bluuebunny/crossref_metadata_2025 huggingface dataset:
Formative evaluation of the dietary assessment component of Children's and Adolescents' Nutrition Assessment and Advice on the Web (CANAA‐W)
Authors: Vereecken C. , Covents M. , Maes L. , Moyson T.
Published: August 2013

Background

The increased availability of computers and the efficiency and user‐acceptability of computer‐assisted questioning have increased the attractiveness of computer‐administered querying for large‐scale population nutrition research during the last decade. The Young Adolescents' Nutrition Assessment on Computer (YANA‐C), a computer‐based 24‐h dietary recall, was originally developed to collect dietary data among Belgian–Flemish adolescents. A web‐based version was created to collect parentally reported dietary data of preschoolers, called Young Children's Nutrition Assessment on the Web (YCNA‐W), which has been improved and adapted for use in young adolescents: Children and Adolescents' Nutrition Assessment and Advice on the Web (CANAA‐W). The present study describes recent developments and the formative evaluation of the dietary assessment component.

Methods

A feasibility questionnaire was completed by 131 children [mean (SD) age: 11.3 (0.7) years] and 53 parents. Eight focus groups were held with children (n = 65) and three with parents (n = 17).

Results

Children (C) and parents (P) found the instrument clear (C: 97%; P: 94%), comprehensible (C: 92%; P: 100%), attractive (C: 84%; P: 85%), fun (C: 93%; P: 83%) and easy to complete (C: 91%; P: 83%). There was ample explanation (C: 95%; P: 94%); the pictures were clear (C: 97%; P: 96%); and most respondents found the food items easy to find (C: 71%, P: 85%). The results helped to refine the lay out and structure of the instrument and the list of food items included.

Conclusions

Children and parents were enthusiastic. The major challenge will be to convince parents who are less interested in dietary intake and less computer literate to participate in this type of study. Children in this age group (11–12 years) should complete the instrument with assistance from an adult.
Melanoma in skin of color in Connecticut: an analysis of melanoma incidence and stage at diagnosis in non‐Hispanic blacks, non‐Hispanic whites, and Hispanics
Authors: Clairwood MariMeg , Ricketts Janelle , Grant‐Kels Jane , Gonsalves Lou
Published: August 2013

Background

The incidence of melanoma is increasing in Caucasians and in Hispanic subgroups in California and Florida. There is a paucity of information regarding melanoma incidence, stage at diagnosis, and other patient and tumor factors among minority subgroups in the northeast USA. This report examines melanoma in non‐Hispanic white, non‐Hispanic black, and Hispanic residents of Connecticut.

Methods

Trends in age‐adjusted melanoma incidence rates (1992–2007) and the corresponding annual percentage changes in rates were calculated for Connecticut residents by race and Hispanic ethnicity. The racial/ethnic variation was evaluated for a number of patient and tumor characteristics: gender, age at diagnosis, marital status, anatomic site, histology, ulceration, Breslow thickness, and stage at diagnosis. Statistical significance at the 95% level was assessed using confidence intervals (95% CIs) and Pearson's chi‐squared tests.

Results

Between 1992 and 2007, melanoma incidence increased by 4.1% per year in non‐Hispanic whites in Connecticut (95% CI 3.1–5.1%; P < 0.05). Melanoma incidence remained relatively stable for Hispanics and non‐Hispanic blacks over the same period. A significantly higher proportion of advanced (regional and distant) melanomas were diagnosed in non‐Hispanic blacks (19.1%) and Hispanics (17.1%) than in non‐Hispanic whites (8.7%) (P < 0.001).

Conclusions

A significantly higher proportion of advanced melanomas were diagnosed in non‐Hispanic blacks and Hispanics than in non‐Hispanic whites. There is a growing need to educate patients and healthcare providers of the necessity for skin cancer surveillance regardless of the race of the patient.
Immunohistochemical analysis of FOXP3+ regulatory T cells in healthy human skin and autoimmune dermatoses
Authors: Terras Sarah , Gambichler Thilo , Moritz Rose K. C. , Altmeyer Peter , Lambert Jo
Published: August 2013

Background

Regulatory T cells (Tregs) play an important role in autoimmune diseases. In skin, the presence of Tregs is thought to be mandatory for suppression of autoreactive T cells. Here, we assess the number of Tregs in skin of healthy subjects and patients with an autoimmune dermatosis.

Methods

Immunohistochemical stainings for CD3 and FOXP3 on skin biopsies of healthy subjects and subjects with psoriasis, vitiligo, pemphigus vulgaris, bullous pemphigoid, and halo nevus to assess the number of T and regulatory T cells, respectively.

Results

Low numbers of CD3+ and FOXP3+ cells were seen in the skin of healthy controls (median = 0.5%). A significantly higher frequency of Tregs was seen in lesional skin of patients with psoriasis (median = 12.4%) and patients with bullous pemphigoid (median = 10.1%) as compared to controls. In vitiligo (median = 0.0%), pemphigus vulgaris (median = 5.2%), and halo nevi (median = 5.4%), no significant difference in number of FOXP3+ cells was observed when compared to controls.

Conclusions

As confirmed in the literature, few Tregs were seen in healthy skin. A high number of Tregs were present in lesional skin from patients with psoriasis and bullous pemphigoid. These results support the hypothesis that not a decrease in number but rather a decrease in function of Tregs would be at the basis of autoimmune skin diseases, which could result in unrestrained activation autoreactive T cells in skin of patients with autoimmune dermatoses.
Clinical and dermoscopic patterns of melanocytic nevi in Hispanic adolescents: a descriptive study
Authors: Sosa‐Seda Ivette M. , Valentín‐Nogueras Sheila , Figueroa Luz D. , Sánchez Jorge L. , Mercado Rogelio
Published: August 2013

Background

Melanocytic nevi are well‐known, important precursors of melanoma among children and adults. The adolescence period is an important period for nevi formation and evolution. This study provides data of a longitudinal study of nevi in a Hispanic adolescent population.

Materials and methods

A cross‐sectional survey and 1‐year prospective follow‐up study was performed on Hispanic students from grades 6 and 7 at a school in Caguas, Puerto Rico (n = 90). The survey was completed by the students and one of their parents. The backs of the children were clinically examined for melanocytic nevi using digital photography and dermoscopy. Follow‐up was conducted one year later.

Results

The study cohort consisted of 53 (59%) boys and 37 (41%) girls, with an average age of 11.9 years (range 11–13 years). At the beginning of the study, 85% (n = 71/90) of the students presented with melanocytic nevi on their backs. After one year, new nevi were identified in 62% (n = 44/71), and there was a mean increase in nevus count of 1.8 (P < 0.001). A trend toward increased nevus count in lighter skin types was observed (P < 0.001). The predominant dermoscopic pattern was reticular (44%). The globular pattern was found most commonly in children with skin‐type II (100%), while the reticular pattern was the most common among skin‐types III (32%), IV (56%), and V (45%).

Conclusions

This study supports the utility of digital photography and dermoscopy for the evaluation of melanocytic nevi, providing evidence of the interrelationship between nevus count, dermoscopic pattern, and skin phenotype.
Biomechanical evaluation of the helica femoral implant system using traditional and modified techniques
Authors: Dosch Mark , Hayashi Kei , Garcia Tanya C. , Weeren Robert , Stover Susan M.
Published: August 2013

Objective

To determine the effect of implant placement on proximal femoral axial bone strains, implant subsidence, implant motion, and failure mechanical properties of Helica implants.

Study Design

In vitro biomechanical study.

Sample Population

Cadaveric canine femora (n = 8 pairs).

Methods

Femora instrumented with strain gauges and kinematic markers were cyclically loaded in axial compression before (intact femora) and after implantation with a Helica prosthesis that engaged only cancellous bone (traditional technique) or cancellous bone and lateral cortex (modified technique) to evaluate bone strains, subsidence, and motion; femora were then loaded to failure to evaluate failure mechanical properties.

Results

After implantation, modified femoral prosthesis angle was 5% less than intact femora and 5.7% less than traditional implanted femora. Medial femoral bone strain was lower (P ≤ .05) for intact (−570 µstrain) than modified (−790), but not (P = .08) traditional (−700) implanted femora. High‐load implant subsidence was present but small (−0.087 mm) for the modified technique. Motion (traditional and modified) increased (P = .05) during cyclic loading (−0.17 and −0.328 mm) and failure (P = .04) (−2.121 and −3.390 mm); remaining yield and failure properties revealed no significant findings (P ≤ .05).

Conclusions

The modified technique resulted in a smaller neck angle and minimal subsidence. Bone strain was minimally altered so stress shielding may be less compared to findings with traditional implants. Motion detected during cyclic and failure testing may lead to implant loosening in vivo.
Optimal collusion with limited liability
Authors: Billette de Villemeur Etienne , Flochel Laurent , Versaevel Bruno
Published: August 2013

Collusion sustainability depends on firms’ ability to impose sufficiently severe punishments in the event of deviation from the collusive rule. We extend results from the literature on optimal collusion by investigating the role of a limited liability constraint. We examine all situations in which either structural conditions, financial considerations, or institutional circumstances set a lower bound, possibly negative, to firms’ profits. For a large class of repeated games we show that, when the limited liability constraint binds, there exists an infinity of multi‐period punishment paths that permit firms to implement the optimal collusive strategy. The usual front‐loading scheme is only a specific case and an optimal punishment profile can take the form of a price asymmetric cycle. We characterize the situations in which a longer punishment does not perform as a perfect substitute for more immediate severity. In this case, the lowest discount factor that permits collusion is strictly higher than without the limited liability constraint, which hinders collusion.
A volumetric study of guided bone regeneration around titanium implants in the New Zealand white rabbit
Authors: Pal George L. , Stevenson Alastair , Klineberg Iven J. , Pearson Martin , Albrektsson Tomas , Johansson Carina
Published: August 2013

Previous studies have shown the ability for bone to grow under occlusive membranes. This study was undertaken to determine the time required for bone to form in the space created under the membrane and to determine the amount of bone that may be grown under the membrane. Thirty‐two New Zealand white rabbits were divided into three groups. A Brånemark implant, having a diameter of 3.75 mm with a length of 7 mm, was placed in each tibia and Gore‐Tex membrane was draped over the implant on the experimental side and tethered to the wound margin. Sixteen rabbits were sacrificed at six weeks, eight at twelve weeks, and eight at eighteen weeks. At six weeks the available space under the membrane was filled to 68 per cent, at twelve weeks it was 45 per cent, and at eighteen weeks 54 per cent. A comparison of bone height measurements on test and control sides showed a significant difference (p=0.0001) at the three time intervals. A comparison of grown bone volumes (test vs control) was also statistically significant (p=0.0001). The ability to grow bone under an occlusive membrane was confirmed but the long‐term survival rate and ability to support load needs to be investigated.
Purification and characterization of a putative fimbrial protein/receptor of Porphyromonas gingivalis
Authors: Dashper S. G. , O'Brien‐Simpson N. M. , Bhogal P. S. , Franzmann A. D. , Reynolds E. C.
Published: August 2013

Porphyromonas gingivalis has been implicated as a major aetiological agent in certain forms of periodontal disease. P. gingivalis is a Gram‐negative, asaccharolytic bacterium that obtains energy from the fermentation of amino acids derived from the hydrolysis of host protein. Virulence factors of this bacterium include the capsule, fimbrial adhesins, cytotoxins and extracellular hydrolytic enzymes. A 43 kDa fimbrillin from P. gingivalis has been isolated and characterized. However, there is evidence that a second type of fimbria exists on the surface of P. gingivalis. A putative P. gingivalis fimbrial protein from a membrane preparation has been isolated and identified. This protein was shown to be reactive with sera from patients harbouring P. gingivalis. A 28 kDa protein fragment was purified by anion exchange, gel filtration and reversed‐phase chromatography. N‐terminal sequence analysis of the 28 kDa protein fragment revealed homology to the fimbrial precursor protein of Dichelobacter nodosus. A peptide corresponding to the N‐terminal 26 amino acyl residues of the 28 kDa protein fragment was synthesized and used to raise antibodies to the protein. Western blot analysis after SDS‐PAGE of a P. gingivalis membrane preparation using the antibodies raised to the synthetic peptide detected three proteins of 36, 41 and 67 kDa. When protease inhibitors were not included in the extraction procedure only the 36 and 41 kDa bands were detected. It would appear, therefore, that the intact protein has an Mr of 67 kDa and that the 28, 36 and 41 kDa bands represent protein fragments produced by endogenous proteolytic activity. Based on sequence homology, the 67 kDa protein is possibly a sub‐unit of a second P. gingivalis fimbrial type or a surface receptor.
Studies on fusobacteria associated with periodontal diseases
Authors: Rogers A. H.
Published: August 2013

The physiological and metabolic characteristics of representative isolates of the various subspecies of Fusobacterium nucleatum were investigated by growing them in continuous culture in chemically‐defined media. Behaving almost identically, these organisms were found to obtain energy from the fermentation of simple carbohydrates such as glucose or fructose or from the fermentation of certain amino acids, free or in the form of small peptides. The latter can be attacked by aminopeptidase activity which was shown to be essential for the growth of the organism in an environment lacking fermentable carbohydrate and free amino acids but replete with small peptides. This metabolic versatility may explain the presence of F nucleatum in both supra‐ and sub‐gingival dental plaque and why it is often found together with organisms such as Porphyromonas gingivalis which display powerful endopeptidase activities. Using the technique of allozyme electrophoresis, the current subspeciation of F. nucleatum was shown to be of doubtful validity and evidence, based upon physiological and metabolic properties, for differences in pathogenicity between isolates was not detected. While this organism is a member of various bacterial consortia associated with periodontal diseases, its contribution to the disease process remains unclear.
Enamel cracks. The role of enamel lamellae in caries initiation
Authors: Walker B. N. , Makinson O. F. , Peters M. C. R. B.
Published: August 2013

Lamellae or cracks are distributed throughout tooth enamel in both deciduous and permanent dentitions. While earlier authors postulated that lamellae may be pathways of entry for caries, no evidence was adduced and the theory appears to have been discounted. The present study seeks to show that, at least in some cases, lamellae are permeable to dyes, may be associated with caries initiated in the dentine, supporting the hypothesis of Hardwick and Manly of lamellae penetration by Streptococcus mutans and lactobacilli.

The enamel lamellae are shown to be a permeable pathway allowing caries‐producing bacteria access to the dentine‐enamel junction. Caries can thus be established within the tooth without visible evidence at the surface.
Percolation in Borosilicate Glass Matrix Composites Containing Antimony‐Doped Tin Oxide Segregated Networks. Part I: Fabrication of Segregated Networks
Authors: Pruyn Timothy L. , Gerhardt Rosario A.
Published: August 2013

The percolation threshold in a composite depends on the processing conditions used to fabricate it along with the size and shape of the filler and the matrix. In this study, borosilicate glass microspheres were used as the matrix material, and nanosized antimony tin oxide (ATO) particles were used as the filler. The glass microsphere/ATO composites were fabricated by hot pressing at temperatures in the range between the glass transition temperature and the softening temperature of the glass to control the viscosity. The pressure and temperature applied allowed the ATO to be confined to the spaces between certain glass particles, forming percolating networks at low volume fractions of the ATO. The viscous flow of the glass allowed for the composite to have near full densities, while allowing for the nanoparticle segregation to occur. Even though apparently similar microstructures were made using different heating schedules, the percolation behavior and electrical conductivity showed noticeable differences. The percolation threshold ranged from 0.1 to 2.5 phr (parts per hundred glass) and the change in electrical conductivity was around seven to nine orders of magnitude. The differences were attributed to the interaction of the segregated ATO particles with one another. The electrical properties were examined using ac impedance spectroscopy along with current atomic force microscopy (C‐AFM), which allowed for valuable insights in the structure–property–processing relationships in these materials.
Subjective sleep quality in relation to objective sleep estimates: comparison, gender differences and changes between the acute phase and the six‐month follow‐up after stroke
Authors: Bakken Linda N. , Kim Hesook Suzie , Finset Arnstein , Lerdal Anners
Published: August 2013

Aims

To describe sleep experiences after stroke using subjective and objective indicators and identify possible gender differences in sleep in the acute phase and at 6‐month follow‐up.

Background

Sleep disturbances after stoke are recognized, but poorly described. Gender differences in sleep exist in other populations, but have not been reported after stroke.

Design

A longitudinal cohort study.

Method

Subjective sleep quality was measured with the Pittsburgh Sleep Quality Index and objective sleep was estimated with actigraphy in 100 patients in the acute phase and six months after stroke, from April 2007–March 2009.

Findings

Subjective sleep quality was better and objective wake percentage was lower at follow‐up than in the acute phase after stroke. Actigraphy estimated low sleep efficiency and many awakenings at both time points. Subjective and objective measures were correlated at the 6‐month follow‐up, but not in the acute phase. Women's subjective sleep efficiency and total score on the Pittsburgh Sleep Quality Index were worse than men's in the acute phase, but actigraphy estimated that women slept more than men in the course of a day. Women's subjective sleep quality was better at follow‐up than in the acute phase. Men reported worse subjective sleep quality, but better subjective sleep efficiency at follow‐up than in the acute phase, and also had lower objective wake percentage at follow‐up.

Conclusions

Subjective sleep quality was poor and actigraphy indicated disturbed sleep–wake patterns in the acute phase and at 6‐month follow‐up. Gender differences existed in subjective and objective sleep in the acute phase, but not at follow‐up.
Hospital‐integrated general practice: a promising way to manage walk‐in patients in emergency departments
Authors: Wang Mathyas , Wild Stefanie , Hilfiker Gabriela , Chmiel Corinne , Sidler Patrick , Eichler Klaus , Rosemann Thomas , Senn Oliver
Published: August 2013

Rationale, aims and objectives

The inappropriate use and overcrowding of emergency departments (EDs) by walk‐in patients are well‐known problems in many countries. The current study aimed to determine whether ambulatory walk‐in patients could be treated more efficiently in a new hospital‐integrated general practice (HGP) for emergency care services compared to a traditionalED.

Methods

We conducted a pre‐post comparison before and after the implementation of a newHGP. Participants were walk‐in patients attending theEDof a city hospital inZurich. Main outcome measures were differences in total process time, time intervals between stages of care and diagnostic resources used.

Results

The median process time from admission to discharge was 120 minutes in theED[interquartile range (IQR): 80–165] versus 60 minutes in theHGP(IQR: 40–90) (P < 0.001). The adjusted odds ratio of receiving any additional diagnostics was 1.86 (95% confidence interval 1.06–3.27;P = 0.032) forEDdoctors versus general practitioners (GPs) when controlling for patients' age, sex and injury‐related medical problems.

Conclusion

TheHGPis an efficient way to manage walk‐in patients with regard to process time and utilization of additional diagnostic resources. The involvement ofGPsin theHGPsshould be considered as a promising model to overcome the inappropriate use of resources inEDsfor walk‐in patients who can be treated by ambulatory care.
Bacterial and Heterotrophic Nanoflagellate Densities and C‐biomass Estimates Along an Alaskan Tundra Transect with Prediction of Respiratory CO2 Efflux
Authors: Anderson O. R.
Published: August 2013

Although tundra terrestrial ecology is significantly affected by global warming, we know relatively little about how eukaryotic microbial communities respond and how much microbial respiratory CO2 may be released due to available organic nutrient sources in the permafrost melt. Prior research has shown a strong positive correlation between bacteria and fungi in some Arctic locales; this research focused on the relationships of terrestrial bacteria and heterotrophic nanoflagellates. The densities and estimated C‐biomass of bacteria and heterotrophic nanoflagellates (a major occurring group of protozoa) were assessed in 14 samples obtained along a 10 km transect in northwest AK during the summer of 2012. Two samples were taken, one at the top and one near the base of seven hummocks along the transect. Densities (no./g soil) of bacteria varied from 2.7–16 × 109, and nanoflagellates 0.7–7.9 × 107. C‐biomass (μg/g soil) of bacteria varied from 358 to 2,114, and nanoflagellates 12–37. Additionally, the rate of respiration was analyzed in the laboratory for each soil sample. A linear relationship between soil respiration and bacterial densities was obtained (20 °C): Rs = 12.32 + 14.07 Bd (p ≪ 0.01); where Rs is soil respiration (nmol/min/g soil) and Bd = bacterial density (no. × 109/g soil).
Regulation by resveratrol of the cellular factors mediating liver damage and regeneration after acute toxic liver injury
Authors: Chan Che‐Chang , Lee Kuei‐Chuan , Huang Yi‐Hsiang , Chou Chung‐Kai , Lin Han‐Chieh , Lee Fa‐Yauh
Published: August 2013

Background and Aim

Acute liver injury is manifested by different degree of hepatocyte necrosis and may recover via the process of hepatocyte regeneration once the injury is discontinued. Most of the liver injury is associating with inflammatory cytokines. Resveratrol (RSV) is a natural phytoalexin with powerful anti‐inflammatory effects.

Aim

The effects of RSV on cellular factors mediating liver damage and regeneration in acute carbon tetrachloride (CCl4) liver injury were investigated.

Results

RSV decreased alanine aminotransferase, aspartate aminotransferase, necrosis, and 4‐hydroxynonenal in the CCl4‐injured liver. RSV decreased hepatocyte apoptosis by reducing caspase 8 and caspase 3 but not Bax and Bcl‐xL. RSV reduced Kupffer cells recruitment, the expressions of tumor necrosis factor‐α and interleukin‐6, but not interleukin‐10. RSV lowered the numbers of anti‐5‐bromon‐2'‐deoxyuridine and anti‐Ki67‐positive hepatocytes. Hepatic hepatocyte growth factor, c‐Met and transforming growth factor‐α expressions were reduced by RSV, while transforming growth factor‐β1 and hepatic stellate cells activation were not changed. RSV reduced the injury‐induced CXCL10 elevations in serum and liver in vivo. Besides, RSV inhibited CXCL10 release from CCl4‐injured hepatocytes in vitro. In contrast, recombinant CXCL10 improved the viability of CCl4‐injured hepatocytes.

Conclusions

RSV therapy can be beneficial for acute toxic liver injury. RSV reduced hepatocyte apoptosis but limited hepatocyte regeneration possibly through reducing the hepatomitogenic signaling and the release of CXCL10.
Relevance of ineffective esophageal motility to secondary peristalsis in patients with gastroesophageal reflux disease
Authors: Chen Chien‐Lin , Yi Chih‐Hsun , Liu Tso‐Tsai
Published: August 2013

Background and Aims

The study aimed to investigate the hypothesis whether the presence of Ineffective esophageal motility would affect physiological characteristics of secondary peristalsis.

Methods

Secondary peristalsis was performed with slow and rapid air injections into mid‐esophagus of 18 ineffective esophageal motility patients and 15 age‐matched controls. Severity of ineffective esophageal motility was defined by the application of combined multichannel intraluminal impedance and manometry.

Results

Ineffective esophageal motility patients included 11 patients without impedance abnormality and seven patients with impedance abnormality during liquid and/or viscous swallowing. The prevalence of failed secondary peristaltic response during slow air injection was significantly greater in ineffective esophageal motility patients without impedance abnormality (3/11 [27%], P < 0.001) and with impedance abnormality (4/7 [57%], P = 0.04) than healthy subjects. The threshold volume for inducing secondary peristalsis during rapid air injection was significantly greater in ineffective esophageal motility patients with impedance abnormality (6.1 ± 0.3 mL) than healthy subjects (4.6 ± 0.3 mL, P < 0.05) and ineffective esophageal motility patients without impedance abnormality (4.1 ± 0.4 mL, P < 0.05). The frequency of peristaltic response during rapid air injection was significantly lower in ineffective esophageal motility patients with impedance abnormality (40% [20–50%] than healthy subjects (90% [90–100%], P < 0.05).

Conclusions

Defective activation of secondary peristalsis is present in ineffective esophageal motility patients with impedance abnormality. Our study indicates that increased ineffective esophageal motility severity associated with defective triggering of secondary peristalsis may contribute to impaired esophageal clearance in patients with gastroesophageal reflux disease.
Clinical features and predictors of clinical outcomes in Korean patients with Crohn's disease: A Korean Association for the Study of Intestinal Diseases multicenter study
Authors: Moon Chang Mo , Park Dong Il , Kim Eun Ran , Kim Young‐Ho , Lee Chang Kyun , Lee Suck‐Ho , Kim Jae Hak , Huh Kyu‐Chan , Jung Sung‐Ae , Yoon Soon Man , Song Hyun Joo , Jang Hyun Joo , Kim You Sun , Lee Kang‐Moon , Shin Jeong Eun
Published: August 2013

Background and Aim

Although differences in genetic susceptibility and the clinical features of Crohn's disease (CD) have been reported between Asian and Caucasian patients, the disease course and predictors of CD in Asians remains poorly defined. The study therefore aimed to investigate factors predictive of the clinical outcomes of patients with CD in a Korean population.

Methods

This retrospective multicenter cohort study included 728 Korean CD patients from 13 university hospitals. The first CD‐related surgery or need for immunosuppressive or biological agents were regarded as the clinical outcomes of interest.

Results

A total of 126 (17.3%) CD patients underwent CD‐related surgery, while 473 (65.0%) and 196 (26.9%) were prescribed thiopurine drugs and infliximab, respectively. Multivariate Cox regression analysis identified current (hazard ratio [HR] = 1.86; P = 0.018) and former smoking habits (HR = 1.78; P = 0.049), stricturing (HR = 2.24; P < 0.001), and penetrating disease behavior at diagnosis (HR = 3.07; P < 0.001) as independent predictors associated with the first CD‐related surgery. With respect to immunosuppressive and biological agents, younger age (< 40 years) (HR = 2.17; P < 0.001 and HR = 2.10; P = 0.006, respectively), ileal involvement (HR = 1.36; P = 0.035 and HR = 2.17; P = 0.006, respectively), and perianal disease (HR = 1.42; P = 0.001 and HR = 1.38; P = 0.038, respectively) at diagnosis were significant predictors for the need of these medications.

Conclusions

In Korean patients with CD, stricturing, penetrating disease behavior, and smoking habits at the time of diagnosis are independent predictors for CD‐related surgery. It was also identified that younger age (< 40 years), ileal involvement, and perianal disease at diagnosis are predictive of a need for immunosuppressive or biological agents.
Prognostic value of hepatocyte nuclear factors 4α and 1α identified by tissue microarray in resectable hepatocellular carcinoma
Authors: Shim Ju Hyun , Kang Hyo Jeong , Han Seungbong , Lee Young‐Joo , Lee Sung‐Gyu , Yu Eunsil , Lee Han Chu
Published: August 2013

Background and Aim

This study aimed to investigate the prognostic value of expression of hepatocyte nuclear factors (HNFs) involved in hepatic gene transcription in patients undergoing curative resection for hepatocellular carcinoma (HCC).

Methods

We performed immunohistochemical analyses on microarrays of the tumors and matched adjacent tissue using antibodies against HNF1α, HNF1β, HNF4α, and α‐fetoprotein (AFP). We evaluated the prognostic value of biomarker expression using Cox regression and the Kaplan–Meier method in a training cohort of 220 patients and conducted an independent validation in 232 patients. We also determined whether measurement of HNFs improved risk prediction beyond the use of established factors, using net reclassification improvement (NRI).

Results

Post‐surgical recurrence and hepatic death were predicted by intratumoral HNF4α underexpression in both cohorts. In the training cohort they were also predicted by peritumoral HNF1α positivity. A pooled cohort analysis showed that these predictors were independently associated with early but not late‐phase recurrence, and resultant mortality. Intratumoral expression levels of HNF4α were correlated with those of HNF1α, HNF1β, and AFP (P < 0.05). Similarly, HNF1α expression in peritumoral tissue was correlated with that of other markers (P < 0.05). There was no significant correlation between expression of HNF4α in tumors and HNF1α in peritumoral tissue. Adding combinations of intratumoral HNF4α and peritumoral HNF1α to 2‐year recurrence and 5‐year mortality models including known clinicopathological prognostic factors significantly improved the NRI indexes (39% and 44%, respectively; P < 0.05).

Conclusions

Immunohistological activation of intratumoral HNF4α and depletion of peritumoral HNF1α have prognostic significance for delayed recurrence and death after HCC resection.
Is small‐bowel capsule endoscopy effective for diagnosis of esophagogastric lesions related to portal hypertension?
Authors: Aoyama Taiki , Oka Shiro , Aikata Hiroshi , Nakano Makoto , Watari Ikue , Naeshiro Noriaki , Yoshida Shigeto , Tanaka Shinji , Chayama Kazuaki
Published: August 2013

Background and Aim

Effectiveness of capsule endoscopy (CE) for screening the small bowel in patients with portal hypertension (PHT) has been reported. However, few reports discuss CE detection of specific esophagogastric lesions related to PHT. Thus, we assessed whether CE is useful for detecting such lesions.

Methods

One hundred nineteen consecutive patients with PHT comprised the study group. All had undergone esophagogastroduodenoscopy (EGD) prior to CE. The diagnostic yield of CE for esophageal varices (EVs), gastric varices (GVs), and portal hypertensive gastropathy (PHG) was evaluated. In addition, diagnostic yield in relation to form, location of the varices, grade, and extent of PHG was evaluated.

Results

EVs were found by EGD in 71 patients. The overall diagnostic yield of CE for EVs was 72% (51/71). The diagnostic yield was significantly greater for F2/F3 EVs than for F1 EVs (87% vs 61%, P = 0.03). The diagnostic yield was significantly greater for Lm/Ls EVs than for Li EVs (85% vs 55%, P = 0.01). The diagnostic yield was significantly greater for locus superior/locus medialis EVs than for locus inferior EVs (85% vs 55%, P = 0.01). GVs were found by EGD in 29 patients. Only one case was detected by CE. PHG was found by EGD in 35 patients. The diagnostic yield of CE for PHG was 69% (24/35). There was no difference in diagnostic yield between cases of severe and mild PHG (82% vs 63%, P = 0.44). Diagnostic yield of CE for PHG in the gastric body was significantly greater than that in the fundus (100% vs 48%, P = 0.0009).

Conclusion

CE is reliable for diagnosis of F2/F3 and/or Lm/Ls EVs and of PHG in the gastric body.
Preventive effect of agaro‐oligosaccharides on non‐steroidal anti‐inflammatory drug‐induced small intestinal injury in mice
Authors: Higashimura Yasuki , Naito Yuji , Takagi Tomohisa , Tanimura Yuko , Mizushima Katsura , Harusato Akihito , Fukui Akifumi , Yoriki Hiroyuki , Handa Osamu , Ohnogi Hiromu , Yoshikawa Toshikazu
Published: August 2013

Background and Aim

Non‐steroidal anti‐inflammatory drugs (NSAIDs), which are commonly used in clinical medicine, cause erosion, ulcers, and bleeding in the gastrointestinal tract. No effective agent for the prevention and treatment of small intestinal injury by NSAIDs has been established. This study investigates the effects of agaro‐oligosaccharides (AGOs) on NSAID‐induced small intestinal injury in mice.

Methods

Mice were treated with indomethacin, an NSAID, to induce intestinal injury. The respective degrees of mucosal injury of mice that received AGO and control mice were compared. Heme oxygenase‐1 (HO‐1) expression using quantitative real‐time polymerase chain reaction (qRT‐PCR), Western blotting, and immunohistochemistry were measured. The expression of keratinocyte chemoattractant (KC) was measured using qRT‐PCR and enzyme‐linked immunosorbent assay.

Results

AGO administration induced HO‐1 expression in mouse small intestinal mucosa. Induction was observed mainly in F4/80 positive macrophages. The increased ulcers score, myeloperoxidase activity, and KC expression by indomethacin were inhibited by AGO administration. Conversely, HO inhibitor cancelled AGO‐mediated prevention of intestinal injury. In mouse peritoneal macrophages, AGOs enhanced HO‐1 expression and suppressed lipopolysaccharide‐induced KC expression. Furthermore, AGOs enhanced the expressions of alternatively activated macrophage markers arginase‐1, mannose receptor‐1, and chitinase 3‐like 3.

Conclusions

Results suggest that oral administration of AGOs prevents NSAID‐induced intestinal injury.
Relationship between inosine triphosphate genotype and outcome of extended therapy in hepatitis C virus patients with a late viral response to pegylated‐interferon and ribavirin
Authors: Hai Hoang , Tamori Akihiro , Enomoto Masaru , Morikawa Hiroyasu , Uchida‐Kobayashi Sawako , Fujii Hideki , Hagihara Atsushi , Kawamura Etsushi , Thuy Le Thi Thanh , Tanaka Yasuhito , Kawada Norifumi
Published: August 2013

Background and Aim

It is not yet clear which factors are associated with the outcome of 72‐week treatment with pegylated‐interferon and ribavirin (RBV) in patients with chronic hepatitis C virus (HCV) infection.

Methods

In 66 patients with HCV genotype 1 who had a late viral response (LVR) to 72‐week treatment of pegylated‐interferon and RBV, we examined the factors that determined the outcome, including single nucleotide polymorphisms of interleukin‐28B and inosine triphosphatase (ITPA) genes.

Results

Thirty seven of 66 (56%) patients with LVR achieved a sustained viral response (SVR). The mean age of these 37 SVR patients was 55, compared with 61 in 29 relapsed patients (P = 0.009). Twenty six of 54 (48%) patients with the CC genotype and 11 of 12 (92%) with the CA/AA genotype of ITPA rs1127354 achieved SVR (P = 0.006). The SVR rates were 79%, 40%, 60%, and 33% in patients with undetectable HCV RNA on weeks 16, 20, 24, and 28 or later, respectively (P = 0.014). Finally, serum RBV concentration at week 44 of treatment was significantly higher in the SVR group (2651 ng/mL) than in the relapse group (1989 ng/mL, P = 0.002). In contrast, the rate of the interleukin‐28B genotype was not different between the groups. Multiple regression analysis showed that age < 60 years, ITPA CA/AA genotype, and serum RBV concentration were significant independent predictive factors for SVR.

Conclusions

Our findings elucidated the association of four factors, including ITPA genotype, with the outcome of 72‐week treatment in LVR patients.
Effect modification of body mass index and body fat percentage on fatty liver disease in a Japanese population
Authors: Saida Tomomi , Fukushima Wakaba , Ohfuji Satoko , Kondo Kyoko , Matsunaga Ichiro , Hirota Yoshio
Published: August 2013

Background and Aim

No previous study has performed multivariate analysis of the risk factors of fatty liver disease (FL), focusing on the effect of weight gain of ≥ 10 kg since the age of 20, and no analysis model exists that simultaneously evaluates body mass index (BMI) and body fat percentage (BFP) as adjustment variables.

Methods

To investigate these, we collected anthropometric data from health checkups, and conducted a cross‐sectional study (targeting 1851 males and 1259 females aged 30 years or over).

Results

Regardless of sex, weight gain of ≥10 kg since the age of 20 was positively associated with FL. Our stratified analysis of BFP into two categories, to evaluate the interaction between BMI and BFP in FL, indicated an approximately fivefold increase in the odds ratio in the male group with high BMI and BFP values compared to those with low BMI and BFP values, with a synergy index of 1.77 > 1. On the other hand, females demonstrated no significant additive interaction, with a synergy index of 0.49 < 1.

Conclusions

We revealed that weight gain ≥ 10 kg since the age of 20 is significantly associated with FL regardless of sex. In addition, by performing a synergy index (S), we showed that the additive interaction between BMI and BFP in FL differs according to gender.
HLA‐DP and γ‐interferon receptor‐2 gene variants and their association with viral hepatitis activity in chronic hepatitis B infection
Authors: Lam Yuk‐Fai , Wong Danny Ka‐Ho , Seto Wai‐Kay , To Kelvin Kai‐Wang , Hung Ivan Fan‐Ngai , Fung James , Lai Ching‐Lung , Yuen Man‐Fung
Published: August 2013

Background and Aim

Studies show that polymorphisms in human leukocyte antigen (HLA)‐DP loci and certain γ‐interferon (IFN‐γ) signaling pathway genes are related to persistence of hepatitis B virus (HBV) infection and viral load in chronic HBV (CHB) infection respectively. Our study aims to determine whether single‐nucleotide polymorphisms (SNPs) linked to HLA‐DP loci and IFN‐γ signaling pathway are associated with HBV activities.

Methods

We compared the SNPs in the HLA‐DPA1 gene (rs3077) and the IFN‐γ receptor‐2 gene (rs2284553 and rs9808753) of 100 treatment‐naive hepatitis B e antigen (HBeAg)‐negative CHB patients with undetectable HBV DNA with 100 age‐ and sex‐matched controls with HBV DNA > 2000 IU/mL.

Results

The median age of the study group was 47.9 years, and 61% were male patients. The distribution of the three polymorphisms was in Hardy–Weinberg equilibrium. Both rs3077 and rs2284553 polymorphisms were not associated with HBV viral load in terms of allelic frequency, genotypic frequency, dominant/recessive gene action. rs9808753 (G allele) was associated with a reduced chance of “undetectable HBV DNA” for patients below the age of 50 years in allelic frequency analysis (odds ratio 0.562; 95% confidence interval, 0.326–0.967; P value = 0.037). IFN‐γ receptor‐2 gene haplotype block (rs2284553/rs9808753) was not associated with HBV viral activity.

Conclusion

There was no significant association between HLA‐DP polymorphism (rs3077) and IFN‐γ receptor‐2 gene polymorphism (rs2284553) with viral activity in HBeAg‐negative CHB patients. Further studies are required to confirm the association between IFN‐γ receptor‐2 gene polymorphism (rs9808753) and reduced chance of having “undetectable HBV DNA” in young CHB patients.
Energy expenditure in preterm infants during periods of environmental stress in the neonatal intensive care unit
Authors: Peng Niang‐Huei , Bachman Jean , Chen Chau‐Huei , Huang Li‐Chi , Lin Hong‐Chin , Li Tsai‐Chung
Published: August 2013

Aim

To explore the energy expenditure (EE) in a group of preterm infants during the periods of environmental stress, and to explore the relationship between EE and physiological stress signals of preterm infants.

Methods

Research design was an explorative secondary analysis of 4164 research data from 37 preterm infants which included physiological signals and environmental stressors in neonatal intensive care units. The current study investigated the data of EE calculated using heart‐rate‐based EE estimate.

Results

A significantly positive relationship between EE and different levels of nursing intervention was found (P < 0.005). In addition, there was a significantly negative relationship between EE and oxygen saturation (P < 0.001).

Conclusion

These research results confirmed that environmental stressors may impact the growth and developmental outcomes in preterm infants by increasing their EE. Neonatal clinicians should minimize excessive stimulations in order to conserve energy for the growth and developmental needs of preterm infants. Research found a significant relationship between an increase in EE and a decrease in oxygen saturation in preterm infants. The authors further hypothesized that EE of preterm infants may be predicted by estimating the oxygen saturation. Further study using different research methods and an enlarged sample size is needed.
Hispanic parents' reading language preference and pediatric oral health‐related quality of life
Authors: Yazicioglu Iffet , Jones Judith A. , Cortés Dharma , Rich Sharron , Garcia Raul
Published: August 2013

Objectives

This study compared scores and psychometric properties from self‐identified Hispanic parents who completed Pediatric Oral Health‐related Quality of life (POQL) parent report‐on‐child questionnaires in Spanish or English. The study hypothesized that there were no differences in psychometric properties or POQL scores by parent reading language preference, controlling for dental needs, child's place of birth, age, insurance and use of care.

Methods

POQL scores were computed, and the internal consistency, feasibility, factor structure and construct validity of the Spanish language version assessed.

Results

Hispanic parents (N = 387) of 8‐14 year old children (mean age 10.2) completed the survey; 237 in Spanish and 150 in English. Internal consistency scores were higher (Cronbach α range = .86‐.93) among Hispanic parents who completed the questionnaire in Spanish than in English (.66‐.86). POQL scores from parents who completed questionnaires in Spanish were higher (worse) overall (6.03 vs. 3.82, P = 0.022), as were physical (11.61 vs. 6.54, P = 0.001) and role functioning domains (1.87 vs. 0.82, P = 0.029). Items for crying, pain, and eating were higher (P < 0.05) for the Spanish than the English completers. However, POQL scores were associated only with need for care (P = 0.05), parent reports of dental visit in the last year (P = 0.05) and worse oral health than a year ago (P = 0.002), controlling for reading language (not significant) and visit in last year in the final multivariate linear regression.
Synthesis and adenosine receptors binding affinities of a series of 3-arylcoumarins
Authors: Matos Maria João , Hogger Veronika , Gaspar Alexandra , Kachler Sonja , Borges Fernanda , Uriarte Eugenio , Santana Lourdes , Klotz Karl-Norbert
Published: August 2013

Objectives

In the present communication, we report the synthesis, pharmacological evaluation, theoretical evaluation of absorption, distribution, metabolism and excretion properties and structure–activity relationship study of a selected series of 3-arylcoumarins (compounds 1–9). Adenosine receptors (ARs) binding activity and selectivity of the synthesized compounds 1–9 were evaluated in this study. Different substituents were introduced in both benzene rings of the evaluated scaffold, at positions 6 and 3′ or 4′ of the moiety. The lack of data on the 3-arylcoumarin scaffold encouraged us to explore the ARs' binding activity of a selected series of derivatives.

Methods

A new series of coumarins (compounds 1–9) were synthesized and evaluated by radioligand binding studies towards ARs.

Key findings

Analysing the experimental data, it can be observed that neither the simple 3-arylcoumarin nor the 4′-nitro derivatives presented detectable binding affinity for the evaluated receptors, although most of the other substituted derivatives have good binding affinity profiles, especially against the hA1/hA3 or only hA3 AR.

Conclusions

The most remarkable derivative is compound 2, presenting the best affinity for hA3 AR (Ki = 2680 nM) and significant selectivity for this subtype.
Distress of Japanese parents of children with intellectual disabilities: Correlations with age of parent and negative mood regulation expectancies
Authors: Kono Keiko , Mearns Jack
Published: August 2013

Parents caring for a child with an intellectual disability (ID) face many challenges. Few studies in Japan have focused on parents of children with an ID. We investigated the psychological factors that might help these parents maintain well‐being, in particular negative mood regulation expectancies (NMRE). NMRE are beliefs about one's ability to diminish one's negative moods. Research has shown NMRE to buffer the effects of stress: stronger NMRE are associated with less symptoms of distress, including depression and anxiety. We examined the associations of NMRE, coping, and severity of the child's ID with parental distress (somatization, depression, and anxiety) among 106 Japanese parents (mean age = 56.7 years) caring for at least one child with an ID. The age of the parent was negatively associated with parental distress, particularly anxiety. NMRE were also negatively related to distress, independent of the age of the parent and coping. The severity of the child's ID was not related to coping or parental distress. Stronger beliefs that they could control their negative moods and being older seemed to protect parents of an ID child from symptoms of distress.
Investigation of the association between mobbing and musculoskeletal discomfort in academicians
Authors: Taspinar Betul , Taspinar Ferruh , Guclu Sultan , Nalbant Abdurrahman , Calik Bilge Basakci , Uslu Ahmet , Inal Sermet
Published: August 2013

This study aimed to identify the association between exposure to mobbing and musculoskeletal discomfort in academicians. One hundred academicians working at a university were included in the study. Permission was granted by the Rector prior to the study and questionnaires were delivered to the academicians. The Turkish version of the Leymann Inventory of Psychological Terror (LIPT) was used to evaluate mobbing and the Turkish version of the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was used to assess musculoskeletal discomfort. When the data were analyzed, a moderate association was found between mobbing perceived by the academic staff and musculoskeletal discomfort. In conclusion, this study showed that mobbing is a risk factor for musculoskeletal discomfort.