bluuebunny/crossref_metadata_2025 huggingface dataset:
Uterine fibroid embolization: can fertility be preserved?
Authors: Mailli Leto , Parthipun Aneeta , Ahmed Irfan
Published: November 2015

Uterine fibroid embolization (UFE) is a well-established, safe, and effective treatment for symptomatic fibroids. It has been proved to provide a significant improvement in quality of life, equivalent to that obtained with myomectomy but with a shorter hospital stay and fewer major complications. However, the effects of UFE on preserving fertility remain unclear. At present, myomectomy is considered the only surgical option for women in whom future fertility is desired [1]. Clinicians are facing an increasing predicament as more and more women are considering UFE as a minimally invasive form of treatment [2]. The current case highlights a relatively common but challenging dilemma of a scenario involving a woman with symptomatic fibroids concerned about her fertility and requesting non-surgical treatment.
Postpartum haemorrhage: what is the role of occlusion balloons?
Authors: Das Raj , Belli Anna Maria
Published: November 2015

Post-partum haemorrhage remains a significant cause of maternal morbidity and mortality in childbirth, and interventional radiology now has a crucial role in improving patient outcomes and survival. The prevalence of abnormal placentation is increasing, and with improved ultrasound and MRI detection an increasing number of cases at high risk of post-partum haemorrhage from placenta accreta and percreta are being identified that can benefit from the ’electiveʼ use of prophylactic internal iliac artery occlusion balloons. Prophylactic occlusion balloons in high-risk pregnancies can reduce haemorrhage and promote uterine-conserving surgical techniques. We discuss the technique of occlusion balloon placement, indications, potential complications, and evidence base.
Prostate artery embolization for benign prostate hypertrophy
Authors: Shaw Aidan , Ahmed Irfan , Sabharwal Tarun
Published: November 2015

Prostate artery embolization (PAE) has been performed for intractable haematuria for many years and has most recently come to the forefront as a novel treatment for benign prostate hypertrophy (BPH). PAE has many advantages over surgical treatment options. The current literature for PAE has shown the procedure to be a safe, effective, and minimally invasive treatment option for BPH. We describe a case of PAE and discuss tips and tricks, including pre-operative imaging techniques as well as techniques for optimal visualization of the arteries for successful cannulation.
Tracheobronchial stenting: covered versus uncovered
Authors: Inchingolo Riccardo , Sabharwal Tarun
Published: November 2015

A 67-year old patient with non-operable lung cancer underwent tracheobronchial stenting because of progressive dyspnoea (FEV1 at presentation was 1.03L, which was 44% of the expected value). Pre-procedural CT showed the presence of a central mass involving the left main bronchus and carina and enlarged lymph nodes. CT also confirmed the presence of multiple bone metastases. A kissing stent procedure was performed using covered stents for the left bronchus and uncovered for the right, with significant improvement of the patient’s symptoms. The follow-up CT scan after six months showed tumour in-growth causing severe stenosis of the right stent. Although there was no significant dyspnoea, a new covered stent was placed proximally on the right side to prevent a further occlusion
Early-stage hepatocellular carcinoma: the percutaneous approach
Authors: Hedayati Venus , Peddu Praveen
Published: November 2015

Hepatocellular carcinoma (HCC) is the fifth most common cancer. The majority of hepatocellular cancers occur in patients with established liver cirrhosis. The most common causes of cirrhosis are alcohol and hepatotrophic viruses. Diagnosis of HCC is made on imaging based on enhancement characteristics. The typical enhancement features, such as arterial hyper-enhancement and washout, are seen in moderately differentiated HCCs. Well differentiated and poorly differentiated tumours can have atypical enhancement and be difficult to diagnose on axial imaging. Early stage HCC constitutes a single lesion or up to three lesions <3cm in diameter without extrahepatic disease. Treatment of early-stage HCC depends on the severity of the background liver disease and the performance status of the patient. Surgical resection and liver transplantation offer the best chance of long-term survival. Percutaneous treatments, such as transarterial chemoembolization (TACE), percutaneous ablation (RFA/microwave), and ethanol injection (PEI) are offered to control disease in those patients on the surgical waiting list or as palliative treatment in those who are unfit for surgery.
Small renal tumours: is radiofrequency ablation better than surgery?
Authors: Krokidis Miltiadis , Adam Andy
Published: November 2015

The main tools in the management of small renal tumours are partial nephrectomy (PN) and percutaneous radiofrequency ablation (RFA). We describe a case where RFA was used for the treatment of a small renal mass with satisfactory long-term results. The case includes an overview of the technique used for RFA, and the current evidence regarding the results of RFA treatment of small renal tumours and the comparison with surgery.
Vertebral augmentation techniques and pain management: is there a role in metastatic disease?
Authors: Orgera Gianluigi , Krokidis Miltiadis , Rossi Michele
Published: November 2015

The management of metastatic spinal disease aims at pain control, maintenance or restoration of neurological function, and stability. Standard treatments are radiation therapy, chemotherapy, and surgery. Technological advances combined with interventional radiology techniques can now offer alternative treatment options which are less invasive for many patients with malignant vertebral body infiltration.Vertebral augmentation (VA) techniques deliver biocompatible cement into the fractured vertebral body via percutaneous needles aiming for an increase in stability. Adjunctive thermal ablation techniques can be used aiming for destruction of sensory nerve fibres and reduction of the size of the lesion. We report a case of an L2 metastasis from a thyroid carcinoma that was successfully treated with a combination of percutaneous vertebroplasty and radiofrequency ablation, and discuss the options of percutaneous vertebral augmentation techniques.
Technical Aspects of Videotaping
Authors: Barton Brandon R. , Hall Deborah A.
Published: November 2015

The videographer should research which camera will fulfill the desired quality at an acceptable cost. The use of a stable tripod is recommended to reduce jitter, which is inevitable in handheld recording devices. A small detachable microphone is essential in recording movement disorder patients because this can greatly enhance the speech comprehension and reduce background noise without interfering with the patient’s movements. High-definition (HD) video is now available on most cameras and provides reasonably manageable file sizes of acceptable quality, which are easily edited. Videos can be saved or converted into many formats or edited by one of many editing programs. Editing is now relatively simple and can be learned using online tutoring videos or associated instructions for each program. Given the confidential nature of patient videos and their inherent value in education, patient care, and research, security and reliability of file storage is of extreme importance.
Environment for Taping
Authors: Barton Brandon R. , Hall Deborah A.
Published: November 2015

Environmental conditions are crucial to producing a good video. A designated area for videotaping is necessary to consistently produce consistently high-quality standardized videos. For those who evaluate movement disorder patients frequently, a special video room dedicated to filming patients is ideal, with controlled conditions for quality background and lighting. An identified hallway or space where patients can walk a longer distance is also needed. Key video room equipment and technical equipment kept in the video room will assure all resources are needed for adequate videotaping, including props, furniture, and writing tools. We provide tips that will prevent some of the common mistakes observed on poor-quality videotapes.
Consent Issues for Videotaping
Authors: Barton Brandon R. , Hall Deborah A.
Published: November 2015

Ideally, all patients with movement disorders would sign a consent for videotaping, even if the taping is for clinical care only. It is necessary to explain the rationale for the video recording to the patient, and to obtain a written consent form from the patient or their legal representative. It is important to collect identifying information to link to the video record, for accurate storage and retrieval purposes. Guidelines detailed earlier pertaining to HIPAA should be followed in using videotapes for research use. However, additional regulations and consents need to be addressed when videotapes are specifically used for research, education or publication.
Editing for Publication
Authors: Barton Brandon R. , Hall Deborah A.
Published: November 2015

Some publications, including medical journals, will accept videos with manuscript or document submission. For most journals, the video is a supplement to the article and only accessible online, although some journals (such as the Movement Disorders Journal) send periodic DVDs to journal subscribers or maintain an online searchable database of videos. In contrast to the more comprehensive protocols, videos submitted for publication need to be short and to the point in order to meet the requirements of limited data space and precision. However, if one has followed the comprehensive protocols, finding a few portions of the examination that best represent the patient and their movement disorders should be easy.
Tremor
Authors: Barton Brandon R. , Hall Deborah A.
Published: November 2015

Tremor is the most common movement disorder. It is a rhythmic oscillation that can occur at rest or with action. It can be seen in isolation or in the setting of other movement disorders. The tremor video protocol focuses on features of the most common presentation of tremor (essential tremor). Tasks in the protocol illustrate postural sustention and various actions (spiral drawing and water pouring). Taping of more unusual tremors is addressed, such as orthostatic and palatal tremor. Although rest tremor is included in this protocol, since rest tremor is nearly always associated with parkinsonism, parkinsonism patients are best best filmed with other protocols.
Chorea
Authors: Barton Brandon R. , Hall Deborah A.
Published: November 2015

Chorea is defined as involuntary, irregular, arrhythmic, nonpatterned, purposeless movements that flow randomly from one body part to the other. Patients with chorea commonly demonstrate other features including motor impersistence (inability to sustain voluntary muscle contraction), exaggerated gestures, which are caused by superimposition of chorea onto voluntary movements, and an irregular, dancelike gait. Due to the unpredictable nature of chorea, videotaping should show different areas of the body under various conditions. Abnormalities seen in Huntington disease, such as eye movements and tests of executive function are also included in the chorea protocol.
Myoclonus
Authors: Barton Brandon R. , Hall Deborah A.
Published: November 2015

Myoclonus is defined as a sudden, brief, “shocklike,” involuntary movement. It has a broad differential diagnosis. It can be further divided into positive myoclonus, which is active contraction of the muscle, and negative myoclonus or asterixis, defined as sudden loss of tone in the muscle. It must be distinguished from other hyperkinetic movements such as tics, chorea, tremor, and dystonia, which can all also have fast, jerky movements. The goal of videotaping is to capture the myoclonus in all the possible positions of occurrence and localize them to particular body regions. This is done by first observing at rest, then providing multiple types of stimulus including startle, touch, reflex elicitation, and finally provocation of myoclonus by voluntary activation of each body region.
Development of a Damage Function Model for Pratylenchus penetrans on Corn
Authors: MacGuidwin Ann E. , Bender Breann E.
Published: November 2015

The lesion nematode Pratylenchus penetrans is a common pest of corn in the north-central United States. There are relatively few studies documenting the impact of Pratylenchus spp. on grain yield even though they are recognized as pests of corn and the target of commercial seed treatments. We adapted a component error modeling approach to develop a damage function for P. penetrans that included the influence of year and site in the yield loss relationship. Field data from six site-years was used to derive panel data consisting of all pairwise comparisons of the difference in nematode population densities and the associated proportional yield difference. Fourteen regression models of the relationship between proportional yield loss and the difference in nematode density were developed from soil and root assays at different corn growth stages. Seven models were significant: four models based on nematode population densities in soil (initial and final samples) and three based on nematode densities in seminal roots (corn growth stages V1 to V2 and V6) and adventitious roots (corn growth stage R1 to R2). The model we consider to be the most important, that based on the initial soil assay, estimated the yield loss caused by each nematode to be 0.0142%. The grand mean of the 118 plots we sampled implied a yield loss of 3.79%. The random effects of year and field did not contribute significantly to any of the models but were close to significance for some, suggesting a benefit from larger data sets. Experimental error was the largest component of the variance for all of the models; therefore, the damage function is more useful for demonstrating impact of P. penetrans rather than for accurately predicting yield loss at the field level. All of the fields in our study were an irrigated loamy sand soil, with grain yields above the county average; therefore, it is possible that our damage function is conservative. The value of soil sampling has been questioned for P. penetrans and this study shows it to be equal to if not better than root assays for predicting yield.
Infection of Maize by Clavibacter michiganensis subsp. nebraskensis Does Not Require Severe Wounding
Authors: Mallowa Sally O. , Mbofung Gladys Y. , Eggenberger Sharon K. , Den Adel Randall L. , Scheiding Sheila R. , Robertson Alison E.
Published: November 2015

Goss’s bacterial wilt and leaf blight of maize is caused by Clavibacter michiganensis subsp. nebraskensis. Infested residue is the primary source of inoculum and infection occurs via wounds caused by sand blasting, hail, or wind damage. The pathogen survives as an epiphyte on maize leaves and, because the disease has been observed on plants in the field with no obvious wounding, we wondered whether infection by epiphytic C. michiganensis subsp. nebraskensis and disease development could occur in the absence of severe wounding. Consequently, greenhouse experiments were done to evaluate disease development in the absence of wounding in ambient and increased humidity conditions. Maize plants at the V4 to V5 crop development stage were spray inoculated with a suspension of C. michiganensis subsp. nebraskensis (108 cells ml−1). Leaf blight incidence was assessed on whole plants and individual leaves; epiphytic populations of C. michiganensis subsp. nebraskensis were monitored by dilution plating of leaf washes; and epiphytic C. michiganensis subsp. nebraskensis colonization was visualized using scanning electron microscopy (SEM). Goss’s leaf blight symptoms were observed on nonwounded plants in ambient (37.0% plant incidence) and increased humidity conditions (60.0% plant incidence). Populations of epiphytic C. michiganensis subsp. nebraskensis survived and increased on maize leaves, particularly at increased humidity. We observed C. michiganensis subsp. nebraskensis colonizing maize leaves in localized sites that included epidermal junctions, cuticle depressions, in and around stomata, and at the base of trichomes. Single cells and aggregates of C. michiganensis subsp. nebraskensis were observed within substomatal chambers using SEM. These data indicate that severe wounding is not necessary for C. michiganensis subsp. nebraskensis infection of maize, and stomata or trichomes may serve as entry points for the bacterium.
Natural Infection of Soybean with Soybean vein necrosis-associated virus Grown under Greenhouse Conditions: An Accidental Observation
Authors: Hajimorad M. R. , Halter M. C. , Mengistu A.
Published: November 2015

These data demonstrate occurrence of natural infection of SVNaV in soybean under greenhouse conditions during winter in the absence of field-grown soybeans or any infected host plant within the greenhouse. The observations point to the likelihood that overwintering viruliferous adult thrips may have the potential to serve as a local source of SVNaV; however, the epidemiological significance needs to be determined.

Accepted for publication 5 October 2015. Published 14 October 2015.
Isolation and Characterization of Plant-PathogenicStreptomycesSpecies Associated with Common Scab-Infected Potato Tubers in Newfoundland
Authors: Fyans Joanna K. , Bown Luke , Bignell Dawn R. D.
Published: November 2015

Potato common scab (CS) is an economically important crop disease that is caused by several members of the genus Streptomyces. In this study, we characterized the plant-pathogenic Streptomyces spp. associated with CS-infected potato tubers harvested in Newfoundland, Canada. A total of 17 pathogenic Streptomyces isolates were recovered from potato scab lesions, of which eight were determined to be most similar to the known CS pathogen S. europaeiscabiei. All eight S. europaeiscabiei isolates were found to produce the thaxtomin A phytotoxin and to harbor the nec1 virulence gene, and most also carry the putative virulence gene tomA. The remaining isolates appear to be novel pathogenic species that do not produce thaxtomin A, and only two of these isolates were determined to harbor the nec1 or tomA genes. Of the non-thaxtomin-producing isolates, strain 11-1-2 was shown to exhibit a severe pathogenic phenotype against different plant hosts and to produce a novel, secreted phytotoxic substance. This is the first report documenting the plant-pathogenic Streptomyces spp. associated with CS disease in Newfoundland. Furthermore, our findings provide further evidence that phytotoxins other than thaxtomin A may also contribute to the development of CS by Streptomyces spp.
Quantification of Lysosomal Membrane Permeabilization by Cytosolic Cathepsin and β-N-Acetyl-Glucosaminidase Activity Measurements
Authors: Jäättelä Marja , Nylandsted Jesper
Published: November 2015

Programmed cell death involving lysosomal membrane permeabilization (LMP) is an alternative cell death pathway induced under various cellular conditions and by numerous cytotoxic stimuli. The method presented here to quantify LMP takes advantage of the detergent digitonin, which creates pores in cellular membranes by replacing cholesterol. The difference in cholesterol content between the plasma membrane (high) and lysosomal membrane (low) allows titration of digitonin to a concentration that permeabilizes the plasma membrane but leaves lysosomal membranes intact. The extent of LMP is determined by measuring the cytosolic activity of lysosomal hydrolases (e.g., cysteine cathepsins) and/or β-N-acetyl-glucosaminidase in the digitonin-extracted cytoplasm and comparing it to the total cellular enzyme activity. Digitonin extraction of the cytosol can be combined with precipitation of protein and/or western blot analysis for detection of lysosomal proteins (e.g., cathepsins).
Assembling the μs-ALEX Setup
Authors: Kapanidis Achillefs , Majumdar Devdoot , Heilemann Mike , Nir Eyal , Weiss Shimon
Published: November 2015

This protocol describes the construction of a microsecond-alternating laser excitation (μs-ALEX) using two lasers, a green 532-nm acousto-optically modulated laser and a red 635-nm directly modulated laser.
Aligning the μs-ALEX Setup
Authors: Kapanidis Achillefs , Majumdar Devdoot , Heilemann Mike , Nir Eyal , Weiss Shimon
Published: November 2015

To achieve single-molecule sensitivity and thus have the ability to detect single diffusing fluorophores, careful alignment of the microsecond-alternating laser excitation (μs-Alex) setup is crucial. The following protocol describes routine alignment for 2c-ALEX (532 nm/635 nm) with spectral windows G550–620R650–750.
RNA Sequencing and Analysis
Authors: Kukurba Kimberly R. , Montgomery Stephen B.
Published: November 2015

RNA sequencing (RNA-Seq) uses the capabilities of high-throughput sequencing methods to provide insight into the transcriptome of a cell. Compared to previous Sanger sequencing- and microarray-based methods, RNA-Seq provides far higher coverage and greater resolution of the dynamic nature of the transcriptome. Beyond quantifying gene expression, the data generated by RNA-Seq facilitate the discovery of novel transcripts, identification of alternatively spliced genes, and detection of allele-specific expression. Recent advances in the RNA-Seq workflow, from sample preparation to library construction to data analysis, have enabled researchers to further elucidate the functional complexity of the transcription. In addition to polyadenylated messenger RNA (mRNA) transcripts, RNA-Seq can be applied to investigate different populations of RNA, including total RNA, pre-mRNA, and noncoding RNA, such as microRNA and long ncRNA. This article provides an introduction to RNA-Seq methods, including applications, experimental design, and technical challenges.
Alternating Laser Excitation for Solution-Based Single-Molecule FRET
Authors: Kapanidis Achillefs , Majumdar Devdoot , Heilemann Mike , Nir Eyal , Weiss Shimon
Published: November 2015

Single-molecule fluorescence resonance energy transfer (smFRET) has been widely applied to the study of fluorescently labeled biomolecules on surfaces and in solution. Sorting single molecules based on fluorescent dye stoichiometry provides one with further layers of information and also enables “filtering” of unwanted molecules from the analysis. We accomplish this sorting by using alternating laser excitation (ALEX) in combination with smFRET measurements; here we describe the implementation of these methodologies for the study of biomolecules in solution.
Corporate dividend policy in practice: the views of Nigerian financial managers
Authors: Ozo Friday Kennedy , Arun Thankom Gopinath , Kostov Philip , Uzonwanne Godfrey Chidozie
Published: November 2015

Purpose

– The purpose of this paper is to provide an additional insight into the dividend puzzle by investigating the field practice of dividend policy in an emerging market such as Nigeria. It also aims to contribute to the literature on industry-related dividend effect by examining whether managerial views on dividend policy vary between financial and non-financial firms.

Design/methodology/approach

– The study employs semi-structured interviews with the financial managers of 21 Nigerian listed firms. The interviewees were divided into two broad groups of financial vs non-financial firms based on the industry classification of the firms.

Findings

– The findings suggest that, despite differences in institutional environment, the dividend-setting process in Nigerian companies is similar in many extents to those in the USA and other developed markets. Nigerian companies exhibit dividend conservatism and typically focus on current earnings, stability of earnings and availability of cash when determining their current dividend levels. However, unlike in prior studies, the interviewees suggest that their companies do not have a target payout ratio; instead, they target the dividend per share when determining the disbursement level. Nevertheless, views regarding these issues vary significantly between financial and non-financial firms.

Originality/value

– This paper adds to the extant literature that has examined the behavioural aspects of dividend policy using interviews, especially in the context of less-developed markets such as Nigeria. The study also updates and extends prior evidence on an industry-related effect on managerial perceptions of dividend policy.
Corporate social responsibility, stock salience, and the asymmetric market impact of consumer sentiment news on Spanish firms
Authors: Oliver Barry , Pérez-Gladish Blanca , Méndez-Rodríguez Paz
Published: November 2015

Purpose

– The purpose of this paper is to identify whether the Spanish stock market experiences a negativity effect on the announcement of Spanish consumer sentiment information and if firms that are signatory to the UN Global Compact on corporate social responsibility are relatively more salient in the minds of investors.

Design/methodology/approach

– The authors use consumer sentiment announcements to show how the negativity effects on the Spanish stock market are significantly influenced by how salient the stock is in the minds of investors. If a firm’s stock exhibits negativity effects on the release of consumer sentiment information then this stock is salient to investors. If firms who are signatory to the UN Global Compact exhibit significant negativity effects, it could be concluded that these stocks are salient, particularly if firms that are not signatory to the Global Compact do not exhibit a similar negativity effect.

Findings

– The IBEX35 index experiences significant negativity effects upon the release of Spanish consumer sentiment announcements. This is similar to that reported in other countries, notably Australia and the USA. Using the constituent firms in the IBEX35 index, the authors find that those firms that are signatory to the UN Global Compact are significantly more likely to experience negativity effects upon the release of Spanish consumer sentiment information than if they are not signatory to the Global Compact. This indicates that firms that are part of the UN Global Compact are more salient to investors.

Research limitations/implications

– Available published Spanish data on consumer sentiment.

Practical implications

– Little is understood of the impact that consumer sentiment announcements have on stock prices. Studies in USA and Australia have identified significant negativity effects in stock markets when consumer sentiment information is released. This research has found that a psychological negativity bias occurs in firms that are salient to investors. Salience has been found to be important in asset pricing.

Originality/value

– This paper tries to find out which companies are more likely to sign the UN Global Compact. These companies are more sensitive to consumer sentiment, because they depend on the everyday decisions of the consumers. The more the companies depend on consumers, the more they care about them. And, when the consumer sentiment goes down, they are more affected by this sentiment. These firms are also more worried about the long term. They are not only thinking about the profits in the short term but also about maintaining the generation of profits in the long term.
Taking Silk: An Empirical Study of the Award of Queen's Counsel Status 1981–2015
Authors: Blackwell Michael
Published: November 2015

This article considers which junior barristers are appointed to the rank of Queen's Counsel. The criticisms of the old appointments system are discussed and statistical methods are used to assess whether the changes to the QC appointments system introduced in 2004 improved the prospects of appointment for groups, such as women, that were disadvantaged by the previous system. The results show that under the reformed system groups that were historically less likely to be appointed QCs, such as women, continue to be so. However it is discussed how this may (partly) be attributable to lower rates of application, rather than unfair discrimination among applicants.
Shaken not stirred: A molecular contribution to the systematics of genus Mugil (Teleostei, Mugilidae)
Authors: HERAS Sandra , MALTAGLIATI Ferruccio , FERNÁNDEZ Maria Victoria , ROLDÁN María Inés
Published: November 2015

With this work we addressed some molecular systematic issues within the Mugil cephalus species complex. Particular attention was paid to the debated situations of: (i) Mugil liza, occurring in partial sympatry with Mugil cephalus in the northwestern Atlantic, and (ii) Mugil platanus, considered by some authors a synonymy of the former species and distributed in the southwestern Atlantic. We sequenced 79 individuals of a 465‐bp portion of the mitochondrial control region (CR) from 8 western Atlantic and 2 Mediterranean localities. In addition, all CR sequences available from GenBank for the studied taxa were added to our dataset, for a total of 323 individuals. Overall, 229 haplotypes corresponding to 8 divergent monophyletic lineages were detected. Results of phylogenetic analyses were consistent with the occurrence of past speciation events producing the observed lineages. Of these lineages, 7 correspond to cryptic species and one is constituted by M. liza and M. platanus. As a matter of fact, these 2 taxa constitute a single lineage within the M. cephalus species complex. However, individuals of M. liza/M. platanus lineage analyzed by means of the 18 mitochondrial markers available in GenBank exhibited a degree of genetic diversity consistent with highly divergent populations. Of the 8 lineages detected, the Mediterraean one (type locality) corresponds to M. cephalus; the lineage M. liza/M. platanus should be named M. liza, under the priority principle, and the left 6 lineages need formal description.
Decreased tryptophan and increased kynurenine levels in mastocytosis associated with digestive symptoms
Authors: Georgin‐Lavialle S. , Launay J.‐M. , Côté F. , Soucié E. , Soria A. , Damaj G. , Moura D. S. , Canioni D. , Hanssens K. , Chandesris M.‐O. , Barète S. , Dubreuil P. , Lortholary O. , Hermine O. , Sokol H.
Published: November 2015

The main metabolism pathway of tryptophan is protein formation, but it can also be metabolized into serotonin and kynurenine. Indoleamine 2,3‐dioxygenase (IDO) is the enzyme that catalyzes the degradation of tryptophan into kynurenine. Mastocytosis is a heterogeneous disease characterized by mast cell accumulation in various tissues with 57% of patients having gastrointestinal involvement. We studied tryptophan metabolism in mastocytosis patients displaying or not gastrointestinal features and healthy subjects (n = 26 in each group). Mastocytosis patients with digestive symptoms displayed significantly increased kynurenine level and IDO activity as compared to healthy controls and mastocytosis patients without digestive symptoms. This could be linked to mast cell‐mediated digestive inflammation among patients with mastocytosis. This work is the first focusing on kynurenine pathway in a mast cell disease and could help to understand the pathogenesis of digestive features in mastocytosis as well as in other mast cell‐mediated diseases.
Assessment of Microvolt T Wave Alternans in Children with Repaired Tetralogy of Fallot during 24‐Hour Holter Electrocardiography
Authors: Doksöz Önder , Meşe Timur , Karaarslan Utku , Ceylan Gökhan , Demirpençe Savaş , Tavlı Vedide , Ünal Nurettin
Published: November 2015

Background

We aimed to examine microvolt T wave alternans (MTWA) in 24‐hour Holter electrocardiography (ECG) of children with repaired tetralogy of Fallot (TOF) to assess associations of MTWA with ventricular arrhythmias, ECG parameters, and echocardiographic findings.

Methods

Holter ECG records and archive files of 56 repaired TOF patients (62.5% male) who were analyzed retrospectively. Subjects’ ECG parameters and MTWA values were compared with age–sex‐matched control group. T wave changes were analyzed by time‐domain‐modified moving average method from the three channels of 24‐hour Holter ECG.

Results

Mean age was 123.4 ± 48.3 months. Median MTWA value was 55.5 μV in the control group, whereas 95.5 μV in patients group (P < 0.001). A significant weak positive correlation was found between the presence of ventricular extrasystoles and tricuspid regurgitation. There was no correlation between ECG parameters, echocardiographic findings, and MTWA.

Conclusions

MTWA was increased in children with repaired TOF as reported before. To our knowledge, this is the first study analyzing MTWA with 24‐hour Holter ECG in repaired TOF patients.
Prolonged Cardiac Monitoring to Detect Atrial Fibrillation after Cryptogenic Stroke or Transient Ischemic Attack: A Meta‐Analysis of Randomized Controlled Trials
Authors: Dahal Khagendra , Chapagain Bikash , Maharjan Raju , Farah Husam H. , Nazeer Ayesha , Lootens Robert J. , Rosenfeld Alan
Published: November 2015

Background

The cause of ischemic stroke or transient ischemic attack (TIA) remains unclear after initial cardiac monitoring in approximately one‐third of patients. Randomized controlled trials (RCTs) showed that the prolonged cardiac monitoring of patients with cryptogenic stroke or TIA increased detection of atrial fibrillation (AF). We aimed to perform a meta‐analysis of all RCTs that evaluated the prolonged monitoring ≥7 days in patients with cryptogenic stroke or TIA.

Methods

We searched PubMed, EMBASE, Cochrane CENTRAL, and relevant references for RCTs without language restriction (inception through December 2014) and performed meta‐analysis using random effects model. Detection of AF, use of anticoagulation at follow‐up, recurrent stroke or TIA, and mortality were major outcomes.

Results

Four RCTs with 1149 total patients were included in the meta‐analysis. Prolonged cardiac monitoring ≥7 days compared to shorter cardiac monitoring of ≤48 hours duration increased the detection of AF (≥30 seconds duration) in patients after cryptogenic stroke or TIA (13.8% vs. 2.5%; odds ratio [OR], 6.4; 95% confidence interval [CI], 3.50–11.73; P < 0.00001; I2, 0%]. It also increased the odds of AF detection of any duration (22.6% vs. 5.2%; 5.68[3.3–9.77]; P < 0.00001; I2, 0%). The patients who underwent prolonged monitoring were more likely to be on anticoagulation at follow‐up (2.21[1.52–3.21]; P < 0.0001; I2, 0%). No differences in recurrent stroke or TIA (0.78[0.40–1.55]; P = 0.48; I2, 0%) and mortality (1.33[0.29–6.00]; P = 0.71; I2, 0%] were observed between two strategies.

Conclusion

Prolonged cardiac monitoring improves detection of atrial fibrillation and anti‐coagulation use after cryptogenic stroke or TIA and therefore should be considered instead of shorter duration of cardiac monitoring.
Positive Effects of the Reversion of Depression on the Sympathovagal Balance after Telerehabilitation in Heart Failure Patients
Authors: Piotrowicz Ewa , Piotrowski Walerian , Piotrowicz Ryszard
Published: November 2015

Background

Autonomic nervous system (ANS) dysfunction appears in the course of both chronic heart failure (CHF) and depression. Comprehensive cardiac rehabilitation (CCR), apart from improving physical capacity, can reduce depressive symptoms and leads to the restoration of ANS function among CHF patients.

The purpose was to evaluate the influence of the reversion of depression (measured by Beck Depression Inventory [BDI] score, cut point <10) and the physical capacity improvement (measured by peak oxygen consumption [peak VO2; ml/kg per minute]) on the sympathovagal balance (measured by low/high frequency ratio [LF/HF]) after CCR in CHF patients.

Methods

The study group comprised 111 CHF patients (New York Heart Association II–III; left ventricular ejection fraction ≤ 40%). Patients were randomized (2:1) to 8‐week CCR based on Nordic walking training (five times weekly) at 40–70% of maximal heart rate, training group (TG) n = 77, or to control group (CG) n = 34. The effectiveness of CCR was assessed by changes—delta (Δ) in LF/HF, BDI score, and peak VO2, as a result of comparing these parameters from the beginning and the end of the program.

Results

Eventually, 46 patients in TG and 23 patients in CG were eligible for simultaneous ANS and psychological status analysis. Only in TG the LF/HF decreased 2.06 ± 1.14 versus 1.19 ± 0.80 (P < 0.0001) and peak VO2 increased 16.83 ± 3.72 versus 19.14 ± 4.20 ml/kg per minute (P < 0.0001). Favorable results in CG were not observed. The differences between TG and CG were significant: Δpeak VO2 (P < 0.0001); ΔLF/HF (P = 0.0001). Depressive symptoms were substantially reduced in both groups (TG, P = 0.0006; CG, P = 0.0490). Nevertheless, the greatest improvement of sympathovagal balance was observed in patients whose depression was reversed, thanks to the CCR in comparison to other patients from TG and the entire CG.

Conclusion

Positive effect of the sympatho‐parasympathetic balance obtained during the home CCR based on Nordic walking training results from the additive effects of the reversion of depression and physical capacity improvement in CHF patients.
The Value of Lead aVR ST Segment Changes in Localizing Culprit Lesion in Acute Inferior Myocardial Infarction and Its Prognostic Impact
Authors: Pourafkari Leili , Tajlil Arezou , Mahmoudi Seyed Sajjad , Ghaffari Samad
Published: November 2015

Background

Identifying infarct‐related artery (IRA) in patients with inferior ST elevation myocardial infarction (STEMI) has prognostic and therapeutic benefits.

Objectives

To differentiate IRA and the location of culprit lesion in inferior STEMI, using ST segment changes in lead aVR.

Methods

ST segment changes in lead aVR were recorded in 150 patients, admitted with first inferior STEMI. The association of IRA and the location of culprit lesion with ST segment changes in aVR were investigated.

Results

ST elevation ≥ 0.5 mm in lead aVR was present in 17 patients (11.3%), ST depression ≥ 0.5 mm in 74 patients (49.3%) and 59 patients (39.3%) did not have significant ST segment changes. Right coronary artery (RCA) was the IRA in 117 patients (78%) and left circumflex artery (LCX) in 33 patients (22%). Prevalence of RCA involvement as the IRA was different in three study groups (94.1% in ST elevation group, 83.1% in isoelectric group and 70.3% in ST depression group, P = 0.049). Presence of ST elevation had a sensitivity and specificity of 13.68 % and 96.97%, for detecting RCA lesions, respectively. ST depression had 66.67% sensitivity and 55.56% specificity for identifying LCX lesions. Clinical complications were low in our study with no significant difference among patients of three groups.

Conclusions

Presence of ST elevation is highly suggestive of RCA lesions versus LCX lesions, whereas absence of ST elevation cannot rule out RCA lesions. Presence of ST depression has a moderate sensitivity and specificity for LCX lesions.
Total Mortality, Major Adverse Cardiac Events, and Echocardiographic‐Derived Cardiac Parameters with Fragmented QRS Complex
Authors: Gong Bojun , Li Zicheng
Published: November 2015

Background

Fragmented QRS complex (fQRS), an easily evaluated noninvasive electrocardiographic parameter, is associated with worse outcomes in patients with several cardiovascular conditions. The presence of fQRS on ECG may be an indicator of myocardial damage in patients with coronary artery disease (CAD). In this article, we performed a meta‐analysis in order to characterize the presence of fQRS on ECG in patients with CAD.

Methods

We searched English‐language randomized controlled trials involving fQRS on ECG in patients with CAD (n = 3279 patients, 12 trials). Two reviewers independently extracted data. Data on LVEF, LVESD, LVEDD, LVESV, LVEDV, total mortality, stroke, and MACE were collected. fQRS was performed a comparison with non‐fQRS, calculating pooled relatives risk (RRs) and weighted mean difference (WMD), and associated 95% confidence intervals (CIs).

Results

fQRS was associated with significant increased WMD of LVEDD (WMD, 2.26; 95%CI, 0.92 to 0.36, P = 0.0009), LVESD (WMD, 2.71; 95%CI, 1.23 to 4.19, P = 0.0003), LVEDV (WMD, 31.37; 95%CI, 24.82 to 37.92, P < 0.00001), and LVESV (WMD, 28.45; 95%CI, 22.92 to 33.98, P < 0.00001). As compared to non‐fQRS, fQRS increased risk of total mortality (RR, 3.09; 95%CI, 1.76 to 5.44, P < 0.0001) and MACE (RR, 2.85; 95%CI, 1.98 to 4.09, P < 0.00001) in patients with CAD. However, a decreased trend was observed for LVEF (WMD, –3.59; 95%CI, –7.05 to –0.12, P = 0.04). For the incidence of stoke, there was no difference between fQRS and non‐fQRS group.

Conclusions

Our findings indicate that fQRS is a valuable factor to predict total mortality and MACE in patients with CAD.
Recognition‐Difficulty‐Aware Hidden Images Based on Clue‐Map
Authors: Zhao Yandan , Du Hui , Jin Xiaogang
Published: November 2015

Hidden images contain one or several concealed foregrounds which can be recognized with the assistance of clues preserved by artists. Experienced artists are trained for years to be skilled enough to find appropriate hidden positions for a given image. However, it is not an easy task for amateurs to quickly find these positions when they try to create satisfactory hidden images. In this paper, we present an interactive framework to suggest the hidden positions and corresponding results. The suggested results generated by our approach are sequenced according to the levels of their recognition difficulties. To this end, we propose a novel approach for assessing the levels of recognition difficulty of the hidden images and a new hidden image synthesis method that takes spatial influence into account to make the foreground harmonious with the local surroundings. During the synthesis stage, we extract the characteristics of the foreground as the clues based on the visual attention model. We validate the effectiveness of our approach by performing two user studies, including the quality of the hidden images and the suggestion accuracy.
Six‐year analysis of compliance to weekly concurrent chemoradiotherapy in head and neck carcinomas
Authors: Sharma A. , Jagadesan P. , Chaudhari P. , Das S. , Bhaskar S. , Thakar A. , Sharma A. , Mohanti B.K.
Published: November 2015

Objectives

To evaluate treatment compliance to weekly concurrent chemoradiotherapy (CRT) in head and neck squamous cell carcinoma (HNSCC).

Study design

Retrospective analysis.

Setting

Tertiary care hospital.

Main outcome measures

Overall treatment time (OTT), acute radiation morbidity and treatment completion rate without prolongation of overall treatment time of more than 2 days.

Results

Three hundred and seventy‐eight head and neck carcinoma patients treated with radical CRT with 70 Gy/35 fractions of radiotherapy with weekly cisplatin 40 mg/m2 were included in the study. Median age was 52 years (range 22–77 years), oropharynx was most commonly (54%) involved site, and 55% were in stage IV disease. Majority (86%) of patients were able to complete cancer‐directed therapy, median OTT was 52 days (46–140 days). Nineteen per cent of patients completed treatment without prolongation of OTT beyond 2 days and 68% of patients there completed treatment prolongation of OTT beyond 7 days. Nearly, sixty‐six of the patients experienced grade II or higher acute radiation morbidities.

Conclusions

Delivery of weekly low‐dose concurrent CRT is safe and feasible. Two‐thirds of the patients experienced treatment prolongation of more than 2 days and 14% could not complete treatment. Results within in the study suggest to a greater need to lay emphasis on continuity of a course of radical CRT for HNSCC.
A New Look at Regulating Bankers’ Remuneration
Authors: Zalewska Anna
Published: November 2015

Manuscript Type

Conceptual

Research Questions/Issues

Executive remuneration, whether as a tool for resolving agency problems or as a sign of them, has been discussed in the literature for decades. The discussion, however, has been focused on non‐financial firms, and bankers’ remuneration, particularly in the context of corporate governance, has been overlooked until recently. However, following the financial crisis, regulators have begun intervening into banking boards’ responsibilities, including remuneration. This raises numerous questions, in particular, how far the existing non‐financial literature applies to banks, and if not, why and how this impacts on appropriate corporate governance in banking, and what challenges this brings?

Research Findings/Insights

The paper argues that due to numerous externalities, notably the interconnectivity and systemic risk of the banking sector, a traditional approach to remuneration based on resolving the principal‐agent conflict is inappropriate. Active involvement of regulators is needed to balance the short‐term performance of the banking sector with the long‐term needs of society. This, however, means that remuneration and corporate governance of banks is no longer an individual bank issue but is a national and probably an international phenomenon. In some cases this may require fundamental changes to the national governance structure, culture, and practices.

Theoretical/Academic Implications

The analysis questions the suitability of the common idea of assessing corporate governance in banks in the same way as is done for non‐financial institutions. Given that several traditional non‐financial board responsibilities have been partially passed over to regulators in the banking sector, a new theoretical model of corporate governance is needed for banks. The paper examines relational contracts (echoed to some extent in stewardship, stakeholder, and network theories), and argues that these cannot be expected to be successful in the banking environment.

Practitioner/Policy Implications

The paper highlights the importance of tying the corporate governance of banks with other regulatory measures employed to restrict risk taking. It also stresses the need for harmonization of corporate governance metrics for the banking sector at a national/international level.
Testing the efficiency of protected areas in the Amazon for conserving freshwater turtles
Authors: Fagundes Camila K. , Vogt Richard C. , De Marco Júnior Paulo
Published: November 2015

Aim

We used chelonian distribution data to (1) predict suitable areas of the occurrence for freshwater turtle species using species distribution models and (2) evaluate whether these species are protected by the current network of protected areas (PAs).

Location

The Brazilian Amazon.

Methods

We generated predictions of suitable areas for chelonian occurrence based onBIOCLIM,SVM,GLMand maximum entropy modelling procedures. We used maximum entropy to run the gap analysis and compared the effectiveness of three kinds of protected areas with different levels of protection: (1) integral protection areas (IPA) only; (2) integral protection areas + sustainable use areas (IPA+SUA); and (3) integral protection areas + sustainable use areas + indigenous lands (IPA + SUA + IL).

Results

We identified only one full gap species,Mesoclemmys nasuta, whose distribution is not included in anyPAs. Other chelonian species have at least a portion of their distribution included inPAs. Some protected species and partial gap species occur in areas with high rates of deforestation. ConsideringPAs with the highest level of protection (IPA), onlyRhinoclemmys punctulariaandKinosternon scorpioidesachieve their conservation targets. In theIPA + SUAscenario, conservation targets of some species with small range sizes are not achieved. When allPAtypes were considered (IPA + SUA + IL), only two species fail to achieve their conservation targets,Acanthochelys macrocephalaandM. nasuta.

Main conclusions

Despite the large number ofPAs in the Brazilian Amazon,IPAs alone are not sufficient for capturing suitable areas for freshwater turtles. The inclusion ofSUAandILis crucial for achieving coverage targets for most species. However, chelonians may be overharvested inSUAs andILs, due to their importance as a food resource. Areas that have high turtle richness next to existingPAs and the needs of traditional cultures should be considered in management planning for freshwater turtles.