bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Endobronchial Coil Treatment for Lung Volume Reduction in Patients with Severe Heterogeneous Emphysema and Bilateral Incomplete Fissures: A Six-Month Follow-Up
Authors: Kontogianni Konstantina , Gerovasili Vasiliki , Gompelmann Daniela , Schuhmann Maren , Heussel Claus Peter , Herth Felix J.F. , Eberhardt Ralf
Published: May 2014

Background: Treatment with lung volume reduction coils (LVRC) may be effective in patients with severe heterogeneous emphysema and incomplete fissures. Objective: We hypothesized that LVRC placement improves pulmonary function, exercise tolerance and quality of life in these patients. Methods: Twenty-six patients with chronic obstructive pulmonary disease (COPD), 13 males and 13 females, aged 66 ± 8 years with heterogeneous emphysema and incomplete fissures were included in this retrospective analysis. The coils were implanted unilaterally in the upper or lower lobe. Patients were followed up at 30, 90 and 180 days after treatment and changes in pulmonary function test and 6-minute-walk-test (6MWT) values as well as scores for the modified Medical Research Council (mMRC) dyspnea scale and the St. George's Respiratory Questionnaire (SGRQ) were recorded. Results: FEV1 improved significantly at 90 days and tended to decrease at the 180-day follow-up (0.67 ± 0.17 vs. 0.78 ± 0.25 vs. 0.73 ± 0.21 liters, respectively, p < 0.001). The 6MWT score had improved significantly at 90 days and had tended to decrease at the 180-day follow-up (216 ± 107 vs. 262 ± 97 vs. 262 ± 112 m, respectively, p = 0.001). SGRQ was significantly improved at 90 days. Multivariate analysis showed that worse 6MWT performance at baseline was independently associated with a greater improvement in 6MWT at the 90-day follow-up. The total complication rate was 54% (n = 14) and included light hemorrhage in 6 patients, COPD exacerbation in 6, pneumothorax in 1 and both COPD exacerbation and pneumothorax in 1 patient. Conclusions: This is the first study to show that LVRC in patients with heterogeneous emphysema and incomplete fissures improves exercise capacity, quality of life and lung function up to 90 days after the intervention. Further studies are needed to assess the long-term effects of LVRC in these patients.
Effect of Fetal and Infant Malnutrition on Metabolism in Older Age
Authors: Klimek Peter , Leitner Miriam , Kautzky-Willer Alexandra , Thurner Stefan
Published: May 2014

Background: While malnutrition is an important concern in the developing world, Western countries are experiencing a pandemic of obesity and metabolic diseases. Objective: This work reviews the current state of knowledge of the effects of malnutrition during early life on metabolism in older age. Methods: The impact of early-life determinants on diabetes and related metabolic diseases in later life is elucidated by three different methodological approaches. First, results from animal studies in dietary manipulation models are reviewed. Second, findings from epidemiological studies that often use natural experiments to determine the effects of famines on the health status of the population are discussed. Finally, the relation between maternal or childhood malnutrition and diabetes in adulthood is explored in a big-data study using the entire population of a country across a century. Results: We present overwhelming evidence that the maternal or early childhood nutritional status negatively affects both the short- and long-term health status and development of the offspring, thereby providing starting points to formulate intervention and prevention strategies. In particular, it was found that in the case of early-life exposure to famine, the risk of the offspring to develop type 2 diabetes in older age is up to 125% higher than without famine exposure. Conclusion: Due to its inherent complexity, an understanding of the long-term effects of maternal and childhood malnutrition on metabolism in older age necessitates interdisciplinary and big-data approaches. Only then can we hope to prevent chronic diseases at their earliest beginning.
The Impact of Aging and Alzheimer's Disease on Emotional Enhancement of Memory
Authors: Baran Zeynel , Baran Zeynel , Cangöz Banu , Ozel-Kizil Erguvan T.
Published: May 2014

Emotional enhancement of memory (EEM) has been a well-known phenomenon which corresponds to the advantage of emotional stimuli to be better recalled than neutral ones. Previous studies suggest that aging favours recollection of positive items and this pattern is disrupted in Alzheimer's disease (AD). Emotional valence of different stimulus modalities, i.e. pictures and words, may also have an effect on each other's memory performances. However, none of these were clearly studied in AD. This study aimed to evaluate how emotional valences of simultaneously presented stimuli affected recall in healthy young (YG, n = 30), healthy elderly (HE, n = 30) participants and in patients with AD (n = 30). A battery consisting of emotional words presented on emotional pictures was developed. An analysis of a 3 (Groups) × 3 (Emotional Valence of Picture) × 3 (Emotional Valence of Word) mixed ANOVA design was carried out. Patients with AD could process emotional information similarly to healthy participants; however, they had EEM only for picture recalling. Emotional valence of the co-presented stimulus had a boosting effect both in the YG and HE, but not in AD group, especially if both of the stimuli had the same emotional valence. This study highlights the impaired EEM for verbal and preserved EEM for non-verbal declarative memory in patients with AD, the neurobiological underpinnings of which should be addressed by future studies.
Tissue-Specific Patterning of Host Innate Immune Responses by Staphylococcus aureus α-Toxin
Authors: Becker Russell E.N. , Berube Bryan J. , Sampedro Georgia R. , DeDent Andrea C. , Bubeck Wardenburg Juliane
Published: May 2014

Immunomodulatory cytotoxins are prominent virulence factors produced by Staphylococcus aureus, a leading cause of bacterial sepsis, skin infection, and pneumonia. S. aureus α-toxin is a pore-forming toxin that utilizes a widely expressed receptor, ADAM10, to injure the host epithelium, endothelium, and immune cells. As each host tissue is characterized by a unique composition of resident cells and recruited immune cells, the outcome of α-toxin-mediated injury may depend on the infected tissue environment. Utilizing myeloid lineage-specific Adam10 knockout mice, we show that α-toxin exerts tissue-specific effects on innate immunity to staphylococcal infection. Loss of ADAM10 expression exacerbates skin infection, yet affords protection against lethal pneumonia. These diverse outcomes are not related to altered immune cell recruitment, but rather correlate with a defect in toxin-induced IL-1β production. Extension of these studies through analysis of ADAM10 double-knockout mice affecting both the myeloid lineage and either the skin or lung epithelium highlight the prominence of toxin-induced injury to the epithelium in governing the outcome of infection. Together, these studies provide evidence of tissue specificity of pore-forming cytotoxin action in the modulation of host immunity, and illustrate that the outcome of infection is a collective manifestation of all effects of the toxin within the tissue microenvironment.
Quality of Life in Children with Non-Cystic-Fibrosis Bronchiectasis
Authors: Gokdemir Yasemin , Hamzah Ameer , Erdem Ela , Cimsit Cagatay , Ersu Refika , Karakoc Fazilet , Karadag Bulent
Published: May 2014

Background: Non-cystic-fibrosis bronchiectasis (non-CF BE) continues to be a problem in developing countries and it is therefore important to examine and assess this disease. Objectives: The aims of this prospective study were to evaluate the health-related quality of life (HRQOL) in non-CF BE children and also to assess the risk factors associated with HRQOL. Methods: Forty-two non-CF BE patients between the ages of 9 and 18 years were enrolled in the study. All recruited patients completed the generic Short-Form-36 (SF-36), the St. George's Respiratory Questionnaire (SGRQ) for disease-specific QOL scale and forms on socioeconomic status (SES). The extent and severity of CT abnormalities were evaluated by using the modified Bhalla scoring system. Association between HRQOL questionnaires and demographic variables, pulmonary function test, high-resolution CT scores and SES were evaluated. Results: SF-36 and SGRQ subscales all correlated inversely with each other (SF-36 physical component summary with SGRQ symptoms score: r = -0.466, p = 0.001, activity score: r = -0.666, p = 0.000 and impact score: r = -0.667, p = 0.000. SF-36 mental component summary with SGRQ symptoms score: r = -0.396, p = 0.005, activity score: r = -0.533, p = 0.000 and impact score: r = -0.512, p = 0.000). There was an inverse correlation between SGRQ symptoms scores and the duration of regular follow-up (r = -0.3, p = 0.04). The symptoms subscale of SGRQ correlated positively with low values for pulmonary function testing (r = -0.417, p = 0.003) and frequent antibiotic requirements (r = 0.303, p = 0.035). Conclusions: Early diagnosis and regular follow-up of children with non-CF BE is important for improving their QOL. As expected, the severity and frequency of symptoms are inversely related to the pulmonary function and the QOL scores. A disease-specific questionnaire should be developed to monitor QOL in children with non-CF BE.
Influence of Recurrent Electroconvulsive Therapy on Cardiac Function
Authors: Alpak Gokay , Ercan Suleyman , Alici Hayri , Bulbul Feridun , Altunbas Gokhan , Alici Demet , Saricicek Vahap , Davutoglu Vedat
Published: May 2014

Objective: To investigate the effects of recurrent electroconvulsive therapy (ECT) on cardiac function as assessed by echocardiography. Subjects and Methods: Twenty-three patients (11 males and 12 females) with different psychiatric disorders who were apparently free of any cardiovascular disorders and underwent ECT were enrolled in the study. Echocardiographic findings including diastolic mitral inflow and tissue Doppler features were recorded at baseline and at the end of the 7th and last ECT in all patients. Results: The mean age of the patients was 37.95 ± 13.28 years (range 19-71). There was no significant difference in mitral E wave velocities and tissue Doppler E' velocities between the baseline and after the 1st ECT (p = 0.161 and p = 0.083, respectively). The results were similar after the last ECT session (p = 0.463 and p = 0.310, respectively). However, there was a significant increase in transmitral A wave velocity after the 1st and 7th ECT session compared to the values at baseline (p = 0.008 and p = 0.017, respectively). Conclusion: The mitral diastolic inflow A wave velocity increased 20 min after ECT, and this increase persisted after recurrent ECT sessions. This finding could be considered as an indicator of acutely increased sympathetic tone.
Best Supportive Care from the Conservative/Non-Surgical Perspective and Its Costs in the Treatment of Patients with Advanced Medullary Thyroid Cancer: Results of a Delphi Panel
Authors: Kreissl Michael C. , Jacob Christian , Führer Dagmar , Karges Wolfram , Luster Markus , Lux Michael P. , Mann Klaus , Mittendorf Thomas , Schott Matthias , Spitzweg Christine , Schmoll Hans-Joachim
Published: May 2014

Background: Medullary thyroid cancer (MTC) is a rare tumor entity. The contents of best supportive care (BSC) have not been defined in advanced MTC. The objective of this work is to describe the epidemiology, the treatment patterns with respect to symptom management, as well as palliative treatment and associated costs. Method: A Delphi panel with 9 clinical experts experienced in treating MTC was conducted to obtain details on the epidemiology of MTC and to gain insights into the therapeutic options considered for BSC in advanced MTC in Germany. Unit costs were applied to the described resources from the perspective of the German National Healthcare System in 2011. Results: The annual incidence of MTC in Germany was estimated at about 220. 32% of all patients were estimated to have aggressive/symptomatic MTC, with an estimated mean survival of 36.7 months (median: 36 months). The core element of BSC is relief of symptoms to maintain quality of life. The total mean cost of BSC per patient/year was estimated at € 9,248, lifetime cost at € 28,283. Conclusion: There was consistent agreement within the panel on the epidemiology of MTC and on the structure of the provided therapeutic measures for BSC in advanced MTC, also defining the management of symptoms as a crucial goal of treatment.
Image-Guided Radiation Therapy Based on Helical Tomotherapy in Prostate Cancer: Minimizing Toxicity
Authors: Acevedo-Henao Catalina M. , Lopez Guerra Jose L. , Matute Raul , Puebla Fernando , Russo Moises , Rivin Eleonor , Sanchez-Reyes Alberto , Ortiz M. José , Azinovic Ignacio
Published: May 2014

Background: We report the clinical results and prognostic factors of image-guided radiation therapy (RT) with helical tomotherapy (HT) for localized and recurrent prostate cancer (PC). Patients and Methods: We evaluated 70 patients with PC (primary diagnosis, n = 48; adjuvant, n = 5; salvage, n = 17) treated with HT from May 2006 through January 2011. The dose prescribed to the prostate/surgical bed ranged between 60 and 78 Gy. Potential risk factors for genitourinary (GU) and gastrointestinal (GI) toxicity were assessed. Results: The median age was 68 years (range 51-87 years). The median follow-up was 37 months (range 3-74 months). The rates of acute grade 2 GI and GU toxicities were 10 and 13%, respectively. Only 1 patient experienced acute grade 3 GU toxicity. The rates of late grade ≥ 2 GI and GU toxicities were 1% each. Multivariate analysis showed an association between rectum mean dose > median (39 Gy) and bladder median dose > median (46 Gy) with a higher grade of acute GI (p = 0.017) and GU (p = 0.019) toxicity, respectively. Additionally, older age was associated with late GU toxicity (p = 0.026). Conclusion: Toxicity with HT is low and is associated with higher median/mean doses in organs at risk as well as with older age. A prospective validation would be necessary to confirm these results.
Role of the VDR Bsm I and Apa I Polymorphisms in the Risk of Colorectal Cancer in Kashmir
Authors: Rasool Sabha , Kadla Showkat A. , Rasool Vamiq , Qazi Falak , Khan Tanzeela , Shah Nisar A. , Ganai Bashir A.
Published: May 2014

Objective: A case-control study aiming to evaluate the relationship between Bsm I and Apa I restriction fragment gene polymorphisms and colorectal cancer (CRC) was carried out in Kashmir, including a total of 368 subjects (180 cases and 188 controls). Methods: DNA samples extracted from the blood of the subjects were analyzed for 3' untranslated region (3' UTR) Apa I and Bsm I polymorphisms using restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). Results: A statistically significant 2.7-fold increased risk was observed in individuals found homozygous for the presence of the ‘b' allele, in comparison to subjects homozygous for the ‘B' allele (odds ratio (OR) 2.7, 95% confidence interval (CI) 1.49-4.86 (Bsm I)), and a statistically insignificant 2-fold increased risk was found among individuals with the ‘aa' genotype, as compared to subjects with the ‘AA' genotype (OR 2.017, 95% CI 0.86-4.7). Our study also yielded statistically significant results when the Apa I polymorphism was stratified by age (≤ 50 years) and dwelling area (rural area), and the Bsm I polymorphism by gender (male gender), suggesting a possible role of Apa I and Bsm I polymorphisms in the etiology of CRC in Kashmir. Conclusion: We conclude that Apa I and Bsm I single-nucleotide polymorphisms (SNPs) in the vitamin D receptor gene (VDR) might be associated with susceptibility to CRC among Kashmiris.
Grundkonzepte der gastrointestinalen Psychophysiologie
Authors: Cuntz Ulrich
Published: May 2014

Die wissenschaftliche Beschäftigung mit der Psychophysiologie des Gastrointestinaltrakts hat mittlerweile eine lange Tradition und hat zu beachtlichen Ergebnissen geführt. Dabei haben sich die Grundkonzepte und Forschungsansätze in den letzten 50 Jahren erheblich gewandelt, weisen dabei aber doch eine bemerkenswerte Konvergenz auf. Der Gastrointestinaltrakt reagiert auf unterschiedliche Stressoren mit unterschiedlichen Motilitätsmustern; verschiedene Abschnitte des Gastrointestinaltrakts können dabei in unterschiedlicher, gegebenenfalls auch gegensinniger Weise reagieren. Es gibt Hinweise, aber keine zweifelsfreien Belege dafür, dass unterschiedliche Emotionen mit unterschiedlichen Reaktionsmustern assoziiert sind. Entgegen der ursprünglichen Annahme gibt es keinen eindeutigen Zusammenhang zwischen Motilitätsmustern und gastrointestinalen Beschwerden. Das Reizdarmsymdrom, die funktionelle gastrointestinale Störung mit der größten klinischen Bedeutung, ist mit einer intestinalen Hyperalgesie, Hypersensitivität und Hypervigilanz assoziiert. Dies hängt unmittelbar mit der zentralnervösen Reizverarbeitung zusammen: Bei Reizdarmpatienten werden bei intestinalen Schmerzreizen vermehrt Kerngebiete aktiviert, die mit der Schmerzwahrnehmung und der Stressverarbeitung zusammenhängen. Es lässt sich auch zeigen, dass an der viszeralen Hyperalgesie die Hypothalamus-Hypophysen-Nebennierenrinden (HPA)-Achse und insbesondere die Corticotropin-Releasing-Factor-1 (CRF1)-Rezeptoren beteiligt sind. Entgegen früheren Annahmen sind auch immunologische Prozesse beim Reizdarmsyndrom involviert, und auch diese sind von psychologischen Faktoren abhängig. Stress nimmt über verschiedene Wege Einfluss auf die immunologische Reaktion. Diese Entzündungsvorgänge entstehen dabei in Auseinandersetzung mit der bakteriellen Besiedelung des Darms, insbesondere des Colons. Stress nimmt Einfluss auf die qualitative und quantitative Zusammensetzung unseres «Mikrobioms», und die Zusammensetzung des Mikrobioms moderiert wiederum die Stressantwort. Offensichtlich erfordert ein vollständiges Verständnis funktioneller gastorintestinaler Beschwerden auch die Einbeziehung des Mikrobioms und der damit verbundenen immunologischen Vorgänge.
Retroperitoneal Sarcoma Involving Unilateral Double Ureter: Management, Treatment and Psychological Implications
Authors: Leanza Vito , Garraffo Claudia , Leanza Gianluca , Leanza Antonio
Published: May 2014

The case of a 45-year-old woman who was admitted to our university hospital for polymenorrhea, weight gain and pain in the left iliac region is reported. An abdominal ultrasound revealed a 9.5 × 5.2-cm, hypoechoic and inhomogeneous mass located on the left side of the pelvis and behind the ovary. The patient underwent surgery. The pelvic mass was firmly anchored to the small intestine, colon, sigma and uterine fundus. After removing the adhesions, double ureters, which had been incorporated in the mass, were observed on the left side. Resection of the unilateral double ureters was necessary in order to remove the entire mass, and thereafter, a left salpingoophorectomy was performed. A histological examination showed a malignant retroperitoneal mass. Termino-terminal ureteral anastomosis with two double-J stents was carried out. Total hysterectomy with preservation of the right adenexum and regional lymphadenectomy was performed. The purpose of this case report is to discuss the physical and psychological implications related to the combination of two rare entities: leiomyosarcoma and a double ureter located within the mass. A literature review on the clinical management and psychological aspects from a female cancer patient's perspective undergoing surgery with the aforementioned disorders will be discussed.
Acute Retinal Necrosis in Childhood
Authors: Pikkel Yoav Y. , Pikkel Joseph
Published: May 2014

Background: Acute retinal necrosis (ARN) is a viral syndrome consisting of uveitis/vitritis, occlusive vasculitis and peripheral necrosis. Few incidents are reported in children. The etiology is reactivated herpes simplex virus (HSV) or varicella-zoster virus (VZV). Treatment with acyclovir is often used. The administration of oral glucocorticosteroids is of unproven benefit. Prognosis is variable but poor. Methods: Three weeks after contracting mild chickenpox, a healthy 4-year-old girl developed blurred vision in her right eye. Severely reduced visual acuity was noted, together with anterior uveitis, ‘mutton-fat' precipitates and vitral flare. Retinal vasculitis with necrosis was present. Serology for toxoplasma, cytomegalovirus and HIV was negative, while HSV and VZV IgG antibodies were positive. She was treated with 30 mg/kg of intravenous methylprednisolone (3 days), 30 mg of oral prednisone (3 days), and tapering for 8 weeks. Intravenous acyclovir was given for 10 days, followed by oral acyclovir for 4 months. Aspirin (100 mg/day) was given for 4 months. Results: At 12 months, the girl felt good. Her right eye acuity was 6/9, with an intraocular pressure of 17 mm Hg. The peripheral retina showed scarring but no detachment. Conclusions: This is the first report of a once-daily high-dose methylprednisolone pulse therapy in one of the youngest known ARN cases. Pulsed steroid therapy was based on its known effectiveness in vasculitis, which is the main pathophysiology in ARN. There was no evidence of steroid-related viral over-replication. Our case achieved an excellent clinical and ophthalmic recovery in spite of the poor prognosis. The positive result of this case report provides a basis for further evaluation of high-dose steroid pulse therapy in ARN.
Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube
Authors: Zuiki Toru , Meguro Yoshiyuki , Kumano Hidetoshi , Koinuma Koji , Miyakura Yasuyuki , Horie Hisanaga , Lefor Alan T. , Sata Naohiro , Yasuda Yoshikazu
Published: May 2014

A 41-year-old woman was admitted with upper abdominal pain, vomiting and fever. Abdominal CT scan showed a colo-duodenal fistula with inflammatory thickening of the transverse colon. The patient's general health was poor because of hypoalbuminemia and coagulopathy. Endoscopy showed a fistula at the lower duodenal angle and the stomach was filled with refluxed stool. Ileostomy and percutaneous endoscopic gastrostomy were performed at that time and a double lumen gastro-jejunostomy inserted through the gastrostomy to allow both gastric drainage and distal enteral feeding. Nutrition support was gradually converted from parenteral to enteral feeding. Colonoscopy showed stenosis of the transverse colon with a colo-colonic fistula near the stenosis. Two months later, right hemi-colectomy and closure of the colo-duodenal fistula were performed. The resected specimen showed stenosis and a fistula in the transverse colon due to Crohn's disease. The colo-colonic fistula was present and the colo-duodenal fistula had almost closed due to fibrosis. The postoperative course was uneventful and the patient was discharged after administration of infliximab. Use of a double lumen gastro-jejunostomy tube was effective in improving the patient's general condition. This therapeutic strategy allowed the safe conduct of major resection in a high-risk patient.
Cystic Liver Infection after Living Donor Liver Transplantation: A Case Report
Authors: Kudou Kensuke , Ninomiya Mizuki , Iguchi Tomohiro , Harimoto Norifumi , Itoh Shinji , Harada Noboru , Takeishi Kazuki , Yamashita Yo-ichi , Yoshizumi Tomoharu , Soejima Yuji , Ikeda Tetsuo , Shirabe Ken , Maehara Yoshihiko
Published: May 2014

There are no reports of cystic liver infection after liver transplantation. Herein, we report a rare case of cystic liver graft infection after living donor liver transplantation (LDLT). The patient was a 24-year-old man with primary sclerosing cholangitis who underwent right lobe graft LDLT. Preoperative abdominal computed tomography (CT) revealed a liver cyst at segment 8 of the donor liver. Biliary reconstruction was performed with hepaticojejunostomy. The postoperative course was uneventful until the patient developed a high fever and abdominal pain 15 months after LDLT. Abdominal contrast CT revealed abscess formation. Percutaneous drainage of the cyst was performed and purulent liquid was drained. The fever gradually subsided after treatment. On follow-up CT, the size of the infected liver cyst was decreased. Clinicians should be aware of the potential for cystic liver infection when using grafts with liver cysts, particularly when biliary reconstruction is performed with hepaticojejunostomy.
Decision Making for Destination Therapy Left Ventricular Assist Devices
Authors: McIlvennan Colleen K. , Allen Larry A. , Nowels Carolyn , Brieke Andreas , Cleveland Joseph C. , Matlock Daniel D.
Published: May 2014

Background—

Destination therapy left ventricular assist devices (DT LVADs) are one of the most invasive medical interventions for end-stage illness. How patients decide whether or not to proceed with device implantation is unknown. We aimed to understand the decision-making processes of patients who either accept or decline DT LVADs.

Methods and Results—

Between October 2012 and September 2013, we conducted semistructured, in-depth interviews to understand patients’ decision-making experiences. Data were analyzed using a mixed inductive and deductive approach. Twenty-two eligible patients were interviewed, 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being automatic and others (3 accepters, 7 decliners) being reflective in their approach to decision making. The automatic group was characterized by a fear of dying and an over-riding desire to live as long as possible: “[LVAD] was the only option I had…that or push up daisies…so I automatically took this.” By contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: “There are worse things than death.” Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually.

Conclusions—

Some patients offered a DT LVAD face the decision by reflecting on a process and reasoning through risks and benefits. For others, the desire to live supersedes such reflective processing. Acknowledging this difference is important when considering how to support patients who are faced with this complex decision.
Drivers of Costs Associated With Reperfusion Therapy in Acute Stroke
Authors: Simpson Kit N. , Simpson Annie N. , Mauldin Patrick D. , Hill Michael D. , Yeatts Sharon D. , Spilker Judith A. , Foster Lydia D. , Khatri Pooja , Martin Renee , Jauch Edward C. , Kleindorfer Dawn , Palesch Yuko Y. , Broderick Joseph P.
Published: May 2014

Background and Purpose—

The Interventional Management of Stroke (IMS) III study tested the effect of intravenous tissue-type plasminogen activator (tPA) alone when compared with intravenous tPA followed by endovascular therapy and collected cost data to assess the economic implications of the 2 therapies. This report describes the factors affecting the costs of the initial hospitalization for acute stroke subjects from the United States.

Methods—

Prospective cost analysis of the US subjects was treated with intravenous tPA alone or with intravenous tPA followed by endovascular therapy in the IMS III trial. Results were compared with expected Medicare payments.

Results—

The adjusted cost of a stroke admission in the study was $35 130 for subjects treated with endovascular therapy after intravenous tPA treatment and $25 630 for subjects treated with intravenous tPA alone (
P
<0.0001). Significant factors related to costs included treatment group, baseline National Institutes of Health Stroke Scale, time from stroke onset to intravenous tPA, age, stroke location, and comorbid diabetes mellitus. The mean cost for subjects who had routine use of general anesthesia as part of endovascular therapy was $46 444 when compared with $30 350 for those who did not have general anesthesia. The costs of embolectomy for IMS III subjects and patients from the National Inpatient Sample cohort exceeded the Medicare diagnosis-related group payment in ≥75% of patients.

Conclusions—

Minimizing the time to start of intravenous tPA and decreasing the use of routine general anesthesia may improve the cost-effectiveness of medical and endovascular therapy for acute stroke.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00359424.
Postacute Stromal Cell–Derived Factor-1α Expression Promotes Neurovascular Recovery in Ischemic Mice
Authors: Li Yaning , Huang Jun , He Xiaosong , Tang Guanghui , Tang Yao-Hui , Liu Yanqun , Lin Xiaojie , Lu Yifan , Yang Guo-Yuan , Wang Yongting
Published: May 2014

Background and Purpose—

Acute interventions of stroke are often challenged by a narrow treatment window. In this study, we explore treatments in the postacute phase of stroke with wider windows of opportunity. We investigated the effects of stromal cell–derived factor (SDF-1α) in neurovascular recovery during the postacute phase and downstream signaling pathways, underlying SDF-1α–mediated neurovascular recovery.

Methods—

Adult male Institute of Cancer Research (ICR) mice underwent middle cerebral artery occlusion. One week after middle cerebral artery occlusion, the animals received stereotactic injection of adenoassociated virus (AAV) carrying SDF-1α gene as treatment or AAV-green fluorescent protein as control and were monitored for 5 weeks. Neurobehavioral outcomes were evaluated, and brain atrophy was measured. Neurogenesis and angiogenesis were examined. The proliferation and migration of neural progenitor cells were evaluated. Downstream pathways of SDF-1α were investigated. Inflammatory response was monitored.

Results—

Neurobehavioral outcomes were improved, and brain atrophy was greatly reduced for ≤5 weeks in AAV-SDF-1α groups when compared with the control. SDF-1 receptor CXCR4 was upregulated and colocalized with neural and endothelial progenitor cells. The number of nestin
+
and doublecortin
+
/bromodeoxyuridine
+
cells in the subventricular zone, doublecortin
+
and neuron
+
/bromodeoxyuridine
+
cells in the perifocal region, and cluster of differentiation (CD)31
+
and bromodeoxyuridine
+
/CD31
+
microvessels are also significantly increased in AAV-SDF-1α groups. Administration of CXCR4 antagonist AMD3100 eliminated the beneficial effects of SDF-1α. SDF-1α/CXCR4 interaction activated AKT, extracellular signal-regulated kinases (ERK), and P38 mitogen-activated protein kinase (MAPK) signaling pathways but not the c-Jun N-terminal kinase (JNK) pathway.

Conclusions—

SDF-1α promoted neurogenesis and angiogenesis during the postacute phase of ischemia without eliciting an inflammatory response. AAV-SDF-1α expression represents a promising avenue for ischemic stroke therapy with a wider treatment window.
Vitamin K Antagonists and Risk of Subdural Hematoma
Authors: Connolly Ben J. , Pearce Lesly A. , Hart Robert G.
Published: May 2014

Background and Purpose—

Subdural hematomas are an important bleeding complication of anticoagulation. We quantify the risk of subdural hematoma associated with anticoagulation with vitamin K antagonists (VKAs) compared with other oral antithrombotic therapies.

Methods—

Randomized trials were identified from the Cochrane Central Register of Controlled Trials and were included if published since 1980 and compared oral VKAs with antiplatelet therapy or with direct-acting oral anticoagulants. Two reviewers independently extracted data with differences resolved by joint review.

Results—

Nineteen randomized trials were included that involved 92 156 patients and 275 subdural hematomas. By meta-analysis, VKAs were associated with a significantly increased risk of subdural hematoma (odds ratios, 3.0; 95% confidence interval, 1.5–6.1) compared with antiplatelet therapy (9 trials, 11 603 participants). The risk of subdural hematoma was also significantly higher with VKAs versus factor Xa inhibitors (meta-analysis odds ratios, 2.9; 95% confidence interval, 2.1–4.1; 5 trials, 49 687 patients) and direct thrombin inhibitors (meta-analysis odds ratios, 1.8; 95% confidence interval, 1.2–2.7; 5 trials, 30 866 patients) versus VKAs. The absolute rate of subdural hematoma among 24 485 patients with atrial fibrillation treated with VKAs pooled from 6 trials testing direct-acting oral anticoagulants was 2.9 (95% confidence interval, 2.5–3.5) per 1000 patient-years.

Conclusions—

VKA use significantly increases the risk of subdural hematoma by ≈3-fold relative to antiplatelet therapy. Direct-acting oral anticoagulants are associated with a significantly reduced risk of subdural hematomas versus VKAs. Based on indirect comparisons to VKAs, the risks of subdural hematoma are similar with antiplatelet monotherapies and factor Xa inhibitors.
Molecular phylogeny of Faberia (Asteraceae: Cichorieae) based on nuclear and chloroplast sequences
Authors: WANG GUANG-YAN , MENG YING , DENG TAO , YANG YONG-PING
Published: May 2014

Faberia is a perennial herbaceous member of Asteraceae that is mainly distributed in central and southwestern China. Nuclear (ITS) and plastid (psbA–trnH, rbcL, matK, and trnL–F) sequences representing five Faberia species were analyzed with maximum parsimony, maximum likelihood, and Bayesian inference, all of which strongly supported the monophyly of Faberia. Faberia nanchuanensis, F. cavaleriei, and F. faberi from central China form a well-supported clade. Additionally, F. sinensis and F. thibetica from southwestern China also form a well-supported clade. Incongruence between nuclear and plastid fragments was interpreted as hybridization or limited character evolution in the plastid DNA. Faberia may have descended from hybridization between Lactucinae and Crepidinae. Besides phylogenetic results, Faberia nanchuanensis is recorded for the first time from Hunan Province, and F. sinensis from the Tibet Autonomous Region.
Rinorea calcicola (Violaceae), an endangered new species from south-eastern Gabon
Authors: VAN VELZEN ROBIN , WIERINGA JAN J.
Published: May 2014

Rinorea calcicola, endemic to south-eastern Gabon, is described as a new species. Its most striking characteristic is the laminate fruit, a character so far only known for R. zenkeri. Rinorea calcicola has a limited distribution and appears to be restricted to limestone outcroppings. We have assessed it as endangered—EN B1ab(ii,iii,iv,v)—according to IUCN criteria. Morphological affinities of R. calcicola are discussed, and a key to R. zenkeri and the Gabonese species of Rinorea with textured fruits is given. The new species is one of many endemic species from the same region, and we recommend that a study of their distribution and ecology is undertaken to inform conservation planning. Because of the presence of so many narrow endemic species in the region, we suggest that the area be considered for protected status.
A new subgenus and three new species of oribatid mites of the genus Yoshiobodes (Acari, Oribatida, Carabodidae) from Vietnam
Authors: ERMILOV SERGEY G. , SHTANCHAEVA UMUKUSUM YA. , SUBÍAS LUIS S. , ANICHKIN ALEXANDER E.
Published: May 2014

A new subgenus and three new species of oribatid mites of the genus Yoshiobodes, Yoshiobodes (Dongnaiobodes) subgen. nov., Y. (D.) hexasetosus sp. nov., Y. (D.) biconcavus sp. nov. and Y. (Yoshiobodes) neotrichorostralis sp. nov., are described from southern Vietnam. Yoshiobodes (Dongnaiobodes) subgen. nov. differs from the other subgenera, Yoshiobodes (Yoshiobodes) and Yoshiobodes (Berndobodes), by the presence of five to six pairs of genital setae (versus four). Yoshiobodes (D.) hexasetosus sp. nov. differs from Yoshiobodes (D.) biconcavus sp. nov. by the absence of two large concavities in humeral regions of the notogaster and the presence of short, clavate sensilli (versus concavities well developed, sensilli long, thickened, setiform). Yoshiobodes (Y.) neotrichorostralis sp. nov. differs from the other species of the subgenus by the presence of three additional pairs of setae on the lateral sides of the rostrum and the foveolate ornamentation on the notogaster (versus additional setae absent, surface tuberculate). The new generic diagnosis and an identification key to all known species of Yoshiobodes are given. Yoshiobodes ornatus Mahunka, 1987 is proposed as “nomen nudum”. Austrocarabodes (Austrocarabodes) polytrichus Balogh & Mahunka, 1978 combined in the subgenus Austrocarabodes (Uluguroides): A. (U.) polytrichus comb. nov..
The dating of the ornithological section of Middendorff's Reise in den äussersten Norden und Osten Sibiriens, with comments on the nomenclature of Pallas’s Bunting Emberiza pallasi Cabanis (Aves: Emberizidae)
Authors: MLÍKOVSKÝ JIŘÍ
Published: May 2014

Middendorff's work on the Säugethiere, Vögel und Amphibien, published as part 2 of volume 2 of his Reise in den äussersten Norden und Osten Sibiriens, was variably dated from 1851, 1852 or 1853. I document that the work was published shortly before 15 December 1852 and I recommend using this date for the purposes of zoological nomenclature.Due to this, Emberiza polaris Middendorff, 1852 has precedence over Cynchramus pallasi Cabanis, 1853. This bunting species thus should be called Emberiza polaris and its four subspecies should be called Emberiza polaris polaris Middendorff, 1852, E. polaris minor Middendorff, 1852, E. polaris pallasi (Cabanis, 1853) and E. polaris lydiae Portenko, 1929.
Description of Trichodorus iranicus sp. n. (Diphtherophorina, Trichodoridae) from Iran
Authors: PEDRAM MAJID , POURJAM EBRAHIM
Published: May 2014

Trichodorus iranicus sp. n. is described and illustrated based on morphological and molecular characters and morphometric data. It belongs to the T. lusitanicus morphospecies group based on the shape of the spicules and vaginal sclerotised pieces. Males have a body length of 844–942 µm, onchiostyle length of 59 µm, three cervical papillae (CP), curved spicules, 28–30 µm in length, with narrow mid-part, sometimes provided with a few bristles, and slightly developed manubrium. Females of the new species are 727–870 µm long with secretory-excretory pore located opposite anterior end of pharyngeal bulb, vagina length 46–57% of corresponding body width, with triangular to triangular-rounded sclerotised pieces 3.5 µm long, 1–2 µm apart from each other, and vulva a transverse slit. In its morphology, the new species resembles T. andalusicus, T. asturanus, T. azorensis, T. beirensis, T. lusitanicus, T. velatus and T. viruliferus and the morphological and morphometric differences separating T. iranicus from these known species are discussed. The D2-D3 region of 28S rDNA for the new species was amplified and the 679 bp newly-obtained sequence was used in a Bayesian inference (BI) analysis which confirmed the close relationship of the new species with T. lusitanicus morphospecies group members and placed it as a sister taxon to T. andalusicus in a well-supported clade that also includes T. asturanus.
Additional dates of Sir Andrew Smith’s Illustrations of the Zoology of South Africa
Authors: LOW MARTYN E. Y. , EVENHUIS NEAL L.
Published: May 2014

We update the collation of the dates of publication of Smith’s Illustrations of the Zoology of South Africa provided by Waterhouse (1880) and Barnard (1950, 1952). In the case of nine parts, we are able to provide more accurate dates of publication (including day-dates for seven of these parts). For workers of invertebrate taxonomy, we provide an accurate date of publication for W. S. Macleay’s volume on Annulosa.
First record of Megacydnus secundus J. A. Lis, 2002, a representative of Afrotropical endemic burrower bug genus from Uganda, and an annotated checklist of Ugandan Cydnidae (Hemiptera: Heteroptera)
Authors: LIS JERZY A. , LIS BARBARA
Published: May 2014

The Cydnidae (Hemiptera: Heteroptera: Pentatomoidea) is a true bug family with almost 700 species distributed worldwide (Lis 1996, 1999, 2006). These bugs usually dig in the ground (e.g., sand, soil, litter) and, therefore, are commonly known as the burrower bugs or burrowing bugs. Digging in the ground is possible because of several morphological adaptations, including well-developed tibial combs (Lis and Schaefer 2005), coxal combs (Lis 2010), and strong hair-like and peg-like setae on the head margins in larval and adult stages (Lis and Pluot-Sigwalt 2002) (see: Fig. 1A).
Understanding Marikana Through The Mpondo Revolts
Authors: Bruchhausen Sarah
Published: May 2014

The purpose of this article is to demonstrate some of the ways in which rural histories can enhance our understanding of both rural and urban resistance, both past and present, in contemporary South Africa. In order to do so, it explores two books in conversation with each other, Thembela Kepe and Lungisile Ntsebeza’s edited volume Rural Resistance in South Africa: The Mpondo Revolts after Fifty Years as well as Peter Alexander, Thapelo Lekgowa, Botsang Mmope, Luke Sinwell and Bongani Xezwi’s Marikana: A View from the Mountain and a Case to Answer. These two books provide a useful platform from which to engage in a re-examination of rurally based protest and repression in order to locate some of the suggestive links, particularly in regard to the transmission of repertoires of struggle, between the Marikana strike and the Mpondo revolts, as well as the on-going struggles of the organised poor in some of South Africa’s urban centres.
Fracture failure analysis and strength criterion for PTFE-coated woven fabrics
Authors: Yingying Zhang , Xiaoguang Song , Qilin Zhang , Henglin LV
Published: May 2014

This paper presents the research on fracture failure analysis and failure criterion for PTFE-coated woven fabrics. First, groups of on-axial and off-axial tensile tests are carried out, and the corresponding failure mechanisms are analyzed. Then, the samples with initial defects are tested and the fracture toughness is discussed. Finally, several current strength criteria are compared to predict the failure strength of PTFE-coated woven fabrics and a new strength criterion is proposed. Results show the material failure strength depends on the stress ratio and off-axial angle of sample. The ratio of principal stress decides the material strength, and the angle between the principal stress and yarn orientation decides the failure mode. The predictions of current strength criteria agree well with most of the experiment data, except for the samples of small off-axial angles. The disagreements could be attributed to the unbalanced woven structure due primarily to the crimp interchange in the weaving and coating processes. The new strength criterion can make a good prediction of the failure strength of PTFE-coated woven fabrics.
Dimensional stability of epoxy-based and cyanate-based carbon fiber-reinforced plastics
Authors: Arao Yoshihiko , Fukui Taro , Niwa Tomoyuki , Kawada Hiroyuki
Published: May 2014

In this article, the dimensional stability of epoxy- and cyanate-based laminates is discussed, focusing on the thermal deformation, moisture-induced deformation, and deformation induced by relaxation of thermal residual stress. Each of the deformations was calculated independently based on the laminate theory. The material properties of the unidirectional laminates were obtained by conducting thermal mechanical analysis, moisture absorption tests, and tensile creep tests. These material properties were adopted to the laminate theory to predict the deformation of quasi-isotropic laminate, and it was calculated that each type of deformation induced micron-level dimensional instability. The moisture-induced deformation was an order of magnitude larger than that caused by the other factors. The validity of the calculations was confirmed by comparing the calculated results with the experimental ones. It is important to control moisture absorption even if cyanate resin, which has high moisture resistance, is used.
Rival Rebels
Authors: Yan Fei
Published: May 2014

Factional conflicts in China’s provinces from 1966 to 1968 have long been identified as a split between “conservative” and “radical” groups, with the former more supportive of the status quo and the latter more supportive of fundamental change. Accounts of the Guangzhou case consistently identify the Red Flag faction of 1967 as “radical” and the East Wind faction as “conservative.” A closer look at this rivalry with the more abundant sources available today suggests a very different interpretation. The split between the Red Flag and the East Wind was between former allies who were united in the movement against the provincial authorities in 1966. Their split originated in tactical disagreements and evolved into an intense rivalry over a power seizure that excluded one wing of the rebel movement. This generated a competitive rivalry within the ranks of the rebels, expressed as different attitudes toward the military forces ordered by Beijing to “support the left,” which in turn led them into different alliances with forces in Beijing. The famous Guangzhou factions were not interest groups with different orientations toward the status quo ante, but rival rebels who became entangled in factional divisions in Beijing, raising the stakes of their rivalry and intensifying the conflict.
A Cytokine‐Delivering Polymer Is Effective in Reducing Tumor Burden in a Head and Neck Squamous Cell Carcinoma Murine Model
Authors: Lin Yuan , Luo Jie , Zhu Weichao Eric , Srivastava Minu , Schaue Dorthe , Elashoff David A. , Dubinett Steven M. , Sharma Sherven , Wu Benjamin , St. John Maie A.
Published: May 2014

Objective

This study aimed to evaluate the therapeutic efficacy of a novel polymer platform delivering cisplatin and cytokines in the treatment of head and neck squamous cell carcinoma (HNSCC).

Study Design

In vivo study.

Setting

Academic research laboratory.

Subjects and Methods

Mice were randomized to receive implantation of (1) no polymer, (2) plain polymer, (3) plain polymer with local cisplatin injection, or (4) cisplatin polymer. The 2 groups of mice implanted with cisplatin polymer or no polymer were further randomized to receive (1) 4 Grays external beam radiation for 4 days or (2) no radiation. For cytokine studies, mice were grouped into (1) no polymer, (2) plain polymer, (3) plain polymer with intratumoral injection of recombinant CCL21 twice a week, (4) polymer containing parental dendritic cells, or (5) polymer containing dendritic cells secreting CCL21 (DC‐CCL21).

Results

The cisplatin‐secreting polymer effectively reduced tumors in the mice by more than 16‐fold (P <. 01). We also observed a statistically significant lower tumor weight among mice treated with cisplatin polymer and concomitant radiation compared to control groups. The DC‐CCL21 polymer reduced SCCVII/SF tumors in the C3H/HeJ mice by more than 41% (P <. 01).

Conclusion

Herein, we demonstrate the efficacy of a novel polymer platform in delivering cisplatin and cytokines. We also demonstrate that we can effectively grow dendritic cells in the polymer that can actively secrete CCL21 for a minimum of 5 days. This polymer may represent a new therapeutic modality for patients with HNSCC. Once this polymer platform is optimized, we will plan to pursue prospective trials in patients with HNSCC.
Anomic Strain and External Constraints
Authors: Antonaccio Olena , Smith William R. , Gostjev Feodor A.
Published: May 2014

This study provides a new assessment of Merton’s anomie/strain theory and fills in several gaps in the literature. First, using the data from the sample of adolescents in an especially suitable and interesting setting, post-Soviet Ukraine, it investigates the applicability of the theory to this context and reveals that predictive powers of anomic strain may be influenced by larger sociocultural environments. Second, it evaluates the possibility of theoretical elaboration of Merton’s theory through identifying contingencies such as external constraints on behavior and finds limited support for moderating effects of perceptions of risks of sanctioning and social bonds on anomic strain–delinquency relationships. Finally, it confirms that additional clarifications of the concept of anomic strain may be promising.