bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome of heparin‐treated patients with acute cerebral venous sinus thrombosis: influence of the temporal pattern of intracerebral haemorrhage
Authors: Busch M. A. , Hoffmann O. , Einhäupl K. M. , Masuhr F.
Published: June 2016

Background and purpose

The influence of temporal patterns of intracerebral haemorrhage (ICH) on the outcome of heparin‐treated patients with cerebral venous sinus thrombosis (CVST) has not been examined systematically.

Methods

Temporal patterns of ICH and their influence on survival without disability (modified Rankin Scale score ≤1 point) at hospital discharge were examined in 141 consecutive hospital‐admitted patients with acute CVST who were treated with intravenous unfractionated heparin.

Results

Of all 141 patients (median age 40 years; 73% women), 59 (42%) had ICH at the time of diagnosis (early ICH). Of these, seven (12%) subsequently had extension of ICH and 13 (22%) had additional ICHs at other locations (delayed ICH). Of 82 patients without early ICH, nine (11%) later had delayed ICH. After a median hospital stay of 26 days, 107 patients (76%) were discharged without disability. Patients with early ICH were less likely to survive without disability until discharge than those without early ICH [63% vs. 85%; risk ratio (RR) 0.73; P = 0.005]. The association was attenuated after adjusting for age, sex and impaired consciousness on admission (RR 0.83; P = 0.03). Taking temporal patterns of ICH into account, early ICH with subsequent complication (extension or delayed ICH) had a larger influence on survival without disability (RR 0.57; 95% confidence interval 0.35–0.95) than early ICH without complications (RR 0.78; 95% confidence interval 0.67–0.91).

Conclusions

Heparin‐treated CVST patients were less likely to survive without disability when ICH was present on admission. This association may largely be driven by subsequent extension of haemorrhage or additionally occurring delayed haemorrhage.
Objective assessment of gait in xylazine‐induced ataxic horses
Authors: Nout‐Lomas Y.S. , Page K.M. , Kang H.G. , Aanstoos M.E. , Greene H.M.
Published: June 2016

Background

There is poor agreement between observers of equine neurological gait abnormalities using the modified Mayhew grading scale.

Objectives

To stimulate a dose‐dependent ataxia in horses through xylazine administration and identify quantifiable relevant gait parameters.

Study design

Balanced, randomised, 2‐way crossover design.

Methods

Eight horses were assessed before and after administration of xylazine (low dose and high dose). Gait analyses performed before and after xylazine administration included: 1) kinematic data collected on an equine high‐speed treadmill (flat and 10% decline) and from accelerometers placed on head and sacrum; and 2) kinetic data collected on a force plate.

Results

All horses developed dose‐dependent ataxia. Horses developed a dose‐dependent increased stride time, stride length, and time of contact (P<0.0001), and a decreased stride frequency (P<0.0002) after administration of xylazine. Although pelvic acceleration increased in the mediolateral direction (P<0.05) in horses walked on the treadmill, this movement decreased when walking over ground after administration of xylazine (P<0.05). Furthermore, centre of pressure and path length indices changed significantly in horses following administration of xylazine (P<0.05).

Main limitations

This study examined one breed of horse (Arabian), all of similar height and weight. Accelerometers were attached to skin, not bone; no correction was made for artefacts from skin displacement. The sedative drug effect is of certain duration, limiting the data collection period.

Conclusions

Administration of xylazine induced a dose‐dependent ataxia in horses and resulted in significant changes of gait parameters, pelvic accelerations, and stabilographic variables, some of which changed in a dose‐dependent fashion. Some of the altered gait parameters in this model were probably a result of overall slowing down of the stride cycle secondary to the sedative effect. Continued efforts to discover and evaluate quantifiable gait parameters that are susceptible to change following development of clinical neurological disease in horses is warranted.
Range geometry and socio‐economics dominate species‐level biases in occurrence information
Authors: Meyer Carsten , Jetz Walter , Guralnick Robert P. , Fritz Susanne A. , Kreft Holger
Published: June 2016

Aim

Despite the central role of species distributions in ecology and conservation, occurrence information remains geographically and taxonomically incomplete and biased. Efforts to address this problem, such as targeted data mobilization and advanced distribution modelling, all crucially rely on a solid understanding of the patterns and determinants of occurrence information. Numerous socio‐economic and ecological drivers of uneven record collection and mobilization among species have been suggested, but the generality of their effects remains untested. Here, we provide the first global analysis of patterns and drivers of species‐level variation in different metrics of occurrence information.

Location

Global, including separate analyses for six zoogeographical realms.

Methods

We evaluated three alternative metrics of occurrence information: (1) the record count per species, (2) the coverage of a range with records and (3) the geographical bias in how the records represent different range parts. To this end, we developed scale‐independent metrics of range coverage and geographical record bias. We applied the three metrics to 2.8 million point‐occurrence records and extent‐of‐occurrence range maps of 3625 mammalian species. We used multi‐model inference to evaluate 13 putative drivers of species‐level variation in data availability.

Results

All three metrics of occurrence information revealed severe species‐level biases. These data limitations were mainly linked to range size and shape, and the within‐range geography of socio‐economic conditions. Species attributes related to detection and collection probabilities, such as body size or diurnality, were remarkably weak predictors of record count and range coverage.

Main conclusions

Species‐level biases in mobilized occurrence information hamper its broader application in basic and applied biodiversity research. To successfully account for these limitations, the site‐specific socio‐economic constraints to record collection and mobilization, rather than species‐specific constraints to detection, should be explicitly incorporated into ecological models. Furthermore, our results strongly suggest that range‐restricted species should be prioritized in future data mobilization efforts.
Association between sedentary time and kidney function in community‐dwelling elderly Japanese people
Authors: Lee Sungchul , Shimada Hiroyuki , Lee Sangyoon , Makizako Hyuma , Doi Takehiko , Harada Kazuhiro , Bae Seongryu , Harada Kenji , Hotta Ryo , Tsutsumimoto Kota , Yoshida Daisuke , Nakakubo Sho , Anan Yuya , Park Hyuntae , Suzuki Takao
Published: June 2016

Aim

The aim of the present study was to evaluate the relationship between sedentary time and declines in kidney function among community‐dwelling older adults.

Methods

Participants comprised 10 242 community‐dwelling older adults who were participating in the National Center for Geriatrics and Gerontology – Study of Geriatric Syndromes. Sedentary time was determined by asking participants to record the total amount of hours usually spent sitting each day, with values divided into quartiles of 0 to <4 h (reference), 4 to <6 h, 6 to <8 h and ≥8 h of sitting time per day. The estimated glomerular filtration rate was determined according to creatinine levels, and participants were classified into two categories: ≥60.0 or <60 mL/min/1.73 m2.

Results

After multivariate adjustment, the highest quartiles of sedentary time showed a higher rate of kidney function decline than those in the lowest quartile (odds ratio 1.42, 95% CI 1.02–1.37). In addition, participants with a history of cancer (odds ratio 1.18, 95% CI 1.01–1.39) or hypertension (odds ratio 1.38; 95% CI 1.07–1.60) had significantly increased risks of kidney function decline in the highest sedentary time group, regardless of multivariate control. Furthermore, analyses showed an increased risk of kidney function decline for a history of both cancer and hypertension (odds ratio 2.02, 95% CI 1.08–3.80).

Conclusions

A higher level of sedentary time was associated with kidney function decline among community‐dwelling older adults. Geriatr Gerontol Int 2017; 17: 730–736.
Oxidative stress and inflammation are associated with physical frailty in patients with Alzheimer's disease
Authors: Namioka Nayuta , Hanyu Haruo , Hirose Daisuke , Hatanaka Hirokuni , Sato Tomohiko , Shimizu Soichiro
Published: June 2016

Aims

Dementia is closely connected with frailty, and these two conditions are common in older adults. However, the biological mechanism that causes frailty in patients with Alzheimer's disease (AD) is not fully understood. We determined whether oxidative stress and inflammatory mechanisms could be associated with physical frailty in patients with AD.

Methods

We studied 140 elderly outpatients with mild‐to‐moderate AD. Frailty status was determined according to the presence of the following five measurable characteristics: weight loss, exhaustion, low physical activity, slowness and weakness. We measured oxidative stress markers, including plasma levels of diacron reactive oxygen metabolite and biological anti‐oxidant potential, endogenous plasma anti‐oxidants, such as albumin, bilirubin and uric acid, and urinary 8‐hydroxy‐2′‐deoxyguanosine (8‐OHdG) and 8‐epiPGF2α (8‐isoprostane), and inflammatory markers, including interleukin‐6 and tumor necrosis factor‐α.

Results

Among patients, 44 (31%) were non‐frail, 62 (44%) were prefrail and 34 (24%) were frail. Frail and prefrail patients were older, more likely to be women and had more comorbid medical conditions than non‐frail patients. Frail or prefrail patients showed significantly higher diacron reactive oxygen metabolite and lower biological anti‐oxidant potential levels, a significant decrease in bilirubin, a significant increase in urinary 8‐OHdG and 8‐isoprostane levels, and a significantly higher interleukin‐6 level, in contrast to non‐frail patients.

Conclusions

Physical frailty is common in old and female AD patients with comorbid medical diseases. The present results strongly suggest that oxidative stress and inflammation are involved in the pathophysiology of frailty status in individuals with AD. Geriatr Gerontol Int 2017; 17: 913–918.
Cyclophilin PpiB is involved in motility and biofilm formation via its functional association with certain proteins
Authors: Skagia Aggeliki , Zografou Chrysoula , Vezyri Eleni , Venieraki Anastasia , Katinakis Panagiotis , Dimou Maria
Published: June 2016

PpiB belongs to the superfamily of peptidyl‐prolyl cis/trans isomerases (PPIases, EC: 5.2.1.8), which catalyze the rate‐limiting protein folding step at peptidyl‐prolyl bonds and control several biological processes. In this study, we show that PpiB acts as a negative effector of motility and biofilm formation ability of Escherichia coli. We identify multicopy suppressors of each ΔppiB phenotype among putative PpiB prey proteins which upon deletion are often characterized by analogous phenotypes. Many putative preys show similar gene expression in wild‐type and ΔppiB genetic backgrounds implying possible post‐translational modifications by PpiB. We further conducted in vivo and in vitro interaction screens to determine which of them represent true preys. For DnaK, acetyl‐CoA carboxylase, biotin carboxylase subunit (AccC) and phosphate acetyltransferase (Pta) we also showed a direct role of PpiB in the functional control of these proteins because it increased the measured enzyme activity of each protein and further interfered with DnaK localization and the correct folding of AccC. Taken together, these results indicate that PpiB is involved in diverse regulatory mechanisms to negatively modulate motility and biofilm formation via its functional association with certain protein substrates.
Proplatelet formation in megakaryocytes is associated with endoplasmic reticulum stress
Authors: Morishima Nobuhiro , Nakanishi Keiko
Published: June 2016

Although previous studies suggest that proplatelet formation in megakaryocytes involves caspase‐3, the mechanism underlying the activation of caspase‐3 is unknown. Here, we analyzed caspase activation in a human megakaryoblastic cell line, MEG‐01, which forms proplatelets spontaneously. Specific activation of caspase‐3 and caspase‐4 was found in proplatelets. Consistent with previous observations of caspase‐4 autoactivation in response to endoplasmic reticulum (ER) stress, several ER stress marker proteins were expressed during proplatelet formation. A pharmacological ER stressor enhanced platelet production via proplatelet formation, whereas inhibition of caspase‐4 caused suppression. These results suggest that ER stress is a mechanism underlying the maturation of megakaryocytes.
Management of Adults With Acute Migraine in the Emergency Department: The American Headache Society Evidence Assessment of Parenteral Pharmacotherapies
Authors: Orr Serena L. , Friedman Benjamin W. , Christie Suzanne , Minen Mia T. , Bamford Cynthia , Kelley Nancy E. , Tepper Deborah
Published: June 2016

Objective

To provide evidence‐based treatment recommendations for adults with acute migraine who require treatment with injectable medication in an emergency department (ED). We addressed two clinically relevant questions: (1) Which injectable medications should be considered first‐line treatment for adults who present to an ED with acute migraine? (2) Do parenteral corticosteroids prevent recurrence of migraine in adults discharged from an ED?

Methods

The American Headache Society convened an expert panel of authors who defined a search strategy and then performed a search of Medline, Embase, the Cochrane database and clinical trial registries from inception through 2015. Identified articles were rated using the American Academy of Neurology's risk of bias tool. For each medication, the expert panel determined likelihood of efficacy. Recommendations were created accounting for efficacy, adverse events, availability of alternate therapies, and principles of medication action.

Results/Conclusions

The search identified 68 unique randomized controlled trials utilizing 28 injectable medications. Of these, 19 were rated class 1 (low risk of bias), 21 were rated class 2 (higher risk of bias), and 28 were rated class 3 (highest risk of bias). Metoclopramide, prochlorperazine, and sumatriptan each had multiple class 1 studies supporting acute efficacy, as did dexamethasone for prevention of headache recurrence. All other medications had lower levels of evidence.

Recommendations

Intravenous metoclopramide and prochlorperazine, and subcutaneous sumatriptan should be offered to eligible adults who present to an ED with acute migraine (Should offer—Level B). Dexamethasone should be offered to these patients to prevent recurrence of headache (Should offer—Level B). Because of lack of evidence demonstrating efficacy and concern about sub‐acute or long‐term sequelae, injectable morphine and hydromorphone are best avoided as first‐line therapy (May avoid–Level C).
Recurrent mutations in genes involved in nuclear factor‐κB signalling in nodal marginal zone lymphoma—diagnostic and therapeutic implications
Authors: van den Brand Michiel , Rijntjes Jos , Hebeda Konnie M , Menting Laura , Bregitha Carolyn V , Stevens Wendy B C , van der Velden Walter J F M , Tops Bastiaan B J , van Krieken J Han J M , Groenen Patricia J T A
Published: June 2016

Aims

To investigate the spectrum of mutations in 20 genes involved in B‐cell receptor and/or Toll‐like receptor signalling resulting in activation of nuclear factor‐κB (NF‐κB) in 20 nodal marginal zone lymphomas (NMZLs), 20 follicular lymphomas (FLs), and 11 cases of B‐cell lymphoma, unclassifiable (BCL‐u).

Methods and results

Nodal marginal zone lymphomas were diagnosed according to strict criteria, including the expression of at least one putative marginal zone marker (MNDA and/or IRTA1). Cases that showed features of NMZL but did not fulfil all criteria were included as BCL‐u. All FLs were required to have a BCL2 rearrangement. Mutations were found in: nine NMZLs, with recurrent mutations in TNFAIP3 and CD79B; 12 FLs, with recurrent mutations in TNFRSF14, TNFAIP3, and CARD11; and five cases of BCL‐u, with recurrent mutations in TNFRSF14. TNFRSF14 mutations were present in FL and BCL‐u, but not in any of the NMZLs. In the BCL‐u group, TNFRSF14 mutations clustered with a FL immunophenotype.

Conclusions

These results suggest that TNFRSF14 mutations point towards a diagnosis of FL, and can be used in the sometimes difficult distinction between NMZL and FL, but to apply this in diagnostics would require confirmation in an independent cohort. In addition, the presence or absence of specific mutations in pathways converging on NF‐κB could be important for decisions regarding targeted treatment.
Modelling environmental and survey influences on lek attendance using long‐term lek survey data
Authors: Sadoti Giancarlo , Johnson Kristine , Albright Thomas P.
Published: June 2016

Targeted lek surveys, in which historically active lekking areas are surveyed over multiple years, are commonly used to monitor lek‐mating birds. Lek surveys are usually used in habitats and species in which individuals are not easily detected when they are not lekking. Unfortunately, lek surveys suffer from a number of shortcomings, most notably the failure to observe lekking individuals when they are near but not actively attending a lek. Like other sources of imperfect detection, inconsistency in lek attendance may bias estimates of annual population sizes or the proportion of lekking arenas active in a given year. In turn, this may result in unreliable estimates of trends, distributions or other parameters of interest. An improved understanding of the factors affecting lek attendance is crucial to improving the efficacy of many lek monitoring programmes and the utility of lek surveys in estimating population and distributional dynamics. We assess variation in lek attendance in the Lesser Prairie Chicken Tympanuchus pallidicinctus using a subset of data from a long‐term monitoring programme in eastern New Mexico, USA. Focusing on lek‐years in which at least one male was observed, we used generalized linear models to assess the influence of lek size and survey and environmental characteristics on the probability that at least one male was observed in attendance. Our best‐supported model provided evidence for influences of each of these sources of variation. Models suggested that surveyors may improve the likelihood of detecting lek attendance by making small changes to survey duration, targeted survey dates and by considering environmental factors such as weather, habitat and human disturbance. In addition to improving detection, consideration of lek attendance patterns and associated behaviours may improve estimation for more effective conservation in a variety of lekking bird species.
The common gamma chain cytokine interleukin‐21 is expressed by activated lymphocytes from two macropod marsupials, Macropus eugenii and Onychogalea fraenata
Authors: Suthers A. N. , Old J. M. , Young L. J.
Published: June 2016

In mammals, interleukin‐21 is a member of the common gamma chain cytokine family that also includes IL‐2, IL‐4, IL‐7, IL‐9 and IL‐15. IL‐21 has pleiotropic effects on both myeloid and lymphoid immune cells and as a consequence, the biological actions of IL‐21 are broad: regulating both innate and adaptive immune responses and playing a pivotal role in antiviral, inflammatory and antitumour cellular responses. While IL‐21 genes have been characterized in mammals, birds, fish and amphibians, there are no reports for any marsupial species to date. We characterized the expressed IL‐21 gene from immune tissues of two macropod species, the tammar wallaby (Macropus eugenii), a model macropod, and the closely related endangered bridled nailtail wallaby (Onychogalea fraenata). The open reading frame of macropod IL‐21 is 462 nucleotides in length and encodes a 153‐mer putative protein that has 46% identity with human IL‐21. Despite the somewhat low amino acid conservation with other mammals, structural elements and residues essential for IL‐21 conformation and receptor association were conserved in the macropod IL‐21 predicted peptides. The detection of IL‐21 gene expression in T‐cell‐enriched tissues, combined with analysis of the promotor region of the tammar wallaby gene, suggests that macropod IL‐21 is expressed in stimulated T cells but is not readily detected in other cells and tissues. The similarity of gene expression profile and functionally important amino acid residues to eutherian IL‐21 makes it unlikely that the differences in B‐ and T‐cell responses that are reported for some marsupial species are due to a lack of important functional residues or IL‐21 gene expression in this group of mammals.
Nothing is more practical than a good conceptual artifact… which may be a theory, framework, model, metaphor, paradigm or perhaps some other abstraction
Authors: Alter Steven
Published: June 2016

This research commentary proposes a way to make progress in the IS discipline's inconclusive discussion about the nature and role of theory. In some ways, the creation and testing of theory seems to be the primary goal of IS research. Despite that, there are persistent questions whether theory has become a fetish in the IS discipline and whether the routinized production and testing of mid‐range theories is little more than an uninspired script that reduces the value and interest of IS research. This paper reframes the discussion around the idea of ‘conceptual artifact’ that has been discussed widely in educational psychology for over a decade. Conceptual artifacts are abstract knowledge objects that can be produced, tested and improved. This paper recognizes the value of both abstract knowledge (conceptual artifacts) and non‐abstract knowledge. It explains that theorizing produces, evaluates or improves useful conceptual artifacts that may or may not be theories. It validates four premises related to conceptual artifacts by showing that theorizing related to work system theory created or used many different types of conceptual artifacts. It identifies nine criteria for evaluating conceptual artifacts and shows that some of them differ from typical criteria for evaluating Gregor Type IV theories. As a whole, it argues that that privileging theory over other types of conceptual artifacts may not be beneficial in pursuing the research questions that the IS discipline needs to study.
Composition‐ and Pressure‐Induced Relaxor Ferroelectrics: First‐Principles Calculations and Landau‐Devonshire Theory
Authors: Liu Shi‐Yu , Zhang E , Liu Shiyang , Li De‐Jun , Li Yaping , Liu Yingdi , Shen Yaogen , Wang Sanwu
Published: June 2016

We report calculations with first‐principles density‐functional theory and Landau–Devonshire theory that provide an atomic‐scale mechanism for the composition‐ and pressure‐induced relaxor ferroelectrics. A multiphase with coexisted cubic structures (MPCCS) is found to correspond to any of the composition‐ and pressure‐induced relaxor ferroelectrics. On the other hand, a normal ferroelectric without relaxor behavior is structurally characterized by a single phase. Furthermore, the presence of the MPCCS in a composition‐ and pressure‐induced relaxor increases the degrees of freedom of relaxors and no energy barriers are involved for the rotations of the polarization direction, leading to high electromechanical coefficients.
The treatment experiences of people living with ileostomies: an interpretative phenomenological analysis
Authors: Spiers Johanna , Smith Jonathan A. , Simpson Phillip , Nicholls Adam R.
Published: June 2016

Aims

The aim of this study was to explore treatment and healthcare experiences of people living with ileostomies, so nurses can build on best practice while caring for these patients.

Background

Ileostomies, where the small intestine is re‐directed out of a stoma in the abdominal wall so waste is collected using a bag, are used to treat conditions including inflammatory bowel disease. Existing research suggests that although life with a stoma can be challenging, ileostomy patients are largely supported by multi‐disciplinary teams. However, more research is needed to understand the nuances of these relationships and experiences of treatment, with a view to improving clinical care.

Design

Participants took part in semi‐structured interviews consisting of open‐ended questions about their experiences of life with an ileostomy and their treatments and time in hospital. Points of interest were followed up. Data were collected between July–December of 2014.

Methods

The qualitative method interpretative phenomenological analysis was used to analyse interviews with 21 people living with ileostomies.

Findings

We present findings from two clinical themes: Issues around treatment and Relationships with multi‐disciplinary teams. Surgical complications were common and several participants reported concerns about addiction to painkillers. Varying attitudes were found around reversal surgery. Many reported experiencing distressing, dehumanizing care, while some felt supported by excellent healthcare providers.

Conclusion

People living with ileostomies have a very mixed experience of multi‐disciplinary teams and treatments and much could be done to support them more fully. For example, more information about ileostomies could be given to patients and more training given to nurses around stomas.
Leadless Cardiac Pacemaker Implantation After Lead Extraction in Patients With Severe Device Infection
Authors: KYPTA ALEXANDER , BLESSBERGER HERMANN , KAMMLER JUERGEN , LAMBERT THOMAS , LICHTENAUER MICHAEL , BRANDSTAETTER WALTER , GABRIEL MICHAEL , STEINWENDER CLEMENS
Published: June 2016

Leadless Cardiac Pacemaker Implantation After Lead Extraction

Background

Conventional pacemaker therapy is limited by short‐ and long‐term complications, most notably device infection. Transcatheter pacing systems (TPS) may be beneficial in this kind of patients as they eliminate the need for a device pocket and leads and thus may reduce the risk of re‐infection.

Methods

We assessed a novel procedure in 6 patients with severe device infection who were pacemaker dependent. After lead extraction a single chamber TPS was implanted into the right ventricle.

Results

Of the 6 patients who underwent lead extraction due to severe device infection at our institution, 3 were diagnosed with a pocket infection only, whereas the other 3 showed symptoms of both pocket and lead infection. Successful lead extraction and TPS implantation was accomplished in all patients. Four patients were bridged with a temporary pacemaker between 2 hours and 2 days after lead extraction, whereas 2 patients had the TPS implanted during the same procedure just before traditional pacemaker system removal. All patients stayed free of infection during the follow‐up period of 12 weeks. An additional positron emission tomography scan was performed in each patient and indicated no signs of an infection around the TPS.

Conclusion

Transcather pacemaker implantation was safe and feasible in 6 patients and did not result in re‐infection even if implanted before removal of the infected pacemaker system within the same procedure. Therefore, implantation of a TPS may be an option for patients with severe device infection, especially in those with blocked venous access or who are pacemaker dependent.
Add‐On Use of Eplerenone Is Effective for Lowering Home and Ambulatory Blood Pressure in Drug‐Resistant Hypertension
Authors: Eguchi Kazuo , Kabutoya Tomoyuki , Hoshide Satoshi , Ishikawa Shizukiyo , Kario Kazuomi
Published: June 2016

The authors aimed to investigate the blood pressure (BP)–lowering ability of eplerenone in drug‐resistant hypertensive patients. A total of 57 drug‐resistant hypertensive patients whose home BP was ≥135/85 mm Hg were investigated. The patients were randomized to either an eplerenone group or a control group and followed for 12 weeks. The efficacy was evaluated by clinic, home, and ambulatory BP monitoring. Urinary albumin, pulse wave velocity, and flow‐mediated vasodilation (FMD) were also evaluated. Home morning systolic BP (148±15 vs 140±15 mm Hg) and evening systolic BP (137±16 vs 130±16 mm Hg) were significantly lowered in the eplerenone group (n=35) compared with baseline (both P<.05), while unchanged in the control group (n=22). BP reductions in the eplerenone group were most pronounced for ambulatory awake systolic BP (P=.04), awake diastolic BP (P=.004), and 24‐hour diastolic BP (P=.02). FMD was significantly improved in the eplerenone group. In patients with drug‐resistant hypertension, add‐on use of eplerenone was effective in lowering BP, especially home and ambulatory awake BP.
Advanced glycation end products impair the functions of saphenous vein but not thoracic artery smooth muscle cells through RAGE/MAPK signalling pathway in diabetes
Authors: Sun Yongxin , Kang Le , Li Jun , Liu Huan , Wang Yulin , Wang Chunsheng , Zou Yunzeng
Published: June 2016

Saphenous vein (SV) and internal thoracic artery (ITA) are commonly used bypass conduits. However, graft failure occurs in SV rather than in ITA, especially in diabetes (DM). The mechanism for this difference has not been fully understood. Accumulation of advanced glycation end products (AGEs) and activation of AGEs receptor (RAGE) could accelerate smooth muscle cells (SMC) proliferation in DM, we thus asked whether AGEs‐RAGE could mediate the differences between SMC from SV (SMCV) and from ITA (SMCA). Twenty‐five patients with DM and other 25 patients without DM were enclosed in DM and control group, respectively. AGEs (100 μg/ml) were added to cultured SMCA and SMCV obtained at coronary artery bypass graft (CABG) and proliferative rates were determined. Transcript expression, phosphorylation or protein expression levels of MAP kinase family (ERK, p38 and JNK), matrix metalloproteinases (MMP)‐2 and MMP‐9 were analysed by real‐time PCR, Western‐blot or immunofluorescence staining, respectively. Compared with paired SMCA, SMCV showed significantly increased proliferation rate, MAP kinase family phosphorylation, and MMP‐2/9 expression in both groups, especially in DM group. The responses of SMCV induced by AGEs were significantly larger in DM than in control group, which could be suppressed by inhibition of RAGE and ERK. However, all the cellular events of SMCV were not found in paired SMCA. This study suggests that AGEs‐RAGE could induce the proliferation of SMCV but not SMCA via MAP kinase pathway in DM. It is the intrinsic ‘inactive’ tendency of SMCA that contributes to the different rates of graft disease between SV and ITA after CABG.
The association of six non‐synonymous variants in three DNA repair genes with hepatocellular carcinoma risk: a meta‐analysis
Authors: Shi Yan‐Hui , Wang Bin , Xu Bai‐Ping , Jiang Dan‐Na , Zhao Dong‐Mei , Ji Man‐Ru , Zhou Li , Li Xue , Lu Chang‐Zhu
Published: June 2016

Hepatocellular carcinoma is a complex polygenic disease. Despite the huge advances in genetic epidemiology, it still remains a challenge to unveil the genetic architecture of hepatocellular carcinoma. We, therefore, decided to meta‐analytically assess the association of six non‐synonymous coding variants from XRCC1, XRCC3 and XPD genes with hepatocellular carcinoma risk by pooling the results of 20 English articles. This meta‐analysis was conducted according to the PRISMA statement, and data collection was independently completed in duplicate. In overall analyses, the minor alleles of four variants, Arg280His (odds ratio, 95% confidence interval, P: 1.37, 1.13–1.66, 0.001), Thr241Met (1.93, 1.17–3.20, 0.011), Asp312Asn (1.22, 1.08–1.38, 0.001) and Lys751Gln (1.42, 1.02–1.97, 0.038), were associated with the significant risk for hepatocellular carcinoma. There were low probabilities of publication bias for all variants. Subgroup analyses revealed significant association of XRCC1 gene Arg399Gln with hepatocellular carcinoma in Chinese especially from south China (odds ratio, 95% confidence interval, P: 1.57, 1.16–2.14, 0.004), in larger studies (1.48, 1.11–1.98, 0.007) and in studies with population‐based controls (1.33, 1.06–1.68, 0.016). Taken together, our findings demonstrated that XPD gene Asp312Asn and XRCC1 gene Arg399Gln might be candidate susceptibility loci for hepatocellular carcinoma. Considering the ubiquity of genetic heterogeneity, further validation in a broad range of ethnic populations is warranted.
Local Responses to the European Social Fund: A Cross‐City Comparison of Usage and Change
Authors: Zimmermann Katharina
Published: June 2016

Governance in the European Union has become increasingly complex and multi‐facetted in the last decades. The article argues that the ESF (European Social Fund) is a crucial example in this regard since it combines financial incentives, procedural requirements and programmatic conditions. In order to analyse local responses to this complex governance tool, the article deploys analytical tools from the Europeanization literature and builds on in‐depth case knowledge from 18 cities in six European countries. A QCA (Qualitative Comparative Analysis) combined with case discussions reveals three different types of responses to the ESF. In ‘transformer‐cases’, both usage of the ESF and change brought by it can be observed. In ‘cream‐skimmer‐cases’, only usage but no change was measured, and in ‘refusenik‐cases’, neither usage nor change was detected. While usage of the ESF can be explained by individual motivation of local actors or the incentivizing dimension of the funds, change is apparently more complex.
Can Information Increase Turnout in European Parliament Elections? Evidence from a Quasi‐experiment in Denmark
Authors: Hogh Esben , Larsen Martin Vinæs
Published: June 2016

We examine the effect of information on turnout at a European Parliament election in Denmark. We utilize a quasi‐experimental design to sidestep the substantial problems related to causal inference associated with identifying the effect of information. Specifically, we look at a group of Danish first‐time voters, some of whom were exogenously exposed to information in the run‐up to the 2014 European Parliament election, by participating in a one‐day workshop about EU (European Union) politics. We find that those who participated were more knowledgeable about and more likely to vote in the upcoming European Parliament election. This suggests that increasing political participation in the EU could, in part, be a matter of exposing the European public to more information about EU politics.
Alterations of gut microbiota in patients with irritable bowel syndrome: A systematic review and meta‐analysis
Authors: Zhuang Xiaojun , Xiong Lishou , Li Li , Li Manying , Chen Minhu
Published: June 2016

Background and Aims

Alterations of gut microbiota were assumed to be the etiology and pathogenesis of irritable bowel syndrome (IBS) in some studies. However, alterations of gut microbiota in IBS patients had not been systematically assessed with a meta‐analysis. We performed a mate‐analysis to explore and compare the alterations of gut microbiota in IBS patients from China and other regions around the world.

Methods

Case–control studies detecting gut microbiota in IBS patients were identified through English and Chinese databases. The standardized mean difference (SMD) with 95% confidence interval (CI) of bacterial counts was calculated.

Results

Ten studies from China and seven studies from other regions around the world were included in our study. As compared with healthy controls, the SMDs of Bifidobacteria, Lactobacillus, Escherichia Coli, and Enterobacter in Chinese IBS patients were −1.42 (CI: −2.10, −0.75), −0.91 (95% CI: −1.31, −0.52), 0.83 (95% CI: 0.26, 1.40), and 0.57 (95% CI: 0.33, 0.82), respectively. But the SMDs of Bacteroides and Enterococcus were found no significant differences in Chinese IBS patients. However, the SMDs of Bifidobacteria and Bacteroides in IBS patients from other regions were −0.76 (CI: −1.43, −0.09) and 1.17 (CI: 0.00, 2.35), while the SMDs of Lactobacillus, E. Coli, Enterobacter, and Enterococcus were found no significant differences.

Conclusions

There were alterations of gut microbiota in IBS patients, and it implied that alterations of gut microbiota might be involved in the pathogenesis of IBS. However, the species‐specific alterations of gut microbiota were different between IBS patients from China and other regions.
Evaluation of the nutritional status of older hospitalised geriatric patients: a comparative analysis of a Mini Nutritional Assessment (MNA) version and the Nutritional Risk Screening (NRS 2002)
Authors: Christner S. , Ritt M. , Volkert D. , Wirth R. , Sieber C. C. , Gaßmann K.‐G.
Published: June 2016

Background

The present study aimed to evaluate a short‐form (MNA‐SF) version of the Mini Nutritional Assessment (MNA), in which some of the items were operationalised, based on scores from tools used for a comprehensive geriatric assessment, as a method for analysing the nutritional status of hospitalised geriatric patients. We compared this MNA‐SF version with the corresponding MNA long‐form (MNA‐LF) and Nutritional Risk Screening 2002 (NRS 2002) in terms of completion rate, prevalence and agreement regarding malnutrition and/or the risk of this.

Methods

In total, 201 patients aged ≥65 years who were hospitalised in geriatric wards were included in this analysis.

Results

The MNA‐SF, MNA‐LF and NRS 2002 were completed in 98.0%, 95.5% and 99.5% of patients (P = 0.06), respectively. The MNA‐SF, MNA‐LF and NRS 2002 categorised 93.4%, 91.1% and 66.0% of patients as being malnourished or at risk of being malnourished (P < 0.001). Agreement between the MNA‐SF and MNA‐LF was substantial (κ = 0.70, P < 0.001). No agreement between the MNA‐SF and NRS 2002 was found (κ = −0.12, P < 0.001). Interestingly, NRS 2002 part 1 (prescreening) revealed a false negative rate of 21.0% (only in patients aged ≥70 years who showed moderate disease severity) in relation to the NRS 2002 part 2.

Conclusions

The MNA‐SF version emerged as a useful tool for evaluating the nutritional status of hospitalised geriatric patients. The NRS 2002 part 1 showed limited value as a prescreening aid in relation to the NRS 2002 part 2 in the same group of patients.
Taste preference, food neophobia and nutritional intake in children consuming a cows’ milk exclusion diet: a prospective study
Authors: Maslin K. , Grimshaw K. , Oliver E. , Roberts G. , Arshad S. H. , Dean T. , Grundy J. , Glasbey G. , Venter C.
Published: June 2016

Background

Taste exposure in infancy is known to predict food preferences later in childhood. This is particularly relevant in children with cows’ milk allergy who consume a substitute formula and/or a cows’ milk exclusion (CME) diet early in life. This prospective study aimed to show whether there is a long‐term effect of consuming a substitute formula and CME diet on taste preferences and dietary intake.

Methods

Children were predominantly recruited from two large birth cohort studies in the UK. Two groups were recruited: an experimental group of children who had consumed a CME diet during infancy and a control group who had consumed an unrestricted diet during infancy. Parents completed a food neophobia questionnaire and an estimated prospective food diary. Children completed a taste preference test and their growth was assessed.

Results

One hundred and one children with a mean age of 11.5 years were recruited (28 CME and 73 controls). Children in the CME group had a significantly higher preference for bitter taste than those in the control group (P < 0.05). There were significant differences between the groups with respect to the intake of some micronutrients, including riboflavin, iodine, sodium and selenium. Food neophobia did not differ between groups. Some 28% of the CME group were overweight/obese compared to 15% of the control group; however, this difference was not statistically significant.

Conclusions

Consuming a substitute formula and/or a CME diet in infancy has a long‐term effect on the preference for bitter taste. Differences exist with respect to the intake of some micronutrients, but not macronutrients. There was a nonsignificant trend towards being overweight and obese in children in the CME group.
The Effects of Formal Legal Pluralism on Indigenous Authorities in the Ecuadorian Highlands
Authors: Simon Thomas Marc
Published: June 2016

El artículo analiza las distintas formas en que el pluralismo legal formal en Ecuador es percibido y utilizado. Se enfoca en el vacío legal generado tras el reconocimiento constitucional del derecho consuetudinario en 1998 y la subsecuente ausencia de reglas de coordinación tendientes a definir la relación entre éste y el derecho nacional. A adoptarse una perspectiva de antropología legal sobre el cabildo, este artículo describe las variaciones en el tratamiento de distintos tipos de “conflictos internos”, dependiendo de la gravedad del caso y de las partes involucradas. Se sostiene que el reconocimiento constitucional del pluralismo legal puede funcionar a favor o en contra del empoderamiento político y legal de las autoridades indígenas locales. Mientras por un lado extendio la jurisdicción de autoridades locales, también causó tensiones políticas nacionales relacionadas con la interpretación de los artículos relevantes en la constitución y con los intentos de limitar la jurisdicción indígena.
Unique Characteristics of Cohabiters Seeking Therapy
Authors: Shannon Samuel , Bartle‐Harring Suzanne
Published: June 2016

There is limited information on cohabiters presenting for therapy. The authors examined the characteristics of 143 married and 54 cohabiting, young (m = 30.39), Caucasian, couples presenting for therapy. We hypothesized that cohabiters presenting for therapy would be more satisfied and committed than married couples and that they would be similarly emotionally differentiated. We conducted a repeated‐measures MANOVA to test the hypothesis. Significant effects between partners and between dyads were found, indicating a difference between clients based on relationship status. Cohabiting clients presented earlier in their relationship and were more satisfied and committed. Cohabiting male partners were less emotionally reactive. Without the institutionalized rules of marriage, cohabiting couples may perceive threats to their relationship earlier than married couples.
Clinical Assessment of a Point‐of‐Care Serum Amyloid A Assay in Foals with Bronchopneumonia
Authors: Giguère S. , Berghaus L.J. , Miller C.D.
Published: June 2016

Background

Despite the paucity of data available, stall‐side serum amyloid (SAA) assays are commonly used to make diagnostic and treatment decisions in foals with bronchopneumonia.

Hypothesis

Measurement ofSAAconcentrations can accurately differentiate pneumonic from healthy foals.

Animals

Fifty‐four pneumonic foals between 3 weeks and 5 months of age were compared to 44 healthy controls. In addition, 47 foals on a farm endemic forR. equiinfections were studied.

Methods

Serum samples were collected from pneumonic foals at hospital admission. Foals were categorized as having pneumonia caused byR. equior by other microorganisms based on culture of a tracheobronchial aspirate. In addition, serum samples were obtained at 2‐week intervals from foals born at a farm endemic forR. equi.SAAconcentrations were measured by a point‐of‐care assay. Diagnostic performance ofSAAwas assessed by use of receiver operating characteristic curves.

Results

Concentrations ofSAAin foals with bronchopneumonia were significantly (P< 0.001) higher than those of healthy foals, but 15 of 54 pneumonic foals (28%) hadSAAconcentrations <5 μg/mL. There was no correlation betweenSAAconcentrations and radiographic score in foals withR. equipneumonia. The ability ofSAAto predict development ofR. equipneumonia at the endemic farm was limited with a sensitivity of 64% and a specificity of 77%.

Conclusion and clinical importance

Overall,SAAconcentrations are significantly higher in pneumonic than in healthy foals. However, performance ofSAAin detecting pneumonic foals is limited by the high proportion of false‐positive and false‐negative results.
Biogeography of polymorphic phenotypes: Mapping and ecological modelling of coat colour variants in an elusive Neotropical cat, the jaguarundi (Puma yagouaroundi)
Authors: da Silva L. G. , de Oliveira T. G. , Kasper C. B. , Cherem J. J. , Moraes E. A. , Paviolo A. , Eizirik E.
Published: June 2016

The jaguarundiPuma yagouaroundiis a small Neotropical cat that presents two main coloration phenotypes (grey/dark vs. reddish). Although these coat colour variants have been known for decades, and historically speculated to be associated with different habitats, their exact geographical distribution has never been mapped. Moreover, their association to different habitats has so far not been tested statistically, so that their ecological relevance with respect to varying environmental features remains unknown. Based on 566 location records encompassing the entire historical range of the species obtained from camera‐traps, captures and skins held in scientific collections, we produced suitability models for both jaguarundi phenotypes using maximum entropy algorithms of niche modelling. The frequency of grey/dark jaguarundis isc. 80%, whereas reddish animals representc. 20% of our overall sample set. However, there were marked differences in these frequencies across regions. Although the spatial distribution of grey/dark animals did not depart substantially from random expectations (as it encompassed the whole species range), the occurrence of the ancestral reddish form was strongly and significantly non‐random. In spite of their broad distribution across multiple habitats, grey/dark animals were significantly associated with moist and dense forests, whereas reddish forms were associated with dry and open areas such as deserts and xeric landscapes. Furthermore, there were clear spatial differences in the suitability models generated for these coat colour phenotypes. We also employed the distribution models to investigate whether particular environmental predictors could explain these different distributions. Predictors related to moisture were especially influential on the differences between the grey/dark and reddish models, and demonstrate an effect of natural selection on coloration traits, suggesting that a complex interplay of different ecological processes regulates this system over evolutionary time.
The use of generics to treat chronic hepatitis C: not quite ready for the big stage
Authors: Sarpel Dost , Dieterich Douglas
Published: June 2016

Recently developed direct acting antivirals have been highly effective in treating patients with chronic hepatitis C infection. Due to their expense, there has been development of generic formulations of these medications in many countries. However, there has been controversy regarding the bioequivalence of generics when compared to brand name medications. Inactive ingredients, which may differ in generic medications, can alter the bioequivalence of the active ingredient as well as provoke intolerance or confusion among patients. There is also concern regarding the quality control and assessment of the manufacturing process of generics. When taken together these issues have the potential to lead to treatment failure. The use of generics to treat chronic hepatitis C will remain controversial, until these issues are adequately addressed.