bluuebunny/crossref_metadata_2025 huggingface dataset:
Phylogenetic and functional diversity area relationships in two temperate forests
Authors: Wang Xugao , Swenson Nathan G. , Wiegand Thorsten , Wolf Amy , Howe Robert , Lin Fei , Ye Ji , Yuan Zuoqiang , Shi Shuai , Bai Xuejiao , Xing Dingliang , Hao Zhanqing
Published: February 2013

Phylogenetic diversity (PD, the diversity of lineages) and functional diversity (FD, the diversity of functional traits or groups in a biological community) reflect important yet poorly understood attributes of species assemblages. Until recently, few studies have examined the spatial variation of PD and FD in natural communities. Yet the relationships between PD and FD and area (termed PDAR and FDAR), like the analogous species–area relationship (SAR), have received less attention and may provide insights into the mechanisms that shape the composition and dynamics of ecological communities. In this study, we used four spatial point process models to evaluate the likely roles of the random placement of species, habitat filtering, dispersal limitation, and the combined effects of habitat filtering and dispersal limitation in producing observed PDARs and FDARs in two large, fully mapped temperate forest research plots in northeast China and in north‐central USA. We found that the dispersal limitation hypothesis provided a good approximation of the accumulation of PD and FD with increasing area, as it did for the species area curves. PDAR and FDAR patterns were highly correlated with the SAR. We interpret this as evidence that species interactions, which are often influenced by phylogenetic and functional similarity, may be relatively unimportant in structuring temperate forest tree assemblages at this scale. However, the scale‐dependent departures of the PDAR and FDAR that emerged for the dispersal limitation hypothesis agree with operation of competitive exclusion at small scales and habitat filtering at larger scales. Our analysis illustrates how emergent community patterns in fully mapped temperate forest plots can be influenced by multiple underlying processes at different spatial scales.
Arctic arthropod assemblages in habitats of differing shrub dominance
Authors: Rich Matthew E. , Gough Laura , Boelman Natalie T.
Published: February 2013

Recent climate warming in the Arctic has caused advancement in the timing of snowmelt and expansion of shrubs into open tundra. Such an altered climate may directly and indirectly (via effects on vegetation) affect arctic arthropod abundance, diversity and assemblage taxonomic composition. To allow better predictions about how climate changes may affect these organisms, we compared arthropod assemblages between open and shrub‐dominated tundra at three field sites in northern Alaska that encompass a range of shrub communities. Over ten weeks of sampling in 2011, pitfall traps captured significantly more arthropods in shrub plots than open tundra plots at two of the three sites. Furthermore, taxonomic richness and diversity were significantly greater in shrub plots than open tundra plots, although this pattern was site‐specific as well. Patterns of abundance within the five most abundant arthropod orders differed, with spiders (Order: Araneae) more abundant in open tundra habitats and true bugs (Order: Hemiptera), flies (Order: Diptera), and wasps and bees (Order: Hymenoptera) more abundant in shrub‐dominated habitats. Few strong relationships were found between vegetation and environmental variables and arthropod abundance; however, lichen cover seemed to be important for the overall abundance of arthropods. Some arthropod orders showed significant relationships with other vegetation variables, including maximum shrub height (Coleoptera) and foliar canopy cover (Diptera). As climate warming continues over the coming decades, and with further shrub expansion likely to occur, changes in arthropod abundance, richness, and diversity associated with shrub‐dominated habitat may have important ecological effects on arctic food webs since arthropods play important ecological roles in the tundra, including in decomposition and trophic interactions.
Species’ thermal preferences affect forest bird communities along landscape and local scale habitat gradients
Authors: Barnagaud Jean‐Yves , Barbaro Luc , Hampe Arndt , Jiguet Frédéric , Archaux Frédéric
Published: February 2013

The spatial distributions of species, and the resulting composition of local communities, are shaped by a complex interplay between species’ climatic and habitat preferences. We investigated this interaction by analyzing how the climatic niches of bird species within given communities (measured as a community thermal index, CTI) are related to vegetation structure. Using 3129 bird communities from the French Breeding Bird Survey and an information theoretic multimodel inference framework, we assessed patterns of CTI variation along landscape scale gradients of forest cover and configuration. We then tested whether the CTI varies along local scale gradients of forest structure and composition using a detailed data set of 659 communities from six forests located in northwestern France. At landscape scale, CTI values decreased with increasing forest cover, indicating that bird communities were increasingly dominated by cold‐dwelling species. This tendency was strongest at low latitudes and in landscapes dominated by unfragmented forest. At local scale, CTI values were higher in mature deciduous stands than in conifer or early stage deciduous stands, and they decreased consistently with distance from the edge of forest. These trends underpin the assertion that species’ habitat use along forest gradients is linked with their climatic niche, although it remains unclear to what extent it is a direct consequence of microclimatic variation among habitats, or a reflection of macroscale correlations between species’ thermal preferences and their habitat choice. Moreover, our results highlight the need to address issues of scale in determining how habitat and climate interact to drive the spatial distribution of species. This will be a crucial step towards accurate predictions of changes in the composition and dynamics of bird communities under global warming.
Seven in a Row?: The Tour de France and the Likelihood of Lance
Authors: Kasdan David Oliver
Published: February 2013

Lance Armstrong won seven Tours de France in a row. Even the great Eddy Merckx won only five. Was Armstrongs string of successes too unlikely to have been true? David Oliver Kasdan investigated.
The Timing Hypothesis and Hormone Replacement Therapy: A Paradigm Shift in the Primary Prevention of Coronary Heart Disease in Women. Part 1: Comparison of Therapeutic Efficacy
Authors: Hodis Howard N. , Mack Wendy J.
Published: February 2013

The long‐held belief that outcome data from intervention trials in men are generalizable to women has created the framework in which the primary prevention of coronary heart disease (CHD) in women is viewed, but over the past decade, data have accumulated to refute such a supposition of generalizability. These lines of evidence concern the sex‐specific efficacy of CHD primary prevention therapies and timing of postmenopausal hormone replacement therapy (HRT) initiation according to age and time since menopause as modifiers of efficacy and risk. Although the standard primary prevention therapies of statins and aspirin reduce CHD in men, neither therapy reduces CHD and, more importantly, mortality in women under primary prevention conditions. Nonetheless, HRT significantly reduces CHD and mortality in primary prevention when it is initiated in women who are younger than 60 or are less than 10 years since menopause. Herein, the efficacy of the commonly used therapies for the primary prevention of CHD in women, statins, aspirin, and postmenopausal HRT is discussed. The comparative risks of these therapies will be discussed in Part 2 of this series.
Transient and rapid activation of Akt/GSK‐3β and mTORC1 signaling by D3 dopamine receptor stimulation in dorsal striatum and nucleus accumbens
Authors: Salles Marie‐Josèphe , Hervé Denis , Rivet Jean‐Michel , Longueville Sophie , Millan Mark J. , Girault Jean–Antoine , Cour Clotilde Mannoury la
Published: February 2013

D2/D3 dopamine receptors (D2R/D3R) agonists regulate Akt, but their effects display a complex time‐course. In addition, the respective roles of D2R and D3R are not defined and downstream targets remain poorly characterized, especially in vivo. These issues were addressed here for D3R. Systemic administration of quinelorane, a D2R/D3R agonist, transiently increased phosphorylation of Akt and GSK‐3β in rat nucleus accumbens and dorsal striatum with maximal effects 10 min after injection. Akt activation was associated with phosphorylation of several effectors of the mammalian target of rapamycin complex 1 (mTORC1): p70S6 kinase, ribosomal protein‐S6 (Ser240/244), and eukaryotic initiation factor‐4E binding protein‐1. The action of quinelorane was antagonized by a D2/D3R antagonist, raclopride, and the selective D3R antagonist S33084, inactive by themselves. Furthermore, no effect of quinerolane was seen in knock‐out mice lacking D3R. In drd1a‐EGFP transgenic mice, quinelorane activated Akt/GSK‐3β in both neurons expressing and lacking D1 receptor. Thus, the stimulation of D3R transiently activates the Akt/GSK‐3β pathway in the two populations of medium‐size spiny neurons of the nucleus accumbens and dorsal striatum. This effect may contribute to the influence of D3R ligands on reward, cognition, and processes disrupted in schizophrenia, drug abuse, and Parkinson's disease.
A synthetic peptide corresponding to a region of the human pericentriolar material 1 (PCM‐1) protein binds β‐amyloid (Aβ1‐42) oligomers
Authors: Chakravarthy Balu , Ménard Michel , Brown Leslie , Hewitt Melissa , Atkinson Trevor , Whitfield James
Published: February 2013

We have recently reported that a ~19‐kDa polypeptide, rPK‐4, is a protein kinase Cs inhibitor that is 89% homologous to the 1171–1323 amino acid region of the 228‐kDa human pericentriolar material‐1 (PCM‐1) protein (Chakravarthy et al. 2012). We have now discovered that rPK‐4 binds oligomeric amyloid‐β peptide (Aβ)1‐42 with high affinity. Most importantly, a PCM‐1‐selective antibody co‐precipitated Aβ and amyloid β precursor protein (AβPP) from cerebral cortices and hippocampi from AD (Alzheimer's disease) transgenic mice that produce human AβPP and Aβ1‐42, suggesting that PCM‐1 may interact with amyloid precursor protein/Aβ in vivo. We have identified rPK‐4′s Aβ‐binding domain using a set of overlapping synthetic peptides. We have found with ELISA, dot‐blot, and polyacrylamide gel electrophoresis techniques that a ~ 5 kDa synthetic peptide, amyloid binding peptide (ABP)‐p4‐5 binds Aβ1‐42 at nM levels. Most importantly, ABP‐p4‐5, like rPK‐4, appears to preferentially bind Aβ1‐42 oligomers, believed to be the toxic AD‐drivers. As expected from these observations, ABP‐p4‐5 prevented Aβ1‐42 from killing human SH‐SY5Y neuroblastoma cells via apoptosis. These findings indicate that ABP‐p4‐5 is a possible candidate therapeutic for AD.
Self‐management programmes for people living with chronic obstructive pulmonary disease: a call for a reconceptualisation
Authors: Jonsdottir Helga
Published: February 2013

Aims and objectives

To synthesise findings from previously published studies on the effectiveness of self‐management programmes for people with chronic obstructive pulmonary disease.

Background

Self‐management is a widely valued concept to address contemporary issues of chronic health problems. Yet, findings of self‐management programmes for people with chronic obstructive pulmonary disease are indecisive.

Design

Literature review of (1) previously published systematic reviews and (2) an integrative literature review.

Method

Synthesis of findings from previously published systematic reviews (n = 4) of the effectiveness of self‐management programmes for people with chronic obstructive pulmonary disease and an integrated review that was performed on papers published between January 2007–June 2012 (n = 9).

Results

Findings demonstrate that there are few studies on the effectiveness of self‐management programmes on people with chronic obstructive pulmonary disease despite more than a decade of research activities. Outcomes of the studies reveal some increase in health‐related quality of life and reduction in use of healthcare resources. The methodological approaches vary, and the sample size is primarily small. Families are not acknowledged. Features of patient‐centredness exist in self‐management programmes, particularly in the more recent articles.

Conclusions

The effectiveness of self‐management programmes for people with chronic obstructive pulmonary disease remains indecisive.

Relevance to clinical practice

A reconceptualisation of self‐management programmes is called for with attention to a family‐centred, holistic and relational care focusing on living with and minimising the handicapping consequences of the health problems in their entirety.
Residual sleepiness in sleep apnea patients treated by continuous positive airway pressure
Authors: Gasa Merce , Tamisier Renaud , Launois Sandrine H. , Sapene Marc , Martin Francis , Stach Bruno , Grillet Yves , Levy Patrick , Pepin Jean‐Louis
Published: February 2013

Hypoxic brain damage might explain persistent sleepiness in some continuous positive airway pressure‐compliant obstructive sleep apnea called residual excessive sleepiness. Although continuous positive airway pressure may not be fully efficient in treating this symptom, wake‐promoting drug prescription in residual excessive sleepiness is no longer allowed by the European Medicines Agency. The aim of this study is to describe residual excessive sleepiness phenotypes in a large prospective sample of patients with obstructive sleep apnea. Residual excessive sleepiness was defined by an Epworth Sleepiness Scale score ≥ 11. Eligible patients from the French National Sleep Registry attending follow‐up continuous positive airway pressure visits numbered 1047. Patients using continuous positive airway pressure < 3 h (n = 275), with residual apnea–hypopnea index > 15 h−1 (n = 31) or with major depression were excluded (n = 150). Residual excessive sleepiness prevalence in continuous positive airway pressure‐treated obstructive sleep apnea was 13% (18% for those with an initial Epworth Sleepiness Scale score > 11), and significantly decreased with continuous positive airway pressure use (9% in ≥ 6 h night−1 continuous positive airway pressure users, P < 0.005). At the time of diagnosis, patients with residual excessive sleepiness had worse subjective appreciation of their disease (general health scale, Epworth Sleepiness Scale and fatigue score), and complained more frequently of continuous positive airway pressure side‐effects. Residual excessive sleepiness prevalence was lower in severe obstructive sleep apnea than in moderate obstructive sleep apnea (11% when AHI > 30 h−1 versus 18% when AHI 15–30, P < 0.005). There was no relationship between residual excessive sleepiness and body mass index, cardiovascular co‐morbidities or diabetes. Continuous positive airway pressure improved symptoms in the whole population, but to a lower extent in patients with residual excessive sleepiness (fatigue scale: −5.2 versus −2.7 in residual excessive sleepiness− and residual excessive sleepiness+ patients, respectively, P < 0.001). Residual excessive sleepiness prevalence decreased with continuous positive airway pressure compliance. Hypoxic insult is unlikely to explain residual excessive sleepiness as obstructive sleep apnea severity does not seem to be critical. Residual symptoms are not limited to sleepiness, suggesting a true ‘continuous positive airway pressure‐resistant syndrome’, which may justify treatment by wake‐promoting drugs.
All Judges Are Political—Except When They Are Not: A Response
Authors: Bybee Keith J.
Published: February 2013

The author explains the origins of All Judges Are Political—Except When They Are Not: Acceptable Hypocrisies and the Rule of Law (2010) as a response to a fundamental question posed by legal realism: How can the judicial process be permeated with politics and yet remain an accepted part of a legitimate legal system? The author demonstrates the ongoing importance of this question by examining debates over the place of constitutional law in the law school curriculum and by assessing public perceptions of the Supreme Court's ruling on health care reform. The author then addresses the critical appraisals presented by the symposium contributors. The critiques are taken as road maps for extending the author's arguments in new directions.
An evaluation of lipid extraction techniques for interpretation of carbon and nitrogen isotope values in bottlenose dolphin (Tursiops truncatus) skin tissue
Authors: Wilson Rachel Marie , Chanton Jeffrey P. , Balmer Brian C. , Nowacek Douglas P.
Published: February 2013

We studied the effects of two common chemical extraction techniques on bottlenose dolphin (Tursiops truncatus) skin tissues with the intent to develop a mathematical lipid correction for dolphin skin δ13C. One method employs a hot solvent mixture (chloroform and methanol) while the other method requires washing the samples with cold solvent followed by water. The water wash method resulted in significant alteration of tissue δ15N. We found no correlation between change in sample mass and C/N or between change in sample mass and the change in δ13C (Δδ13C) following lipid extraction. Although Δδ13C was positive following lipid extraction (mean = 1.6‰ and 1.2‰, for the two methods), there was no correlation between C/N and Δδ13C for either method. Cumulatively, these results prevented us from applying a mathematical lipid normalization. Based on our findings and consideration of previously reported results, we suggest that applying these extraction techniques to dolphin skin with C/N < 4.5 introduces greater uncertainty than is warranted. We recommend against lipid correction for dolphin skins with C/N < 4.5, but stress that the resulting uncertainty in δ13C needs to be accounted for when implementing isotope mixing models to assess diet or organic matter sources.
Trends in Tinea Capitis in an Irish Pediatric Population and a Comparison of Scalp Brushings Versus Scalp Scrapings as Methods of Investigation
Authors: Nasir Shaaira , Ralph Nicola , O'Neill Charles , Cunney Robert , Lenane Patricia , O'Donnell Brigid
Published: February 2013

A retrospective study of 391 children with suspected tinea capitis was analyzed to examine the prevalence of dermatophyte species and to compare the efficacy of the scalp scraping method with that of the hairbrush method for diagnoses over a 6‐year period. Trichophyton tonsurans tinea capitis is the most common pathogen. The hairbrush method of obtaining specimens for fungal culture was superior to scalp scrapings (p = 0.03) in making the diagnosis, and using two methods (p < 0.001) increased the yield of identifying a dermatophyte infection.
Characterization and host range of five tumorigenic Agrobacterium tumefaciens strains and possible application in plant transient transformation assays
Authors: Hwang H.‐H. , Wu E. T. , Liu S.‐Y. , Chang S.‐C. , Tzeng K.‐C. , Kado C. I.
Published: February 2013

Agrobacterium tumefaciens is a Gram‐negative bacterium. It causes plants to produce crown gall disease because of the transfer, integration and expression of oncogenes encoded by the T‐DNA (transferred DNA) region of the tumour‐inducing (Ti) plasmid. A set of transferred genes directs the production of bacterial nutrients, called opines, formed by condensation of an amino acid and a keto acid or a sugar. Transformed cells synthesize and secrete substantial quantities of particular opines, which A. tumefaciens then uses as a carbon and sometimes nitrogen source. Agrobacterium tumefaciens strains are usually classified on the basis of the opines they can catabolize. Because of the ability to transfer DNA between different kingdoms, A. tumefaciens is also frequently used to generate transgenic plants. This study analyses five poorly characterized wildtype Agrobacterium strains, 1D1108, 1D1460, 1D132, 1D1478 and 1D1487, isolated from Euonymus, cane, cherry, Salix and apple, respectively. Partial Ti‐plasmid sequence analysis demonstrated that the five strains harbour the nopaline‐type Ti plasmid. Tumorigenesis and transient transformation assays of the five analysed and six wildtype A. tumefaciens strains were performed with selected plant species, including two or three species of Brassicaceae, Asteraceae, Solanaceae, Apiaceae and Leguminosae. The A. tumefaciens strains 1D1108, 1D1460 and 1D1478 showed higher transformation efficiencies than the previously characterized A. tumefaciens strains with several economically important crops. These data suggest the potential use of these newly characterized wildtype A. tumefaciens strains in transient transformation assays with certain plant species.
The Decoupling of Social Policy Reforms in Romania
Authors: Pop Luana
Published: February 2013

Social reforms in Romania have been, from the beginning of the 1990s and throughout the EU post‐accession phase, the battlefield for many domestic and international actors. The article identifies, from an historical institutionalist perspective, the international actors who decisively influenced reforms of social protection in Romania during the transition, with a special emphasis on the EU pre‐ and post‐accession stages. Further, the article attempts to understand the impact of the various external influences on the sustainability and effectiveness of domestic reforms, by assessing the convergence, or the decoupling, between the rationales – i.e. ideologies and values – that explicitly grounded social reforms in Romania and the domestic public rhetoric on social risks and values. Answers to these questions can provide important insights in regard to both the impact of the EU upon new member states and the challenges of EU enlargement for the EU and its core member states.
Biological behaviour of canine mandibular osteosarcoma. A retrospective study of 50 cases (1999–2007)
Authors: Coyle V. J. , Rassnick K. M. , Borst L. B. , Rodriguez C. O. , Northrup N. C. , Fan T. M. , Garrett L. D.
Published: February 2013

The purpose of this retrospective study was to describe the biological behaviour of canine mandibular osteosarcoma (OSA) and to examine factors for their impact on metastasis‐free interval (MFI) and survival time (ST). Records from dogs treated with mandibulectomy forOSA(1999–2007) were reviewed. Archived tumour samples were evaluated for mitotic index (MI) and tumour grade. Fifty dogs were included, 21 received chemotherapy. Twenty‐nine dogs (58%) developed metastatic disease. The medianMFIwas 627 days, and medianSTwas 525 days. In univariate analysisMI> 40 was prognostic for decreasedMFIandST. Grade also influencedMFIandST, with 5/21 (24%) dogs with gradeII/IIItumours metastasis‐free at one year versus 16/22 (72%) dogs with grade I tumours (P= 0.002); and 5/21 (24%) dogs with gradeII/IIItumours alive versus 17/22 (77%) dogs with grade I tumours (P= 0.001). In multivariate analysis, histological grade and adjuvant chemotherapy were prognostic forMFIandST.
The impacts of traditional and novel herbicide application methods on target plants, non‐target plants and production in intensive grasslands
Authors: Power E F , Kelly D L , Stout J C
Published: February 2013

Herbicides contribute significantly to agricultural intensification, but some negatively impact non‐target organisms. Much research has focused on reducing herbicide use through technological improvements in application and herbicide selectivity, but impacts on non‐target organisms are less well understood. Using experimental plots in silage systems, we investigated impacts of herbicides (both narrow spectrum targeting broad‐leaved plants and selective and non‐selective broad spectrum) applied using traditional techniques (blanket‐ and manual spot‐spraying) and a novel application technique (automated spot‐spraying) on non‐target plant richness/diversity, target weed presence (Rumex species) and production (DM yield). All herbicides reduced non‐target plant richness/diversity and sometimes target weeds (when applied using traditional methods). Automated spot‐spraying had fewer negative effects on non‐target organisms, but did not reduce target weeds. No differences in production levels among treatments were observed. The automated spot‐spraying technique requires further research and development. Our results indicate that 20–30% weed cover does not significantly alter production and so, as herbicides are expensive, their effects on non‐target organisms and the environment can be more significant than their benefits to production. We advocate more research into the relationships between weed infestation and production in grasslands, so that the propensity to overuse herbicides is reduced.
A Framework for Decisions About Research with HPAI H5N1 Viruses
Authors: Patterson Amy P. , Tabak Lawrence A. , Fauci Anthony S. , Collins Francis S. , Howard Sally
Published: February 2013

The U.S. Department of Health and Human Services unveils a Framework for funding decisions about highly pathogenic avian influenza H5N1 research.
Complete Genome Sequences of New Emerging Newcastle Disease Virus Strains Isolated from China
Authors: Liu Hualei , Lv Yan , Afonso Claudio L. , Ge Shengqiang , Zheng Dongxia , Zhao Yunling , Wang Zhiliang
Published: February 2013

Five Newcastle disease virus strains isolated from geese were classified into a new genotype, designated genotype XII. The complete genome sequences of two strains indicated that these viruses were distinct from viruses of genotype VII. More investigations need to be conducted for us to understand the origin of these new strains.
Draft Genome of Spiribacter salinus M19-40, an Abundant Gammaproteobacterium in Aquatic Hypersaline Environments
Authors: Leon Maria Jose , Ghai Rohit , Fernandez Ana Beatriz , Sanchez-Porro Cristina , Rodriguez-Valera Francisco , Ventosa Antonio
Published: February 2013

We have previously used a
de novo
metagenomic assembly approach to describe the presence of an abundant gammaproteobacterium comprising nearly 15% of the microbial community in an intermediate salinity solar saltern pond. We have obtained this microbe in pure culture and describe the genome sequencing of the halophilic photoheterotrophic microbe,
Spiribacter salinus
M19-40.
‘Hot cross bun’ sign in a case of cerebrotendinous xanthomatosis: a rare neuroimaging observation
Authors: Jain Rajendra Singh , Sannegowda Raghavendra Bakki , Agrawal Amit , Hemrajani Deepika , Jain Rahul , Mathur Tarun
Published: February 2013

We report a 25-year-old young man presenting with cognitive decline, pancerebellar features, spastic quadriparesis, bilateral cataract (operated) and tendo-Achilles swelling (xanthoma). The CT of the head showed bilateral cerebellar hypodensities. There were bilateral cerebellar hypointensities involving dentate nuclei on T1-weighted images with corresponding hyperintensities on T2-weighted MRI. Additionally, an interesting MRI finding—‘hot cross bun’ appearance was seen in pons which has not been reported in the literature so far. Biopsy from tendo-Achilles confirmed xanthoma. He was treated with chenodeoxycholic acid following which he showed improvement in cognition and weakness.
Relapsing-remitting multiple sclerosis and chronic idiopathic neutropenia: a challenging combination
Authors: Münzel Eva Jolanda , Wimperis Jennie Z , Williams Anna
Published: February 2013

We report the challenges of treating relapsing-remitting multiple sclerosis (MS) in a 31-year-old woman with long-standing chronic idiopathic neutropenia. The treatment with the disease-modifying therapy interferon-β was significantly complicated by a further fall in her generally low neutrophil count, to values below 0.5×109/l, although this recovered rapidly when the treatment was stopped. We discuss the difficulties of balancing the risk of neutropenia with a risk of MS relapse.
Improving outcome following life-threatening gastrointestinal bleeding not amenable to endoscopy in an ASA grade 5 patient: lessons learned
Authors: Demetriou George A , Nair Manojkumar S , Dinneen Eoin , Oluwajobi Olu
Published: February 2013

We present a 74-year-old woman, who developed massive haematemesis and hypovolaemic shock. Her management was challenging, as the bleeding site could not be identified during oesophagogastroduodenoscopy, she was not fit for a general anaesthesia and not able to lie flat due to heart failure, caused by pericardial effusion. She underwent an emergency laparotomy and gastrotomy under a combined thoracic epidural and lumbar spinal regional anaesthesia in a sitting position, 45° to horizontal plane. The bleeding site was identified as a Dieulafoy lesion on the posterior wall of the stomach and was controlled by under running the lesion. She had an uneventful recovery and is symptom-free post-surgery for a year at present.
An unusual cause of spontaneous bacterial peritonitis due toCampylobacter fetuswith alcoholic liver cirrhosis
Authors: Hadano Yoshiro , Iwata Hiroyoshi
Published: February 2013

A 40-year-old man with severe alcoholic liver cirrhosis with a 2-day history of fatigue and abdominal pain was admitted. He reported eating sushi and sliced raw chicken a few days previously. His abdomen was distended, with shifting dullness. Based on the patient's history, physical examination and the results of abdominocentesis, he was diagnosed as having spontaneous bacterial peritonitis; blood and ascitic fluid cultures were positive forCampylobacter fetus. The patient was started on treatment with cefotaxime, which was switched after 1 week to ampicillin for an additional 3 weeks. The patient was successfully treated with the 4-week course of intravenous antibiotic therapy.
The effect of integrated cardiac rehabilitation versus treatment as usual for atrial fibrillation patients treated with ablation: the randomised CopenHeartRFAtrial protocol
Authors: Risom Signe Stelling , Zwisler Ann-Dorth Olsen , Rasmussen Trine Bernholdt , Sibilitz Kirstine Lærum , Svendsen Jesper Hastrup , Gluud Christian , Hansen Jane Lindschou , Winkel Per , Thygesen Lau Caspar , Perhonen Merja , Hansen Jim , Dunbar Sandra B , Berg Selina Kikkenborg
Published: February 2013

Introduction

Atrial fibrillation affects almost 2% of the population in the Western world. To preserve sinus rhythm, ablation is undertaken in symptomatic patients. Observational studies show that patients with atrial fibrillation often report a low quality of life and are less prone to be physically active due to fear of triggering fibrillation. Small trials indicate that exercise training has a positive effect on exercise capacity and mental health, and both patients with recurrent atrial fibrillation and in sinus rhythm may benefit from rehabilitation in managing life after ablation. No randomised trials have been published on cardiac rehabilitation for atrial fibrillation patients treated with ablation that includes exercise and psychoeducational components.

Aim

To test the effects of an integrated cardiac rehabilitation programme versus treatment as usual for patients with atrial fibrillation treated with ablation.

Methods and analysis design

The trial is a multicentre parallel arm design with 1:1 randomisation to the intervention and control group with blinded outcome assessment. 210 patients treated for atrial fibrillation with radiofrequency ablation will be included. The intervention consists of a rehabilitation programme including four psychoeducative consultations with a specially trained nurse and 12 weeks of individualised exercise training, plus the standard medical follow-up. Patients in the control group will receive the standard medical follow-up. The primary outcome measure is exercise capacity measured by the VO2peak. The secondary outcome measure is self-rated mental health measured by the Short Form 36 questionnaire. Postintervention, qualitative interviews will be conducted in 10% of the intervention group.

Ethics and dissemination

The protocol is approved by the regional research ethics committee (number H-1-2011-135), the Danish Data Protection Agency (reg. nr. 2007-58-0015) and follows the latest version of the Declaration of Helsinki. The results will be published in peer-reviewed journals and may possibly impact on rehabilitation guidelines.

Trial registration

Clinicaltrials.gov identifier:NCT01523145.
The eye of the beholder: inter-rater agreement among experts on psychogenic jerky movement disorders
Authors: van der Salm Sandra M A , de Haan Rob J , Cath Daniëlle C , van Rootselaar Anne-Fleur , Tijssen Marina A J
Published: February 2013

Objective

The current criteria for conversion disorder in the Diagnostic and Statistical Manual of Mental Disorders rely on the assumption that neurological disorders can be distinguished from conversion disorders through clinical assessment. This study aims to assess inter-rater agreement among clinicians with experience in the diagnosis of various hyperkinetic jerky movements, including psychogenic jerks.

Methods

60 patients with psychogenic jerks, myoclonus or tics were rated by international experts using a standardised survey resembling daily clinical practice. The survey included the following diagnostic steps: a short video offering a visual impression of the patients and their jerky movements, medical history, neurological examination (on video), additional investigations and the findings of a standardised psychiatric interview. The diagnosis and diagnostic certainty were scored after each step.

Results

After all clinical information was given, moderate inter-rater agreement was reached (κ=0.56±0.1) with absolute agreement (100%) of experts on the diagnosis in 12 (20%) patients and reasonable agreement (>75%) in 43 (72%) patients. Psychiatric evaluation did not contribute to inter-rater agreement or diagnostic certainty.

Conclusions

Our findings illustrate the fact that experienced movement disorder specialists moderately agree on the clinical diagnosis of jerky movements. Clinical assessment, especially by a team of clinicians in challenging individual cases, might improve diagnostic agreement.
Successful endovascular treatment of three fusiform cerebral aneurysms with the Pipeline Embolization Device in a patient with dilating HIV vasculopathy
Authors: Delgado Almandoz Josser E , Crandall Benjamin M , Fease Jennifer L , Scholz Jill M , Anderson Ruth E , Kadkhodayan Yasha , Tubman David E
Published: February 2013

Dilating HIV vasculopathy can be a cause of ischemic and hemorrhagic stroke in patients with HIV. Although first identified in children, this condition is increasingly being recognized in adults and has a dismal natural history under medical or expectant management. Vessel wall invasion by varicella zoster virus, HIV orMycobacterium avium intracellularecomplex (MAI) has been postulated as a possible etiology. We present a case of an adult patient with HIV and chronic disseminated MAI infection who presented with ischemic stroke and three fusiform cerebral aneurysms that were successfully treated with the pipeline embolization device (PED). Flow diversion may be a viable treatment option for patients presenting with this serious neurovascular condition when aneurysm location precludes parent vessel sacrifice or surgical bypass. In addition, platelet function testing with VerifyNow may be valuable in selecting the appropriate P2Y12 receptor antagonist to be used in order to prevent PED thrombosis, since some of the antiretroviral drugs may inhibit clopidogrel or prasugrel metabolism.
Small intestinal adenocarcinoma: rarely considered, often missed?
Authors: Neely David , Ong Justin , Patterson James , Kirkpatrick Dianne , Skelly Roderick
Published: February 2013

Adenocarcinoma of the small intestine is rare in comparison with other gastrointestinal malignancies but its incidence is rising. It often presents at an advanced stage due to the non-specific symptomatology. More recent advances in small intestinal visualisation including video capsule endoscopy and double balloon enteroscopy may facilitate diagnosis in patients with suspected small intestinal neoplasia. At present aggressive surgical resection provides the best chance of cure of small intestinal adenocarcinoma. Despite apparent curative resection the long-term outlook remains poor. The role of adjuvant chemotherapy is not well defined due to the rarity of the disease and lack of randomised controlled trials; however, there appears to be a survival benefit in advanced disease with the use of oxaliplatin and 5-fluorouracil. We reviewed the clinical aspects of this aggressive condition focusing on the pathological associations, available diagnostic modalities and current management options. Three cases are included to illustrate the review.
Republished: Drug-induced valvular heart disease
Authors: Cosyns Bernard , Droogmans Steven , Rosenhek Raphael , Lancellotti Patrizio
Published: February 2013

Drug-induced valvular heart disease (DIVHD) was first described in the 1960s. Initially, associations with ergot derivatives used for migraine prevention, or with anorectic drugs, were described. Drugs used for the treatment of Parkinson's disease and endocrine diseases, like hyperprolactinemia, may also induce VHD. More recently, the use of 3,4-methylendioxymetamphetamine (MDMA, ‘Ecstasy’) and benfluorexhave been found to be associated with DIVHD. Although some of these drugs were withdrawn from the market, several cases of patients requiring valve surgery even years after the cessation of therapy have been reported. DIVHD is not infrequent, may be severe, and has been described in association with several drugs. Even after drug cessation, long-term implications of this type of VHD may persist. The present review underlines the need for a careful evaluation of the associated clinical and echocardiographic risk factors to allow early recognition so as not to delay appropriate management.
Sexual behaviour, structural vulnerabilities and HIV prevalence among female sex workers in Pakistan
Authors: Mishra Sharmistha , Thompson Laura H , Sonia Altaf , Khalid Nosheen , Emmanuel Faran , Blanchard James F
Published: February 2013

Background

We sought to describe differences in individual and structural vulnerabilities faced by female sex workers (FSWs) in Pakistan between 2006 and 2011, and to characterise risk factors for inconsistent condom use and HIV prevalence in this population.

Methods

To describe differences in vulnerabilities, we analysed behavioural data from serial cross-sectional surveys conducted across nine cities in 2006 and 2011. Using data from 12 cities in 2011, we used logistic regression to characterise risk factors for (a) inconsistent condom use in the past month (N=6987), and (b) HIV (N=4301).

Results

Compared to FSWs in 2006, FSWs in 2011 were significantly more likely to solicit clients via cell phones, and to report a larger client volume and anal sex with clients, but also consistent condom use with clients (30.0% vs 23.6% in 2006). In 2011, independent risk factors for inconsistent condom use with clients included: recent sexual violence, recent sex with a person who injects drugs, and absence of programme exposure. HIV prevalence was 0.63% (95% CI 0.43% to 0.92%) in 2011, and was associated with a recent history of injection drug use and absence of programme exposure.

Conclusions

While condom use with clients was higher in 2011, protective behaviours remained low and vulnerabilities related to sex work may have risen. HIV is emerging in this population and an adaptive HIV prevention programme that addresses different vulnerabilities and the intersection of sexual networks with injection drug use is needed.
Night and postexercise cardiac autonomic control in functional overreaching
Authors: Dupuy Olivier , Bherer Louis , Audiffren Michel , Bosquet Laurent
Published: February 2013

The purpose of this study was to evaluate the effect of a 2-week overload period immediately followed by a 1-week taper period on the autonomic control of heart rate during the night or after exercise cessation. Eleven male endurance athletes increased their usual training volume by 100% for 2 weeks (overload) and decreased it by 50% for 1 week (taper). A maximal graded exercise test and a constant-speed test at 85% of peak treadmill speed, both followed by a 10-min passive recovery period, were performed at baseline and after each period. Heart rate variability was also measured during a 4-h period in the night or during estimated slow-wave sleep. All participants were considered to be overreached based on performance and physiological and psychological criteria. We found a decrease in cardiac parasympathetic control during slow-wave sleep (HFnu = 61.3% ± 11.7% vs 50.0% ± 10.1%, p < 0.05) but not during the 4-h period, as well as a faster heart rate recovery following the maximal graded exercise test (τ = 61.8 ± 14.5 s vs 54.7 ± 9.0 s, p < 0.05) but not after the constant-speed test, after the overload period. There was a return to baseline for both measures after the taper period. Other indices of cardiac autonomic control were not altered by the overload period. Care should be taken in selecting the most sensitive heart rate measures in the follow-up of athletes, because cardiac autonomic control is not affected uniformly by overload training.
Module-Based Synthesis of Digital Microfluidic Biochips with Droplet-Aware Operation Execution
Authors: Maftei Elena , Pop Paul , Madsen Jan
Published: February 2013

Microfluidic biochips represent an alternative to conventional biochemical analyzers. A digital biochip manipulates liquids not as continuous flow, but as discrete droplets on a two-dimensional array of electrodes. Several electrodes are dynamically grouped to form a virtual device, on which operations are executed by moving the droplets. So far, researchers have ignored the locations of droplets inside devices, considering that all the electrodes forming the device are occupied throughout the operation execution. In this article, we consider a droplet-aware execution of microfluidic operations, which means that we know the exact position of droplets inside the modules at each time-step. We propose a Tabu Search-based metaheuristic for the synthesis of digital biochips with droplet-aware operation execution. Experimental results show that our approach can significantly reduce the application completion time, allowing us to use smaller area biochips and thus reduce costs.
Making the mobile web faster
Authors: Matsudaira Kate
Published: February 2013

Mobile performance issues? Fix the back end, not just the client.
Decorin, lumican, and their GAG chain-synthesizing enzymes are regulated in myocardial remodeling and reverse remodeling in the mouse
Authors: Engebretsen Kristin V. T. , Waehre Anne , Bjørnstad Johannes L. , Skrbic Biljana , Sjaastad Ivar , Behmen Dina , Marstein Henriette S. , Yndestad Arne , Aukrust Pål , Christensen Geir , Tønnessen Theis
Published: February 2013

On the basis of the role of small, leucine-rich proteoglycans (SLRPs) in fibrogenesis and inflammation, we hypothesized that they could be involved in cardiac remodeling and reverse remodeling as occurs during aortic stenosis and after aortic valve replacement. Thus, in a well-characterized aortic banding-debanding mouse model, we examined the SLRPs decorin and lumican and enzymes responsible for synthesis of their glycosaminoglycan (GAG) chains. Four weeks after banding of the ascending aorta, mice were subjected to a debanding operation (DB) and were subsequently followed for 3 or 14 days. Sham-operated mice served as controls. Western blotting revealed a 2.5-fold increase in the protein levels of glycosylated decorin in mice with left ventricular pressure overload after aortic banding (AB) with a gradual decrease after DB. Interestingly, protein levels of three key enzymes responsible for decorin GAG chain synthesis were also increased after AB, two of them gradually declining after DB. The inflammatory chemokine (C-X-C motif) ligand 16 (CXCL16) was increased after AB but was not significantly altered following DB. In cardiac fibroblasts CXCL16 increased the expression of the GAG-synthesizing enzyme chondroitin polymerizing factor (CHPF). The protein levels of lumican core protein with N-linked oligosaccharides increased by sevenfold after AB and decreased again 14 days after DB. Lumican with keratan sulfate chains was not regulated. In conclusion, this study shows alterations in glycosylated decorin and lumican core protein that might be implicated in myocardial remodeling and reverse remodeling, with a potential important role for CS/DS GAG chain-synthesizing enzymes.
Mechanisms of nasal high flow on ventilation during wakefulness and sleep
Authors: Mündel Toby , Feng Sheng , Tatkov Stanislav , Schneider Hartmut
Published: February 2013

Nasal high flow (NHF) has been shown to increase expiratory pressure and reduce respiratory rate but the mechanisms involved remain unclear. Ten healthy participants [age, 22 ± 2 yr; body mass index (BMI), 24 ± 2 kg/m2] were recruited to determine ventilatory responses to NHF of air at 37°C and fully saturated with water. We conducted a randomized, controlled, cross-over study consisting of four separate ∼60-min visits, each 1 wk apart, to determine the effect of NHF on ventilation during wakefulness (NHF at 0, 15, 30, and 45 liters/min) and sleep (NHF at 0, 15, and 30 liters/min). In addition, a nasal cavity model was used to compare pressure/air-flow relationships of NHF and continuous positive airway pressure (CPAP) throughout simulated breathing. During wakefulness, NHF led to an increase in tidal volume from 0.7 ± 0.1 liter to 0.8 ± 0.2, 1.0 ± 0.2, and 1.3 ± 0.2 liters, and a reduction in respiratory rate ( fR) from 16 ± 2 to 13 ± 3, 10 ± 3, and 8 ± 3 breaths/min (baseline to 15, 30, and 45 liters/min NHF, respectively; P < 0.01). In contrast, during sleep, NHF led to a ∼20% fall in minute ventilation due to a decrease in tidal volume and no change in fR. In the nasal cavity model, NHF increased expiratory but decreased inspiratory resistance depending on both the cannula size and the expiratory flow rate. The mechanisms of action for NHF differ from those of CPAP and are sleep/wake-state dependent. NHF may be utilized to increase tidal breathing during wakefulness and to relieve respiratory loads during sleep.
Two Cases of Malignant Struma Ovarii with Metastasis to Pelvic Bone
Authors: Steinman Rachel A. , De Castro Ismary O. , Shrayyef Muhammad , Chengazi Vaseem , Giampoli Ellen , Van Der Sloot Paul , Calvi Laura M. , Wittlin Steven D. , Hammes Stephen R. , Hou Runhua
Published: February 2013

Histologically, malignant struma ovarii metastasizes rarely, and only a few cases reported bone metastasis. Here, we describe 2 cases of biologically malignant struma ovarii with pelvic bone metastasis. Case 1 is a 22-year-old female who was found to have a large left ovarian mass during routine prenatal ultrasound. Papillary thyroid cancer arising in struma ovarii was identified after laparoscopic salpingo-oophorectomy. After total thyroidectomy, radioactive iodine whole-body scan revealed extrathyroidal iodine uptake in left anterior pelvis. Subsequent I-131 treatment resolved the pelvic metastasis. Case 2 is a 49-year-old female who was diagnosed with malignant struma ovarii in 1996 and presented in 2007 with pelvic recurrence and extensive left hip metastasis. Treatment with resection of the pelvic tumor, total thyroidectomy, and multiple I-131 ablation led to eventual resolution of the abdominal and left hip foci. In conclusion, we present 2 rare cases of malignant struma ovarii, both with metastasis to the pelvic bone. This report makes pelvic bone the most frequent site for bone metastasis in malignant struma ovarii. It also emphasizes the importance of total thyroidectomy in allowing identification and treatment of bony metastasis with radioactive iodine.