bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential of Cultivated Ganoderma lucidum Mushrooms for the Production of Supplements Enriched with Essential Elements
Authors: Rzymski Piotr , Mleczek Mirosław , Niedzielski Przemysław , Siwulski Marek , Gąsecka Monika
Published: January 2016

Ganoderma lucidum is an important medicinal mushroom species and there is continuous interest in its bioactive properties. This study evaluated whether it may additionally serve as a nutritional supplement for the trace elements: selenium (Se), copper (Cu), and zinc (Zn). Mushrooms were cultivated on substrates enriched with 0.1 to 0.8 mM of inorganic Se alone or in combination with Zn and/or Cu. Supplementation increased accumulation of the elements in fruiting bodies regardless of the applied cultivation model. G. lucidum demonstrated the ability to accumulate significant amounts of organic Se, maximally amounting to (i) over 44 mg/kg when the substrate was supplemented only with Se, (ii) over 20 mg/kg in the Se+Cu model, (iii) over 25 mg/kg in the Se+Zn model, and (iv) 15 mg/kg in the Se+Cu+Zn model. The accumulation of Cu and Zn steadily increased with their initial substrate concentrations. Maximum concentrations found after supplementation with 0.8 mM amounted to over 55 mg/kg (Se+Zn) and 52 mg/kg (Se+Cu+Zn) of Zn, and 29 mg/kg (Se+Cu) and over 31 mg/kg (Se+Cu+Zn) of Cu. The greater the supplemented concentration and number of supplemented elements, the lower the biomass of G. lucidum fruiting bodies. Nevertheless, it still remained high when the substrate was supplemented up to 0.4 mM with each element. These results highlight that G. lucidum can easily incorporate elements from the substrate and that, when biofortified, its dried fruiting bodies may serve as a nutritional source of these essential elements.
Age at menarche is associated with the prevalence of non‐alcoholic fatty liver disease later in life
Authors: Lu Jieli , Zhang Jie , Du Rui , Wang Tiange , Xu Min , Xu Yu , Wang Weiqing , Bi Yufang , Li Donghui , Chen Yuhong , Ning Guang
Published: January 2016

Background

The aim of the present study was to investigate whether age at menarche is associated with non‐alcoholic fatty liver disease (NAFLD) later in life.

Methods

The association between age at menarche and obesity, insulin resistance, and NAFLD after menopause was investigated in a cross‐sectional study of 4128 postmenopausal Chinese women; NAFLD was diagnosed by hepatic ultrasound and information regarding age at menarche was collected using an interviewer‐administered questionnaire.

Results

Women with age at menarche <15 years had higher prevalence of overweight/obesity, insulin resistance, and NAFLD compared with women with age at menarche 15–18 or >18 years. Logistic regression revealed that women with earlier menarche had a higher risk for the age‐adjusted prevalence of overweight/obesity, insulin resistance, and NAFLD, whereas later menarche showed a weaker, but still significant, association with a lower prevalence of NAFLD. However, further adjustment for some variables and current body mass index (BMI) or homeostasis model assessment of insulin resistance (HOMA‐IR) attenuated the association between later menarche and a lower prevalence of NAFLD. A decreasing trend in the risk of NAFLD was seen across increasing levels of age at menarche (age‐adjusted Ptrend < 0.001; multivariate‐adjusted Ptrend < 0.001; multivariate + current BMI‐adjusted Ptrend = 0.03; multivariate + HOMA‐IR‐adjusted Ptrend = 0.06).

Conclusion

Age at menarche is associated with the prevalence of NAFLD later in life, independent of BMI and insulin resistance.
External Validation of the Manchester Acute Coronary Syndromes Decision Rule
Authors: Carlton Edward , Body Richard , Greaves Kim
Published: January 2016

Objectives

The Manchester Acute Coronary Syndromes (MACS) decision rule has been shown to be a powerful diagnostic tool in emergency department (ED) patients with suspected acute coronary syndromes (ACS). It has the potential to improve system efficiency by identifying patients suitable for discharge after a single blood draw for high‐sensitivity troponin and heart‐type fatty acid–binding protein (h‐FABP) analysis at presentation to the ED. The objective was to externally validate the MACS decision rule and establish its diagnostic accuracy as a discharge tool in a new set of prospectively recruited ED patients.

Methods

In this preplanned analysis of a prospectively recruited single‐center cohort, consecutive ED patients ≥18 years with suspected ACS were included. Testing for h‐FABP and high‐sensitivity troponin T was undertaken on serum drawn on arrival, and any clinical features required to calculate the MACS rule were recorded. The primary outcome was major adverse cardiac events (MACE) within 30 days (acute myocardial infarction [AMI], death, or revascularization). The secondary outcome was AMI alone, adjudicated using 6‐hour troponin results.

Results

Of the 782 participants included, 78 (10.0%) developed MACE and 61 (7.8%) had an AMI. Of participants, 133 (17.0%) were identified as “very low risk” and therefore suitable for immediate discharge with a 0% incidence of MACE or AMI. Of remaining patients, 314 (40.2%) were “low risk,” 320 (40.9%) were “moderate risk,” and 15 (1.9%) were “high risk,” with incidences of MACE of 2.2, 19.7, and 53.3%, respectively. The sensitivity was 100% (95% confidence interval [CI] = 95.4% to 100%) for MACE at 30 days and 100% (95% CI = 94.1% to 100%) for AMI. The area under the receiver operating characteristic curve was 0.87 (95% CI = 0.83 to 0.91) for the MACS rule in the prediction of MACE.

Conclusions

In this prospectively recruited cohort of ED patients with suspected ACS, the MACS decision rule identifies a significant proportion of patients who are suitable for immediate discharge after a single blood draw at presentation, with a very low risk of MACE at 30 days. This study externally validates previous findings that the MACS rule is a powerful diagnostic tool in this setting. A randomized controlled trial to establish the utility of the rule in an everyday clinical setting is justified.
Incidence of Adverse Events in Adults Undergoing Procedural Sedation in the Emergency Department: A Systematic Review and Meta‐analysis
Authors: Bellolio M. Fernanda , Gilani Waqas I. , Barrionuevo Patricia , Murad M. Hassan , Erwin Patricia J. , Anderson Joel R. , Miner James R. , Hess Erik P.
Published: January 2016

Objectives

This was a systematic review and meta‐analysis to evaluate the incidence of adverse events in adults undergoing procedural sedation in the emergency department (ED).

Methods

Eight electronic databases were searched, includingMEDLINE,EMBASE,EBSCO,CINAHL,CENTRAL, Cochrane Database of Systematic Reviews, Web of Science, and Scopus, from January 2005 through 2015. Randomized controlled trials and observational studies of adults undergoing procedural sedation in theEDthat reported a priori selected outcomes and adverse events were included. Meta‐analysis was performed using a random‐effects model and reported as incidence rates with 95% confidence intervals (CIs).

Results

The search yielded 2,046 titles for review. Fifty‐five articles were eligible, including 9,652 procedural sedations. The most common adverse event was hypoxia, with an incidence of 40.2 per 1,000 sedations (95%CI = 32.5 to 47.9), followed by vomiting with 16.4 per 1,000 sedations (95%CI = 9.7 to 23.0) and hypotension with 15.2 per 1,000 sedations (95%CI = 10.7 to 19.7). Severe adverse events requiring emergent medical intervention were rare, with one case of aspiration in 2,370 sedations (1.2 per 1,000), one case of laryngospasm in 883 sedations (4.2 per 1,000), and two intubations in 3,636 sedations (1.6 per 1,000). The incidence of agitation and vomiting were higher with ketamine (164.1 per 1,000 and 170.0 per 1,000, respectively). Apnea was more frequent with midazolam (51.4 per 1,000), and hypoxia was less frequent in patients who received ketamine/propofol compared to other combinations. The case of laryngospasm was in a patient who received ketamine, and the aspiration and intubations were in patients who received propofol. When propofol and ketamine are combined, the incidences of agitation, apnea, hypoxia, bradycardia, hypotension, and vomiting were lower compared to each medication separately.

Conclusions

Serious adverse events during procedural sedation like laryngospasm, aspiration, and intubation are exceedingly rare. Quantitative risk estimates are provided to facilitate shared decision‐making, risk communication, and informed consent.
Sex differences in genetic and environmental contributions to alcohol consumption from early adolescence to young adulthood
Authors: Seglem Karoline B. , Waaktaar Trine , Ask Helga , Torgersen Svenn
Published: January 2016

Aims

To estimate genetic and environmental contributions to alcohol consumption from early adolescence to young adulthood, and test whether gender moderates these effects.

Design

Longitudinal twin cohort design.

Setting

Population‐based sample from Norway.

Participants

A total of 2862 male and female twins, aged 14–22 years, were assessed at one (n = 881), two (n = 898) or three (n = 1083) occasions. The percentage of females was between 56 and 63 in the different age groups (in the different waves).

Measurements

Alcohol consumption was measured by two questionnaire items about frequency of alcohol use and frequency of being drunk.

Findings

Additive genetic effects showed low to moderate contributions [proportion estimate, 95% confidence interval (CI) = range from 0.03 (0.00–0.14) to 0.49 (0.37–0.59) in males and from 0.09 (0.00–0.57) to 0.41 (0.24–0.58) in females] from adolescence to young adulthood, while environmental influences shared by twin pairs and contributing to twin similarity were moderate to highly influential during this developmental period [proportion estimate, 95% CI = range from 0.04 (0.00–0.13) to 0.45 (0.26–0.60) in males for shared environment in common with females, from 0.25 (0.09–0.42) to 0.54 (0.06–0.78) for shared environment specific to males and from 0.36 (0.20–0.52) to 0.51 (0.37–0.71) in females]. There was evidence of qualitative sex differences with shared environmental influences being largely sex‐specific from middle adolescence onwards.

Conclusions

Alcohol consumption from early adolescence to young adulthood appears to be influenced to a small to moderate degree by genetic factors and to a moderate to high degree by shared environmental factors (e.g. rearing influences, shared friends). The shared environmental factors influencing alcohol consumption appear to be largely gender‐specific.
Interest in dental implantology and preferences for implant therapy: a survey of Victorian dentists
Authors: Cheung MC , Kao PLH , Lee N , Sivathasan D , Vong CW , Zhu J , Polster A , Darby I
Published: January 2016

Background

The purpose of this study was to gauge dentists’ interest, knowledge and training in implantology, and to compare their treatment preferences with current literature. Subsequently, this information may be used to evaluate implantology education pathways.

Methods

A cross‐sectional postal survey of 600 randomly selected dentists registered with the Dental Practice Board of Victoria was conducted. Respondents were asked about background, interest and training in implantology, and implant treatment preferences. Results were analysed according to primary practice location, decade of graduation and attendance at continuing professional development (CPD) programmes.

Results

One hundred and seventy‐six questionnaires were included for analysis. In general, dentists rate their implant knowledge, interest and enjoyment in restoring implants favourably. No differences were found between city and country practitioners, and different graduation decades. The level of CPD significantly influenced treatment preferences. Practitioners were generally unwilling to treat patients taking bisphosphonates, or to perform grafting procedures. Most dentists provide common services to treat peri‐implant conditions. Direct‐to‐fixture is the most popular fixture‐abutment connection.

Conclusions

Overall, there is a high level of implant knowledge corresponding to current evidence in the literature. Level of CPD attendance is the most important factor in dentists’ willingness to provide more implant therapy options.
Lesser auger beetle Heterobostrychus aequalis (Coleoptera: Bostrichidae) in Australia: absent or elusive?
Authors: Wylie F Ross , Peters Brenton C
Published: January 2016

The lesser auger beetle, Heterobostrychus aequalis (Waterhouse), is a serious pest of seasoned hardwood timber throughout the Oriental region and several areas beyond. Some early collection records of H. aequalis from Australia in the 1950s and 1960s indicated that the insect was present in northern Queensland, but no confirmed breeding population has been found in the past few decades suggesting either that it may have not established permanently or it is difficult to detect. The ambiguity about the breeding status of the pest in Australia has caused confusion for regulating authorities needing to respond to each new post‐border detection. We examined records of H. aequalis in Australian insect collections and from intensive plant pest surveillance activities in Queensland and northern Australia over the past 48 years to resolve this confusion. Until very recently, available evidence suggested that H. aequalis was not established in Australia, despite multiple introductions and apparently suitable climate and hosts. Collection records of the pest are predominantly linked to intercepted items or are recorded as of unknown origin, and no established populations have been found during many years of targeted surveillance. However, a detection of H. aequalis in suburban Cairns, north Queensland, in late 2013 and two more in mid‐2015 in the same general locality do not appear to be linked to any imported material, indicating that there is at least a tenuously established local population. Investigations are underway to confirm this, but the insect is not widely established in Australia and, if present, remains elusive. Our recommended response to any future detection of H. aequalis is to fumigate or destroy the infested material, conduct tracing enquiries and limit surveys to the immediate vicinity of the detection.
Cyclophosphamide in dermatology
Authors: Kim Janet , Chan Jonathan J
Published: January 2016

Cyclophosphamide is a chemotherapeutic agent which was first discovered in experimental tumours in rats, and it has since been widely used to treat malignancies and severe manifestations of various auto‐immune diseases. High‐dose chemotherapy and continuous daily oral regimens are associated with significant toxicity profiles, but i.v. pulsed regimens have lowered the rates of adverse effects in rheumatological studies. Cyclophosphamide has been shown to be useful in the treatment of severe autoimmune conditions due to its powerful immunosuppressive ability; however, it remains a relatively underused modality in dermatology. This article reviews the current literature on cyclophosphamide and its clinical applications in dermatology.
What Drives Credit Rating Changes? A Return Decomposition Approach
Authors: Cho Hyungjin , Choi Sunhwa
Published: January 2016

This paper examines the relative importance of a shock to expected cash flows (i.e., cash‐flow news) and a shock to expected discount rates (i.e., discount‐rate news) in credit rating changes. Specifically, we use a Vector Autoregressive model to implement the return decomposition of Campbell and Shiller (Review of Financial Studies, 1, 1988, 195) and Vuolteenaho (Journal of Finance, 57, 2002, 233) to extract cash‐flow news and discount‐rate news from stock returns at the firm‐level. We find that credit rating changes are, on average, more strongly associated with cash‐flow news than with discount‐rate news, consistent with cash‐flow news being more permanent than discount‐rate news. We further find that both cash‐flow news and discount‐rate news are more strongly related to credit rating changes when they convey negative information about firm value. This asymmetric association is consistent with the non‐linear nature of default risk and with the fact that rating agencies incorporate bad news sooner than good news into their rating revisions. This paper contributes to the literature by providing evidence on the relative importance of cash‐flow news and discount‐rate news in the credit rating process.
Systematic review with meta‐analysis: coffee consumption and the risk of cirrhosis
Authors: Kennedy O. J. , Roderick P. , Buchanan R. , Fallowfield J. A. , Hayes P. C. , Parkes J.
Published: January 2016

Background

Liver cirrhosis is a large burden on global health, causing over one million deaths per year. Observational studies have reported an inverse association between coffee and cirrhosis.

Aims

To perform a systematic review and meta‐analysis to characterise the relationship between coffee consumption and cirrhosis.

Methods

We searched for studies published until July 2015 that reported odds ratios, relative risks (RR) or hazard ratios for cirrhosis stratified by coffee consumption. We calculated RRs of cirrhosis for an increase in daily coffee consumption of two cups for each study and overall. We performed analyses by study design, type of cirrhosis and mortality. We assessed the risk of bias in each study and the overall quality of evidence for the effect of coffee on cirrhosis.

Results

We identified five cohort studies and four case–control studies involving 1990 cases and 432 133 participants. We observed a dose–response in most studies and overall. The pooled RR of cirrhosis for a daily increase in coffee consumption of two cups was 0.56 (95% CI 0.44–0.68; I2 83.3%). The RR pooled from cohort studies for a daily increase of two cups was 0.58 (95% CI 0.41–0.76; I2 91.1%) and from case–control studies it was 0.52 (95% CI 0.40–0.63; I2 0.0%). The pooled RR of alcoholic cirrhosis for a daily increase of two cups was 0.62 (95% CI 0.51–0.73; I2 0%) and of death from cirrhosis it was 0.55 (95% CI 0.35–0.74; I2 90.3%).

Conclusion

This meta‐analysis suggests that increasing coffee consumption may substantially reduce the risk of cirrhosis.
Targeting mTOR for the treatment of B cell malignancies
Authors: Lee Jong‐Hoon Scott , Vo Thanh‐Trang , Fruman David A.
Published: January 2016

Mechanistic target of rapamycin (mTOR) is a serine/threonine kinase that functions as a key regulator of cell growth, division and survival. Many haematologic malignancies exhibit elevated or aberrant mTOR activation, supporting the launch of numerous clinical trials aimed at evaluating the potential of single agent mTOR‐targeted therapies. While promising early clinical data using allosteric mTOR inhibitors (rapamycin and its derivatives, rapalogs) have suggested activity in a subset of haematologic malignancies, these agents have shown limited efficacy in most contexts. Whether the efficacy of these partial mTOR inhibitors might be enhanced by more complete target inhibition is being actively addressed with second generation ATP‐competitive mTOR kinase inhibitors (TOR‐KIs), which have only recently entered clinical trials. However, emerging preclinical data suggest that despite their biochemical advantage over rapalogs, TOR‐KIs may retain a primarily cytostatic response. Rather, combinations of mTOR inhibition with other targeted therapies have demonstrated promising efficacy in several preclinical models. This review investigates the current status of rapalogs and TOR‐KIs in B cell malignancies, with an emphasis on emerging preclinical evidence of synergistic combinations involving mTOR inhibition.
Unethical behavior in organizations: empirical findings that challenge CSR and egoism theory
Authors: Overall Jeffrey
Published: January 2016

In the egoism philosophical framework, it is contended that when organizations focus on their long‐term interests, they, without knowing it, advance the interests of society as a whole, which is perceived as ethical. In this research, this premise is challenged using data collected from the social media outlets of 29 randomly selected companies from the 2013 Fortune 500 list. Through qualitative comparative analysis, the exact opposite was found. In fact, the organizations that focused on striving for their long‐term success are perceived as unethical. It was also found that socially responsible organizations are perceived as ethical whereas those that misrepresent their positions and attempt to influence the decisions of others are perceived as unethical. Implications for managers are discussed, and future directions are suggested.
No Understanding, No Consent: The Case Against Alternative Medicine
Authors: Shahvisi Arianne
Published: January 2016

The demand for informed consent in clinical medicine is usually justified on the basis that it promotes patient autonomy. In this article I argue that the most effective way to promote autonomy is to improve patient understanding in order to reduce the epistemic disparity between patient and medical professional. Informed consent therefore derives its moral value from its capacity to reduce inequalities of power as they derive from epistemic inequalities. So in order for a patient to have given informed consent, she must understand the treatment. I take this to mean that she has sufficient knowledge of its causal mechanisms and has accepted the explanations in which the treatment is implicated. If this interpretation of informed consent is correct, it is unethical for medical professionals to offer or endorse ‘alternative medicine’ treatments, for which there is no known causal mechanism, for if they do, they may end up widening the epistemic disparity. In this way, informed consent may be understood as an effective way of ruling out particular treatments in order to improve patient autonomy and maintain trust in the medical profession.
OSL‐based chronostratigraphy of river terraces in mountainous areas,Dunajec basin,WestCarpathians: a revision of the climatostratigraphical approach
Authors: Olszak Janusz , Adamiec Grzegorz
Published: January 2016

The technique of optically stimulated luminescence (OSL) dating applied to fluvial sediments provided a geochronological framework of river terrace formation in the middle part of the Dunajec River basin – a reference area for studies of evolution of river valleys in the northern part of the Carpathians (West Carpathians). Fluvial sediments at 18–90 m above valley bottoms were dated in the valleys of the Dunajec River and one of its tributaries. The resulting ages range from 158.9±8.3 to 12.2±1.3 ka. This indicates that some of the terrace sediments were deposited much later than previously assumed on the grounds of a combined morphostratigraphical and climatostratigraphical approach. TheOSL‐based chronostratigraphy of terrace formation consists of seven separate phases of fluvial aggradation, separated by periods of incision and lateral erosion. Some of the ages determined correspond to warm stages of the Pleistocene – Marine Isotope Stage 3 (MIS3) andMIS5 – demonstrating that some terraces were formed during interstadial or interglacial periods. The results provide a key for evaluating rates of neotectonic uplift, allowing us to decipher the response of a fluvial system to climate change within the context of the glacial–interglacial scheme.
Fibroblast growth factor receptor‐1 protein expression is associated with prognosis in estrogen receptor‐positive/human epidermal growth factor receptor‐2‐negative primary breast cancer
Authors: Tomiguchi Mai , Yamamoto Yutaka , Yamamoto‐Ibusuki Mutsuko , Goto‐Yamaguchi Lisa , Fujiki Yoshitaka , Fujiwara Saori , Sueta Aiko , Hayashi Mitsuhiro , Takeshita Takashi , Inao Touko , Iwase Hirotaka
Published: January 2016

Recently, research into the development of new targeted therapies has focused on specific genetic alterations to create advanced, more personalized treatment. One of the target genes, fibroblast growth factor receptor‐1 (FGFR1), has been reported to be amplified in estrogen receptor (ER)‐positive subtype breast cancer, and is considered one possible mechanism of endocrine resistance through cross‐talk between ER and growth factor receptor signaling. We performed a comprehensive analysis of FGFR1 at the levels of gene copy number, transcript and protein expression, and examined the relationships between FGFR1 status and clinicopathological parameters, including prognosis in 307 ER‐positive/HER2‐negative primary breast cancer patients treated with standard care at our institute. Most notably, a high level of FGFR1 protein expression was observed in 85 patients (27.7%), and was positively associated with invasive tumor size (P = 0.039). Furthermore, univariate analysis revealed that high FGFR1 protein expression was significantly correlated with poor relapse‐free survival rate (P = 0.0019, HR: 2.63, 95% confidence interval: 1.17–5.98), and showed a tendency towards an increase in recurrent events if the observation period extended beyond the 5 years of the standard endocrine treatment term. FGFR1 gain/amplification was found in 43 (14.0%) patients, which was only associated with higher nuclear grade (P = 0.010). No correlation was found between FGFR1 mRNA expression levels and any clinicopathological factors. Overall, the level of FGFR1 protein expression may be a biomarker of ER‐positive/HER2‐negative primary breast cancer with possible resistance to standard treatment, and may be a useful tool to identify more specific patients who would benefit from FGFR‐1 targeted therapy.
Comparison of clinical and radiographic status around dental implants placed in patients with and without prediabetes: 1‐year follow‐up outcomes
Authors: Al Amri Mohammad D. , Abduljabbar Tariq S. , Al‐Kheraif Abdulaziz A. , Romanos Georgios E. , Javed Fawad
Published: January 2016

Objective

We hypothesized that peri‐implant soft tissue inflammation is worse and peri‐implant marginal bone loss (MBL) is higher around dental implants placed in patients with prediabetes compared to healthy subjects. The aim of the present 12‐month follow‐up study was to compare the clinical and radiographic status around dental implants placed in patients with and without prediabetes.

Material and methods

Twelve patients with medically diagnosed prediabetes (Group‐1) and 12 controls (Group‐2) were included. All patients were indicated for single tooth maxillary or mandibular premolar replacement with the adjacent teeth intact. Success of the restored implants was assessed by comparing clinical (peri‐implant bleeding on probing [BOP], and probing pocket depth [PPD]) and radiographic (peri‐implant MBL) parameters at baseline and at 12‐months follow‐up. Statistical analysis was performed using one‐way analysis of variance, and P‐values <0.05 were considered statistically significant.

Results

At 12 months of follow‐up, there was no clinical evidence for the presence of plaque, BOP and peri‐implant pockets with PPD ≥ 4 mm in both groups. At 12‐month follow‐up, the mean MBL among implants placed in groups 1 and 2 were 0.2 ± 0.1 mm and 0.1 ± 0.01 mm, respectively. Overall, the periodontal status (PI, BOP and PPD ≥ 4 mm) at 12‐month follow‐up was comparable among patients in both groups.

Conclusion

Within the limitations of this study, it is concluded that dental implants inserted in prediabetic and healthy patients have similar success rates and remain clinically and radiographically stable after 1‐year follow‐up.
A case of IgG4‐related lung disease complicated by asymptomatic chronic Epstein‐Barr virus infection
Authors: Kotetsu Yasuaki , Ikegame Satoshi , Takebe‐Akazawa Keiko , Koga Takaomi , Okabayashi Kan , Takata Shohei
Published: January 2016

Introduction

IgG4‐related disease is characterized by IgG4‐positive plasmacyte infiltration into various organs, but its etiology is not unknown.

Objectives

To elucidate the etiology of IgG4‐related disease.

Methods

We experienced an interesting case of IgG4‐related lung disease complicated by chronic EB virus infection.

Results

A 70‐year‐old male visited our hospital due to failure of pneumonia treatment. Chest computed tomography (CT) showed consolidation in the right middle field and slight mediastinal lymphadenopathy in the subcarinal region. Lung consolidation improved with antibiotics; subcarinal lymphadenopathy progressed after 4 months. Malignant lymphoma was suspected given elevated sIL2‐R levels (1862 U/mL). Patchy ground glass opacities appeared in the bilateral lung field just before surgical biopsy. He was diagnosed with IgG4‐related lung disease after inspection of a pathological specimen obtained from the right upper lung and right hilar lymph node. EB virus‐infected cells were also detected in the lymph node. Blood examination revealed EB virus viremia, but the patient did not present with symptoms or organ involvement. This led to a diagnosis of asymptomatic chronic EB virus infection.

Conclusion

Recent studies have suggested an association between EB virus infection and IgG4‐related diseases in the pathological exploration of surgically resected lymph nodes. Our case is the first case of IgG4‐related lung disease in which EB virus infection was both pathologically and clinically proved. The present case is of particular interest in view of this newly reported association, and may serve as a fundamental report for future studies connecting EB virus infection with IgG4‐related diseases.
Limited value of transbronchial lung biopsy for diagnosing Mycobacterium avium complex lung disease
Authors: Sekine Akimasa , Saito Takefumi , Satoh Hiroaki , Morishita Yukio , Tsunoda Yoshiya , Tanaka Toru , Yatagai Yohei , Lin Shih‐Yuen , Miyazaki Kunihiko , Miura Yukiko , Hayashihara Kenji
Published: January 2016

Background and Aims

It remains unclear whether transbronchial lung biopsy (TBLB) is useful for diagnosing Mycobacterium avium complex (MAC) lung disease.

Methods

Thirty‐eight consecutive patients with MAC lung disease, who were evaluated with TBLB tissue culture between June 2006 and May 2010, were included. Bronchial washing (BW) and histopathological evaluation were performed in all patients. The positivity rates of BW and TBLB tissue culture, and typical histopathological findings for MAC disease were investigated. Furthermore, all patients were divided into two groups according to the presence of intrabronchial purulent or mucopurulent secretion and the clinical, bacteriological and pathological characteristics were compared between the two groups.

Results

The positive culture rates of BW and TBLB specimens for MAC were 100% (38 patients) and 28.9% (11 patients). BW materials were much more sensitive for culture positivity than TBLB specimens (P < 0.0001). Typical pathological findings for MAC disease were present in the TBLB specimens of only 11 patients (28.9%). Intrabronchial secretion was identified in 15 patients (39.5%, secretion‐positive group) and absent in 23 patients (60.5%, secretion‐negative group). Typical histopathological findings for MAC disease were more common in the secretion‐positive group than in the secretion‐negative group (53.3% vs 13.0%, P = 0.01), although the radiological classification and smear positivity of BW were not different between the two groups.

Conclusion

TBLB for pathological and bacterial investigations would provide only a limited value for MAC diagnosis. Moreover, the presence of intrabronchial secretion may be an important manifestation of ongoing airway damage, which would require early treatment.
Twin pregnancies complicated by gestational diabetes mellitus: a single centre cohort study
Authors: Dinham G. K. , Henry A. , Lowe S. A. , Nassar N. , Lui K. , Spear V. , Shand A. W.
Published: January 2016

Aims

In women with a twin pregnancy, to determine the incidence of, risk factors for and outcomes of women with gestational diabetes mellitus, and assess how these have changed with a change in gestational diabetes screening.

Methods

Retrospective cohort study of women with a twin pregnancy attending an Australian tertiary hospital, 2002–2013. Information on gestational diabetes status, gestational diabetes risk factors and pregnancy outcomes was ascertained. Pregnancy outcomes included hypertensive disorders, twin birthweight centile and a composite adverse pregnancy outcome. Analysis was stratified pre/post screening protocol change (epoch 1: 2002–2009, epoch 2: 2010–2013) and by gestational diabetes status.

Results

Gestational diabetes was diagnosed in 86/982 (8.8%) women, increasing from 4.4% to 14.7% between epochs (P = 0.0001). The proportion of women with hypertensive disorders increased (11.7% vs. 13.4%, P = 0.009), but the proportion of infant's birthweight > 90th centile decreased (11.0% vs. 7.6%, P = 0.02) between epochs. Overall, 33.6% of women had ≥ 1 risk factors for gestational diabetes. Three‐quarters (73.7%) of women overall had an adverse pregnancy outcome, with a slightly higher proportion in women with gestational diabetes compared with those with no gestational diabetes (79.7% vs. 73.1%, P = 0.06). The rate of the adverse pregnancy outcome did not change by epoch, after adjusting for maternal and pregnancy risk factors (adjusted odds ratio = 0.96, 95% confidence interval 0.73–1.26).

Conclusions

Almost 1 in 10 women with a twin pregnancy were diagnosed with gestational diabetes, with the incidence of gestational diabetes increasing threefold with a new screening protocol. The pregnancy outcomes of women with a twin pregnancy did not change with increased detection and treatment for gestational diabetes.
Oestrogen activity of the serum in adolescents with Type 1 diabetes
Authors: Martínez D. , Castro A. , Merino P. M. , López P. , Lardone M. C. , Iñiguez G. , Cassorla F. , Codner E.
Published: January 2016

Aims

To assess serum oestrogen levels and oestrogenic activity in adolescents with Type 1 diabetes compared with a healthy control group.

Methods

We conducted a cross‐sectional study that evaluated adolescents with Type 1 diabetes (n = 38) and healthy adolescents (control group; n = 32). Serum oestrogens, urinary oestrogen metabolites and serum oestrogenic activity were assessed. Oestrogenic activity was evaluated in an in vitro cell proliferation assay using a modified E‐screen assay with MCF‐7/BUS cells.

Results

Adolescents with Type 1 diabetes had lower oestrogenic activity levels in both phases of the menstrual cycle compared with the control group (follicular phase: 76 vs 94%; luteal phase: 97 vs 131%; P < 0.01), even after adjusting for BMI, oestradiol and oestrone levels. Postmenarcheal adolescents with Type 1 diabetes had lower oestradiol levels compared with control subjects in the follicular phase (63.3 pmol/l vs 89.4 pmol/l; P < 0.01) and higher oestrone levels compared with controls in the luteal phase (196 vs 151.9 pmol/l; P < 0.05).

Conclusions

Adolescents with Type 1 diabetes had lower levels of serum oestrogenic activity, and these were lower than expected based on their serum oestradiol levels. We postulate that changes in the serum milieu of oestrogens in patients with Type 1 diabetes may explain their decreased oestrogenic activity and may play a role in their adverse metabolic profile.
Heart acceleration and deceleration capacities associated with dilated cardiomyopathy
Authors: Zou Cao , Dong Hongkai , Wang Fengyan , Gao Meiwen , Huang Xingmei , Jin Jianling , Zhou Bingyuan , Yang Xiangjun
Published: January 2016

Background

Heart rate deceleration capacity and acceleration capacity are novel autonomic nervous system indicators of cardiac neural regulation. Dilated cardiomyopathy (DCM) changes cardiac electrophysiology; however, how deceleration capacity and acceleration capacity associated with DCM remain unclear.

Materials and methods

To evaluate the association between heart rate acceleration capacity, deceleration capacity and DCM, 66 DCM patients with DCM and 209 controls were enrolled in the study. Demographic data, echocardiographic data, heart rate variability, deceleration capacity and acceleration capacity were collected. The association pattern between DCM and these indexes were studied by multiple logistic regression analysis.

Results

Deceleration capacity and acceleration capacity were independent risk factors for DCM with an odds ratio (OR) and 95% confidence interval (CI), determined by multiple logistic regression analysis, of 7·97 (3·87–16·42) and 0·09 (0·05–0·19), respectively. Univariate ordinal logistic regression analysis showed that acceleration capacity, fastest heart rate, standard deviation of normal‐to‐normal RR intervals (SDNN) and left ventricular ejection fraction (LEVF) associated with heart failure grade. The OR for each covariate was further adjusted for the effects of other significant covariates in multivariate ordinal logistic regression analysis. Acceleration capacity, fastest heart rate and LVEF were still independent risk factors in the final equation with ORs of 1·32 (1·03–1·79), 1·04 (0·01–1·07) and 0·46 (0·23–0·93), respectively.

Conclusion

Heart rate acceleration capacity and deceleration capacity are independent risk factors for DCM, and acceleration capacity is a predictive factor for heart failure exacerbation in patients with DCM.
Sitting on the Board or Sitting on the Throne? Evidence of Boards' Overconfidence from the Italian Market
Authors: Fattobene Lucrezia , Caiffa Marco
Published: January 2016

Between things we know with certainty and things we do not know absolutely there is a continuum spectrum of things we know something about: but how much do we know? People think they know more than they actually do: this tendency is defined as overconfidence. We explore the phenomenon with respect to mergers and acquisitions (M&As) and we introduce a new proxy for overconfidence: interlocking directorship (ID). We review different factors at the origin of this decision making (DM) bias and we theoretically justify why directors may be affected by it. Using event‐study methodology, an empirical analysis is conducted on a multi‐sector sample of Italian listed companies, which includes 296 M&A deals realized over the period 2000–2013. We analyse the impact of these extraordinary operations using cumulative abnormal returns (CARs) adding in the model control variables and measures of overconfidence. Results show negative and statistically significant average CARs around the date of announcement of the operations, suggesting that M&As are value destructive in the short term, and sitting on more than one board even increases this result, corroborating the hypothesis of managerial overconfident evaluations.
Long term effect of early intervention service on duration of untreated psychosis in youth and adult population in Hong Kong
Authors: Chan Sherry K.W. , Chau Esther H.S. , Hui Christy L.M. , Chang Wing C. , Lee Edwin H.M. , Chen Eric Y.H.
Published: January 2016

Aim

The current study explored the effect of an early intervention (EI) service for psychosis in Hong Kong (EASY) on the reduction of the duration of untreated psychosis (DUP) at 10 years, in adolescent and adult patients.

Method

Data from three first‐episode psychosis (FEP) studies conducted over 10 years using the same DUP assessment was analysed. FEP study 1 year before the EI service (2000) was used as a control, with those aged <25 comprising the youth psychosis control group and those aged over 25 comprising the adult psychosis control group. Data from the EASY service collected in 2010 constituted the youth psychosis EI group and data from an adult EI service collected from 2009 to 2011 constituted the adult psychosis EI group. DUP of EI and control groups was compared. The effect of the mode of onset and family history of psychosis on DUP was studied.

Results

DUP in the adult group was significantly reduced from median of 180 days to 93 days after 10 years (U = 12 906.50, P = 0.01), particularly in those with gradual onset and without family history. However, no significant change of DUP was found in the youth psychosis group.

Conclusions

Results of the current study provide evidence that EI programmes with public awareness campaign can significantly reduce DUP of adult patients but not in youth group. The effect is more specific in those with long DUP. Further research should explore the specific factors contributed to the long DUP of patients of different age groups so as to establish targeted intervention strategies.
Changes in psychological well‐being among heroin‐dependent adolescents during psychologically supported opiate substitution treatment
Authors: Smyth Bobby P. , Ducray Kevin , Cullen Walter
Published: January 2016

Aim

Heroin‐dependent adolescents demonstrate high rates of comorbid psychological problems. Among heroin‐dependent adults, opiate substitution treatment (OST) programmes appear to reduce mental health problems. We sought to examine the impact of OST on psychological well‐being in adolescents, as this is unknown.

Methods

We conducted a prospective study examining psychological well‐being in heroin dependent adolescents, aged 18 years or younger, engaged in outpatient psychologically supported OST. Patients were treated with either methadone or buprenorphine. This was complimented with individual key working, counselling (motivational interviewing and cognitive behavioral therapy) and group work focusing on life skills. The Beck Youth Inventory was used to measure psychological well‐being at treatment entry and repeated after 4 months of treatment.

Results

Among 55 consecutive treatment episodes, we examined the 32 episodes where the patient persisted with the OST programme. Polysubstance use was the norm at treatment entry. At follow‐up, the median doses of methadone and buprenorphine were 50 mgs and 8 mgs, respectively. Only three patients were treated with antidepressant medication. There was significant improvement in the mean depression (65.0 to 57.9, P = 0.001), anxiety (61.7 to 57.0, P = 0.006) and anger (57.8 to 54.6, P = 0.009) subscale scores. The self‐concept and disruptive behaviour subscale scores did not improve significantly.

Conclusion

In this relatively short‐term follow‐up, psychosocially assisted OST appears to be associated with improved psychological well‐being in heroin‐dependent adolescents, especially in the area of depressive and anxiety symptoms.
Students’ perceptions of vertical and horizontal integration in a discipline‐based dental school
Authors: Postma T. C. , White J. G.
Published: January 2016

Introduction

Integration is a key concern in discipline‐based undergraduate dental curricula. Therefore, this study compared feedback on integration from students who participated in different instructional designs in a Comprehensive Patient Care course.

Methods

The study was conducted at the University of Pretoria (2009–2011). Third‐year cohorts (Cohorts A, B and C) participated in pre‐clinical case‐based learning, whilst fourth‐year cohorts (Cohorts D and E) received didactic teaching in Comprehensive Patient Care. Cohorts A, D and E practised clinical Comprehensive Patient Care in a discipline‐based clinic. Cohort B conducted their Comprehensive Patient Care patient examinations in a dedicated facility supervised by dedicated faculty responsible to teach integration. Students had to indicate on visual analogue scales whether the way they were taught at the school helped them to integrate knowledge from the same (horizontal integration) and preceding (vertical integration) year of study. The end‐points of the scales were defined as ‘definitely’ and ‘not at all’. Analysis of variance (ANOVA) was employed to measure the differences between cohorts according to the year of study.

Results

Third‐year case‐based learning cohorts rated the horizontal integration close to 80/100 and vertical integration ranging from 64 to 71/100. In year four, Cohort B rated vertical and horizontal integration 9–15% higher (ANOVA, P < 0.05) than Cohorts A and D. In year five, Cohort A rated vertical and horizontal integration 11–18% higher (ANOVA, P < 0.05) than Cohorts D and E.

Conclusion

Pre‐clinical case‐based learning and Comprehensive Patient Care supervised by dedicated faculty were associated with more favourable perceptions about integration in the discipline‐based undergraduate dental curriculum.
Involvement of spinal α2‐adrenoceptors in prolonged modulation of hind limb withdrawal reflexes following acute noxious stimulation in the anaesthetized rabbit
Authors: Harris John
Published: January 2016

The role of spinal α2‐adrenoceptors in mediating long‐lasting modulation of hind limb withdrawal reflexes following acute noxious chemical stimulation of distant heterotopic and local homotopic locations has been investigated in pentobarbitone‐anaesthetized rabbits. Reflexes evoked in the ankle extensor muscle medial gastrocnemius (MG) by electrical stimulation of the ipsilateral heel, and reflexes elicited in the ankle flexor tibialis anterior and the knee flexor semitendinosus by stimulation at the base of the ipsilateral toes, could be inhibited for over 1 h after mustard oil (20%) was applied to either the snout or into the contralateral MG. The heel–MG response was also inhibited after applying mustard oil across the plantar metatarsophalangeal joints of the ipsilateral foot, whereas this homotopic stimulus facilitated both flexor responses. Mustard oil also caused a significant pressor effect when applied to any of the three test sites. The selective α2‐adrenoceptor antagonist, RX 821002 (100–300 μg, intrathecally), had no effect on reflexes per se, but did cause a decrease in mean arterial blood pressure. In the presence of the α2‐blocker, inhibitory and facilitatory effects of mustard oil on reflexes were completely abolished. These data imply that long‐lasting inhibition of spinal reflexes following acute noxious stimulation of distant locations involves activation of supraspinal noradrenergic pathways, the effects of which are dependent on an intact α2‐adrenoceptor system at the spinal level. These pathways and receptors also appear to be involved in facilitation (sensitization) as well as inhibition of reflexes following a noxious stimulus applied to the same limb.
Organizational and Managerial Activities in the Development Process of Successful SME Marketing Networks
Authors: Agostini Lara
Published: January 2016

The aim of this paper is to investigate how the development process of small and medium‐sized enterprise (SME) marketing networks is carried out, in terms of organizational and managerial activities, in successful networks compared to unsuccessful ones. In other words, this study investigates which activities are carried out in successful (compared to unsuccessful) SME marketing networks and how they are carried out. Although much attention has been focused on this phenomenon by both academics and practitioners, a high percentage of networks still fail. A qualitative approach based on multiple case studies allowed me to provide managers with a series of guidelines regarding the development process of successful SME marketing networks. The present study therefore represents a noteworthy academic contribution to marketing network theory and practice.