bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients' anxiety and hope: predictors and adherence intentions in an acute care context
Authors: Legg Angela M. , Andrews Sara E. , Huynh Ho , Ghane Arezou , Tabuenca Arnold , Sweeny Kate
Published: October 2014

Context

Good patient–provider interactions promote satisfaction with health care, adherence to treatment recommendations and improved health. However, little research has examined patients' emotions and how they relate to patients' experiences with health care and their adherence intentions in acute care settings.

Objective

This study examined the predictors and consequences of two emotions pertinent to the uncertainty of acute health‐care experiences: anxiety and hopefulness.

Design

Patients who arrived at a general surgery clinic for an initial consultation were interviewed before and after the consultation. Prior to the consultation with a physician, patients completed baseline measures of their emotional state. Following the consultation, patients completed measures of understanding of the information provided by the surgeon, perceived control over treatment decisions, adherence intentions and emotional state.

Results

Understanding and control predicted less anxiety and greater hopefulness, compared to baseline. Only hopefulness predicted adherence intentions. These relationships remained even after controlling for characteristics of the patients and interactions.

Discussion

These findings identify aspects of psychosocial care that are critical for promoting positive (and mitigating negative) emotional states in patients. Even in a brief consultation in a clinic setting, physicians may be able to improve patients' emotional state by promoting a sense of control and clarifying information they convey, and patients' positive emotional states may be critical for raising adherence intentions.
Defining the doula's role: fostering relational autonomy
Authors: Meadow Sandra L.
Published: October 2014

Background

Training organizations as well as academic and popular literature provide ambiguous or ethically contentious characterizations of the role of the birth doula, a non‐clinical role assisting women in pregnancy and birth with information and physical and emotional support. Doulas have been criticized for attempting to impose their own agendas on their clients and for interfering with the relationship between women and their medical caregivers.

Objective

To develop a theoretically grounded model of the birth doula's role to guide constructive practice and refute some training organizations' and doulas' adoption of an active ‘advocacy’ role with clients that can lead to inappropriate practices.

Design

Apply the theoretical framework of relational autonomy to the components of the work that doulas perform with their clients.

Discussion and Conclusions

The conceptual framework of relational autonomy recognizes the social context in which women make choices about their care in pregnancy and birth, instead of assuming that autonomy is exercised in isolation. To support this understanding of autonomy, a relational model emphasizes women's skills development, self‐confidence and recognition of the social context for decisions. Highlighting these aspects of exercising autonomy reduces the potential for the doula to seek to influence her client. The doula's role is reframed as one of facilitating patient engagement and shared decision‐making.
Knowledge, attitudes and practice of breast cancer screening among female personnel of Walailak University
Authors: Kotepui Manas , Piwkham Duangjai , Chupeerach Chaowanee , Duangmano Suwit
Published: October 2014

Background

Breast cancer is the most common cancer among women worldwide.

Methods

This study aimed to assess the knowledge, awareness and practice of breast cancer screening for early detection of breast cancer among female personnel at a university. A cross‐sectional descriptive study was administered to female personnel of Walailak University in Nakhon Si Thammarat, Thailand. Data were analysed by SPSS version 16.

Results

Among total of 217 female personnel, the lecturers and laboratory scientists and general officers had a significantly higher mean knowledge score about the practice of breast cancer screening than temporary employees (P < 0.0001). The level of education and income of respondents may be involved with this difference in knowledge (P < 0.05).

Conclusion

This study concludes that knowledge about the practice of breast cancer screening could be attributed to different career groups, level of education and income of respondents. There is a very urgent need for regular learning courses for personnel concerning knowledge about the practice of breast cancer screening especially for those personnel with less formal education and low income.
The Doctrine of Scripture in the Heidelberg Catechism Revisited: Heidelberg's Relevance for a Postmodern Age
Authors: van Vlastuin Willem
Published: October 2014

The debate on the doctrine of Scripture is ongoing. In this article, the use of Scripture is investigated in the Heidelberg Catechism, a catechism in which there is no explicit statement about Scripture, the notion of the Word refers to the preached Word, and the focus is placed on soteriology and God's law. I revisit these subjects, exploring what they mean for Reformed theology in a postmodern context, and finally arguing for a Spirit‐filled functioning of Scripture in which the relationship with Christ is basic and the fulfilment of God's law functions as a first fruit of eschatological reality.
Ladislaus von Bortkiewicz—Statistician, Economist and a European Intellectual
Authors: Härdle Wolfgang Karl , Vogt Annette B.
Published: October 2014

Ladislaus von Bortkiewicz (1868–1931) was a European statistician. His scientific work covered theoretical economics, stochastics, mathematical statistics and radiology; today, we would call him a cross‐disciplinary scientist. With his clear views on mathematical principles with their applications in these fields, he stood in conflict with the mainstream economic schools in Germany at the dawn of the 20th century. He had many prominent students (Gumbel, Leontief and Freudenberg among them), and he carved out the path of modern statistical thinking. He was a true European intellectual with a career path from St. Petersburg via Göttingen to Straßburg and finally the Berliner Universität, now Humboldt‐Universität zu Berlin. He is known for the precise calibration of insurance claims applying the—at that time hardly known—Poisson distribution to Prussian horse kick and child suicide data. He proposed a simple solution to the Marxian transformation problem and wrote numerous articles and books on the mathematical treatment of statistical (including radiological physical) data. In this article, we sketch his life and work and point out the prominent role that he has in today's statistical thinking.
Heel bone strength is related to lifestyle factors in Okinawan men with type 2 diabetes mellitus
Authors: Gushiken Michiko , Komiya Ichiro , Ueda Shinichiro , Kobayashi Jun
Published: October 2014

Aims/Introduction

Although male diabetic patients have an increased risk of fracture, there is little information about this in the literature. The association between heel bone stiffness and the lifestyle of male patients with diabetes was evaluated.

Materials and Methods

The study included 108 participants with type 2 diabetes mellitus patients and 168 age‐adjusted, healthy male volunteers. None of the participants had a history of osteoporosis or other severe diseases. Heel bone stiffness was examined by quantitative ultrasound, and each participant completed a health interview survey questionnaire. Bone stiffness was taken as an indicator of bone strength. Stepwise regression analysis was used to investigate associations between bone stiffness and lifestyle‐related factors, such as sunlight exposure, intake of milk or small fish, regular exercise, cigarette smoking, consumption of alcohol, and number of remaining teeth.

Results

Bone stiffness showed a significant negative association with cigarette smoking [standardized coefficient (SC) = −0.297, F‐value (F) = 10.059] and age (SC = −0.207, F = 7.565) in diabetic patients. Bone stiffness showed a significant negative association with age (SC = −0.371, F = 12.076) and height (SC = −0.193, F = 7.898), as well as a significant positive association with sunlight exposure (SC = 0.182, F = 9.589) and intake of small fish (SC = 0.170, F = 7.393) in controls.

Conclusions

These findings suggest that cigarette smoking and age are negatively associated with bone stiffness in Okinawan male patients with type 2 diabetes mellitus.
Trust and its effects on the public's perception of flood risk: a social science investigation of the middle and lower reaches of the Yangtze River
Authors: Su Y. , Sun X.‐p. , Zhao F.
Published: October 2014

To explore the public's risk perception and its causes and effects, it would be helpful to understand the basis for the public's disaster alleviation decisions and improve the effectiveness of risk communication. This paper analyses the relationship between the public's trust and risk perception by investigating the motives for trust building and the effects on public's flood risk perception in an area along the middle and lower reaches of Yangtze River. The objects of trust are disaster alleviation measures of monitoring and early warning, flood control projects, and disaster event management. The study data were obtained by conducting household interviews. The major conclusions are: (1) Public's trust in monitoring and early warning as well as in flood control projects is greater than the one in disaster event management. Trust has changed the public's assessment of flood risk and enhanced public confidence in disaster handling. Meanwhile, it reduces the propensity to adopt long‐term preparation against disasters. Therefore, the public needs guidance in recognising the limits and validity of scientific and technological capabilities. (2) Public's trust is the product of not only individual psychological processes but also the external regional flood risk and social psychological characteristics. The levels of trust vary in different regions. Therefore, risk communication should be conducted according to regional characteristics.
Quantitative expression of bone‐related cytokines induced by mechanical tension–stress during distraction osteogenesis in a rabbit mandible
Authors: Nuntanaranont Thongchai , Suttapreyasri Srisurang , Vongvatcharanon Surapong
Published: October 2014

Aim

The aim of the present study was to investigate the temporal and spatial gene expression of bone morphogenetic proteins (BMP)‐2, ‐4, and ‐7, and transforming growth factor‐β (TGF‐β), during the distraction process of the rabbit mandible.

Methods

Twenty rabbits each had an osteotomy on the left mandibular body, and distraction devices were fixed. After a delay of 3 days, distraction was started at a rate of 0.5 mm/12 h for 10 days, followed by a 3‐week consolidation phase. Four rabbits were killed 5 and 10 days of distraction, and 1, 2, and 3 weeks after the completion of distraction. The clinical, histological, and radiographic appearances were evaluated and analyzed with the concomitant BMP expression pattern at each interval.

Results

After the distraction was started, the fibrous interzone developed between the osteotomy fragments, where intramembranous ossification was noted. The quantitative expression of BMP‐2, ‐4, and ‐7, and TGF‐β, were increased immediately after active distraction before a gradual decline to normal levels after the third week of consolidation.

Conclusion

These results suggest that BMP and TGF‐β play an important role in the induction of bone formation during distraction osteogenesis. The selective expression of each bone‐related cytokine could provide useful insight into accelerated bone maturation and the treatment of poorly‐healing fractures in clinical cases.
Cleaning up after ICH: the role of Nrf2 in modulating microglia function and hematoma clearance
Authors: Zhao Xiurong , Sun Guanghua , Ting Shun‐Ming , Song Shen , Zhang Jie , Edwards Nancy J. , Aronowski Jaroslaw
Published: October 2014

As a consequence of intracerebral hemorrhage (ICH), blood components enter brain parenchyma causing progressive damage to the surrounding brain. Unless hematoma is cleared, the reservoirs of blood continue to inflict injury to neurovascular structures and blunt the brain repair processes. Microglia/macrophages (MMΦ) represent the primary phagocytic system that mediates the cleanup of hematoma. Thus, the efficacy of phagocytic function by MMΦ is an essential step in limiting ICH‐mediated damage. Using primary microglia to model red blood cell (main component of hematoma) clearance, we studied the role of transcription factor nuclear factor‐erythroid 2 p45‐related factor 2 (Nrf2), a master‐regulator of antioxidative defense, in the hematoma clearance process. We showed that in cultured microglia, activators of Nrf2 (i) induce antioxidative defense components, (ii) reduce peroxide formation, (iii) up‐regulate phagocytosis‐mediating scavenger receptor CD36, and (iv) enhance red blood cells (RBC) phagocytosis. Through inhibiting Nrf2 or CD36 in microglia, by DNA decoy or neutralizing antibody, we documented the important role of Nrf2 and CD36 in RBC phagocytosis. Using autologous blood injection ICH model to measure hematoma resolution, we showed that Nrf2 activator, sulforaphane, injected to animals after the onset of ICH, induced CD36 expression in ICH‐affected brain and improved hematoma clearance in rats and wild‐type mice, but expectedly not in Nrf2 knockout (KO) mice. Normal hematoma clearance was impaired in Nrf2‐KO mice. Our experiments suggest that Nrf2 in microglia play an important role in augmenting the antioxidative capacity, phagocytosis, and hematoma clearance after ICH.

image

Microglia/Macrophages (MMφ) utilize the scavenger receptor CD36 to internalize the red blood cells (RBC) during the hematoma cleanup process after intracerebral hemorrhage (ICH). During RBC catabolism in phagosomes of MMφ, reactive oxygen species (ROS) are generated causing oxidative stress and injury to the phagocyte and the neurovascular unit. We propose that the treatment of MMφ with Nrf2 agonist (sulforaphane) could:(1) speed up the phagocytosis process by up‐regulating CD36 expression, and (2) improve MMΦ resistant to oxidative damage by up‐regulating the expression of antioxidative enzymes such as catalase (Cat) or superoxide dismutase‐1 (SOD).
Adult Onset‐Hypothyroidism: Alterations in Hippocampal Field Potentials in the Dentate Gyrus are Largely Associated with Anaesthesia‐Induced Hypothermia
Authors: Sánchez‐Huerta K. , Pacheco‐Rosado J. , Gilbert M. E.
Published: October 2014

Thyroid hormone (TH) is essential for a number of physiological processes and is particularly critical during nervous system development. The hippocampus is strongly implicated in cognition and is sensitive to developmental hypothyroidism. The impact of TH insufficiency in the foetus and neonate on hippocampal synaptic function has been fairly well characterised. Although adult onset hypothyroidism has also been associated with impairments in cognitive function, studies of hippocampal synaptic function with late onset hypothyroidism have yielded inconsistent results. In the present study, we report hypothyroidism induced by the synthesis inhibitor propylthiouracil (10 p.p.m., 0.001%, minimum of 4 weeks), resulted in marginal alterations in excitatory postsynaptic potential (EPSP) and population spike (PS) amplitude in the dentate gyrus measured in vivo. No effects were seen in tests of short‐term plasticity, and a minor enhancement of long‐term potentiation of the EPSP slope was observed. The most robust synaptic alteration evident in hypothyroid animals was an increase in synaptic response latency, which was paralleled by a failure to maintain normal body temperature under anaesthesia, despite warming on a heating pad. Latency shifts could be reversed in hypothyroid animals by increasing the external heat source and, conversely, synaptic delays could be induced in control animals by removing the heat source, with a consequent drop in body and brain temperature. Thermoregulation is TH‐ dependent, and anaesthesia necessary for surgical procedures posed a thermoregulatory challenge that was differentially met in control and hypothyroid animals. Minor increases in field potential EPSP slope, decreases in PS amplitudes and increased latencies are consistent with previous reports of hypothermia in naive control rats. We conclude that failures in thyroid‐dependent temperature regulation rather than direct action of TH in synaptic physiology are responsible for the observed effects. These findings stand in contrast to the synaptic impairments observed in adult offspring following developmental TH insufficiency, and emphasise the need to control for the potential unintended consequences of hypothermia in the interpretation of hypothyroid‐induced changes in physiological systems, most notably synaptic transmission.
Fluid Attenuated Inversion Recovery Vascular Hyperintensities Possibly Indicate Slow Arterial Blood Flow in Vertebrobasilar Dolichoectasia
Authors: Förster Alex , Kerl Hans U. , Wenz Holger , Mürle Bettina , Habich Sonia , Groden Christoph
Published: October 2014

BACKGROUND AND PURPOSE

Vertebrobasilar dolichoectasia (VBD) is a dilatative arteriopathy associated with a decreased blood flow velocity. Fluid attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) is a phenomenon most likely representing slow arterial blood flow. We sought to examine the frequency and extent of FVH in VBD.

METHODS

We analyzed magnetic resonance imaging (MRI) findings in 77 VBD patients with special emphasis on FVH in relation to the diagnostic MRI criteria of VBD and the etiology in symptomatic patients.

RESULTS

In 49 (63.6%) VBD patients, FVH could be detected: in 22 (44.9%) a small hyperintense rim near the vessel wall (grade 1), in 20 (40.8%) a strong hyperintense rim near the vessel wall (grade 2), and in 7 (14.3%) the hyperintense signal filled the complete vessel lumen (grade 3). The diameter of the basilar artery moderately correlated with the extent of FVH. A higher FVH grade (2 and 3) was more common in patients with TIA/stroke related to VBD (9/16 [56.3%]) in comparison to patients with other etiology and asymptomatic patients (18/61 [29.5%]; P = .046).

CONCLUSIONS

FVH may be useful to demonstrate the decreased blood flow velocity in VBD. More pronounced FVH in patients with posterior circulation TIA/stroke might reflect the underlying stroke pathomechanism.
Genetic Analysis of Resistance to Rice Blast: A Study on the Inheritance of Resistance to the Blast Disease Pathogen in an F3 Population of Rice
Authors: Ashkani Sadegh , Yusop Mohd Rafii , Shabanimofrad Mahmoodreza , Harun Abdul Rahim , Sahebi Mahbod , Latif Mohammad Abdul
Published: October 2014

Blast caused by the fungus Magnaporthae grisea (Herbert) Borr. (anamorphe Pyricularia oryza Cav.) is a serious disease of rice (Oryza sativa L.). One method to overcome this disease is to develop disease resistant cultivars. Due to the genetic plasticity in the pathogen genome, there is a continuous threat to the effectiveness of the developed cultivars. Additional studies of the genetics of resistance, virulence stability and functional genomics are required to accelerate research into understanding the molecular basis of blast disease resistance. In this study, individual plants of the F3 population derived from Pongsu Seribu 2 and Mahsuri were used for pathogenesis assays and inheritance studies of blast resistance. The study was performed with two of the most virulent Malaysian M. grisea pathotypes: P7.2 and P5.0. For blast screening, plants were scored based on the IRRI Standard Evaluation System (SES). F3 populations showed a segregation ratio of 3R:1S for pathotype P7.2, indicating that resistance to this pathotype is likely controlled by a single nuclear gene. Chi‐square analysis showed that the F3 families segregated in a 15R:1S ratio for pathotype P5.0. Therefore, locus interactions or epitasis of blast resistance occur against pathotype P5.0 in the F3 population derived from Pongsu Seribu 2 and Mahsuri. This can be explained by the presence of two independent dominant genes that when present simultaneously, provide resistance to the M. gresia pathotype P5.0. These results indicated that blast resistance in rice is due to the combined effects of multiple loci with major and minor effects. The genetic data generated here will be useful in the breeding of local cultivars for resistance to field blast. The methodology reported here will facilitate the mapping of genes and quantitative trait loci (QTLs) underlying the blast resistance trait.
Late Eocene leaves of Nageia (section Dammaroideae) from Maoming Basin, South China and their implications on phytogeography
Authors: Liu Xiao‐Yan , Gao Qi , Jin Jian‐Hua
Published: October 2014

A new species of Nageia, Nageia maomingensis sp. nov., is described from the Late Eocene of Maoming Basin, Guangdong Province, South China. According to its cuticular characteristics, the present fossil species is assigned to N. sect. Dammaroideae, showing the most resemblance to the extant species N. motleyi (Parl.) de Laub. At present, this section is mainly distributed in the Pacific islands region from South Asia to New Guinea. The discovery of N. maomingensis demonstrates that plants of this section inhabited South China at least by the Eocene. The distribution and living habitat of extant N. sect. Dammaroideae imply that South China was warmer during the Late Eocene than today, and may represent one of the centers for early diversification of Nageia and its section Dammaroideae during the Eocene. In addition, we postulate that plants of sect. Dammaroideae migrated southward in response to climate cooling after the Eocene.
Prognostic Value of Left Atrial Function in Dogs with Chronic Mitral Valvular Heart Disease
Authors: Nakamura K. , Osuga T. , Morishita K. , Suzuki S. , Morita T. , Yokoyama N. , Ohta H. , Yamasaki M. , Takiguchi M.
Published: October 2014

Background

A strong correlation between left atrial (LA) dysfunction and the severity of cardiac disease has been described in human patients with various cardiac diseases. The role ofLAdysfunction in dogs with chronic mitral valvular heart disease (CMVHD) has not been addressed.

Objectives

To investigate the correlation betweenLAfunction and the prognosis of dogs withCMVHD.

Animals

Thirty‐eight client‐owned dogs withCMVHD.

Methods

Prospective clinical cohort study. Dogs were divided into 2 groups (survivors and nonsurvivors) based on the onset of cardiac‐related death within 1 year. Physical examination and echocardiographic variables were compared between the groups. For the assessment of the comparative accuracy in identifying patients with cardiac‐related death, receiver operating characteristic (ROC) curves and multivariate logistic analysis were used.

Results

The highest accuracy was obtained for theLAactive fractional area change (LA‐FACact), with an area under theROCcurve (AUC) of 0.95, followed by the left atrial to aortic root ratio (LA/Ao), with anAUCof 0.94; peak early diastolic mitral inflow velocity (E), with anAUCof 0.85; andLAtotal fractional area change (LA‐FACtotal), with anAUCof 0.85. In the multivariate logistic regression analysis,LA‐FACactemerged as the only independent correlate of cardiac‐related death within 1 year (odds ratio = 1.401,P = .002).

Conclusions and Clinical Importance

Regarding both the size and function, theLAhas a strong correlation with the prognosis of dogs withCMVHD. The most significant independent predictor of mortality in this study wasLA‐FACact.
Comparative riverscape genetics reveals reservoirs of genetic diversity for conservation and restoration of Great Plains fishes
Authors: Osborne Megan J. , Perkin Joshuah S. , Gido Keith B. , Turner Thomas F.
Published: October 2014

We used comparative landscape genetics to examine the relative roles of historical events, intrinsic traits and landscape factors in determining the distribution of genetic diversity of river fishes across the North American Great Plains. Spatial patterns of diversity were overlaid on a patch‐based graphical model and then compared within and among three species that co‐occurred across five Great Plains watersheds. Species differing in reproductive strategy (benthic vs. pelagic‐spawning) were hypothesized to have different patterns of genetic diversity, but the overriding factor shaping contemporary patterns of diversity was the signature of past climates and geological history. Allelic diversity was significantly higher at southern latitudes for Cyprinella lutrensis and Hybognathus placitus, consistent with northward expansion from southern Pleistocene refugia. Within the historical context, all species exhibited lowered occupancy and abundance in heavily fragmented and drier upstream reaches, particularly H. placitus; a pelagic‐spawning species, suggesting rates of extirpation have outpaced losses of genetic diversity in this species. Within most tributary basins, genetically diverse populations of each species persisted. Hence, reconnecting genetically diverse populations with those characterized by reduced diversity (regardless of their position within the riverine network) would provide populations with greater genetic and demographic resilience. We discuss cases where cross‐basin transfer may be appropriate to enhance genetic diversity and mitigate negative effects of climate change. Overall, striking similarities in genetic patterns and in response to fragmentation and dewatering suggest a common strategy for genetic resource management in this unique riverine fish assemblage.
Carcinomatous encephalitis presenting with progressive dementia
Authors: Kitagawa Naoyuki , Umahara Takahiko , Kurata Atsushi , Sakurai Michio
Published: October 2014

We report an autopsy case of a 67‐year‐old woman who developed rapidly progressive dementia with left hemianopia. Gadolinium contrast‐enhanced magnetic resonance imaging showed meningeal enhancement of the pons and cerebellum, and enhancement of the right medial occipital region. Post‐mortem examination showed diffuse metastatic dissemination of lung adenocarcinoma. Histopathological changes of Alzheimer's disease were minimal, and neither Lewy body pathology nor prion protein was found. Carcinomatous encephalitis should be considered in the differential diagnosis of progressive dementia in patients with cancer. The present case shows the importance of gadolinium contrast magnetic resonance imaging and neuropathological post‐mortem examination.
Early physiological flood tolerance is followed by slow post‐flooding root recovery in the dryland riparian tree Eucalyptus camaldulensis subsp. refulgens
Authors: ARGUS R. E. , COLMER T. D. , GRIERSON P. F.
Published: October 2014

We investigated physiological and morphological responses to flooding and recovery in Eucalyptus camaldulensis subsp. refulgens, a riparian tree species from a dryland region prone to intense episodic floods. Seedlings in soil flooded for 88 d produced extensive adventitious roots, displayed stem hypertrophy (stem diameter increased by 93%) and increased root porosity owing to aerenchyma formation. Net photosynthesis (Pn) and stomatal conductance (gs) were maintained for at least 2 weeks of soil flooding, contrasting with previous studies of other subspecies of E. camaldulensis. Gradual declines followed in both gs (30% less than controls) and Pn (19% less). Total leaf soluble sugars did not differ between flooded and control plants. Root mass did not recover 32 d after flooding ceased, but gs was not lower than controls, suggesting the root system was able to functionally compensate. However, the limited root growth during recovery after flooding was surprising given the importance of extensive root systems in dryland environments. We conclude that early flood tolerance could be an adaptation to capitalize on scarce water resources in a water‐limited environment. Overall, our findings highlight the need to assess flooding responses in relation to a species' fitness for particular flood regimes or ecological niches.
Fatal sepsis in a child with thalassemia major due to Serratia marcescens
Authors: Paksu Muhammet Sukru , Karli Arzu , Paksu Sule , Guney Akif Koray , Ozsevik Sevinc Nursev , Belet Nursen
Published: October 2014

One of the most important causes of mortality in thalassemic patients is infectious disease. Thalassemic patients develop severe invasive infection caused by microorganisms that are rare in healthy individuals. We describe the case of a 13‐year‐old splenectomized boy who presented with septic shock and who died 36 h after admission, despite broad‐spectrum antibiotics and aggressive supportive care. Serratia marcescens was isolated from cultures of blood and tracheal aspirate. It is known that rare microorganisms will cause severe community‐acquired infection in splenectomized patients with thalassemia major.
Oxidatively Generated Damage to Cellular DNA by UVB and UVA Radiation,
Authors: Cadet Jean , Douki Thierry , Ravanat Jean‐Luc
Published: October 2014

This review article focuses on a critical survey of the main available information on the UVB and UVA oxidative reactions to cellular DNA as the result of direct interactions of UV photons, photosensitized pathways and biochemical responses including inflammation and bystander effects. UVA radiation appears to be much more efficient than UVB in inducing oxidatively generated damage to the bases and 2‐deoxyribose moieties of DNA in isolated cells and skin. The UVA‐induced generation of 8‐oxo‐7,8‐dihydroguanine is mostly rationalized in terms of selective guanine oxidation by singlet oxygen generated through type II photosensitization mechanism. In addition, hydroxyl radical whose formation may be accounted for by metal‐catalyzed Haber–Weiss reactions subsequent to the initial generation of superoxide anion radical contributes in a minor way to the DNA degradation. This leads to the formation of both oxidized purine and pyrimidine bases together with DNA single‐strand breaks at the exclusion, however, of direct double‐strand breaks. No evidence has been provided so far for the implication of delayed oxidative degradation pathways of cellular DNA. In that respect putative characteristic UVA‐induced DNA damage could include single and more complex lesions arising from one‐electron oxidation of the guanine base together with aldehyde adducts to amino‐substituted nucleobases.
Combination of Er:YAG Laser and CO2 Laser Treatment on Skin Tissue
Authors: Anayb Baleg Sana Mohammed , Bidin Noriah , Suan Lau Pik , Sidi Ahmad Muhammad Fakarruddin , Krishnan Ganesan , Johari Abd Rahman , Hamid Asmah
Published: October 2014

Skin is the most important organ in our body, as it protects us from external environmental effects. Study the ability of the skin to stretch and the histological examinations of irradiated tissues have significant values in scientific and medical applications. Only a few studies have been done to study the correlation between epidermis ablation and the changes that occur at dermal levels when using dual lasers in ablative resurfacing mode. The aim of this work is to determine this correlation and to estimate the effects of multiple pulses on induced collagen remodeling and the strength of skin exposed with dual lasers in an in vivo rat model. All laser exposures led to mark improvement in the skin's strength compared to their own controls. The histological investigation indicated that there was a thickness loss in the epidermis layer with the induction of deep collagen coagulation in the dermis layer as the dual laser pulses increased. Additionally, more collagen fibers were remolded in the treated samples by dual wavelengths. We conclude that by combining dual lasers with multiple pulses targeted at not only the epidermis layer of the skin, it could also induce some heat diffusion in the dermis layer which causes more coagulation of collagen fibers. The tensile results confirmed by our histological data demonstrate that the strength of irradiated skin with dual wavelengths increased more than using both lasers separately on the skin tissue since more collagen is induced.
Nausea and Vomiting during Pregnancy and Neurodevelopmental Outcomes in Offspring
Authors: Parker Samantha E. , Starr Jacqueline R. , Collett Brent R. , Speltz Matthew L. , Werler Martha M.
Published: October 2014

Background

Nausea and vomiting during pregnancy (NVP) is the most common complication of pregnancy. NVP has been associated with improved fetal outcomes, but its association with childhood neurodevelopmental outcomes has rarely been studied.

Methods

Subjects were children aged 5–12 years (n = 560) who were controls in a previously conducted case–control study of prenatal risk factors for craniofacial malformations. Information on NVP, including trimester, duration, and treatment, was collected through a maternal interview conducted within 3 years of delivery. Neurocognition was assessed using the Peabody Picture Vocabulary Test (PPVT‐III) and the Beery‐Buktenica Test of Visual Motor Integration‐Fifth Edition (VMI‐5). Psychosocial outcomes, including internalising and externalising behaviour problems, were measured by maternal report, using the Child Behavior Checklist (CBCL), and teacher report, using the Teacher Report Form. Linear regression models were used to calculate adjusted mean (adjMD −3.04, 95% confidence interval (CI) −5.02, −1.06) differences (adjMD) and 95% confidence intervals [CI] on test scores for children exposed and unexposed to NVP in utero. Differences based on trimester, duration, and treatment were assessed.

Results

NVP was reported among 63% of women and was most common in early pregnancy. Children exposed to NVP performed worse on the VMI‐5 [−3.04, 95% CI: −5.02, −1.06] but exhibited few other differences from unexposed children. Durations of NVP ≥4 months were associated with poorer scores on PPVT‐III (adjMD −2.52), VMI‐5 (adjMD −5.41), and CBCL [adjMD 3.38 (internalising) and adjMD 4.19 (externalising)].

Conclusions

Overall, there were few differences between children exposed and unexposed to NVP. NVP was associated with slightly worse visual motor performance, and prolonged NVP and NVP extending late into pregnancy were associated with poorer scores on several neurodevelopmental measures.
A new HLA allele, HLA‐B*08:122, described in an unrelated donor of Caucasian origin
Authors: Buffi O. , Iannelli S. , Iliescu A. , Bontadini A. , Nesci S.
Published: October 2014

A new human leukocyte antigen‐B allele was found in an unrelated Italian donor.
On the track of the elusive Sudbury impact: geochemical evidence for a chondrite or comet bolide
Authors: Petrus Joseph A. , Ames Doreen E. , Kamber Balz S.
Published: October 2014

Siderophile and lithophile trace element data for 69 samples from the Sudbury impact crater fill (Onaping Formation) and quartz diorite offset dikes help constrain the sources of the established moderately elevated platinum group element signature associated with the impact structure. The siderophile element distribution of the crater fill requires contributions from bulk continental crust, mafic rocks and a chondritic component. A mantle component is absent, but the involvement of mid to lower crust is implied. After considering post‐impact hydrothermal alteration, melt heterogeneity and mafic target admixture, the projectile elemental ratios were determined on a more robust data subset. Chondrite discrimination diagrams of these ratios identify an ordinary or enstatite chondrite as the most probable source of meteoritic material in the Sudbury crater fill. However, the relative and absolute siderophile element distributions within the impact structure as well as bolide size models are congruent with the bolide being a comet that had a chondritic refractory component.
The CRISPR/Cas system can be used as nuclease for in planta gene targeting and as paired nickases for directed mutagenesis in Arabidopsis resulting in heritable progeny
Authors: Schiml Simon , Fauser Friedrich , Puchta Holger
Published: October 2014

The CRISPR/Cas nuclease is becoming a major tool for targeted mutagenesis in eukaryotes by inducing double‐strand breaks (DSBs) at pre‐selected genomic sites that are repaired by non‐homologous end joining (NHEJ) in an error‐prone way. In plants, it could be demonstrated that the Cas9 nuclease is able to induce heritable mutations in Arabidopsis thaliana and rice. Gene targeting (GT) by homologous recombination (HR) can also be induced by DSBs. Using a natural nuclease and marker genes, we previously developed an in planta GT strategy in which both a targeting vector and targeting locus are activated simultaneously via DSB induction during plant development. Here, we demonstrate that this strategy can be used for natural genes by CRISPR/Cas‐mediated DSB induction. We were able to integrate a resistance cassette into the ADH1 locus of A. thaliana via HR. Heritable events were identified using a PCR‐based genotyping approach, characterised by Southern blotting and confirmed on the sequence level. A major concern is the specificity of the CRISPR/Cas nucleases. Off‐target effects might be avoided using two adjacent sgRNA target sequences to guide the Cas9 nickase to each of the two DNA strands, resulting in the formation of a DSB. By amplicon deep sequencing, we demonstrate that this Cas9 paired nickase strategy has a mutagenic potential comparable with that of the nuclease, while the resulting mutations are mostly deletions. We also demonstrate the stable inheritance of such mutations in A. thaliana.
Effectiveness of Empowerment‐Based Self‐Management Interventions on Patients with Chronic Metabolic Diseases: A Systematic Review and Meta‐Analysis
Authors: Kuo Chia‐Chi , Lin Chiu‐Chu , Tsai Fu‐Mian
Published: October 2014

Background

Management of chronic metabolic diseases has recently become an important global health issue. Extensive research on empowerment‐based self‐management interventions (EBSMIs) for patients with chronic metabolic diseases has been conducted, but no systematic review has evaluated their effects.

Aim

To evaluate the effects of EBSMIs on patients with chronic metabolic diseases.

Methods

A systematic review and meta‐analysis was conducted. Five electronic databases (Airiti Library, CINAHL, Cochrane Library, PubMed/ MEDLINE, and Index of Taiwan Periodical Literature System) were searched from the earliest year available to October 2012. Controlled trials about the effectiveness of interventions on patients with chronic metabolic diseases were included. Each study was appraised by three reviewers and assigned a level of evidence based on the modified Jadad scale. Extracted data were entered and analyzed using Review Manager 5.2.

Findings

Nineteen studies were reviewed. Most studies showed that EBSMIs improved patients’ hemoglobin A1c test (HbA1c) (p < .00001), waist circumference (p = .02), and empowerment level (p = .004). Four studies compared the effect on body weight and body mass index, but the overall effect was not significant (p = .33 and .73, respectively). Five studies compared the effect on self‐efficacy, four of which indicated significant increase. However, the overall effect on self‐efficacy was not compared because studies used different scales.

Linking Evidence to Action

EBSMIs improved HbA1c test results, waist circumference, self‐efficacy, and empowerment level in patients with chronic metabolic diseases. When implementing the EBSMIs, healthcare institutions need to provide training programs related to empowerment from which health professionals can acquire competence in patient empowerment. Moreover, healthcare leaders should assess and overcome barriers (e.g., time, manpower, cost, etc.) to implementing EBSMIs in clinical settings.
Contribution of sodium channel neuronal isoform Nav1.1 to late sodium current in ventricular myocytes from failing hearts
Authors: Mishra Sudhish , Reznikov Vitaliy , Maltsev Victor A. , Undrovinas Nidas A. , Sabbah Hani N. , Undrovinas Albertas
Published: October 2014

Key points

Late Na+ current (INaL) contributes to action potential remodelling and Ca2+/Na+ changes in heart failure.

The molecular identity of INaL remains unclear.

The contributions of different Na+ channel isoforms, apart from the cardiac isoform, remain unknown.

We discovered and characterized a substantial contribution of neuronal isoform Nav1.1 to INaL.

This new component is physiologically relevant to the control of action potential shape and duration, as well as to cell Ca2+ dynamics, especially in heart failure.

Late Na+ current (INaL) contributes to action potential (AP) duration and Ca2+ handling in cardiac cells. Augmented INaL was implicated in delayed repolarization and impaired Ca2+ handling in heart failure (HF). We tested if Na+ channel (Nav) neuronal isoforms contribute to INaL and Ca2+ cycling defects in HF in 17 dogs in which HF was achieved via sequential coronary artery embolizations. Six normal dogs served as control. Transient Na+ current (INaT) and INaL in left ventricular cardiomyocytes (VCMs) were recorded by patch clamp while Ca2+ dynamics was monitored using Fluo‐4. Virally delivered short interfering RNA (siRNA) ensured Nav1.1 and Nav1.5 post‐transcriptional silencing. The expression of six Navs was observed in failing VCMs as follows: Nav1.5 (57.3%) > Nav1.2 (15.3%) > Nav1.1 (11.6%) > Nav2.1 (10.7%) > Nav1.3 (4.6%) > Nav1.6 (0.5%). Failing VCMs showed up‐regulation of Nav1.1 expression, but reduction of Nav1.6 mRNA. A similar Nav expression pattern was found in samples from human hearts with ischaemic HF. VCMs with silenced Nav1.5 exhibited residual INaT and INaL (∼30% of control) with rightwardly shifted steady‐state activation and inactivation. These currents were tetrodotoxin sensitive but resistant to MTSEA, a specific Nav1.5 blocker. The amplitude of the tetrodotoxin‐sensitive INaL was 0.1709 ± 0.0299 pA pF–1 (n = 7 cells) and the decay time constant was τ = 790 ± 76 ms (n = 5). This INaL component was lacking in VCMs with a silenced Nav1.1 gene, indicating that, among neuronal isoforms, Nav1.1 provides the largest contribution to INaL. At –10 mV this contribution is ∼60% of total INaL. Our further experimental and in silico examinations showed that this new Nav1.1 INaL component contributes to Ca2+ accumulation in failing VCMs and modulates AP shape and duration. In conclusion, we have discovered an Nav1.1‐originated INaL component in dog heart ventricular cells. This component is physiologically relevant to controlling AP shape and duration, as well as to cell Ca2+ dynamics.
Role of membrane cholesterol in spontaneous exocytosis at frog neuromuscular synapses: reactive oxygen species–calcium interplay
Authors: Petrov Alexey M. , Yakovleva Anastasiya A. , Zefirov Andrey L.
Published: October 2014

Key points

Cholesterol depletion increases reactive oxygen species (ROS) levels in extra‐ and intracellular space through NAPDH oxidase activation, which is accompanied by synaptic lipid oxidation.

ROS production due to extraction of cholesterol involves both an enhancement of synaptic vesicle exocytosis and an increase in cytosolic [Ca2+]i.

An ROS‐dependent rise in [Ca2+]i is suppressed by inhibitors of the transient receptor potential vanilloid channel and leads to an increase in synaptic vesicle exocytosis.

The ROS–calcium pathway might influence synaptic vesicle exocytosis via activation of phosphatase protein 2B (calcineurin).

The results help us better understand why a decrease of membrane cholesterol increases spontaneous synaptic vesicle exocytosis.

Using electrophysiological and optical techniques, we studied the mechanisms by which cholesterol depletion stimulates spontaneous transmitter release by exocytosis at the frog neuromuscular junction. We found that methyl‐β‐cyclodextrin (MCD, 10 mm)‐mediated exhaustion of cholesterol resulted in the enhancement of reactive oxygen species (ROS) production, which was prevented by the antioxidant N‐acetyl cysteine (NAC) and the NADPH oxidase inhibitor apocynin. An increase in ROS levels occurred both extra‐ and intracellularly, and it was associated with lipid peroxidation in synaptic regions. Cholesterol depletion provoked a rise in the intracellular Ca2+ concentration, which was diminished by NAC and transient receptor potential vanilloid (TRPV) channel blockers (ruthenium red and capsazepine). By contrast, the MCD‐induced rise in [Ca2+]i remained unaffected if Ca2+ release from endoplasmic stores was blocked by TMB8 (8‐(diethylamino)octyl‐3,4,5‐trimethoxybenzoate hydrochloride). The effects of cholesterol depletion on spontaneous release and exocytosis were significantly reduced by the antioxidant, intracellular Ca2+ chelation with BAPTA‐AM and blockers of TRPV channels. Bath application of the calcineurin antagonist cyclosporine A blocked MCD‐induced enhancement of spontaneous release/exocytosis, whereas okadaic acid, an inhibitor of phosphatases PP1 and PP2A, had no effect. Thus, our findings indicate that enhancement of spontaneous exocytosis induced by cholesterol depletion may depend on ROS generation, leading to an influx of Ca2+ via TRPV channels and, subsequently, activation of calcineurin.
Hypokalaemia induces Ca2+ overload and Ca2+ waves in ventricular myocytes by reducing Na+,K+‐ATPase α2 activity
Authors: Aronsen J. M. , Skogestad J. , Lewalle A. , Louch W. E. , Hougen K. , Stokke M. K. , Swift F. , Niederer S. , Smith N. P. , Sejersted O. M. , Sjaastad I.
Published: October 2014

Key points

Hypokalaemia is a risk factor for development of ventricular arrhythmias.

In rat ventricular myocytes, low extracellular K+ (corresponding to clinical moderate hypokalaemia) increased Ca2+ wave probability, Ca2+ transient amplitude, sarcoplasmic reticulum (SR) Ca2+ load and induced SR Ca2+ leak.

Low extracellular K+ reduced Na+,K+‐ATPase (NKA) activity and hyperpolarized the resting membrane potential in ventricular myocytes. Both experimental data and modelling indicate that reduced NKA activity and subsequent Na+ accumulation sensed by the Na+, Ca2+ exchanger (NCX) lead to increased Ca2+ transient amplitude despite concomitant hyperpolarization of the resting membrane potential.

Low extracellular K+ induced Ca2+ overload by lowering NKA α2 activity. Triggered ventricular arrhythmias in patients with hypokalaemia may therefore be attributed to reduced NCX forward mode activity linked to an effect on the NKA α2 isoform.

Hypokalaemia is a risk factor for development of ventricular arrhythmias. The aim of this study was to determine the cellular mechanisms leading to triggering of arrhythmias in ventricular myocytes exposed to low Ko. Low Ko, corresponding to moderate hypokalaemia, increased Ca2+ transient amplitude, sarcoplasmic reticulum (SR) Ca2+ load, SR Ca2+ leak and Ca2+ wave probability in field stimulated rat ventricular myocytes. The mechanisms leading to Ca2+ overload were examined. Low Ko reduced Na+,K+‐ATPase (NKA) currents, increased cytosolic Na+ concentration and increased the Na+ level sensed by the Na+, Ca2+ exchanger (NCX). Low Ko also hyperpolarized the resting membrane potential (RMP) without significant alterations in action potential duration. Experiments in voltage clamped and field stimulated ventricular myocytes, along with mathematical modelling, suggested that low Ko increases the Ca2+ transient amplitude by reducing NKA activity despite hyperpolarization of the RMP. Selective inhibition of the NKA α2 isoform by low dose ouabain abolished the ability of low Ko to reduce NKA currents, to increase Na+ levels sensed by NCX and to increase the Ca2+ transient amplitude. We conclude that low Ko, within the range of moderate hypokalaemia, increases Ca2+ levels in ventricular myocytes by reducing the pumping rate of the NKA α2 isoform with subsequent Na+ accumulation sensed by the NCX. These data highlight reduced NKA α2‐mediated control of NCX activity as a possible mechanism underlying triggered ventricular arrhythmias in patients with hypokalaemia.