bluuebunny/crossref_metadata_2025 huggingface dataset:
Endothelial progenitor cells in acute ischemic stroke
Authors: Martí‐Fàbregas Joan , Crespo Javier , Delgado‐Mederos Raquel , Martínez‐Ramírez Sergi , Peña Esther , Marín Rebeca , Dinia Lavinia , Jiménez‐Xarrié Elena , Fernández‐Arcos Ana , Pérez‐Pérez Jesús , Querol Luis , Suárez‐Calvet Marc , Badimon Lina
Published: October 2013

Objectives

The levels of circulating endothelial progenitor cells (EPCs) in ischemic stroke have not been studied extensively and reported results are inconsistent. We aimed to investigate the time course, the prognostic relevance, and the variables associated with EPC counts in patients with ischemic stroke at different time points.

Material and methods

We studied prospectively 146 consecutive patients with ischemic stroke within the first 48 h from the onset of symptoms (baseline). We evaluated demographic data, classical vascular risk factors, treatment with thrombolysis and statins, stroke etiology, National Institute of Health and Stroke Scale score and outcome (favorable when Rankin scale score 0–2). Blood samples were collected at baseline, at day 7 after stroke (n = 121) and at 3 months (n = 92). The EPC were measured by flow cytometry.

Results

We included 146 patients with a mean age of 70.8 ± 12.2 years. The circulating EPC levels were higher on day 7 than at baseline or at 3 months (P = 0.045). Pretreatment with statins (odds ratio [OR] 3.11, P = 0.008) and stroke etiology (P = 0.032) were predictive of EPC counts in the baseline sample. EPC counts were not associated with stroke severity or functional outcome in all the patients. However, using multivariate analyses, a better functional outcome was found in patients with higher EPC counts in large‐artery atherosclerosis and small‐vessel disease etiologic subtypes.

Conclusions

After acute ischemic stroke, circulating EPC counts peaked at day 7. Pretreatment with statins increased the levels of EPC. In patients with large‐artery atherosclerosis and small‐vessel disease subtypes, higher counts were related to better outcome at 3 months.
Improving Sludge Dewaterability by Adding the Semi‐Dry Flue Gas Desulfurization Residue under Microwave Radiation
Authors: Liang Hongji , Shi Lin , Yang Guoyou
Published: October 2013

Because of the high moisture content within sludge, it is difficult to obtain a sludge dewatering rate of >60% within municipal sludge treatment. In this study, the semi‐dry flue gas desulfurization residue was added as a sludge conditioner to concentrated sludge under microwave radiation. The results showed that with a gradually increased dosage of the residue to the sludge, the settling velocity of the sludge increased considerably and moisture content in the filtered cake and the specific resistance to filtration value decreased considerably. After treatment by the residue conditioning combined with microwave radiation, the sludge settling performance and filtration dewaterability were further improved. The optimal operation conditions were summarized as a mass ratio of the residue and sludge by a dry weight basis of about 1:1 w/w, and 50 s microwave radiation. The addition of the residue can also speed up the filter cake drying process, effectively kill harmful microorganisms, and promote toxic metal passivation. These improvements may be attributed to the alkalinity of the residue and microwave radiation damaging the stability of biological cells within the sludge, while the CaSO4 · 2 H2O and CaSO3 · 0.5 H2O acts as skeleton formers, thereby facilitating the sludge dewatering process.
The symptom burden of cancer: Evidence for a core set of cancer‐related and treatment‐related symptoms from the Eastern Cooperative Oncology Group Symptom Outcomes and Practice Patterns study
Authors: Cleeland Charles S. , Zhao Fengmin , Chang Victor T. , Sloan Jeff A. , O'Mara Ann M. , Gilman Paul B. , Weiss Matthias , Mendoza Tito R. , Lee Ju‐Whei , Fisch Michael J.
Published: October 2013

BACKGROUND

A set of common cancer‐related and treatment‐related symptoms has been proposed for quality of care assessment and clinical research. Using data from a large, multicenter, prospective study, the authors assessed the effects of disease site and stage on the percentages of patients rating these proposed symptoms as moderate to severe.

METHODS

The severity of 13 symptoms proposed to represent “core” oncology symptoms was rated by 3106 ambulatory patients with cancer of the breast, prostate, colon/rectum, or lung, regardless of disease stage or phase of care; 2801 patients (90%) repeated the assessment 4 to 5 weeks later.

RESULTS

At the time of the initial assessment, approximately 33% of the patients reported ≥ 3 symptoms in the moderate‐to‐severe range; 11 of the 13 symptoms were rated as moderate to severe by at least 10% of all patients and 6 were rated as moderate to severe by at least 20% of those receiving active treatment. Fatigue/tiredness was the most severe symptom, followed by disturbed sleep, pain, dry mouth, and numbness/tingling. More patients with lung cancer and patients receiving active treatment reported moderate to severe symptoms. Percentages of symptomatic patients increased by disease stage, less adequate response to therapy, and declining Eastern Cooperative Oncology Group performance status. The percentages of patients reporting moderate to severe symptoms were stable across both assessments.

CONCLUSIONS

The results of the current study support a core set of moderate to severe symptoms that are common across outpatients with solid tumors, that can guide consideration of progression‐free survival as a trial outcome, and that should be considered in clinical care and in assessments of quality of care and treatment benefit. Cancer 2013;119:4333–4340. © 2013 American Cancer Society.
Association between hospital case volume and the use of bronchoscopy and esophagoscopy during head and neck cancer diagnostic evaluation
Authors: Sun Gordon H. , Aliu Oluseyi , Moloci Nicholas M. , Mondschein Joshua K. , Burke James F. , Hayward Rodney A.
Published: October 2013

BACKGROUND

There are no clinical guidelines on best practices for the use of bronchoscopy and esophagoscopy in diagnosing head and neck cancer. This retrospective cohort study examined variation in the use of bronchoscopy and esophagoscopy across hospitals in Michigan.

METHODS

A total of 17,828 patients were identified with head and neck cancer in the 2006 to 2010 Michigan State Ambulatory Surgery Databases. A hierarchical, mixed‐effect logistic regression was used to examine whether a hospital's risk‐adjusted rate of concurrent bronchoscopy or esophagoscopy was associated with its case volume (< 100, 100‐999, or ≥ 1000 cases per hospital) for those undergoing diagnostic laryngoscopy.

RESULTS

Of 9218 patients undergoing diagnostic laryngoscopy, 1191 (12.9%) received concurrent bronchoscopy and 1675 (18.2%) underwent concurrent esophagoscopy. The median hospital rate of bronchoscopy was 2.7% (range, 0%‐61.1%), and low‐volume (odds ratio [OR] = 27.1; 95% confidence interval [CI] = 1.9, 390.7) and medium‐volume (OR = 28.1; 95% CI = 2.0, 399.0) hospitals were more likely to perform concurrent bronchoscopy compared to high‐volume hospitals. The median hospital rate of esophagoscopy was 5.1% (range, 0%‐47.1%), and low‐volume (OR = 9.8; 95% CI = 1.5, 63.7) and medium‐volume (OR = 8.5; 95% CI = 1.3, 55.0) hospitals were significantly more likely to perform concurrent esophagoscopy relative to high‐volume hospitals.

CONCLUSIONS

Patients with head and neck cancer who are undergoing diagnostic laryngoscopy are much more likely to undergo concurrent bronchoscopy and esophagoscopy at low‐ and medium‐volume hospitals than at high‐volume hospitals. Whether this represents overuse of concurrent procedures or appropriate care that leads to earlier diagnosis and better outcomes merits further investigation. Cancer 2014;120:61–67. © 2013 American Cancer Society.
Altitude exposure in sports: the Athlete Biological Passport standpoint
Authors: Sanchis‐Gomar Fabian , Pareja‐Galeano Helios , Brioche Thomas , Martinez‐Bello Vladimir , Lippi Giuseppe
Published: October 2013

The Athlete Biological Passport (ABP) is principally founded on monitoring an athlete's biological variables over time, to identify abnormal biases on a longitudinal basis. Several factors are known to influence the results of these markers. However, the manner in which the altitude factor is taken into account still needs to be standardized. Causal relationships between haematological variables should be correctly integrated into ABP software. In particular, modifications of haematological parameters during and after exposure to different altitudes/hypoxic protocols need to be properly included within detection models. Copyright © 2013 John Wiley & Sons, Ltd.
Drosophila rely on learning while foraging under semi‐natural conditions
Authors: Zrelec Vukašin , Zini Marco , Guarino Sandra , Mermoud Julien , Oppliger Joël , Valtat Annabelle , Zeender Valérian , Kawecki Tadeusz J.
Published: October 2013

Learning is predicted to affect manifold ecological and evolutionary processes, but the extent to which animals rely on learning in nature remains poorly known, especially for short‐lived non‐social invertebrates. This is in particular the case for Drosophila, a favourite laboratory system to study molecular mechanisms of learning. Here we tested whether Drosophila melanogaster use learned information to choose food while free‐flying in a large greenhouse emulating the natural environment. In a series of experiments flies were first given an opportunity to learn which of two food odours was associated with good versus unpalatable taste; subsequently, their preference for the two odours was assessed with olfactory traps set up in the greenhouse. Flies that had experienced palatable apple‐flavoured food and unpalatable orange‐flavoured food were more likely to be attracted to the odour of apple than flies with the opposite experience. This was true both when the flies first learned in the laboratory and were then released and recaptured in the greenhouse, and when the learning occurred under free‐flying conditions in the greenhouse. Furthermore, flies retained the memory of their experience while exploring the greenhouse overnight in the absence of focal odours, pointing to the involvement of consolidated memory. These results support the notion that even small, short lived insects which are not central‐place foragers make use of learned cues in their natural environments.
Dysregulation in lung immunity — The protective and pathologic Th17 response in infection
Authors: Way Emily E. , Chen Kong , Kolls Jay K.
Published: October 2013

Th17 cytokines can play both protective and pathologic roles in the airways. An emerging theme in Th17 cytokine biology is that these responses can mediate tissue pathology when downstream effector cells are dysfunctional, such as neutrophils lacking functional NADPH oxidase in the case of chronic granulomatous disease, or epithelial cells lacking appropriate ion transport as in the case of cystic fibrosis. In this Mini‐Review we highlight recent advances in the protective and pathologic roles of Th17 cytokines in the context of infection at the pulmonary barrier.
A high‐sensitivity LIF detector with silver mirror coating detection window and small‐angle optical deflection from collinear system for CE
Authors: Li Meng , Ji Hongyun , Li Jing , Yuan Hongyan , Xiao Dan
Published: October 2013

An LIF detector was integrated into a CE system based on silver mirror coating detection window and small‐angle optical deflection from collinear configuration. For this detection scheme, the incident light beam was focused on capillary through the edge of a lens, resulting in a small deflection angle that deviated 18° from the collinear configuration. Meanwhile, the excitation light and emitted fluorescence were effectively reflected by silver mirror coating at the detection window. The fluorescence was collected through the center of the same lens and delivered to a PMT in the vertical direction. In contrast to conventional collinear LIF detection systems, the fluorescence intensity was greatly enhanced and the background level was significantly eliminated. FITC and FITC‐labeled amino acids were used as model analytes to evaluate the performance with respect to design factors of this system. The limit LOD was estimated to be 0.5 pM for FITC (S/N = 3), which is comparable to that of optimized confocal LIF systems. All the results indicate that the proposed detection scheme will be promising for development of sensitive and low‐cost CE system.
Lithological structure of the Galápagos Plume
Authors: Vidito Christopher , Herzberg Claude , Gazel Esteban , Geist Dennis , Harpp Karen
Published: October 2013

We have measured Ni, Ca, and Mn in olivine phenocrysts from volcanoes in the Galápagos Archipelago to infer the mantle source lithologies. Results show that peridotite is the dominant source lithology for Fernandina, Floreana, Genovesa, Wolf Island, and Darwin Island. These volcanoes largely characterize the PLUME, WD, FLO, and DUM Nd, Sr, and Pb isotopic endmembers of Harpp and White (2001). Volcan Wolf, Alcedo, Marchena, and Cerro Azul, also produced from the melting of peridotite sources, have isotopic compositions that can be defined by mixing of the four isotopic endmembers. Our analysis suggests that peridotite was present in the sources of the volcanoes covered in this study and therefore is the dominant source lithology of the Galápagos plume. Pyroxenite melting is generally focused in two isotopically distinct domains: Roca Redonda, Volcan Ecuador, and Sierra Negra in the enriched western part of the archipelago and Santiago, Santa Cruz, and Santa Fe in the depleted east. One implication of this finding is that the Western and Eastern Pyroxenite Domains represent two separate bodies of recycled crust within the Galápagos mantle plume. Furthermore, both isotopically enriched and depleted domains of the archipelago were generated from mixtures of peridotite and pyroxenite. This suggests that there is no relationship between the source lithology of the Galápagos plume and its isotopic characteristics. The identification of peridotite‐source melting in volcanoes with isotopic characteristics that have been attributed to recycled crust points to the importance of mixing in OIB genesis, consistent with studies in the Canary Islands.
Scaling relations of seismic moment, rupture area, average slip, and asperity size for M~9 subduction‐zone earthquakes
Authors: Murotani Satoko , Satake Kenji , Fujii Yushiro
Published: October 2013

Scaling relations for seismic moment M0, rupture area S, average slip D, and asperity size Sa were obtained for large, great, and giant (Mw = 6.7–9.2) subduction‐zone earthquakes. We compiled the source parameters for seven giant (Mw~9) earthquakes globally for which the heterogeneous slip distributions were estimated from tsunami and geodetic data. We defined Sa for subfaults exhibiting slip greater than 1.5 times D. Adding 25 slip models of 10 great earthquakes around Japan, we recalculated regression relations for 32 slip models: S = 1.34 × 10−10 M02/3, D = 1.66 × 10−7 M01/3, Sa = 2.81 × 10−11 M02/3, and Sa/S = 0.2, where S and Sa are in square kilometers, M0 is in newton meters, and D is in meters. These scaling relations are very similar to those obtained by Murotani et al. (2008) for large and great earthquakes. Thus, both scaling relations can be used for future tsunami hazard assessment associated with a giant earthquake.
The effects of presession attention on tacting
Authors: Cengher Mirela , Jones Emily A. , Fienup Daniel M.
Published: October 2013

This study examined the effects of presession attention on tacting. Presession intervals of deprivation and satiation of attention were followed by a progressive‐ratio assessment in which the number of tacts was measured. For 2 participants, deprivation resulted in increased tacting compared to satiation. The 3rd participant showed no differential responding. These results suggest that antecedent‐based interventions could increase the efficiency of tact training.
Virtual Reality Exposure Therapy for the Treatment of Posttraumatic Stress Disorder: A Methodological Review Using CONSORT Guidelines
Authors: Motraghi Terri E. , Seim Richard W. , Meyer Eric C. , Morissette Sandra B.
Published: October 2013

Context

Virtual reality exposure therapy (VRET) is an extension of traditional exposure therapy and has been used to treat a variety of anxiety disorders. VRET utilizes a computer‐generated virtual environment to present fear‐relevant stimuli. Recent studies have evaluated the use of VRET for treatment of PTSD; however, a systematic evaluation of the methodological quality of these studies has yet to be conducted.

Objectives

This review aims to (a) identify treatment outcome studies examining the use of VRET for the treatment of PTSD and (b) appraise the methodological quality of each study using the 2010 Consolidating Standards of Reporting Trials (CONSORT) Statement and its 2008 extension for nonpharmacologic interventions.

Methods

Two independent assessors conducted a database search (PsycINFO, Medline, CINAHL, Google Scholar) of studies published between January 1990 and June 2013 that reported outcome data comparing VRET with another type of treatment or a control condition. Next, a CONSORT quality appraisal of each study was completed.

Results

The search yielded nine unique studies. The CONSORT appraisal revealed that the methodological quality of studies examining VRET as a treatment for PTSD was variable.

Conclusion

Although preliminary findings suggest some positive results for VRET as a form of exposure treatment for PTSD, additional research using well‐specified randomization procedures, assessor blinding, and monitoring of treatment adherence is warranted. Movement toward greater standardization of treatment manuals, virtual environments, and equipment would further facilitate interpretation and consolidation of this literature.
Reproducibility and correlations of right ventricular end‐diastolic volume index measured by real‐time three‐dimensional echocardiography
Authors: Xu Yingjia , Wu Weihua , Fang Weiyi , Chen Hui
Published: October 2013

Background

To correlate right ventricular volumes measured by real‐time three‐dimensional echocardiography (RT3DE) with left ventricular volume indices in patients with or without left‐sided heart diseases.

Methods

For this retrospective, we reviewed 806 consecutive RT3DE examinations with quantitative evaluation of both the left and the right (RV) ventricle. We excluded cases of disease or surgery that would directly affect the size of the RV (eg, intracardiac shunt, significant tricuspid, or pulmonic regurgitation) as well as poor sonographic image quality, leaving a total of 701 studies for analysis. RV volumetric quantification was performed using dedicated software.

Results

Linear regression analysis showed that left ventricular stroke volume index significantly correlated with RV end‐diastolic volume index (RVEDVI) (r = 0.78, p < 0.0001). Overall, 4% (28 of 701) of the patients had RVEDVI lower than 50 ml/m2, and 12% (84 of 701) had RVEDVI greater than 100 ml/m2. Intraclass correlation coefficient ranged from 0.91 to 0.99 for intraobserver and 0.85 to 0.98 for interobserver reproducibility.

Conclusions

RT3DE was feasible and reproducible for quantifying RV volume. In patients without known primary RV pathology, RV volume strongly correlated with left ventricular stroke volume. © 2013 Wiley Periodicals, Inc. J Clin Ultrasound 42:81–88, 2014
“Snowplow” injection front effects
Authors: Moore T. E. , Chandler M. O. , Buzulukova N. , Collinson G. A. , Kepko E. L. , Garcia‐Sage K. S. , Henderson M. G. , Sitnov M. I.
Published: October 2013

As the Polar spacecraft apogee precessed through the magnetic equator in 2001, Polar encountered numerous substorm events in the region between geosynchronous orbit and 10 RE geocentric distance; most of them in the plasma sheet boundary layers. Of these, a small number was recorded near the neutral sheet in the evening sector. Polar/Thermal Ion Dynamics Experiment provides a unique perspective on the lowest‐energy ion plasma, showing that these events exhibited a damped wavelike character, initiated by a burst of radially outward flow transverse to the local magnetic field at ~80 km/s. They then exhibit strongly damped cycles of inward/outward flow with a period of several minutes. After one or two cycles, they culminated in a hot plasma electron and ion injection, quite similar to those observed at geosynchronous orbit. Cold plasmaspheric plasmas comprise the outward flow cycles, while the inward flow cycles contain counterstreaming field‐parallel polar wind‐like flows. The observed wavelike structure, preceding the arrival of an earthward moving substorm injection front, suggests an outward displacement driven by the inward motion at local times closer to midnight, that is, a “snowplow” effect. The damped in/out flows are consistent with interchange oscillations driven by the arrival at the observed local time by an injection originating at greater radius and local time.
Stationary planetary wave and nonmigrating tidal signatures in ionospheric wave 3 and wave 4 variations in 2007–2011 FORMOSAT‐3/COSMIC observations
Authors: Chang Loren C. , Lin Chien‐Hung , Yue Jia , Liu Jann‐Yenq , Lin Jia‐Ting
Published: October 2013

The wave 3 and wave 4 modulations of the Equatorial Ionization Anomalies are a robust feature of the low‐latitude ionosphere, when viewed at constant local time. Although initially associated, respectively, with DE2 and DE3, nonmigrating diurnal tides in the mesosphere and lower thermosphere region, recent results have suggested that the wave 3 and wave 4 may also have significant contributions from other tidal and stationary planetary wave (SPW) signatures. We present observations of total electron content (TEC) variations associated with tidal and SPW signatures comprising the ionospheric wave 3 and wave 4 structures from FORMOSAT‐3/COSMIC from 2007 to 2011. We find that the wave 3 (wave 4) feature is comprised predominately by DE2 (DE3) and SPW3 (SPW4) signatures in TEC throughout all 5 years, with contributions from SE1 (SE2) being less significant. The wave 3 component also has recurring contributions from DW4 during December/January. The absolute amplitudes of all the aforementioned tidal and SPW signatures are directly related to the level of solar activity and the semiannual variation in zonal mean TEC. After normalizing by the zonal mean, the relative amplitudes of the wave 4 signatures are inversely related to solar activity through 2010, which is not seen with the wave 3‐related signatures. The seasonal variation and phases of the main constituents of wave 3 and wave 4 are consistent from year to year, as evidenced by the interannual recurrence in the peak and trough locations of wave 3 and wave 4.
Diagnosis of focal liver lesions with gadoxetic acid‐enhanced MRI: Is a shortened delay time possible by adding diffusion‐weighted imaging?
Authors: Kim Moon Young , Kim Young Kon , Park Hyun Jeong , Park Min Jung , Lee Won Jae , Choi Dongil
Published: October 2013

Purpose

To determine whether the diagnostic performance of combined gadoxetic acid‐enhanced dynamic phases and diffusion‐weighted imaging (DWI) is comparable to the standard protocol with hepatobiliary phase (HBP) and DWI for detection and characterization of focal liver lesions in chronic liver disease.

Materials and Methods

A total of 176 patients with 181 HCCs, 15 cholangiocarcinomas, and 32 benign lesions were included. Three combined gadoxetic acid‐enhanced and DWI sets (dynamic phases [arterial, portal, and 3‐min delay {3‐min set} and dynamic phases with 10‐min HBP [10‐min set] or 20‐min HBP [20‐min set]) were analyzed by two observers to determine the diagnostic accuracy and sensitivity in detection of malignancy, and ability for lesion characterization.

Results

There was a trend, although not statistically significant, toward highest diagnostic accuracy and sensitivity for detecting malignancies in the 20‐min set (mean, 0.945, 96.2), followed by the 10‐min set (0.937, 95.9), and the 3‐min set (0.923, 94.1) (P > 0.05). For lesion characterization, three image sets were equivalent (P > 0.05).

Conclusion

For lesion detection and characterization in chronic liver diseases, 3‐min set with DWI showed comparable efficacy to 10‐min or 20‐min set. However, the best diagnostic performance could be achieved by combination of all image sets. J. Magn. Reson. Imaging 2014;39:31–41. © 2013 Wiley Periodicals, Inc.
Feasibility and reproducibility of free fatty acid profiling in abdominal adipose tissue with 1H‐magnetic resonance spectroscopy at 3 T: Differences between lean and obese individuals
Authors: Schrover Ilse M. , Leiner Tim , Klomp Dennis W.J. , Wijnen Jannie P. , Uiterwaal Cuno S.P.M. , Spiering Wilko , Visseren Frank L.J.
Published: October 2013

Purpose

To evaluate the feasibility and reproducibility of free fatty acid (FFA) measurement for diagnosing adipose tissue dysfunction by 1H‐magnetic resonance spectroscopy (1H‐MRS) in different abdominal adipose tissue depots in healthy obese and lean subjects.

Materials and Methods

Polyunsaturated fatty acids (PUFA), total unsaturated fatty acids (TUFA), triglycerides (TG), and their ratios were determined in three adipose tissue depots of 12 obese and 13 lean subjects. Subjects underwent two separate examinations to assess reproducibility.

Results

In lean subjects, 44% of measurements failed due to inclusion of nonadipose tissue in the spectroscopy voxel, as opposed to 23% in obese subjects. Reproducibility of PUFA, TUFA, and TG was moderate to good in obese subjects (intraclass correlation coefficients [ICCs] 0.18–0.75), and poor to moderate in lean subjects (ICCs −1.04–0.55) in subcutaneous and omental adipose tissue. In the perirenal adipose tissue, ICCs were poor in both lean and obese subjects (−0.794–0.013). PUFA/TUFA and PUFA/TG were higher in omental adipose tissue in obese vs. lean subjects (35*10−3 vs. 0.16*10−3, P = 0.01 and 2.05*10−3 vs. 0.01*10−3, P = 0.02, respectively).

Conclusion

1H‐MRS is a feasible and reproducible method for FFA profiling in abdominal adipose tissue in abdominally obese individuals. 1H‐MRS has potential as diagnostic tool for noninvasive identification of adipose tissue dysfunction. J. Magn. Reson. Imaging 2014;40:423–431. © 2013 Wiley Periodicals, Inc.
Close relationship between immunoglobulin secreting‐cells and Epstein–Barr virus reservoir in patients infected with HIV
Authors: Ouedraogo David Eric , Tuaillon Edouard , Rubbo Pierre‐Alain , Bollore Karine , Foulongne Vincent , Reynes Jacques , Vendrell Jean‐Pierre
Published: October 2013

Individuals infected with HIV have higher circulating Epstein–Barr virus (EBV) DNA load compared to healthy carriers. This study investigated whether level of spontaneous immunoglobulin secreting cells, one of the major hallmarks of HIV infection, is associated with an increase of EBV DNA load in PBMCs and the spontaneous EBV lytic cycle ex vivo in patients infected with HIV. Spontaneous virus production by cells infected with EBV and EBV DNA loads in PBMCs from which CD8+ T‐cells were removed were measured in 20 HIV‐aviremic and 14 HIV‐viremic patients. The number of circulating immunoglobulin‐secreting cells (Ig‐SCs) and CD8+ T‐lymphocyte activation were also investigated. Patients with detectable HIV RNA in plasma exhibited higher spontaneous ex vivo EBV secretion and higher levels of EBV DNA in PBMCs than their aviremic counterparts. In the two groups observed, a positive correlation was found between PBMCs EBV DNA viral load and Ig‐SCs, CD38bright expression on CD8+ T‐cells and EBV DNA load in cell culture supernatants. These findings suggest that B‐cell polyclonal activation and B‐cell terminal differentiation into Ig‐SCs may fuel EBV DNA reservoir and promote EBV production ex vivo in patients infected with HIV. J. Med. Virol. 86:30–37, 2014. © 2013 Wiley Periodicals, Inc.
The relationship between the Atlantic Multidecadal Oscillation and temperature variability in China during the last millennium
Authors: WANG JIANGLIN , YANG BAO , LJUNGQVIST FREDRIK CHARPENTIER , ZHAO YAN
Published: October 2013

Using a large number of temperature‐sensitive proxy records, we investigated the relationship between the Atlantic Multidecadal Oscillation (AMO) and temperature variability in China during the last millennium. The results indicate a relatively homogeneous pattern of cold/warm anomalies in East, West and the whole of China (EC, WC and WOC). The six major AMO cold phases coincided with cold conditions over EC, WC and WOC, while warm conditions across China occurred during the two major AMO warm phases. This close similarity between the AMO and multi‐decadal temperature variability in China is supported by climate model simulations and emphasizes the critical role of surface heating over the Asian continent in linking the AMO and the Indian summer monsoon. The mid‐latitude westerly anomalies and the propagation of Rossby waves related to the AMO may be two channels linking sea surface temperature anomalies in the North Atlantic and temperature variability over East Asia. Additionally, the Atlantic Meridional Overturning Circulation may play an important role in transmitting the AMO signal over the globe. We recommend further climate model studies on the mechanisms responsible for the connection between the AMO and regional to global climate changes.
Laparoscopic gastrectomy for advanced gastric cancer: Are the long‐term results comparable with conventional open gastrectomy? A systematic review and meta‐analysis
Authors: Choi Yoon Young , Bae Jung Min , An Ji Yeong , Hyung Woo Jin , Noh Sung Hoon
Published: October 2013

Background and Objective

Laparoscopic gastrectomy (LG) for gastric cancer has been adopted to treat both early and locally advanced gastric cancer (AGC), but there are still concerns about its oncologic safety especially in AGC. The purpose of this meta‐analysis is to compare the long‐term outcomes of LG with those of open gastrectomy (OG) in patients with AGC.

Methods

The quantitative synthesis of outcomes of studies from three major databases, PubMed, Embase, and the Cochrane Central, was performed using common keywords related to gastric cancer and laparoscopy on July 31, 2012.

Results

Ten studies (one randomized controlled trial and nine retrospective cohort studies) with 1,819 participants (960 patients in OG, and 859 patients in LG) were included in the current meta‐analysis. Nine studies compared the overall survival rate between LG and OG for AGC, and five studies reported the disease‐free survival. There was no statistical difference in overall survival (hazard ratio [HR]: 0.90, 95% confidence interval [CI]: 0.76–1.06, P = 0.22) and disease‐free survival (HR: 1.03, 95% CI: 0.76–1.40, P = 0.86) between the two modalities.

Conclusions

The current clinical evidence revealed that there was no evidence that LG is inferior to OG even for AGC if the surgeons have sufficient experience. J. Surg. Oncol. 2013; 108:550–556. © 2013 Wiley Periodicals, Inc.
Gastric outlet obstruction in gastric cancer: A comparison of three palliative methods
Authors: Keränen Ilona , Kylänpää Leena , Udd Marianne , Louhimo Johanna , Lepistö Anna , Halttunen Jorma , Kokkola Arto
Published: October 2013

Background

Gastric outlet obstruction (GOO) commonly occurs in advanced gastric cancer. Our aim was to evaluate the results of endoscopic stenting (ES), palliative resection (PR), and gastrojejunostomy (GJ) as palliation of GOO.

Methods

A total of 97 patients (50 ES, 26 PR, 21 GJ) were included in this retrospective study. All the patients had primary gastric cancer and symptoms of GOO.

Results

Compared to surgery, ES resulted in a faster improvement on oral intake and symptom relief (P < 0.001) and a shorter hospitalization (P < 0.001). Complication rates, hospital re‐admissions, occurrence of biliary obstruction, and the number of patients receiving chemotherapy were similar. The median symptom‐free and overall survival were longest in the PR group (P < 0.001). In multivariate survival analysis, independent prognostic factors were age, BMI, pre‐procedure GOOSS, palliative resection as treatment modality, and chemotherapy.

Conclusions

In gastric cancer and GOO, the clinical condition of the patient before treatment affects survival and should be taken into account in determining the treatment. PR seems to provide a survival benefit and should be considered as treatment option for patients suitable for surgery. For patients unfit for surgery, ES provides rapid and efficient palliation. Chemotherapy also seems to improve survival in gastric cancer and GOO. J. Surg. Oncol. 2013; 108:537–541. © 2013 Wiley Periodicals, Inc.
Prognostic value of total tumor volume in advanced‐stage laryngeal and hypopharyngeal carcinoma
Authors: Yang Chan‐Joo , Kim Dae‐Yoon , Lee Jeong Hyun , Roh Jong‐Lyel , Choi Seung‐Ho , Nam Soon Yuhl , Kim Sang Yoon
Published: October 2013

Background

To evaluate the prognostic value of total tumor volume (TTV) in patients with laryngeal and hypopharyngeal carcinomas.

Methods

This study involved 182 patients with previously untreated advanced‐stage squamous cell carcinoma of the larynx or hypopharynx. TTV were calculated from pretreatment contrast‐enhanced computed tomography images. Univariate and multivariate analyses were used to identify factors associated with overall (OS), disease‐specific (DSS), and disease‐free survival (DFS).

Results

At a median follow‐up of 63 months (range, 24–139 months), the 5 year OS, DSS, and DFS rates were 60.2%, 73.1%, and 69.4%, respectively. Multivariate analyses showed that tumor site was an independent predictor of DSS (P = 0.03); Charlson comorbidity index for OS (P = 0.001); second primary cancer for OS (P = 0.008) and DFS (P = 0.001); and vocal fold paralysis for DSS (P = 0.014) and DFS (P = 0.033). Extension to the tongue base was an independent predictor of OS (P = 0.007), DSS (P < 0.001), and DFS (P = 0.017), and TTV ≥8.38 ml was an independent predictor of all three survivals (P < 0.001 each).

Conclusion

Radiologically determined TTV is prognostic of survival in patients with advanced‐stage laryngeal and hypopharyngeal carcinoma.J. Surg. Oncol. 2013; 108:509–515. © 2013 Wiley Periodicals, Inc.
Extranodal natural killer/T‐Cell lymphoma: A population‐based comparison of sinonasal and extranasal disease
Authors: Vazquez Alejandro , Khan Mohemmed N. , Blake Danielle M. , Sanghvi Saurin , Baredes Soly , Eloy Jean Anderson
Published: October 2013

Objectives/Hypothesis

Extranodal natural killer/T‐cell Lymphoma (ENKTL) is a rare, aggressive malignancy that preferentially affects the paranasal region. This study analyzes the demographic, clinicopathologic, incidence, and survival characteristics of sinonasal ENKTL (SN‐ENKTL) and extranasal ENKTL (EN‐ENKTL) in a comparative fashion.

Study Design

Retrospective analysis.

Methods

The Surveillance, Epidemiology, and End Results database was queried; 528 cases were available for frequency and incidence analysis, and 473 for survival analysis. Data were examined according to age, gender, race, histology, the presence of systemic (or B) symptoms, treatment, and Ann Arbor stage.

Results

Extranasal disease was a poor prognostic factor (hazard ratio [HR] = 1.69, 95% confidence interval [CI] = 1.30−2.19, P < .05). Patients with EN‐ENKTL were older (mean 53.8 vs. 49.9 years, P < .05), most were male (72.5% vs. 59.8%, P < .05), and they were more likely to present with stage IIIE/IV disease (38.33% vs. 18.26%, P < .05). B symptoms were present in 38.41% of the EN‐ENKTL group (vs. 22.86%, P < .05), and were a poor prognostic factor in this group only (HR = 1.6593, 95% CI = 1.05−2.62, P < .05). Radiation therapy demonstrated a survival advantage among both groups, especially in early stage disease.

Conclusions

SN‐ENKTL carries a significantly better prognosis than EN‐ENKTL, which presents at more advanced stages. Radiation therapy was associated with increased survival in both groups, especially in cases of localized disease.

Level of Evidence

2b. Laryngoscope, 124:888–895, 2014
Augmented real‐time navigation with critical structure proximity alerts for endoscopic skull base surgery
Authors: Dixon Benjamin J. , Daly Michael J. , Chan Harley , Vescan Allan , Witterick Ian J. , Irish Jonathan C.
Published: October 2013

Objectives/Hypothesis

Image‐guided surgery (IGS) systems are frequently utilized during cranial base surgery to aid in orientation and facilitate targeted surgery. We wished to assess the performance of our recently developed localized intraoperative virtual endoscopy (LIVE)‐IGS prototype in a preclinical setting prior to deployment in the operating room. This system combines real‐time ablative instrument tracking, critical structure proximity alerts, three‐dimensional virtual endoscopic views, and intraoperative cone‐beam computed tomographic image updates.

Study Design

Randomized‐controlled trial plus qualitative analysis.

Methods

Skull base procedures were performed on 14 cadaver specimens by seven fellowship‐trained skull base surgeons. Each subject performed two endoscopic transclival approaches; one with LIVE‐IGS and one using a conventional IGS system in random order. National Aeronautics and Space Administration Task Load Index (NASA‐TLX) scores were documented for each dissection, and a semistructured interview was recorded for qualitative assessment.

Results

The NASA‐TLX scores for mental demand, effort, and frustration were significantly reduced with the LIVE‐IGS system in comparison to conventional navigation (P < .05). The system interface was judged to be intuitive and most useful when there was a combination of high spatial demand, reduced or absent surface landmarks, and proximity to critical structures. The development of auditory icons for proximity alerts during the trial better informed the surgeon while limiting distraction.

Conclusions

The LIVE‐IGS system provided accurate, intuitive, and dynamic feedback to the operating surgeon. Further refinements to proximity alerts and visualization settings will enhance orientation while limiting distraction. The system is currently being deployed in a prospective clinical trial in skull base surgery. Laryngoscope, 124:853–859, 2014
Temporal bone squamous cell carcinoma: Analyzing prognosis with univariate and multivariate models
Authors: Zanoletti Elisabetta , Marioni Gino , Stritoni Paola , Lionello Marco , Giacomelli Luciano , Martini Alessandro , Mazzoni Antonio
Published: October 2013

Objectives/Hypothesis

Temporal bone squamous cell carcinoma (SCC) is an uncommon malignancy accounting for less than 0.2% of head and neck cancers. Despite advances in its early diagnosis, skull base microsurgery, radiotherapy, and integrated treatments, prognosis in advanced SCCs remains dismal. The present study aimed to analyze the clinicopathological variables potentially influencing outcome in a series of temporal bone SCCs.

Study Design

The prognosis of 41 patients with temporal bone SCC was assessed retrospectively using univariate and multivariate statistical approaches.

Patients and Methods

Twenty‐two women and 19 men consecutively operated for primary temporal bone SCC with a curative intent at a tertiary referral center between 1980 and 2008.

Results

On univariate analysis, cT stage correlated with disease‐free survival in months (DFS) (P = 0.037), and pT stage correlated with recurrence rate (P = 0.038), DFS (P = 0.013), and disease‐specific survival (DSS) (P = 0.025). Lymph node status (cN0 or pN0 vs. pN+) was associated with DFS (P = 0.025). SCC grading correlated significantly with recurrence rate (P = 0.005), DFS (P = 0.004), and DSS (P = 0.0036). Dura mater involvement was significantly associated with a higher recurrence rate (P = 0.001), a shorter DFS (P = 0.00001), and a lower DSS (P = 0.0001). On multivariate analysis, only dura mater involvement (P = 0.001) and N status (P = 0.012) remained independently prognostic of DFS.

Conclusion

Recurrences occurred despite obtaining block resections according to the tumor's clinical stage and pathologically free margins in all cases. Further analyses are mandatory to investigate hidden microscopic pathways of tumor diffusion, particularly in bone. Multi‐institutional protocols are needed to facilitate comparisons between studies and enable meaningful meta‐analyses.

Level of Evidence

2b. Laryngoscope, 124:1192–1198, 2014
PEG and Cholesterol‐Containing Pyromellitates: Synthesis and Self‐Assembly
Authors: Kudina Olena , Tarnavchyk Ihor , Khomenko Olena , Budishevska Olga , Voronov Stanislav , Voronov Andriy
Published: October 2013

A new synthetic route for two different amphiphilic macromolecular structures containing hydrophilic poly(ethylene glycol) (PEG) and lipophilic cholesterol fragments is described. The novelty of the synthesis is in combining hydrophilic and lipophilic fragments in a backbone using functional groups of the pyromellitic dianhydride (PMDA) molecule. The ability of the new oligomers to undergo self‐assembly and solubilization of lipophilic molecules in an aqueous medium is compared. The new oligomers form self‐assemblies capable of solubilizing lipophilic “guest” molecules in an aqueous medium. Their high solubilization capacity and biodegradability, as well as other properties (size distribution, ζ‐potential), make the synthesized macromolecules good candidates for biomedical applications. Using the developed approach, amphiphilic macromolecules with regulated surface activity can be synthesized by combining PEG of varying lengths with different hydrophobic fragments (for example, fatty alcohols) in the backbone.

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Cyclic AMP regulates the migration and invasion potential of human pancreatic cancer cells
Authors: Zimmerman Noah P. , Roy Ishan , Hauser Andrew D. , Wilson Jessica M. , Williams Carol L. , Dwinell Michael B.
Published: October 2013

Aggressive dissemination and metastasis of pancreatic ductal adenocarcinoma (PDAC) results in poor prognosis and marked lethality. Rho monomeric G protein levels are increased in pancreatic cancer tissue. As the mechanisms underlying PDAC malignancy are little understood, we investigated the role for cAMP in regulating monomeric G protein regulated invasion and migration of pancreatic cancer cells. Treatment of PDAC cells with cAMP elevating agents that activate adenylyl cyclases, forskolin, protein kinase A (PKA), 6‐Bnz‐cAMP, or the cyclic nucleotide phosphodiesterase inhibitor cilostamide significantly decreased migration and Matrigel invasion of PDAC cell lines. Inhibition was dose‐dependent and not significantly different between forskolin or cilostamide treatment. cAMP elevating drugs not only blocked basal migration, but similarly abrogated transforming‐growth factor‐β‐directed PDAC cell migration and invasion. The inhibitory effects of cAMP were prevented by the pharmacological blockade of PKA. Drugs that increase cellular cAMP levels decreased levels of active RhoA or RhoC, with a concomitant increase in phosphorylated RhoA. Diminished Rho signaling was correlated with the appearance of thickened cortical actin bands along the perimeter of non‐motile forskolin or cilostamide‐treated cells. Decreased migration did not reflect alterations in cell growth or programmed cell death. Collectively these data support the notion that increased levels of cAMP specifically hinder PDAC cell motility through F‐actin remodeling. © 2013 Wiley Periodicals, Inc.
The Sensitivity of High‐Tech Entrepreneurial Ventures' Employment to a Sales Contraction in a Negative Growth Scenario: The Moderating Role of Venture Capital Financing
Authors: Colombo Massimo G. , Piva Evila , Rossi‐Lamastra Cristina
Published: October 2013

This article examines the sensitivity of employment to sales contractions in a negative growth scenario for high‐tech entrepreneurial ventures. Using the lens of transaction cost economics, we move from the centrality of human capital for these firms to theoretically discuss and empirically test the moderating effect of venture capital financing on the employment‐sales relationship. In doing so, we take into account (i) the identity of the investor, distinguishing independent, corporate and governmental venture capital investors, and (ii) the presence and composition of a syndicate. Copyright © 2013 John Wiley & Sons, Ltd.
The Wage and Employment Consequences of Ownership Change
Authors: Amess Kevin , Girma Sourafel , Wright Mike
Published: October 2013

This paper provides a comparative examination of the consequences of leveraged buyouts (LBOs) and corporate takeovers on employment growth and wage growth. Employing both difference‐in‐differences combined with propensity score matching and the control function approach, we find evidence that (i) wages remain unchanged after either a private equity (PE)‐backed or non‐PE‐backed LBO, (ii) wages remain unchanged after an unrelated takeover and (iii) related takeovers have negative employment consequences, possibly because of rationalisation. Our evidence does not find strong support for intervention in the market for corporate control on the grounds of protecting employees' welfare. Copyright © 2013 The Authors. Managerial and Decision Economics published by John Wiley & Sons, Ltd.
Effects of fat on MR‐measured metabolite signal strengths: implications for in vivo MRS studies of the human brain
Authors: Mon Anderson , Abé Christoph , Durazzo Timothy C. , Meyerhoff Dieter J.
Published: October 2013

Recent MRS studies have indicated that a higher body mass index (BMI) is associated with lower brain metabolite levels. Generally, individuals with higher BMIs have more body fat deposits than individuals with normal BMIs. This single‐voxel spectroscopy (SVS) study investigated possible effects of fat on MR‐measured metabolite signal areas, which may at least partly explain the observed associations of BMI with MR‐measured brain metabolite levels in vivo. SVS data were acquired at 4 T from a phantom containing N‐acetylaspartate, glutamate and creatine, as well as from three healthy male adults. Back fat obtained from pig was used to assess the effects of fat on metabolite signals. With the same voxel size and placement, the phantom was first scanned without fat (baseline), and then with 0.7‐cm‐ and 1.4‐cm‐thick fat layers placed on it. Each participant was also scanned first without fat and then with two 0.7‐cm fat layers, one placed beneath the occiput and the other on the forehead. Two spectra were acquired per participant from the anterior cingulate and the parieto‐occipital cortices. The metabolite resonance and corresponding water peak areas were then fitted and metabolite to water signal ratios were used for analyses. In both phantom and in vivo experiments, the metabolite‐to‐water ratios decreased in the presence of fat relative to baseline metabolite‐to‐water ratios. The reduced metabolite signals in the presence of fat reported here are reminiscent of the negative correlations observed between BMI and MR‐measured metabolite levels. These apparent physical effects of fat have potentially far‐reaching consequences for the accuracy of MR measurements of brain metabolite levels and their interpretation, particularly when large fat stores exist around the skull, such as in individuals with higher BMI. Copyright © 2013 John Wiley & Sons, Ltd.
Winning the Baldrige Award: How the Henry Ford Health System Undertook a Five‐Year Improvement Process
Authors: O'Reilly Gannon , Dziurman Brooke , Sprague Jordan , Witt Michael D.
Published: October 2013

Henry Ford Health Systems (HFHS) won the 2011 Baldrige Award, a major accomplishment. This achievement resulted from a systemwide focus on minimizing and controlling medical errors, a cultural shift to stimulate innovation and creative problem solving, and service excellence at every level. The five‐year effort centered on meeting Baldrige Award criteria, typically utilized in the for‐profit setting. When applied to the nonprofit sector, HFHS managed to reduce costs, reduce medication and treatment errors, introduce multiple creative clinical programs, and launch a new Ritz Carlton‐quality, hotel‐style service.