves were obtained for rotational speeds of 1000, 1500, 2000, 2500, and 3000 rpm. As the next step, theCFDanalysis and hydrodynamic performance results will be compared with the results of flow visualization studies and hemolysis tests.
A System to Help Physicians With Fracture Detection in Stents
Authors: Ricchetti Pier Marco , Nicolosi Denys Emilio Campion , Kambara Antonio Massamitsu , de Andrade Aron José Pazin
Published: November 2013

Fractures in stents are usually detected by visual analysis, which may be affected by the presence of noise and image deformations. The lack of research into automating stent fracture detection has motivated this work, in which techniques are developed to facilitate diagnosis by observation (Image Delineation Algorithm) and, when possible, to point out areas of possible fractures (Fracture Detection Algorithm). The use of classical elements and the development of additional computational techniques contributed to the process of image analysis, providing a possible way to aid medical diagnosis. The developed algorithms are applied to image samples from femoropopliteal arteries, and the results are compared to those of medical diagnosis. As a result, aside from the improvement of image display, a kappa concordance index of 0.878 for the detection of fractures confirms the method as satisfactory, with very good agreement with medical diagnosis.
Prevalence of thrombophilia according to age at the first manifestation of venous thromboembolism: results from the MAISTHRO registry
Authors: Weingarz Lea , Schwonberg Jan , Schindewolf Marc , Hecking Carola , Wolf Zsuzsanna , Erbe Matthias , Weber Adele , Lindhoff‐Last Edelgard , Linnemann Birgit
Published: November 2013

Thrombophilia is a well‐established risk factor for a venous thromboembolic event (VTE), and it has been proposed that hereditary thrombophilia may substantially contribute to the development of VTE in young patients. We aimed to analyse the prevalence of thrombophilia with special regard to the age of VTE manifestation. The study cohort consisted of 1490 patients (58% females) with a median age 43 years at the time of their first VTE. At least one thrombophilic disorder was identified in 50·1% of patients. The probability of detecting a hereditary thrombophilia declined significantly with advancing age (from 49·3% in patients aged 20 years and younger to 21·9% in patients over the age of 70 years; P < 0·001). This may be primarily attributed to the decreasing frequencies of the F5 R506Q (factor V Leiden) mutation and deficiencies of protein C or protein S with older age at the time of the initial VTE event. Moreover, thrombophilia was more prevalent in unprovoked compared with risk‐associated VTE (57·7% vs. 47·7%; P = 0·001). The decline in the prevalence of hereditary thrombophilia with older ages supports the use of a selected thrombophilia screening strategy dependent on age and the presence or absence of additional VTE risk factors.
Outcomes of surgical treatment of Peyronie's disease
Authors: Carson Culley C. , Levine Laurence A.
Published: November 2013

The aims of the present review were to assess the literature on published outcomes and complications associated with surgical treatments for Peyronie's disease (PD) and to assist clinicians in the effective management of PD by increasing understanding and awareness of the outcomes associated with current surgical treatment options. A PubMed literature search was conducted to identify relevant, peer‐reviewed clinical and review articles published between January 1980 and October 2013 related to outcomes of surgical correction of PD. Search terms for this non‐systematic review included ‘Peyronie's disease’, ‘outcomes’, ‘complications’, ‘erectile dysfunction or ED’, ‘patient expectation’, and ‘patient satisfaction’; search terms were searched separately and in combination. Case studies and editorials were excluded, primary manuscripts and reviews were included, and bibliographies of articles of interest were reviewed and key references were obtained. Assessment of the study design, methodology, clinical relevance and impact on the surgical outcomes of PD was performed on the sixty‐one articles that were selected and analysed. Currently, there are several investigational minimally invasive and non‐surgical treatment options for PD; however, surgical treatment remains the standard of care for patients with stable disease and disabling deformity or drug‐resistant erectile dysfunction. Each of the different surgical procedures that are used for treatment of PD, including tunical shortening, tunical lengthening (plaque incisions or partial excision and grafting), and use of inflatable penile prostheses, carries its own advantages and disadvantages in terms of potential complications and postoperative satisfaction. Because of the variety of ways that PD may present in affected patients, no single, standard, surgical treatment for this disorder has prevailed and multiple variations of each type of procedure may exist. Surgical outcomes of the most commonly used procedures are not substantially different; therefore, the appropriateness of each treatment option may often depend on disease and patient characteristics (e.g. deformity and erectile function). Surgical algorithms have been published to guide surgeons and patients through the selection of surgical procedures in the absence of conclusive, long‐term outcome data. Accumulating data on outcomes associated with established procedures, modifications to these procedures, and new surgical techniques and materials may serve to further guide practice and refine evidence‐based selection of the surgical approach.
Association of hospital volume with conditional 90‐day mortality after cystectomy: an analysis of the National Cancer Data Base
Authors: Nielsen Matthew E. , Mallin Katherine , Weaver Mark A. , Palis Bryan , Stewart Andrew , Winchester David P. , Milowsky Matthew I.
Published: November 2013

Objective

To examine the association of hospital volume and 90‐day mortality after cystectomy, conditional on survival for 30 days.

Patients and Methods

The National Cancer Data Base was used to evaluate 30‐ and 90‐day mortality for 35 055 patients who underwent cystectomy for bladder cancer at one of 1118 hospitals.

Patient data were aggregated into hospital volume categories based on the mean annual number of procedures (low‐volume hospital: <10 procedures; intermediate‐volume hospital: 10–19 procedures; high‐volume hospital: ≥20 procedures).

Associations between mortality and clinical, demographic and hospital characteristics were analysed using hierarchical logistic regression models. To assess the association between hospital volume and 90‐day mortality independently of shorter‐term mortality, 90‐day mortality conditional on 30‐day survival was assessed in the multivariate modelling.

Results

Unadjusted 30‐ and 90‐day mortality rates were 2.7 and 7.2% overall, 1.9 and 5.7% among high‐volume hospitals, and 3.2 and 8.0% among low‐volume hospitals, respectively.

Compared with high‐volume hospitals, the adjusted risks among low‐volume hospitals (odds ratio [95% CI]) of 30‐ and 90‐day mortality, conditional on having survived for 30 days, from the hierarchical models were 1.5 (1.3–1.9), and 1.2 (1.0–1.4), respectively.

Conclusions

A low hospital volume was associated with greater 30‐ and 90‐day mortality. These data support the need for further research to better understand the relatively high mortality rates seen between 30 and 90 days, which are high and less variable across hospital volume strata.

The stronger association between volume and 30‐day mortality suggests that quality‐reporting efforts should focus on shorter‐term outcomes.
Does Aid for Roads Attract Foreign or Domestic Firms? Evidence from Cambodia
Authors: Tanaka Kiyoyasu , Tsubota Kenmei
Published: November 2013

Less developed countries have received substantial foreign aid for transport infrastructure, making its quantitative assessment important. To investigate the effect of aid for road infrastructure on the location of foreign and domestic firms, this study employs the first comprehensive census on all business establishments in Cambodia for 2011 and measures the geographical distribution of aid disbursements in roads. Estimating a negative binomial model, we find that aid disbursements in roads have little influence on the entry of foreign and domestic firms across communes. Compared with the aid effect, the location of firms is more strongly influenced by other determinants such as population size, electricity access, and labor supply.
The Impact of the Width of the Tracking Area on Speckle Tracking Parameters—Methodological Aspects of Deformation Imaging
Authors: Stoebe Stephan , Tarr Adrienn , Pfeiffer Dietrich , Hagendorff Andreas
Published: November 2013

Aims

The aim of this study was to analyze the impact of the tracking area width on myocardial wall motion and deformation parameters in 2D speckle tracking.

Methods and Results

Standardized apical views were acquired in 30 healthy subjects and 15 patients with left ventricular systolic dysfunction using 2D echocardiography. Longitudinal peak systolic strain (PSS), longitudinal peak systolic strain rate (PSSR), postsystolic index (PSI), peak longitudinal (PLD), and peak transverse displacement (PTD) were determined by 2D speckle tracking to analyze the impact of the tracking area width on global and regional myocardial wall motion and deformation parameters. The dimension of the tracking area has a significant impact on all parameters. With increasing width of the tracking area higher values of PSS, PSSR, PSI, and lower values of PLD and PTD were determined. With increasing width of the tracking area a significant number of segments were not tracked. In summary, especially global PSS is significantly influenced by the width of the tracking area.

Conclusions

The strain values determined by 2D speckle tracking are significantly influenced by the tracking area width. The tracking of the subendocardial layers only results in lower global strain values than tracking the complete ventricular wall using the medium or wide tracking area widths. The tracking quality in the far field is worse if the tracking area is too wide. The present data show that standard and reference values of deformation imaging should include detailed information about the position and the width of the tracking area.
Evaluation of Carotid Intima‐Media Thickness and Aortic Elasticity in Patients with Nondipper Hypertension
Authors: Ozdemir Emrah , Yildirimturk Ozlem , Cengiz Betul , Yurdakul Selen , Aytekin Saide
Published: November 2013

Background

The relationship between cardiovascular diseases and the diurnal blood pressure (BP) rhythm was researched in many studies. It has been demonstrated that the nondipping pattern has been associated with target organ damage and worsened cardiovascular outcomes. The aim of our study was to assess the relationship between aortic elasticity parameters and carotid intima‐media thickness (CIMT) and diastolic dysfunction in terms of “dipper” and “nondipper” hypertension subtypes.

Methods

A total of 60 hypertensive patients without known coronary heart disease were recruited to our study. All patients were classified as “dipper” or “nondipper” after ambulatory BP follow‐up. Patients' left ventricular (LV) systolic and diastolic functions were assessed with transthoracic echocardiography. Ascending aorta diameters and CIMT were measured by ultrasonography and the elasticity parameters of aorta were calculated by using relevant formula.

Results

There were no significant differences between the groups with respect to demographic, biochemical data, and cardiovascular risk factors. Aortic stiffness was significantly increased in nondippers, whereas aortic strain and distensibility were significantly decreased (P = 0.005, P = 0.005, and P = 0.024, respectively). Carotid artery IMT was significantly increased in nondippers compared to dippers (P = 0.013). A significant correlation was noted between CIMT and mean BP. No significant difference was detected between 2 groups in terms of LV hypertrophy and diastolic dysfunction.

Conclusion

In our study, we showed that impairment of aortic elasticity parameters and increase in CIMT as a predictor of end organ damage were more often in the nondipper hypertensive patients.
Dietary supplementation with pollen enhances survival and Collembola boosts fitness of a web‐building spider
Authors: Schmidt Jason M. , Peterson Julie A. , Lundgren Jonathan G. , Harwood James D.
Published: November 2013

Uncertainties exist about the value of non‐prey food for predators that are commonly food‐limited, and the dietary conditions where non‐prey foods are beneficial for carnivorous species. Prior studies show that large quantities of pollen grains are intercepted in the webs of web‐building spiders. We examined the nutritional benefits of pollen as a non‐prey food for a common ground‐dwelling, sheet web‐building spider, Mermessus fradeorum (Berland) (Araneae: Linyphiidae). These predators were provided diets of prey or no prey in the presence and absence of pollen. Treatment effects were quantified by measuring predator body nutrient composition, survival, body size, and offspring production. Per unit dry weight, pollen had less nitrogen and lipids than prey, although relative quantities of these nutrients per meal were not measured. Dietary treatments altered the body tissue composition of the spiders, leading to the highest N content and lipid reserves in spiders provided with Collembola. Supplementing diets with pollen increased both juvenile and adult survival, and the greatest survivorship and offspring production was observed when spiders were provided diets of Collembola supplemented with pollen. Our results show that Collembola are high‐quality prey for spiders and pollen has positive effects on nutritional status and survival of a carnivorous species. Foraging on plant material potentially promotes population growth at early and late developmental stages by supplementing diets of poor‐quality prey, and preventing starvation when prey are scarce.
The Intensification of Rankings Logic in an Increasingly Marketised Higher Education Environment
Authors: Locke William
Published: November 2013

Rankings and online comparison sites have both facilitated and shaped the marketisation of higher education in England, the UK as a whole and elsewhere. They have facilitated marketisation by introducing greater competition between and within higher education institutions. Ultimately, they accomplish the transformation of qualities into quantities, which is both required by, and a consequence of, the commodification and privatisation of higher education. Rankings have also helped to embed the logic of the market within organisational structures and processes and within the minds and practices of organisational members. In some ways, in a highly regulated UK higher education market, rankings became a substitute for more authentic market mechanisms. However, these processes have intensified with the transfer (in England) of the majority of the cost of study to students and the emergence of more sophisticated websites presenting detailed statistics that enable prospective students to compare courses and institutions on indicators such as modes of student assessment and employment outcomes. This article seeks to understand how different types of university and college are responding to this intensification of rankings logic amidst the further marketisation of higher education in the UK. It employs the concepts of internalisation and institutionalisation to analyse how these responses evolve and vary between institutions at different places in the rankings, but eschews a completely Foucauldian interpretation which, in the author's view, cannot fully explain the responses within institutions (and over time) to ‘data‐driven technologies’.
When the brain expects pain: common neural responses to pain anticipation are related to clinical pain and distress in fibromyalgia and osteoarthritis
Authors: Brown Christopher A. , El‐Deredy Wael , Jones Anthony K. P.
Published: November 2013

Supraspinal processes in humans can have a top‐down enhancing effect on nociceptive processing in the brain and spinal cord. Studies have begun to suggest that such influences occur in conditions such as fibromyalgia (FM), but it is not clear whether this is unique to FM pain or common to other forms of chronic pain, such as that associated with osteoarthritis (OA). We assessed top‐down processes by measuring anticipation‐evoked potentials and their estimated sources, just prior (< 500 ms) to laser heat pain stimulation, in 16 patients with FM, 16 patients with OA and 15 healthy participants, by using whole‐brain statistical parametric mapping. Clinical pain and psychological coping factors (pain catastrophizing, anxiety, and depression) were well matched between the patient groups, such that these did not confound our comparisons between FM and OA patients. For the same level of heat pain, insula activity was significantly higher in FM patients than in the other two groups during anticipation, and correlated with the intensity and extent of reported clinical pain. However, the same anticipatory insula activity also correlated with OA pain, and with the number of tender points across the two patient groups, suggesting common central mechanisms of tenderness. Activation in the dorsolateral prefrontal cortex was reduced during anticipation in both patient groups, and was related to less effective psychological coping. Our findings suggest common neural correlates of pain and tenderness in FM and OA that are enhanced in FM but not unique to this condition.
Neuropsychological approaches to epileptic encephalopathies
Authors: Filippini Melissa , Arzimanoglou Alexis , Gobbi Giuseppe
Published: November 2013

The International League Against Epilepsy (ILAE) Commission report on classification and terminology indicates that “diagnosing an individual as having an encephalopathic course requires demonstration of a failure to develop as expected relative to the same‐aged peers or to regress in abilities.” In this chapter, basing our discussion on the theoretical framework of neuroconstructivism, on the latest results deriving from functional neuroimaging and on the concept of system epilepsy, we use continuous spike‐waves during slow‐wave sleep (CSWS) as an example of how non–rapid eye movement (NREM) sleep spikes interfere with the organization and consolidation of neuropsychological networks in the sensitive phase of development, affecting also interconnected systems. Indeed, recent discoveries show that the normal overnight downscaling of slow wave activity (SWA) from the first to the last hours of sleep is absent in electrical status epilepticus during sleep (ESES) patients, thus impairing the neural process and possibly the local plastic changes associated with learning and other cognitive functions. Moreover, specific patterns of spike‐induced activation (especially in perisylvian and/or prefrontal areas) and deactivation of default mode network (DMN) have been shown in patients with CSWS. Consequently, to date, we may conceive that the possible mechanisms underlying neuropsychological disorders in encephalopathic epilepsy (EE) may be double, since NREM sleep interictal epileptic discharges (IEDs) induce both a pathologic activation in epileptogenic areas and a pathologic deactivation of DMN beyond the epileptogenic zone. The growing body of literature on the effects of ESES in CSWS provides us with increasing knowledge on the complexity of brain development and a better understanding of plasticity, enlightening the pathogenesis of damage on developing neuropsychological functions. Finally, the need for an individually tailored interpretation of the neuropsychological testing results, expected to integrate neurophysiology and functional neuroimaging data, is suggested.
Topical cholesterol treatment ameliorates hapten‐evoked cutaneous hypersensitivity by sustaining expression of 11β‐HSD1 in epidermis
Authors: Murota Hiroyuki , Itoi Saori , Terao Mika , Matsui Saki , Kawai Hiromi , Satou Yasunari , Suda Kazuma , Katayama Ichiro
Published: November 2013

Changes in the stratum corneum extracellular matrix impair epidermal barrier function and may cause dermatoses. The aim of this study was to examine the effect of exogenous cholesterol application on skin barrier function and cutaneous inflammation. Skin barrier‐disrupted or hapten‐stimulated mice were treated with topical cholesterol. The effect of topical cholesterol application on an oxazolone (OXA)‐induced hypersensitivity reaction was evaluated. Topical application of cholesterol efficiently decreased transepidermal water loss in areas of barrier‐disrupted skin and ameliorated OXA‐induced cutaneous hypersensitivity. These favourable effects may have resulted from sustained expression of 11β‐hydroxysteroid dehydrogenase type 1 (11β‐HSD1) in the cholesterol‐treated skin. As 11β‐HSD1 is known to produce active cortisol, topical cholesterol may attenuate contact hypersensitivity by normalizing secretion of hormonally active cortisol from the skin.
Evidence‐based medicine and complementary and alternative medicine teaching in UK medical courses: a national survey of the student experience
Authors: Ho Derek , Chan Kenneth , Bewley Susan , Bender David A
Published: November 2013

Background

With substantial public interest in complementary and alternative medicine (CAM), future doctors will need to provide evidence‐based advice on their safety and efficacy. Informing medical students of CAM therefore becomes increasingly important.

Objective

To determine the extent and context of teaching on evidence‐based medicine (EBM) and CAM in UK medical schools from the student perspective.

Methods

A web‐based, 10‐item anonymous questionnaire was sent to selected UK medical students to assess their experience of teaching on EBM (including statistics) and CAM. The questionnaire measured the following parameters: number of lectures on EBM, number of lectures or workshops on statistics, number of lectures or availability of student‐selected components on CAM, rating of CAM teaching as critical, uncritical or discursive, and quality of feedback after placements with CAM practitioners.

Results

There were 95 student responses representing 25 different medical courses. Of the respondents, 54% had received lectures on CAM in the core course. Of these students, 46% stated the lectures were ‘critical’, 16% ‘uncritical’ and 39% ‘discursive’. Of the 33 who reported on placements with CAM practitioners, 61% stated there was no feedback, 12% received feedback from a specialist tutor, 15% from a non‐specialist facilitator, 9% via peer‐led reflection and 3% through a tutor‐marked written account.

Conclusions

Teaching of EBM, statistics and CAM is covered by most UK medical schools. However, we have identified areas in which CAM teaching could be improved. The survey demonstrates a need for UK curriculum coordinators to review the teaching of CAM‐related components in their courses.
The effects of tai chi qigong exercise on plasma glucose levels and health status of postpartum Thai women with type 2 diabetes
Authors: Youngwanichsetha Sununta , Phumdoung Sasitorn , Ingkathawornwong Thitiporn
Published: November 2013

Background

Postpartum women with type 2 diabetes are at risk of developing cardiovascular complications. Tai chi qigong is one kind of exercise considered to be effective in improving glycaemic control. However, little is known about the health benefits for postpartum women.

Objectives

This randomised controlled trial was carried out to investigate the effect of tai chi qigong exercise on plasma glucose levels and health status of postpartum women with type 2 diabetes.

Methods

Sixty‐four participants were randomly assigned to an intervention group (n=32) and control group (n=32). Participants in the intervention group practised a 50‐min tai chi qigong exercise programme, three times a week for 12 weeks during the period of 3–6 months postpartum. The control group received usual care.

Results

A statistically significant reduction in fasting plasma glucose, glycosylated haemoglobin and blood pressure were seen in the intervention group when compared with the control group (P<0.05) at 12 weeks. Mean fasting plasma glucose in the intervention and control groups at 12 weeks were 120.19 (standard deviation (SD)=17.51) mg/dl and 129.88 (SD=15.23) mg/dl, respectively. There were no significant between‐group differences in body‐weight or body‐mass index at trial completion.

Conclusions

Tai chi qigong exercise improved glycaemic control and blood pressure in postpartum women with type 2 diabetes. Its use should therefore be considered in clinical and community health services.
Histatins: salivary peptides with copper(II)‐ and zinc(II)‐binding motifs
Authors: Melino Sonia , Santone Celeste , Di Nardo Paolo , Sarkar Bibudhendra
Published: November 2013

Natural antimicrobial peptides represent a primordial mechanism of immunity in both vertebrate and nonvertebrate organisms. Among them, histatins belong to a family of human salivary metal‐binding peptides displaying potent antibacterial, antifungal and wound‐healing activities. These properties, along with the ability of histatins to inhibit collagenases and cysteine proteases, have attracted much attention for their potential use in the treatment of several oral diseases. This review critically assesses the studies carried out to date in order to provide a comprehensive and systematic vision of the information accumulated so far. In particular, the relationship between metal‐binding and peptide activity is extensively analysed. The review provides important clues for developing possible therapeutic applications of histatins and their synthetic peptide analogues by creating a set of necessary resource materials to support investigators and industries interested in exploiting their unique properties.
The New Potential for Understanding Groundwater Contaminant Transport
Authors: Hadley Paul W. , Newell Charles
Published: November 2013

The groundwater remediation field has been changing constantly since it first emerged in the 1970s. The remediation field has evolved from a dissolved‐phase centric conceptual model to a DNAPL‐dominated one, which is now being questioned due to a renewed appreciation of matrix diffusion effects on remediation. Detailed observations about contaminant transport have emerged from the remediation field, and challenge the validity of one of the mainstays of the groundwater solute transport modeling world: the concept of mechanical dispersion (Payne et al. 2008). We review and discuss how a new conceptual model of contaminant transport based on diffusion (the usurper) may topple the well‐established position of mechanical dispersion (the status quo) that is commonly used in almost every groundwater contaminant transport model, and evaluate the status of existing models and modeling studies that were conducted using advection‐dispersion models.
Quality of life and well‐being of people receiving haemodialysis treatment in Scotland: A cross‐sectional survey
Authors: Alshraifeen Ali , McCreaddie May , Evans Josie MM
Published: November 2013

End‐stage renal disease is a complex, progressive and debilitating illness that affects patients’ quality of life, physical and mental health, well‐being, social functioning and emotional health. A cross‐sectional survey was carried out in renal dialysis centres in Scotland to assess patients’ health status and the impact of haemodialysis treatment on quality of life and well‐being. Participants scored considerably lower than the UK general population in all domains of health‐related quality of life, although mental health components were nearer to general population norms than physical health components. However, nearly half of the participants achieved a score on a general well‐being questionnaire that was indicative of stress and anxiety. Increasing age was associated with better overall mental health but worse physical functioning. Increasing levels of hope and support were associated with improved general well‐being.
Association of cardiopulmonary resuscitation psychomotor skills with knowledge and self‐efficacy in nursing students
Authors: Roh Young Sook , Issenberg S Barry
Published: November 2013

Effective cardiopulmonary resuscitation (CPR) skills are essential for better patient survival, but whether these skills are associated with knowledge of and self‐efficacy in CPR is not well known. The purpose of this study was to assess the quality of CPR skills and identify the association of the psychomotor skills with knowledge and self‐efficacy at the time of CPR skills training. A convenience sample of 124 nursing students participated in a one‐group posttest‐only study. The quality of CPR psychomotor skills, as assessed by structured observation using a manikin, was suboptimal. Nursing students who performed correct chest compression skills reported higher self‐efficacy, but there was no association between CPR psychomotor skills and total knowledge. Rigorous skills training sessions with more objective feedback on performance and individual coaching are warranted to enable mastery learning and self‐efficacy.
Study of the distribution of active caspase‐3‐positive cells in turbot, Scophthalmus maximus (L.), enteromyxosis
Authors: Losada A P , Bermúdez R , Faílde L D , de Ocenda M V Ruiz , Quiroga M I
Published: November 2013

Enteromyxosis caused by Enteromyxum scophthalmi is one of the parasitizations with a higher economic impact on turbot, Scophthalmus maximus (L.), aquaculture. This myxosporean produces severe catarrhal enteritis with abundant inflammatory infiltrates in the lamina propria‐submucosa (LP), epithelial detachment and leucocyte depletion of the lymphohaematopoietic organs. Some advances made on the pathogenesis pointed to a role of apoptosis in the enteromyxosis. Therefore, the main aim of this work was to employ the TUNEL assay and the anti‐(active caspase‐3) immunohistochemical assay to detect apoptotic cells in both healthy and E. scophthalmi‐infected turbot in order to establish the presence and distribution of apoptotic cells during development of the disease. More apoptotic cells located within the gastrointestinal epithelium were observed in the initial stages of the infection in E. scophthalmi‐infected turbot compared with non‐infected turbot. As the infection progressed, a higher degree of apoptosis occurred in the epithelium of folds heavily parasitized. In the severely infected turbot, apoptosis was also found among the leucocytes of the intestinal inflammatory infiltrates. Moreover, the number of active caspase‐3‐positive cells in the lymphohaematopoietic organs tended to increase with disease severity. In view of the results, increased apoptosis in the epithelium may favour the scaling that occurs during enteromyxosis and cell death of leucocytes in the intestinal LP, contributing to leucocyte depletion in severe cases.
Clinicopathological significance of the peritumoral decreased uptake area of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid in hepatocellular carcinoma
Authors: Nishie Akihiro , Asayama Yoshiki , Ishigami Kousei , Kakihara Daisuke , Nakayama Tomohiro , Ushijima Yasuhiro , Takayama Yukihisa , Shirabe Ken , Fujita Nobuhiro , Kubo Yuichiro , Hirakawa Masakazu , Honda Hiroshi
Published: November 2013

Background and Aim

A faint hypointensity in the noncancerous tissue around hepatocellular carcinoma (HCC) in the hepatobiliary phase of Gd‐EOB‐DTPA‐enhanced magnetic resonance imaging (MRI) is encountered. The goal is to elucidate the significance of this type of pseudolesion designated as the peritumoral decreased uptake area of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd‐EOB‐DTPA) (PDUAE).

Methods

This study group consisted of 61 patients with 61 surgically resected HCCs who underwent preoperative Gd‐EOB‐DTPA‐enhanced MRI. The presence of a faint and hypointense area around the tumor in the hepatobiliary phase was defined as PDUAE. The frequency with which PDUAE was seen was compared between pairs of groups determined by clinical and pathological parameters using a Fisher's exact probability test. The parameters showing significant differences in this test were further tested by multiple logistic regression analysis.

Results

PDUAE was observed in 25 cases. In univariate analysis, the values of alpha‐fetoprotein and protein‐induced by vitamin K absence or antagonist‐II, maximal diameter, the presence of a capsule, and vascular invasion were significantly correlated with the frequency with which PDUAE was seen. In multivariate analysis, only maximal diameter and vascular invasion were significantly correlated. When the presence of PDUAE was used as an indicator of vascular invasion, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 72%, 80.6%, 77%, 72%, and 80.6%, respectively.

Conclusions

By using this indicator, “microscopic” vascular invasion of HCC can be easily predicted with Gd‐EOB‐DTPA‐enhanced MRI.
Mortality associated with proton pump inhibitors in cirrhotic patients with spontaneous bacterial peritonitis
Authors: Kwon Jee Hye , Koh Seong‐Joon , Kim Won , Jung Yong Jin , Kim Ji Won , Kim Byeong Gwan , Lee Kook Lae , Im Jong Pil , Kim Yoon Jun , Kim Joo Sung , Yoon Jung‐Hwan , Lee Hyo‐Suk , Jung Hyun Chae
Published: November 2013

Background and Aim

The aims of this study were to investigate whether acid suppressive therapy increases the risk of spontaneous bacterial peritonitis (SBP) and to define factors associated with mortality in cirrhotic patients with SBP.

Methods

Cirrhotic patients who had undergone paracentesis after hospitalization were included. Those patients were divided into two groups according to the presence or absence of SBP. Factors associated with the development of SBP were analyzed. Mortality rates during hospitalization or within 30 days after SBP and the factors associated with mortality were also analyzed.

Results

A total of 1140 patients (median age, 62; men, 75%; model for end‐stage liver disease [MELD] score, 17) were included. Five hundred thirty‐three patients were identified as having SBP. In the logistic regression, the use of histamine‐2 receptor antagonists, the use of proton pump inhibitors (PPIs), a high admission MELD score, and old age were associated with the development of SBP. The use of PPIs within 30 days (adjusted odds ratio [aOR] 1.960; 95% confidence interval [CI] 1.190–3.227; P = 0.008), a higher admission MELD score (aOR 1.054; 95% CI 1.032–1.076; P < 0.001), and hepatocellular carcinoma (aOR 1.852; 95% CI 1.256–2.730; P = 0.002) were associated with mortality after SBP.

Conclusions

Acid suppressive therapy is associated with the development of SBP in cirrhotic patients with ascites. The use of PPIs is associated with mortality after SBP independent of the severity of the underlying liver disease in our retrospective cohort study.
A comparative study of 4 Fr versus 6 Fr nasobiliary drainage catheters: A randomized, controlled trial
Authors: Ishigaki Takashi , Sasaki Tamito , Serikawa Masahiro , Minami Tomoyuki , Okazaki Akihito , Yukutake Masanobu , Ishii Yasutaka , Kosaka Keiichi , Mouri Teruo , Yoshimi Satoshi , Chayama Kazuaki
Published: November 2013

Background and Aim

Despite the benefits of endoscopic nasobiliary drainage (NBD) in endoscopic retrograde cholangiopancreatography (ERCP), post‐ERCP pancreatitis (PEP) and nose/throat discomfort can result. We aimed to determine whether the use of a smaller catheter alleviates these complications.

Method

A randomized, controlled trial at a tertiary care center compared 4 Fr and 6 Fr NBD catheters; 165 ERCP patients with naïve papillae were randomly assigned to a catheter‐size group.

Results

The prevalence of PEP was significantly lower in the 4 Fr group (3.7%; 3/82) than in the 6 Fr group (15.7%; 13/83; P = 0.019). No spontaneous catheter displacement occurred within 24 h. Discomfort visual analog scores were 2.6 and 4.3 in the 4 Fr and 6 Fr groups, respectively (P = 0.0048) on procedure day; on the following day, the scores were 2.3 and 3.6 (P = 0.028). Bile output was 16.3 mL/h and 21.4 mL/h in the 4 Fr and 6 Fr groups (P = 0.051). On obstructive jaundice subgroup analysis, bile drainage was 19.2 mL/h and 22.1 mL/h in the 4 Fr and 6 Fr groups (P = 0.40). The 4 Fr group required 5.6 days to reduce bilirubin levels versus 6.1 days in the 6 Fr group (P = 0.51).

Conclusions

In patients with naïve papillae, lower rates of PEP and less nose/throat discomfort are associated with the use of 4 Fr NBD catheters. In patients with obstructive jaundice, 4 Fr and 6 Fr catheters are comparable with regard to bile output and bilirubin level reduction.