bluuebunny/crossref_metadata_2025 huggingface dataset:
Purinergic Signaling in Liver Disease
Authors: Vaughn Byron P. , Robson Simon C. , Longhi Maria Serena
Published: July 2014

Adenosine triphosphate (ATP) is essential for the myriad of metabolic processes upon which life is based and is known widely as the universal energy currency unit of intracellular biologic reactions. ATP, adenosine diphosphate, adenosine, as well as other purines and pyrimidines also serve as ubiquitous extracellular mediators which function through the activation of specific receptors (viz. P2 receptors for nucleotides and purinergic P1 receptors for adenosine). Extracellular nucleotides are rapidly converted to nucleosides, such as adenosine, by highly regulated plasma membrane ectonucleotidases that modulate many of the normal biological and metabolic processes in the liver - such as gluconeogenesis and insulin signaling. Under inflammatory conditions, as with ischemia reperfusion, sepsis or metabolic stress, ATP and other nucleotides can also act as ‘damage-associated molecular patterns' causing inflammasome activation in innate immune cells and endothelium resulting in tissue damage. The phosphohydrolysis of ATP by ectonucleotidases, such as those of the CD39/ENTPD family, results in the generation of immune suppressive adenosine, which in turn markedly limits inflammatory processes. Experimental studies by others and our group have implicated purinergic signaling in experimental models of hepatic ischemia reperfusion and inflammation, transplant rejection, hepatic regeneration, steatohepatitis, fibrosis and cancer, amongst others. Expression of ectonucleotidases on sinusoidal endothelial, stellate or immune cells allows for homeostatic integration and linking of the control of vascular inflammatory and immune cell reactions in the liver. CD39 expression also identifies hepatic myeloid dendritic cells and efficiently distinguishes T-regulatory-type cells from other resting or activated T cells. Our evolving data strongly indicate that CD39 serves as a key ‘molecular switch' and is an integral component of the suppressive machinery of myeloid, dendritic and T cells. Increased understanding of mechanisms of extracellular ATP scavenging and specifically conversion to nucleosides by ectonucleotidases of the CD39 family have also led to novel insights into the exquisite balance of nucleotide P2-receptor and adenosinergic P1-receptor signaling in inflammatory and hepatic diseases. Further, CD39 and other ectonucleotidases exhibit genetic polymorphisms in humans which alter levels of expression/function and are associated with predisposition to inflammatory and immune diseases, diabetes and vascular calcification, amongst other problems. Development of therapeutic strategies targeting purinergic signaling and ectonucleotidases offers promise for the management of disordered inflammation and aberrant immune reactivity.
Update on the Management of Cholangiocarcinoma
Authors: Skipworth J.R.A. , Keane M.G. , Pereira S.P.
Published: July 2014

Cholangiocarcinoma (CC) is a rare cancer arising from the epithelium of the biliary tree, anywhere from the small peripheral hepatic ducts to the distal common bile duct. Classification systems for CC typically group tumours by anatomical location into intrahepatic, hilar or extrahepatic subtypes. Surgical resection or liver transplantation remains the only curative therapy for CC, but up to 80% of patients present with advanced, irresectable disease. Unresectable CC remains resistant to many chemotherapeutic agents, although gemcitabine, particularly in combination with other agents, has been shown to improve overall survival. Ongoing investigation of biological agents has also yielded some promising results. Several novel interventional and endoscopic techniques for the diagnosis and management of non-operable CC have been developed: initial results show improvements in symptoms and progression-free survival, but further randomised studies are required to establish their role in the management of CC.
Adipocyte Cell Death, Fatty Liver Disease and Associated Metabolic Disorders
Authors: Eguchi Akiko , Feldstein Ariel E.
Published: July 2014

Obesity has reached epidemic proportions in the USA and many other parts of the world. Obesity increases the risk of a number of adverse health conditions including type 2 diabetes, insulin resistance, dyslipidemia, hypertension, and hepatic steatosis. Adipocyte hypertrophy occurs during weight gain and is associated with recruitment of immune cells, mainly macrophages, into the adipose tissue (AT). These cells typically surround a dying or dead adipocyte with the formation of crown-like structures that are present in experimental models of obesity as well as obese humans. The immune infiltration of AT results in increased production of various adipokines, cytokines, and chemokines that play a crucial role in the development of insulin resistance and hepatic steatosis. The pathogenic mechanisms resulting in AT macrophage recruitment are under intense investigation and remain incompletely understood. Recent evidence suggests that various programmed cell death pathways are activated in stressed hypertrophied adipocytes and may result in cell death. These events appear to occur at early stages and be important in triggering the metabolic dysregulation associated with obesity.
Prevention of Hepatitis B Virus Reinfection in Liver Transplant Recipients
Authors: Roche Bruno , Samuel Didier
Published: July 2014

Antiviral therapy using newer nucleos(t)ide analogues with lower resistance rates such as entecavir or tenofovir could suppress hepatitis B virus (HBV) replication, improve liver function, delay or obviate the need for liver transplantation in some patients, and reduce the risk of HBV recurrence. The combination of long-term antiviral and low-dose hepatitis B immune globulin (HBIG) can effectively prevent HBV recurrence in more than 90% of transplant recipients. Some form of HBV prophylaxis needs be continued indefinitely after transplantation. However, in patients with a low risk of HBV recurrence (i.e. HBV DNA levels undetectable before transplantation), it is possible to discontinue HBIG and maintain long-term antiviral therapy. A more cautious approach to prophylaxis regimen is necessary for those patients with high pretransplant HBV DNA levels, those with limited antiviral options if HBV recurrence occurs (i.e. HIV or HDV coinfection, preexisting drug resistance), those with a high risk of hepatocellular carcinoma recurrence, and those with a risk of noncompliance to antiviral therapy.
Comparison of the Efficacy of Gefitinib in Patients with Non-Small Cell Lung Cancer according to the Type of Epidermal Growth Factor Receptor Mutation
Authors: Igawa Satoshi , Kasajima Masashi , Ishihara Mikiko , Kimura Michiko , Hiyoshi Yasuhiro , Asakuma Maiko , Otani Sakiko , Katono Ken , Sasaki Jiichiro , Masuda Noriyuki
Published: July 2014

Background: Exon 19 deletion and L858R point mutation of the epidermal growth factor receptor (EGFR) are the most commonly encountered EGFR mutations in non-small cell lung cancer (NSCLC), and predict higher clinical outcomes following treatment with gefitinib. The objective of this study was to evaluate the differential clinical outcomes of gefitinib in patients with NSCLC according to the type of active EGFR mutation, i.e. exon 19 deletion or L858R point mutation. Methods: We identified patients with advanced NSCLC harboring the exon 19 deletion or the L858R point mutation of EGFR who were on gefitinib treatment. The clinical outcomes were evaluated. Results: Of the 124 patients with NSCLC harboring active EGFR mutations, the overall response rate, progression-free survival and overall survival were 60.5%, 11.3 and 27.3 months, respectively, and did not differ significantly between patients with the exon 19 deletion (61.8%, 11.3 and 32.2 months, respectively) and those with the L858R point mutation (58.9%, 9.0 and 27.7 months, respectively). Conclusion: It may be considered that there is no difference in the clinical efficacy of gefitinib between NSCLC patients who harbor the exon 19 deletion and those with the L858R point mutation. © 2014 S. Karger AG, Basel
Cutaneous or Respiratory Exposures to Peanut Allergens in Mice and Their Impacts on Subsequent Oral Exposure
Authors: Wavrin Sophie , Bernard Hervé , Wal Jean-Michel , Adel-Patient Karine
Published: July 2014

Background: Recent data suggested that non-gastrointestinal exposure can lead to sensitisation to food allergens. We thus assessed the immune impact of respiratory or cutaneous exposure to peanut proteins on non-altered epithelium and investigated the effect of such pre-exposure on subsequent oral administration of peanut. Methods: BALB/cJ mice were exposed to purified Ara h 1 or to a non-defatted roasted peanut extract (PE) by simple deposit of allergens solutions on non-altered skin or in the nostrils. Exposures were performed 6 times at weekly intervals. Pre-exposed mice then received intra-gastric administrations of PE alone or in the presence of the Th2 mucosal adjuvant cholera toxin (CT). The specific humoral and cellular immune response was assessed throughout the protocol. Results: Both cutaneous and respiratory exposures led to the production of specific IgG1. Local and systemic IL-5 and IL-13 production were also evidenced, demonstrating activation of specific Th2 cells. This effect was dose-dependent and most efficient via the respiratory route. Moreover, these pre-exposures led to the production of specific IgE antibodies after gavage with PE, whatever the presence of CT. Conclusions: Cutaneous or respiratory exposures to peanut induce Th2 priming in mice. Moreover, pre-exposures promote further sensitisation via the oral route without the use of CT; this proposes a new adjuvant-free experimental model of sensitisation to food that may reflect a realistic exposure pattern in infants. These results also suggest that non-gastrointestinal peanut exposure should be minimised in high-risk infants, even those with non-altered skin, to potentially reduce allergic sensitisation to this major food allergen.
The Impact of Puberty and Social Anxiety on Amygdala Activation to Faces in Adolescence
Authors: Ferri Jamie , Bress Jennifer N. , Eaton Nicholas R. , Proudfit Greg Hajcak
Published: July 2014

Adolescence is associated with the onset of puberty, shifts in social and emotional behavior and an increased vulnerability to social anxiety disorder. These transitions coincide with changes in amygdala response to social and affective stimuli. Utilizing an emotional face-matching task, we examined amygdala response to peer-aged neutral and fearful faces in relation to puberty and social anxiety in a sample of 60 adolescent females between the ages of 8 and 15 years. We observed amygdala activation in response to both neutral and fearful faces compared to the control condition but did not observe differential amygdala activation between fearful and neutral faces. Right amygdala activity in response to neutral faces was negatively correlated with puberty and positively correlated with social anxiety, and these effects were statistically independent. Puberty and social anxiety did not relate to amygdala activation in response to fearful faces. These findings suggest that emotional differentiation between fearful and neutral faces may arise during later pubertal development and may result from decreasing sensitivity to neutral faces rather than increasing sensitivity to threatening faces. Furthermore, these findings highlight the importance of considering individual differences in social anxiety when examining the neural response to social stimuli in adolescents.
Cost–Benefit Analysis of Home Blood Pressure Monitoring in Hypertension Diagnosis and Treatment
Authors: Arrieta Alejandro , Woods John R. , Qiao Nan , Jay Stephen J.
Published: July 2014

Home blood pressure (BP) monitoring has been shown to be more effective than clinic BP monitoring for diagnosing and treating hypertension. However, reimbursement of home BP monitoring is uncommon in the United States because of a lack of evidence that it is cost beneficial for insurers. We develop a decision-analytic model, which we use to conduct a cost–benefit analysis from the perspective of the insurer. Model inputs are derived from the 2008 to 2011 claims data of a private health insurer in the United States, from 2009 to 2010 National Health and the Nutrition Examination Survey data, and from published meta-analyses. The model simulates the transitions among health states from initial physician visit to hypertension diagnosis, to treatment, to hypertension-related cardiovascular diseases, and patient death or resignation from the plan. We use the model to estimate cost–benefit ratios and both short- and long-run return on investment for home BP monitoring compared with clinic BP monitoring. Our results suggest that reimbursement of home BP monitoring is cost beneficial from an insurer’s perspective for diagnosing and treating hypertension. Depending on the insurance plan and age group categories considered, estimated net savings associated with the use of home BP monitoring range from $33 to $166 per member in the first year and from $415 to $1364 in the long run (10 years). Return on investment ranges from $0.85 to $3.75 per dollar invested in the first year and from $7.50 to $19.34 per dollar invested in the long run.
Aortic Stiffness and Interstitial Myocardial Fibrosis by Native T1 Are Independently Associated With Left Ventricular Remodeling in Patients With Dilated Cardiomyopathy
Authors: Puntmann Valentina O. , Arroyo Ucar Eduardo , Hinojar Baydes Rocio , Ngah Ning Binti , Kuo Yen-Shu , Dabir Darius , Macmillan Alexandra , Cummins Ciara , Higgins David M. , Gaddum Nicholas , Chowienczyk Phil , Plein Sven , Carr-White Gerry , Nagel Eike
Published: July 2014

Increased aortic stiffness is related to increased ventricular stiffness and remodeling. Myocardial fibrosis is the pathophysiological hallmark of failing heart. We investigated the relationship between noninvasive imaging markers of myocardial fibrosis, native T1, and late gadolinium enhancement, respectively, and aortic stiffness in ventricular remodeling. Consecutive patients with known dilated cardiomyopathy (n=173) underwent assessment of cardiac volumes and function, T1 mapping, scar imaging, and pulse wave velocity, a measure of aortic stiffness. Asymptomatic healthy volunteers served as controls (n=47). Controls and patients showed an increase in pulse wave velocity with age, which was accelerated in the presence of cardiovascular disease. On the contrary, native T1 increased with age in patients, but not in controls. Pulse wave velocity was associated with native T1 in the presence of disease, but not in health. Native T1 showed a strong relationship with markers of structural and functional left ventricular remodeling and diastolic impairment. Ischemic and nonischemic pathophysiology of ventricular remodeling showed a similar slope of relationship between pulse wave velocity and native T1. However, in nonischemic patients, increase in pulse wave velocity was associated with greater increase in native T1. Aortic stiffness is related to age, and this process is accelerated in the presence of disease. On the contrary, increase in interstitial myocardial fibrosis is associated with age in the presence of disease. Patients with ischemic and nonischemic dilated cardiomyopathy have a similar relationship between native T1 and pulse wave velocity, which is stronger in the latter group.
Capturing the Personal in Politics: Ethnographies of Global Environmental Governance
Authors: Corson Catherine , Campbell Lisa M. , MacDonald Kenneth I.
Published: July 2014

In this article we elaborate on how we use collaborative event ethnography to study global environmental governance. We discuss how it builds on traditional forms of ethnography, as well as on approaches that use ethnography to study policy-making in multiple institutional and geographical sites. We argue that global environmental meetings and negotiations offer opportunities to study critical historical moments in the making of emergent regimes of global environmental governance, and that collaborative ethnography can capture the day-to-day practices that constitute policy paradigm shifts. In this method, the negotiations themselves are not the object of study, but rather how they reflect and transform relations of power in environmental governance. Finally, we propose a new approach to understanding and examining global environmental governance—one that views the ethnographic field as constituted by relationships across time and space that come together at sites such as meetings.
Wave Activity Events and the Variability of the Stratospheric Polar Vortex
Authors: Solomon Abraham
Published: July 2014

During Northern Hemisphere winter, polar stratospheric winds and temperatures exhibit significant variability that is due to the vertical propagation of planetary-scale waves. The most dramatic intraseasonal variations in temperature are associated with sudden stratospheric warmings (SSWs), which are wave-breaking events that occur approximately every other year. This paper will introduce the concept of wave activity events (WAEs), which are periods of enhanced pseudomomentum density in the polar stratosphere that occur every year. It will be demonstrated that all SSWs are associated with WAEs; furthermore, minor warmings and many final warmings in the polar spring are also WAEs, and therefore a better understanding of these more frequent wave events can provide additional insights into stratospheric wave-induced variability. Employing the Interim European Centre for Medium-Range Weather Forecasts (ECMWF) Re-Analysis (ERA-Interim) for 1979–2011, 119 WAEs are identified and their life cycle is compared with that of the 23 SSWs observed during this period.
Direct Estimate of Lateral Eddy Diffusivity Upstream of Drake Passage
Authors: Tulloch Ross , Ferrari Raffaele , Jahn Oliver , Klocker Andreas , LaCasce Joseph , Ledwell James R. , Marshall John , Messias Marie-Jose , Speer Kevin , Watson Andrew
Published: July 2014

The first direct estimate of the rate at which geostrophic turbulence mixes tracers across the Antarctic Circumpolar Current is presented. The estimate is computed from the spreading of a tracer released upstream of Drake Passage as part of the Diapycnal and Isopycnal Mixing Experiment in the Southern Ocean (DIMES). The meridional eddy diffusivity, a measure of the rate at which the area of the tracer spreads along an isopycnal across the Antarctic Circumpolar Current, is 710 ± 260 m2 s−1 at 1500-m depth. The estimate is based on an extrapolation of the tracer-based diffusivity using output from numerical tracers released in a one-twentieth of a degree model simulation of the circulation and turbulence in the Drake Passage region. The model is shown to reproduce the observed spreading rate of the DIMES tracer and suggests that the meridional eddy diffusivity is weak in the upper kilometer of the water column with values below 500 m2 s−1 and peaks at the steering level, near 2 km, where the eddy phase speed is equal to the mean flow speed. These vertical variations are not captured by ocean models presently used for climate studies, but they significantly affect the ventilation of different water masses.
Predictors of Chronic Total Occlusion in Nonculprit Artery in Patients With Acute Coronary Syndrome
Authors: Kurtul Alparslan , Yarlioglues Mikail , Murat Sani Namik , Celik İbrahim Etem , Demircelik Muhammed Bora , Ocek Adil Hakan , Duran Mustafa , Ergun Gokhan , Cetin Mustafa , Ornek Ender
Published: July 2014

Chronic total occlusion (CTO) in a noninfarct-related artery (non-IRA) is an independent predictor of mortality in acute coronary syndrome (ACS). Mean platelet volume (MPV) and serum uric acid (SUA) are associated with cardiovascular events in ACS. We investigated the relationship between the presence of non-IRA-CTO with MPV and SUA levels in patients with ACS. Patients (n = 1024) who underwent urgent coronary angiography for ACS were included in this study. Blood samples were drawn on admission. Patients were categorized into 2 groups: non-IRA-CTO (−) and non-IRA-CTO (+). The MPV and SUA levels on admission were significantly higher in the non-IRA-CTO (+) group than in the non-IRA-CTO (−) group ( P < .001). At multivariate analysis, MPV (odds ratio [OR]: 4.705, P < .001) and SUA (OR: 2.535, P < .001) were independent predictors of non-IRA-CTO together with age, hemoglobin, ejection fraction, and non-ST-segment elevation ACS. The MPV and SUA levels were significant and independent predictors for the presence of non-IRA-CTO in patients with ACS.
Using calculated globulin fraction to reduce diagnostic delay in primary and secondary hypogammaglobulinaemias: results of a demonstration project
Authors: Holding Stephen , Khan Sujoy , Sewell William AC , Jolles Stephen , Dore Philip C
Published: July 2014

Background

Median diagnostic delay of five to six years seen in primary hypogammaglobulinaemia results in morbidity including bronchiectasis. Patients typically have multiple health care encounters and blood tests before the diagnosis is considered. We report outcomes from using the difference between total protein and albumin (globulin fraction) to reduce diagnostic delay in unsuspected hypogammaglobulinaemia.

Methods

A prospective >5 year programme in the setting of a National Health Services Hospital Blood Sciences pathology service processing serum samples from primary and secondary care. Patients with globulin fraction below the first percentile were reviewed in the context of supplied clinical details. Immunoglobulin measurements were performed in selected patients.

Results

Of 2,910,850 globulin fractions 27,304 (0.9%) were below the 1st percentile globulin fraction (<18 g/L). After exclusions, 933 (3% of these) had immunoglobulins measured. Of these, 292 had IgG < 5 g/L, 186 < 4 g/L and 80 < 3 g/L, giving respective positive predictive values of 31%, 20% and 8.6%. Positive predictive value for common variable immunodeficiency was 1.3%. We identified 12 new cases of common variable immunodeficiency, 10 new haematological disorders and 20 hypogammaglobulinaemias secondary to medication. Locally derived cut-offs are required as small differences between analysers have a significant effect on screen-positive rates.

Conclusions

Use of a 1st percentile globulin fraction improved early detection of hypogammaglobulinaemia. This is a useful adjunct to alert clinicians to unsuspected hypogammaglobulinaemia but should not replace immunoglobulin measurement. Patients with globulin fraction below the first percentile should be reviewed for possible hypogammaglobulinaemia.
Healthy Eyes in Schools: An evaluation of a school and community-based intervention to promote eye health in rural Timor-Leste
Authors: Hobday Karen , Ramke Jacqueline , du Toit Rènée , Pereira Sara M
Published: July 2014

Objective:

To assess whether there was an improvement in the knowledge, attitudes and practices of students after the Healthy Eyes in Schools Project intervention and to complete a process evaluation to inform future implementation of health promotion interventions.

Design:

A descriptive, mixed-methods design was used, including questionnaires and interviews.

Setting:

Four primary schools in Aileu District, Timor-Leste. Local teachers received training and resources to implement nine lessons about eye health. The intervention was supported in two schools by the concurrent creation of school gardens and improvements to the water and sanitation, where required.

Method:

Students from classes 5 and 6 participated: 384 students aged 10–17 years (median = 12 years, inter-quartile range = 12–13 years) completed the baseline knowledge, attitudes and practices survey and 237 students participated in a follow-up survey. Interviews with teachers, students and parents informed the process evaluation.

Results:

The intervention was associated with an improvement in eye health knowledge and some attitudes and practices of students. Attitudes about the capabilities of blind children and adults did not change. The teachers’ attitude and support from principals and an international non-governmental organisation appeared to be key factors in the successful implementation of the Healthy Eyes in Schools Project. The limited eye health in the existing curriculum, limited parent participation and access to healthy food may have influenced the effectiveness of the Healthy Eyes in Schools Project intervention.

Conclusion:

A number of benefits appeared to be associated with the inclusion of eye health topics in school health and hygiene education in Timor-Leste. Concurrent development of a supportive environment appeared to enable this initiative. The results of this evaluation can be used to advocate to the Ministries of Education and Health and other education stakeholders for the inclusion of eye health in the health and hygiene curriculum.
The Interplay Between Bicultural Blending and Dual Language Acquisition
Authors: Nguyen Angela-MinhTu D. , Ahmadpanah Seyedeh S.
Published: July 2014

Bilingual individuals acquire their two languages either simultaneously or sequentially, which relates to how these languages are stored and represented in the brain. Because language is used to transmit culture, bilinguals’ mode of dual language acquisition may also relate to different perceptions of the corresponding two cultures as blended and fused versus separate and compartmentalized. With a sample of English–Spanish bilingual Mexican Americans ( N = 149), we found that compound bilinguals (simultaneous dual language acquisition) blended their two cultures to a greater extent than coordinate bilinguals (sequential dual language acquisition), and this finding remained even after controlling for generation status. Our study highlights the interplay of language and culture, particularly the importance of the process of cultural learning and language acquisition to the bicultural experience.
Smad2 Overexpression Reduces the Proliferation of the Junctional Epithelium
Authors: Alotaibi M.K. , Kitase Y. , Shuler C.F.
Published: July 2014

The overexpression of the intracellular signaling molecule of the transforming growth factor–beta family (TGF-β) Smad2 was found to induce apoptosis and inhibit the proliferation rate of oral epithelial cells. Therefore, the aim of this study was to investigate in vivo the effect of Smad2 overexpression on the proliferation rate of the junctional epithelium (JE). Smad2 overexpression was driven by the cytokeratin 14 promoter (K14-Smad2) in transgenic mice. The K14-Smad2 mice were compared with wild-type (WT) mice selected as the control group. Samples were stained with hematoxylin and eosin stains and analyzed by image analysis. Immunohistochemistry was conducted for proliferating cell nuclear antigen (PCNA) and c-Myc as markers of cell proliferation. The expression of cyclin-dependent kinase inhibitors (P15, P21, and P27) was determined by real-time polymerase chain-reaction (RT-PCR). The quantity of phosphorylated retinoblastoma (pRB) was determined with Western blots. The overexpression of Smad2 altered the area of the junctional epithelial cells in one-year-old K14-Smad2 mice. The area was 32,768 (± 3,473) μm2 for the WT and 24,937.25 (± 1,965) μm2 for the K14-Smad2 mice. There was a significant difference in the proliferation rates of the JE (PCNA-positive cells) between the WT and K14-Smad2 mice, 20.7% (± 1.1) and 2.1% (± 0.5), respectively. A significant difference in c-Myc expression occurred between experimental and control samples. The K14-Smad2 mice had a mean of 2.3% (± 0.6), and the WT mice had a mean of 20.1% (± 3.6). Smad2 overexpression up-regulated the mRNA expression of P15 by 2.3-fold and that of P27 by 5.5-fold in the K14-Smad2 mice. Finally, the pRB protein showed a 2.3 (± 0.5)-fold increase in K14-Smad2 mice when compared with WT mice. Smad2 overexpression inhibits the proliferation of JE cells by down-regulating c-Myc and up-regulating P15 and P27, which resulted in an increase in pRB, leading to cell-cycle arrest.
The parenting styles of divorced fathers and their predictors
Authors: Bastaits Kim , Ponnet Koen , Van Peer Christine , Mortelmans Dimitri
Published: July 2014

Research on paternal parenting after divorce indicated that children benefit from authoritative parenting. Fathers are not equally likely to be authoritative. Research on differences in divorced fathers’ parenting styles remains underdeveloped. We sought to address this gap, investigating the predictors of paternal parenting styles following divorce. First, latent class analysis was utilized to derive parenting styles for divorced fathers. Second, predictors of these styles were investigated with multinomial logistic regression. Analyses examined Belgian data on 404 children (49.01% girls) and their parents. Results reveal that important predictors include not only father and child characteristics but also mother characteristics and divorce-related characteristics. The findings therefore lend support to the idea of studying paternal parenting following divorce within a multilateral family framework.
Concurrent filtering and smoothing: A parallel architecture for real-time navigation and full smoothing
Authors: Williams Stephen , Indelman Vadim , Kaess Michael , Roberts Richard , Leonard John J. , Dellaert Frank
Published: July 2014

We present a parallelized navigation architecture that is capable of running in real-time and incorporating long-term loop closure constraints while producing the optimal Bayesian solution. This architecture splits the inference problem into a low-latency update that incorporates new measurements using just the most recent states (filter), and a high-latency update that is capable of closing long loops and smooths using all past states (smoother). This architecture employs the probabilistic graphical models of factor graphs, which allows the low-latency inference and high-latency inference to be viewed as sub-operations of a single optimization performed within a single graphical model. A specific factorization of the full joint density is employed that allows the different inference operations to be performed asynchronously while still recovering the optimal solution produced by a full batch optimization. Due to the real-time, asynchronous nature of this algorithm, updates to the state estimates from the high-latency smoother will naturally be delayed until the smoother calculations have completed. This architecture has been tested within a simulated aerial environment and on real data collected from an autonomous ground vehicle. In all cases, the concurrent architecture is shown to recover the full batch solution, even while updated state estimates are produced in real-time.
Radiation dose and mortality risk to children undergoing therapeutic interventional cardiology
Authors: Song Shanjun , Liu Chenzhi , Zhang Menglong
Published: July 2014

Background

Children undergoing interventional cardiology procedures deserve special concern due to the greater radiation sensitivity of their tissues and more remaining years of life during which a radiation-induced cancer may develop.

Purpose

To determine the patient radiation dose for pediatric therapeutic interventional cardiology and to estimate the patient effective dose and lifetime mortality risk to children associated with five common procedures.

Material and Methods

Ninety children with congenital heart defects undergoing interventional therapy were enrolled in this study. Data regarding fluoroscopy and radiography time, dose-area product (DAP) and peak skin dose (PSD) for each case were measured. Patients were divided into five groups. The patient effective dose (E) was calculated using a multiplicative model of ICRP 60. The overall lifetime mortality risk was evaluated using appropriate risk coefficients.

Results

The mean, median, standard deviation, and range of time, PSD, DAP, and E were presented for the five study groups. When these metrics were considered, there were wide variations for different cases within the same group and statistically significant differences between the five groups. The PSD correlated significantly with DAP (Pearson r = 0.70; P < 0.01), but the correlation in individual cases was poor. For all cases, the range of E was found to be between 0.44 and 66.7 mSv. The corresponding risk of lifetime mortality was 1.16 per thousand.

Conclusion

The current study provides overall data on the time, PSD, E, and lifetime mortality risk for pediatric therapeutic interventional cardiology. Radio frequency ablation showed the highest radiation risk.
Worry Among Mexican American Caregivers of Community-Dwelling Elders
Authors: Evans Bronwynne C. , Coon David W. , Belyea Michael J.
Published: July 2014

This mixed methods, multi-site, National Institute of Nursing Research (NINR)-funded, interdisciplinary, descriptive study aimed to identify expressions of worry in qualitative data obtained from caregiving Mexican American (MA) families assisting older adults. The purpose of this portion of the inquiry was to determine how worry is expressed, what happens to caregivers when they worry, and what adaptive strategies they used. We examined semi-structured interviews completed during six in-home visits with 116 caregivers. We identified 366 worry quotations from 639 primary documents in ATLAS.ti, entered them into matrices, and organized findings under thematic statements. Caregivers expressed cultural and contextual worries, worried about transitions and turning points in care, and identified adaptive strategies. Despite these strategies, worry persisted. Constant worry may be an allied, important aspect of caregiver burden. We need additional longitudinal research to better understand the experience of MA caregivers for older adults and to provide empirically supported interventions, programs, and services that reduce worry.
Perceived Message Influence and Hispanic Women
Authors: Sun Ye , Jensen Jakob D. , Guntzviller Lisa M. , Liu Miao
Published: July 2014

The third-person effect (TPE) hypothesis states that people typically perceive the media messages to have greater influence on others than on themselves. Though this self-other perceptual bias has been shown to be robust across a variety of message contexts, past research has typically utilized Caucasian college student samples. The current study addresses this shortcoming in the literature by examining whether the TPE hypothesis holds for low-income, low-education, Spanish-speaking female adults with regard to the perceived effects of health news coverage. Our findings showed that most participants chose “equal to others” when estimating health news effects on themselves instead of “less than others” or “more than others.” Results from ordinal logistic regression showed that the propensity toward TPE was related to optimistic bias and certain indicators of acculturation. Our findings suggest the need for future TPE research in Hispanic populations and further efforts to investigate TPE from an intercultural perspective.
Great Apes Generate Goal-Based Action Predictions
Authors: Kano Fumihiro , Call Josep
Published: July 2014

To examine great apes’ on-line prediction of other individuals’ actions, we used an eye-tracking technique and an experimental paradigm previously used to test human infants. Twenty-two great apes, including bonobos, chimpanzees, and orangutans, were familiarized to movie clips of a human hand reaching to grasp one of two objects. Then the objects’ locations were swapped, and in the test event, the hand made an incomplete reach between the objects. In a control condition, a mechanical claw performed the same actions. The apes predictively looked at the familiarized goal object rather than the familiarized location when viewing the hand action in the test event. However, they made no prediction when viewing the claw action. These results are similar to those reported previously for human infants, and predictive looking did not differ among the three species of great apes. Thus, great apes make on-line goal-based predictions about the actions of other individuals; this skill is not unique to humans but is shared more widely among primates.
Infants Track the Reliability of Potential Informants
Authors: Tummeltshammer Kristen Swan , Wu Rachel , Sobel David M. , Kirkham Natasha Z.
Published: July 2014

Across two eye-tracking experiments, we showed that infants are sensitive to the statistical reliability of informative cues and selective in their use of information generated by such cues. We familiarized 8-month-olds with faces (Experiment 1) or arrows (Experiment 2) that cued the locations of animated animals with different degrees of reliability. The reliable cue always cued a box containing an animation, whereas the unreliable cue cued a box that contained an animation only 25% of the time. At test, infants searched longer in the boxes that were reliably cued, but did not search longer in the boxes that were unreliably cued. At generalization, when boxes were cued that never contained animations before, only infants in the face experiment followed the reliable cue. These results provide the first evidence that even young infants can track the reliability of potential informants and use this information judiciously to modify their future behavior.
The Pharmacologic Treatment of Intensive Care Unit Delirium
Authors: Bathula Matt , Gonzales Jeffrey P.
Published: July 2014

Objective: To systematically evaluate the treatment of ICU delirium. Data Sources: Literature searches were conducted using PubMed and Ovid MEDLINE (January 1980 to March 2013). Clinical trials/reports evaluating the use of pharmacologic treatment for ICU delirium were selected. References from major guidelines and publications were reviewed. Study Selection and Data Extraction: English-language articles related to the treatment of ICU delirium were included. The following were excluded: (1) used pharmacologic treatment for the prevention of delirium; (2) inclusion of non–critically ill, palliative care, or hospice care patients; (3) letters to the editor; (4) case studies; (5) case series; (6) studies without delirium-related end points; and (7) studies with a predominantly postoperative population. Data extracted included: study design, population, treatment, number of participants, end points, outcomes/authors’ conclusions, and adverse effects. Data Synthesis: Four studies were included in this review. The US Preventative Services Task Force classification scheme was used to assess the quality of evidence. All 4 studies reviewed were level I evidence studies. There are few well-designed, randomized studies that evaluate ICU delirium treatment. The 2 main randomized studies have small sample sizes and methodological concerns. Antipsychotic therapy may reduce the duration of ICU delirium. However, more robust studies are needed to demonstrate benefit. Conclusions: There is a lack of evidence supporting pharmacologic treatment for ICU delirium. Prospective, well-designed studies using proper delirium identification tools and severity are necessary to confirm the overall impact of pharmacologic therapy on the duration of delirium and associated complications.
Teriflunomide for the Treatment of Relapsing Multiple Sclerosis
Authors: Brunetti Luigi , Wagner Mary L. , Maroney Megan , Ryan Melody
Published: July 2014

Objective: To review the pharmacology and clinical data for teriflunomide in relapsing multiple sclerosis (MS). Data Sources: A literature search from 1966 to May 2013 using PubMed/MEDLINE, Web of Science, International Pharmaceutical Abstracts, Academic Search Premiere, Science Citation Index, and the national clinical trials registry was performed using the terms teriflunomide, HMR1726, and A771726. All articles containing human clinical trial data and relevant pharmacologic information were reviewed. Study Selection/Data Extraction: Phase 2 and phase 3 clinical trials for teriflunomide were evaluated. All peer-reviewed articles with clinically relevant information were reviewed. Priority for inclusion was placed on randomized controlled trials. Data Synthesis: Three phase 2 and three phase 3 clinical trials have evaluated teriflunomide as monotherapy or as adjunctive therapy in approximately 3000 patients with relapsing forms of MS. The phase 3 studies used annualized relapse rate, magnetic resonance imaging changes, and Expanded Disability Status Scale scores as outcome measures. One additional Phase 3 clinical study is ongoing. The annualized relapse rates and magnetic resonance imaging findings were improved compared to those with placebo and similar to or improved compared with those with subcutaneously administered interferon-β-1a 44 µg thrice weekly. Durability of response is supported by open-label extension studies. Common adverse events include increased liver function enzymes, alopecia, diarrhea, influenza, nausea, and paresthesias. Treatment discontinuation was not common and occurred in approximately 10% of patients in phase 3 studies. Conclusions: Teriflunomide is an effective and safe oral treatment option for relapsing MS. It can be used as monotherapy or added to an interferon or glatiramer acetate. It reduces the rate of relapse and may slow disease progression. The advantages of this drug are the convenience of oral administration and good tolerability. The disadvantage is the lack of long-term safety data and data about the benefit of combination therapy.
Effect of Inhaled Corticosteroids on Long-Term Growth in Pediatric Patients with Asthma and Allergic Rhinitis
Authors: Hoover Rebecca M. , Erramouspe John , Bell Edward A. , Cleveland Kevin W.
Published: July 2014

Objective: To evaluate the effect of orally and nasally inhaled corticosteroids (ICS) on final adult height in pediatric patients with mild to moderate persistent asthma and allergic rhinitis. Data Sources: MEDLINE (1975–April 2013), Cochrane Library (through 2012), and International Pharmaceutical Abstracts (1975–April 2013) were searched for prospective clinical trials assessing the effects of orally or intranasally ICS use on growth in pediatric patients with asthma or allergic rhinitis using the terms inhaled/intranasal corticosteroid, linear growth, height, and asthma or allergic rhinitis. Study Selection and Data Extraction: Eligible articles included double-blind, randomized, placebo-controlled studies of at least 1 year with growth velocity or height as the primary outcome. Data Synthesis: Seven trials and 1 follow-up study analyzing the effects of orally ICSs were examined. Of these studies, 4 found a delay in growth in at least 1 subset of its participants of approximately 1 cm, 1 study found a decrease in final adult height of 1.2 cm, and 3 studies found no effect. Of the 4 studies examining nasally ICS, 1 found evidence of growth delay in a subgroup using supratherapeutic dosing. There are conflicting data on whether ICS use causes long-term growth reduction in pediatric patients. The concern surrounding their long-term use including a potential delay or decrease in growth may result in underuse and potential mismanagement of persistent asthma and/or allergic rhinitis. Patients should be treated with the lowest effective corticosteroid dose to achieve symptomatic control while minimizing excessive systemic effects. Orally ICS use may cause a delay in growth, but a decrease in final adult height (1.2 cm) has been documented in only one study. This single report should not preclude daily use of inhaled corticosteroids if needed to decrease the morbidity and mortality associated with pediatric reactive airway disease. Conclusions: Continued studies on the systemic effects of ICS are required before truly understanding the class’s effect on growth in pediatric patients with asthma and allergic rhinitis. What is understood, however, is the detriment and potential danger of mismanaged asthma care.
Risperidone-Induced Pisa Syndrome in MS
Authors: Iuppa Courtney A. , Diefenderfer Lauren A.
Published: July 2014

Objective: To report a case of risperidone-induced Pisa syndrome in a patient with multiple sclerosis (MS) that resolved with lurasidone, recurred with chlorpromazine, and was complicated by possible drug-drug interactions. Case Summary: A 31-year-old white male with MS developed Pisa syndrome after years of treatment with risperidone at varying doses for behavioral symptoms associated with pervasive developmental disorder. The patient experienced improvement in symptoms after treatment was switched to lurasidone; however, due to psychiatric decompensation, a switch to chlorpromazine was made and Pisa syndrome recurred. To maintain control of the patient’s behavioral symptoms, chlorpromazine was not discontinued. Discussion: Pisa syndrome is a rare adverse drug reaction induced most often by neuroleptic medications. The reaction is characterized by dystonia affecting cervical and lumbar musculature, resulting in flexion of the head and body to one side with axial rotation of the trunk. The etiology is believed to involve a dopaminergic-cholinergic imbalance. Most practitioners are not familiar with this syndrome, and it has not been reported previously in a patient with MS. Definitive diagnostic criteria and treatment have not been established. We identified 15 case reports involving risperidone, paliperidone, chlorpromazine, clomipramine, or valproic acid. The time to development of Pisa syndrome, patient demographics, dosing and titration of causative medications, approach to treatment, and resolution of Pisa syndrome varied widely in these reports. Dystonia in MS often presents differently than Pisa syndrome. The Naranjo probability scale indicated a probable relationship between either risperidone or chlorpromazine in each instance of Pisa syndrome in our patient. Conclusions: Pisa syndrome is a rare adverse drug reaction associated with neuroleptic medications. Our report highlights the importance of identifying this uncommon type of dystonia in order to consider modification of the medication regimen when appropriate.
Canagliflozin, a Novel SGLT2 Inhibitor for Treatment of Type 2 Diabetes
Authors: Nigro Stefanie C. , Riche Daniel M. , Pheng Michelle , Baker William L.
Published: July 2014

Objective: To evaluate the available clinical data on canagliflozin and provide formulary considerations as to its place in the current treatment approach of type 2 diabetes mellitus (T2DM). Data Sources: A systematic review of the literature in MEDLINE and Web of Science was performed through July 2013 using the key words and medical subject headings canagliflozin, JNJ-28431754, TA-7284, and sodium-glucose co-transporter 2 inhibitor. A manual search of references from reports of clinical trials or review articles was performed to identify additional relevant studies. Study Selection and Data Extraction: Citations eligible for inclusion were in vitro or in vivo evaluations of canagliflozin with no restrictions on patient population or indication used. Data related to the patient populations and outcomes of interest were extracted from each citation. Data Synthesis: Five clinical trials (n = 2775 subjects) have been published evaluating canagliflozin in patients with T2DM. A single study evaluated canagliflozin monotherapy, while the others included various add-on therapies. Four studies included placebo groups with 2 others using sitagliptin as an active control. Compared with placebo (+0.14%), canagliflozin monotherapy at doses of 100 to 300 mg/d decreases hemoglobin A1c by −0.77% to −1.03% from baseline. Reductions in fasting plasma glucose, body weight, and systolic blood pressure were seen. Because of the increase in glucosuria with the drug, patients (especially females) are at increased risk of genital mycotic infections. The overall safety of canagliflozin (eg, cardiovascular, oncologic, pancreatic, bone) is also yet to be fully elucidated. Conclusions: Canagliflozin is comparable to second-line oral medications in terms of effectiveness but has limitations in affordability and long-term safety data.