bluuebunny/crossref_metadata_2025 huggingface dataset:
Subjective Response to Alcohol as a Research Domain Criterion
Authors: Ray Lara A. , Bujarski Spencer , Roche Daniel J. O.
Published: January 2016

Background

Individual differences in the subjective experience of the pharmacological effects of alcohol have long been implicated in the likelihood that one will drink heavily and develop alcoholism. The theme of this conceptual review and perspective article is to synthesize the literature on subjective responses to alcohol and to set an agenda for the next generation of research in the area. Specifically, we contend that in order for subjective response to alcohol to play a prominent role in alcoholism research, it is critical that it be studied as a multimodal phenotype.

Methods

First, we review the human research on subjective response to alcohol measured under controlled laboratory conditions and draw recommendations for the application of these findings to understanding alcoholism neurobiology in humans. Second, we highlight multimodal approaches, including studies of the genetic and neural substrates of individual differences in subjective response to alcohol. Third, we review treatment implications with a focus on subjective response to alcohol as an intervention target. Upon review of the research on subjective response to alcohol across levels of analyses, we provide recommendations for leveraging these phenotypes in a systematic and methodologically rigorous fashion that can address central questions about alcoholism etiology, disease progression, and personalized treatment.

Discussion

The approach recommended herein is largely consistent with the Research Domain Criteria (RDoC) initiative across the National Institute of Mental Health. The defining feature of such domains is that they inform behavior yet be amenable to examination through multiple units of analysis, such as molecular, genetic, circuit‐level, and behavioral measurements. To that end, we contend that subjective response to alcohol represents a behaviorally and biologically plausible phenotype upon which to build using the RDoC framework for understanding alcohol use disorder.
GABBR1 and SLC6A1, Two Genes Involved in Modulation of GABA Synaptic Transmission, Influence Risk for Alcoholism: Results from Three Ethnically Diverse Populations
Authors: Enoch Mary‐Anne , Hodgkinson Colin A. , Shen Pei‐Hong , Gorodetsky Elena , Marietta Cheryl A. , Roy Alec , Goldman David
Published: January 2016

Background

Animal and human studies indicate that GABBR1, encoding the GABAB1 receptor subunit, and SLC6A1, encoding the neuronal gamma‐aminobutyric acid (GABA) transporter GAT1, play a role in addiction by modulating synaptic GABA. Therefore, variants in these genes might predict risk/resilience for alcoholism.

Methods

This study included 3 populations that differed by ethnicity and alcoholism phenotype: African American (AA) men: 401 treatment‐seeking inpatients with single/comorbid diagnoses of alcohol and drug dependence, 193 controls; Finnish Caucasian men: 159 incarcerated alcoholics, half with comorbid antisocial personality disorder, 181 controls; and a community sample of Plains Indian (PI) men and women: 239 alcoholics, 178 controls. Seven GABBR1 tag single nucleotide polymorphisms were genotyped in the AA and Finnish samples; rs29220 was genotyped in the PI for replication. Also, a uniquely African, functional SLC6A1 insertion promoter polymorphism (IND) was genotyped in the AAs.

Results

We found a significant and congruent association between GABBR1 rs29220 and alcoholism in all 3 populations. The major genotype (heterozygotes in AAs, Finns) and the major allele in PIs were significantly more common in alcoholics. Moreover, SLC6A1 IND was more abundant in controls, that is, the major genotype predicted alcoholism. An analysis of combined GABBR1 rs29220 and SLC6A1 IND genotypes showed that rs29220 heterozygotes, irrespective of their IND status, had an increased risk for alcoholism, whereas carriers of the IND allele and either rs29220 homozygote were more resilient.

Conclusions

Our results show that with both GABBR1 and SLC6A1, the minor genotypes/alleles were protective against risk for alcoholism. Finally, GABBR1 rs29220 might predict treatment response/adverse effects for baclofen, a GABAB receptor agonist.
Interhemispheric Functional Brain Connectivity in Neonates with Prenatal Alcohol Exposure: Preliminary Findings
Authors: Donald Kirsten A. , Ipser Jonathan C. , Howells Fleur M. , Roos Annerine , Fouche Jean‐Paul , Riley Edward P. , Koen Nastassja , Woods Roger P. , Biswal Bharat , Zar Heather J. , Narr Katherine L. , Stein Dan J.
Published: January 2016

Background

Children exposed to alcohol in utero demonstrate reduced white matter microstructural integrity. While early evidence suggests altered functional brain connectivity in the lateralization of motor networks in school‐age children with prenatal alcohol exposure (PAE), the specific effects of alcohol exposure on the establishment of intrinsic connectivity in early infancy have not been explored.

Methods

Sixty subjects received functional imaging at 2 to 4 weeks of age for 6 to 8 minutes during quiet natural sleep. Thirteen alcohol‐exposed (PAE) and 14 age‐matched control (CTRL) participants with usable data were included in a multivariate model of connectivity between sensorimotor intrinsic functional connectivity networks. Seed‐based analyses of group differences in interhemispheric connectivity of intrinsic motor networks were also conducted. The Dubowitz neurological assessment was performed at the imaging visit.

Results

Alcohol exposure was associated with significant increases in connectivity between somatosensory, motor networks, brainstem/thalamic, and striatal intrinsic networks. Reductions in interhemispheric connectivity of motor and somatosensory networks did not reach significance.

Conclusions

Although results are preliminary, findings suggest PAE may disrupt the temporal coherence in blood oxygenation utilization in intrinsic networks underlying motor performance in newborn infants. Studies that employ longitudinal designs to investigate the effects of in utero alcohol exposure on the evolving resting‐state networks will be key in establishing the distribution and timing of connectivity disturbances already described in older children.
The Ability of Functional Magnetic Resonance Imaging to Predict Heavy Drinking and Alcohol Problems 5 Years Later
Authors: Schuckit Marc A. , Smith Tom L. , Paulus Martin P. , Tapert Susan F. , Simmons Alan N. , Tolentino Neil J. , Shafir Alexandra
Published: January 2016

Background

Low levels of alcohol responses (low LRs) are genetically influenced phenotypes that are identified before alcohol dependence and predict future heavy drinking and alcohol problems. A recent paper described 13 LR‐related blood oxygen level‐dependent (BOLD) response contrast patterns observed during an emotional face recognition task that might reflect cognitive processes contributing to LR and that might themselves predict adverse alcohol outcomes (Paulus et al., Biol Psychiatry 2012; 72: 848). This paper evaluates the predictive implications of those functional magnetic resonance imaging (fMRI) patterns.

Methods

Of 120 subjects from Paulus and colleagues (2012), 114 (57 low and high LRs; ~50% females) were interviewed 5 years later at age 25. Correlations between baseline fMRI patterns and alcohol‐related outcomes were evaluated, and regression analyses were used to determine if BOLD response contrasts incremented over LR in predicting outcomes.

Results

Baseline fMRI patterns in 5 of 13 baseline regions of interest correlated with adverse outcomes. Such patterns in insular regions, particularly the left anterior insula, and the right frontal gyrus, added to LR in predicting alcohol problems. The relationships remained robust when exact binomial procedures were used, but, reflecting the small sample size, it was not possible to adequately consider Bonferroni corrections.

Conclusions

The data suggest that fMRI BOLD response contrasts predicted heavier drinking and alcohol problems 5 years later, even after considering baseline low LRs. Future work will focus on whether fMRI results can predict outcomes in larger samples and among young nondrinkers, as well as how the imaging results increase understanding of the processes through which LR operates.
Chronic Effects of Ethanol and/or Darunavir/Ritonavir on U937 Monocytic Cells: Regulation of Cytochrome P450 and Antioxidant Enzymes, Oxidative Stress, and Cytotoxicity
Authors: Rao P. S. S. , Kumar Santosh
Published: January 2016

Background

Our recent study has shown that acute treatment with ethanol (EtOH) increases oxidative stress and cytotoxicity through cytochrome P450 2E1 (CYP2E1)‐mediated pathway in U937 monocytic cells. U937 cells are derived from blood monocytes and are considered as the model system for HIV‐related study. Since the prevalence of alcohol use in HIV‐infected population is high, and HIV+ patients are on antiretroviral therapy (ART) soon after they are diagnosed, it is important to study the interactions between EtOH and ART in monocytes.

Methods

This study examined the chronic effects of EtOH and ART (darunavir/ritonavir), alone and in combination, on expression/levels of cytochrome P450 enzymes (CYPs), antioxidant enzymes (AOEs), reactive oxygen species (ROS), and cytotoxicity in U937 cells. The mRNA and protein levels were measured using quantitative reverse transcription polymerase chain reaction and Western blot, respectively. ROS and cytotoxicity were measured using flow cytometry and cell viability assay, respectively.

Results

While chronic ART treatment increased CYP2E1 protein expression by 2‐fold, EtOH and EtOH+ART increased CYP2E1 by ~5‐fold. In contrast, ART and EtOH treatments decreased CYP3A4 protein expression by 38 ± 17% and 74 ± 15%, respectively, and the combination additively decreased CYP3A4 level by 90 ± 8%. Expressions of superoxide dismutase 1 (SOD1) and peroxiredoxin (PRDX6) were decreased by both EtOH and ART, however, the expressions of SOD2 and catalase were unaltered. These results suggested increased EtOH metabolism, increased ART accumulation, and decreased defense against ROS. Therefore, we determined the effects of EtOH and ART on ROS and cytotoxicity. While ART showed a slight increase, EtOH and EtOH+ART displayed significant increase in ROS and cytotoxicity. Moreover, the combination showed additive effects on ROS and cytotoxicity.

Conclusions

These results suggest that chronic EtOH, in the absence and presence of ART, increases ROS and cytotoxicity in monocytes, perhaps via CYP‐ and AOE‐mediated pathways. This study has clinical implications in HIV+ alcohol users who are on ART.
Worldwide Prevalence of Fetal Alcohol Spectrum Disorders: A Systematic Literature Review Including Meta‐Analysis
Authors: Roozen Sylvia , Peters Gjalt‐Jorn Y. , Kok Gerjo , Townend David , Nijhuis Jan , Curfs Leopold
Published: January 2016

Background

Although fetal alcohol spectrum disorders (FASD) affect communities worldwide, little is known about its prevalence. The objective of this study was to provide an overview of the global FASD prevalence.

Methods

We performed a search in multiple electronic bibliographic databases up to August 2015, supplemented with the ascendancy and descendancy approach. Studies were considered when published in English, included human participants, and reported empirical data on prevalence or incidence estimates of FASD. Raw prevalence estimates were transformed using the Freeman–Tukey double arcsine transformation so that the data followed an approximately normal distribution. Once the pooled prevalence estimates, 95% confidence intervals and prediction intervals were calculated based on multiple meta‐analyses with transformed proportions using random effects models, these estimates were transformed back to regular prevalence rates. Heterogeneity was tested using Cochran's Q and described using the I2 statistic.

Results

Among studies that estimated prevalence in general population samples, considerable differences in prevalence rates between countries were found and therefore separate meta‐analyses for country were conducted. Particularly high‐prevalence rates were observed in South Africa for fetal alcohol syndrome (55.42 per 1,000), for alcohol‐related neurodevelopmental disorder (20.25 per 1,000), and FASD (113.22 per 1,000), For partial fetal alcohol syndrome high rates were found in Croatia (43.01 per 1,000), Italy (36.89 per 1,000), and South Africa (28.29 per 1,000). In the case of alcohol‐related birth defects, a prevalence of 10.82 per 1,000 was found in Australia. However, studies into FASD exhibited substantial heterogeneity, which could only partly be explained by moderators, most notably geography and descent, in meta‐regressions. In addition, the moderators were confounded, making conclusions as to each moderator's relevance tentative at best.

Conclusions

The worldwide pooled prevalence estimates are higher than assumed so far, but this was largely explained by geography and descent. Furthermore, prevalence studies varied considerably in terms of used methodology and methodological quality. The pooled estimates must therefore be interpreted with caution and for future research it is highly recommended to report methodology in a more comprehensive way. Finally, clear guidelines on assessing FASD prevalence are urgently needed, and a first step toward these guidelines is presented.
Clinical features, impulsivity, temperament and functioning and their role in suicidality in patients with bipolar disorder
Authors: Jiménez E. , Arias B. , Mitjans M. , Goikolea J. M. , Ruíz V. , Brat M. , Sáiz P. A. , García‐Portilla M. P. , Burón P. , Bobes J. , Oquendo M. A. , Vieta E. , Benabarre A.
Published: January 2016

Objective

Our aim was to analyse sociodemographic and clinical differences between non‐suicidal (NS) bipolar patients (BP), BP reporting only suicidal ideation (SI) and BP suicide attempters according to Columbia–Suicide Severity Rating Scale (C‐SRSS) criteria. Secondarily, we also investigated whether the C‐SRSS Intensity Scale was associated with emergence of suicidal behaviour (SB).

Method

A total of 215 euthymic bipolar out‐patients were recruited. Semistructured interviews including the C‐SRSS were used to assess sociodemographic and clinical data. Patients were grouped according to C‐SRSS criteria: patients who scored ≤1 on the Severity Scale were classified as NS. The remaining patients were grouped into two groups: ‘patients with history of SI’ and ‘patients with history of SI and SB’ according to whether they did or did not have a past actual suicide attempt respectively.

Results

Patients from the three groups differed in illness onset, diagnosis, number of episodes and admissions, family history, comorbidities, rapid cycling and medication, as well as level of education, functioning, impulsivity and temperamental profile.

Conclusion

Our results suggest that increased impulsivity, higher rates of psychiatric admissions and a reported poor controllability of SI significantly increased the risk for suicidal acts among patients presenting SI.
A Business Analysis of Asian Baseball Leagues
Authors: Jang Hayley , Lee Young Hoon
Published: January 2016

This study reviews previous research on sports economics and applied descriptive analyses to derive policy recommendations for the Korean Baseball Organization and the Nippon Professional Baseball. We discuss various aspects of the contemporary baseball business, and compare them with the American Major League Baseball (MLB). One distinctive characteristic common to both Asian leagues is the governance structure, where member teams are owned by major conglomerates. We explore this characteristic to assess the business objectives of the Korean Baseball Organization and the Nippon Professional Baseball, and find that their sources of competitive balance differ from those in MLB. Our conclusion suggests that their business objective should begin to move slowly toward one similar to that of MLB, and safeguards should be implemented to maintain a reasonable competitive balance. We also conclude that sports diplomacy and the creation of international competition are important because international competition and the success of national teams are critical for fan demand.
Heat shock protein‐70 and hypoxia inducible factor‐1α in type 2 diabetes mellitus patients complicated with retinopathy
Authors: Sayed Khulood M. , Mahmoud Aida A.
Published: January 2016

Purpose

To elucidate the role of heat shock protein‐70 (HSP70) and hypoxia inducible factor‐1α (HIF‐1α) in diabetic retinopathy (DR) patients.

Design and methods

A comparative study was done on the serum level of both HSP70 and HIF‐1α in 50 patients with type 2 diabetes mellitus (T2DM) without DR, 50 patients with T2DM and DR and 70 healthy control subjects.

Results

HSP70 and HIF‐1α were significantly increased in T2DM patients compared to controls and increased in patients with T2DM & DR compared to T2DM patients without DR (p < 0.0001). HSP70 did not differ among the patients with different stages of DR, while HIF‐1α increased significantly in grades 3 and 4 DR patients compared to grades 1 and 2 DR patients. A strong correlation was found between HIF‐1α and the development of DR (r = 0.835, p = 0.00) but not with HSP70. HIF‐1α can be used as a predictor for development of DR but not HSP70.

Conclusions

Our study was the first that investigated both HSP70 and HIF‐1α in humans and was the first that measured their levels in serum of patients with DR. The study suggested that HSP70 might have a protective function in T2DM patients rather than a therapeutic function. HIF‐1α had an upper hand in the development and progression of DR. Induction of HSP70 and blockage of HIF‐1α could lead to the development of novel prophylactic and therapeutic strategies for DR and potentially other diabetic complications.
Development of a physiologically based pharmacokinetic model of actinomycin D in children with cancer
Authors: Walsh Christopher , Bonner Jennifer J. , Johnson Trevor N. , Neuhoff Sibylle , Ghazaly Essam A. , Gribben John G. , Boddy Alan V. , Veal Gareth J.
Published: January 2016

Aims

Use of the anti‐tumour antibiotic actinomycin D is associated with development of hepatotoxicity, particularly in young children. A paucity of actinomycin D pharmacokinetic data make it challenging to develop a sound rationale for defining dosing regimens in younger patients. The study aim was to develop a physiologically based pharmacokinetic (PBPK) model using a combination of data from the literature and generated from experimental analyses.

Methods

Assays to determine actinomycin D Log P, blood:plasma partition ratio and ABCB1 kinetics were conducted. These data were combined with physiochemical properties sourced from the literature to generate a compound file for use within the modelling‐simulation software Simcyp (version 14 release 1). For simulation, information was taken from two datasets, one from 117 patients under the age of 21 and one from 20 patients aged 16–48.

Results

The final model incorporated clinical renal and biliary clearance data and an additional systemic clearance value. The mean AUC0‐26h of simulated subjects was within 1.25‐fold of the observed AUC0‐26h (84 ng h ml−1 simulated vs. 93 ng h ml−1 observed). For the younger age ranges, AUC predictions were within two‐fold of observed values, with simulated data from six of the eight age/dose ranges falling within 15% of observed data. Simulated values for actinomycin D AUC0‐26h and clearance in infants aged 0–12 months ranged from 104 to 115 ng h ml−1 and 3.5–3.8 l h−1, respectively.

Conclusions

The model has potential utility for prediction of actinomycin D exposure in younger patients and may help guide future dosing. However, additional independent data from neonates and infants is needed for further validation. Physiological differences between paediatric cancer patients and healthy children also need to be further characterized and incorporated into PBPK models.
Effects of perceived school well‐being and negative emotionality on students' attentional bias for academic stressors
Authors: Scrimin Sara , Moscardino Ughetta , Altoè Gianmarco , Mason Lucia
Published: January 2016

Background

Previous research indicates that children can display different attention allocation patterns in response to threat. However, data are lacking on the possible existence of an attentional bias in response to academic stressors, and whether variables related to school well‐being (SWB) and students' individual characteristics may influence such attentional patterns.

Aim

We aimed to investigate whether students show an attentional bias for school‐related stressors. We sought to identify groups of students who differ in their perceived SWB, and to test whether they display different attention allocation patterns. We also examined whether negative emotionality moderates the expected association between students' SWB and attentional bias.

Methods

Eighth‐grade students completed a dot‐probe detection task to register attentional patterns towards or away from an academic threatening word. SWB in terms of school anxiety, school‐based stress, and perceived class climate was also assessed via self‐reports. In addition, participants reported on their negative emotionality.

Results

The results indicated that students showed an attentional bias towards words describing academic stressors. Cluster analyses allowed the identification of two groups of students with high versus low SWB. Regression analysis indicated that those with low SWB were more likely to show a greater bias and that negative emotionality moderated this relationship. Specifically, within the context of low SWB, students with high negative emotionality were more prone to biased attention towards school‐related stressors compared with students with low negative emotionality.

Conclusions

The present data indicate a perceptual bias for the detection of academic threats. Within the school practice, teachers should promote SWB and devote specific attention to students with high negative emotionality to reduce a biased allocation of attention in response to school‐related stressors.
Examining a one‐hour synchronous chat in a microblogging‐based professional development community
Authors: Gao Fei , Li Lan
Published: January 2016

Research on microblogging in education has suggested its potential to promote community building and collaborative learning, but little is known about the nature of interaction in such microblogging communities. More research is needed to understand how online learning communities can be designed in a way that supports effective learning. The purpose of the study is to explore how people interact in a popular microblogging‐based learning community by examining a one‐hour synchronous chat event and analyzing its network structure, levels of participation, major topics generated and types of interaction. The findings suggested that the levels of participation in the synchronous chat were largely uneven. During the chat, participants were engaged in many types of interaction and discussed a variety of issues related to the topic. Interestingly, people who were different in their levels of participation also varied on the types of topics generated, but not on the types of interaction.
What influences women with intellectual disabilities to attend breast screening? Experiences of women who have and have not participated
Authors: Willis Diane S.
Published: January 2016

Accessible summary

This study looks at the experience of women with learning disabilities who go for breast screening (X‐ray of the breast)

Women with learning disabilities reported that there were many things that encouraged and discouraged them from going for breast screening.

Carers were very important in supporting women with learning disabilities through breast screening

Background: Despite breast screening in Britain being free to all women within the allotted age range, uptake of this service is often poor in women with intellectual disabilities. Reasons put forward are numerous, including poor knowledge, pain and difficulty travelling to the centre. However, what influences the decision to attend is rarely discussed.

Methods: Twelve semi‐structured interviews and three focused observation were undertaken with women with intellectual disabilities to explore what influenced them to participate in breast screening and their experience of having mammography. Data were analysed thematically using a blended framework.

Results: Despite the experience of mammography being negative, high uptake of breast screening services was reported in this study. Pain and previous poor treatment in hospital were reasons for nonparticipation in breast screening. Although awareness about breast screening varied, those who had previous breast problems were more knowledgeable; however, there was poor awareness of the risks of hereditary breast cancer. Overall, paid‐carers were found to play a key role, as means of support, information and a potential influence in determining participation in breast screening.

Conclusions: There was general equality of access but an inequality in the preparation and delivery of the service which was dependent on a complex range of issues and relationships. Key to participation was preparation with the paid‐carer facilitating discussions about breast screening were key to participating in mammography. This has implications on the future direction of funding and policy making. Risks associated with hereditary breast cancer and earlier presentation of breast tumours also needs highlighting.
The association of visceral adipose tissue and subcutaneous adipose tissue with metabolic risk factors in a large population of Chinese adults
Authors: Tang Lizhi , Zhang Fang , Tong Nanwei
Published: January 2016

Objective

Abdominal visceral (VAT) and subcutaneous (SAT) adipose tissues contribute to obesity, but may have different cardiometabolic risk profiles. We examined and compared the associations of abdominal VAT and SAT with metabolic risk factors in a large cohort of Chinese adults.

Methods

This study was based on cross‐sectional analysis of data from 1449 adults aged 40–65 years. VAT and SAT were assessed at L4–L5 level by magnetic resonance imaging. The associations of VAT and SAT with blood pressure, glucose and lipid were examined by linear regression stratified by sex and glucose tolerance status (normal glucose tolerance and prediabetes). Logistic regression was used to analyse the association of VAT and SAT with risk of hypertension, prediabetes and dyslipidaemia.

Results

VAT was more strongly associated with metabolic risk factors. Higher VAT was associated with higher blood pressure (βmen = 3·99, P = 0·0002; βwomen = 6·46, P = 0·0002), higher triglyceride (βmen = 0·45, P < 0·0001; βwomen = 0·6, P < 0·0001), higher total cholesterol (βmen = 0·15, P = 0·02; βwomen = 0·37, P = 0·0002) and higher 2‐h glucose levels (βmen = 0·68, P = 0·003; βwomen = 0·94, P < 0·0001). The association remained significant after subjects were stratified by glucose tolerance status. However, SAT was not associated with any additional risk factors. VAT was associated with increased risk of hypertension (OR = 1·97, P < 0·0001), prediabetes (OR = 1·53, P = 0·0007) and dyslipidaemia (OR = 2·40, P < 0·0001). These associations were not observed for SAT.

Conclusions

VAT was more strongly associated with cardiometabolic risk factors than SAT in a large cohort of Chinese adults. Higher VAT was associated with increased risk of hypertension, dyslipidaemia and prediabetes.
Functional outcome and quality of life after a maxillectomy: a comparison between an implant supported obturator and implant supported fixed prostheses in a free vascularized flap
Authors: Wang Feng , Huang Wei , Zhang Chenping , Sun Jian , Qu Xingzhou , Wu Yiqun
Published: January 2016

Objective

Defects of the maxilla caused by tumor resection create high levels of psychological and physical trauma for patients. The application of osseointegrated dental implants using either an obturator prosthesis or a free vascularized flap has tremendously changed the retention and stability of the superstructure. However, no study has been performed to compare the function of the aforementioned two approaches and the quality of life using the subjective assessments of patients.

Materials and methods

Eligible patients who were treated with maxillary resection and rehabilitated with implant supported obturator prostheses (group 1) or those who received free vascularized flap transfers with implant supported fixed prostheses (group 2) were enrolled between March 2006 and May 2014. A questionnaire that included the indices of the Obturator Functioning Scale (OFS), EORTC Head and Neck 35 assessment and the Mental Health Inventory (MHI) was used to evaluate the functional rehabilitation and QOL of patients in the study.

Results

A total of 42 dental implants, including 25 zygomatic implants, were used in 18 patients (mean age: 56.2 ± 12.3 years) in the obturator prostheses in group 1. Twenty patients (mean age: 45.6 ± 14.1 years) who were treated with a vascularized free flap including the fibula (n = 15) and ilium (n = 5) combined with a total of 71 regular implants for fixed prostheses comprised group 2. No statistically significant median differences in the OFS, EORTC Head and Neck assessment and MHI global scale were observed between the groups. On the MHI subscales item‐levels, higher median subscale scores exhibited by group 1 than group 2 and had statistically significant difference between the groups (P = 0.024).

Conclusion

Within the limitations of this study, it demonstrated no difference in oral function between patients with implant supported obturators and implant supported fixed prostheses in free vascularized flaps after a maxillectomy. However, patients who received obturator therapy seemed to have poorer mental health than did patients with fixed prostheses, but it should be interpreted prudently with the study's limitation.
Sidestream dark field imaging of the serosal microcirculation during gastrointestinal surgery
Authors: de Bruin A. F. J. , Kornmann V. N. N. , van der Sloot K. , van Vugt J. L. , Gosselink M. P. , Smits A. , Van Ramshorst B. , Boerma E. C. , Noordzij P. G. , Boerma D. , van Iterson M.
Published: January 2016

Aim

The study aimed to describe the serosal microcirculation of the human bowel using sidestream dark field imaging, a microscopic technique using polarized light to visualize erythrocytes through capillaries. We also compared its feasibility to the current practice of sublingual microcirculatory assessment.

Method

In 17 patients sidestream dark field measurements were performed during gastrointestinal surgery. Microcirculatory parameters like microvascular flow index (MFI), proportion of perfused vessels (PPV), perfused vessel density (PVD) and total vessel density (TVD) were determined for every patient, sublingually and on the bowel serosa.

Results

Sixty measurements were done on the bowel of which eight (13%) were excluded, five owing to too much bowel peristalsis and three because of pressure artefacts. Image stability was in favour of sublingual measurements [pixel loss per image, bowel 145 (95% CI 126–164) vs sublingual 55 (95% CI 41–68); P < 0.001] and time to acquire a stable image [bowel 96 s (95% CI 63–129) vs sublingual 46 s (95% CI 29–64); P = 0.013]. No difference in the MFI was observed [bowel 2.9 (interquartile range 2.87–2.95) vs sublingual 3.0 (interquartile range 2.91–3.0); P = 0.081]. There was a difference in the PPV [bowel 95% (95% CI 94–96) vs sublingual 97% (95% CI 97–99); P < 0.001], PVD [bowel 12.9 mm/mm2 (95% CI 11.1–14.8) vs sublingual 17.4 mm/mm2 (95% CI 15.6–19.1); P = 0.003] and the TVD [bowel 13.6 mm/mm2 (95% CI 11.6–15.6) vs sublingual 17.7 mm/mm2 (95% CI 16.0–19.4); P = 0.008].

Conclusion

Sidestream dark field imaging is a very promising technique for bowel microcirculatory visualization and assessment. It is comparable to sublingual assessment and the analysis produces a similar outcome with slightly differing anatomical features.
Brain magnetic resonance imaging helps to differentiate atypical multiple sclerosis with cavitary lesions and vanishing white matter disease
Authors: Ayrignac X. , Menjot de Champfleur N. , Menjot de Champfleur S. , Carra‐Dallière C. , Deverdun J. , Corlobe A. , Labauge P.
Published: January 2016

Background and purpose

Multiple sclerosis (MS) patients can present with atypical cavitary lesions mimicking vanishing white matter disease (VWMD). Our objective was to identify brain magnetic resonance imaging (MRI) findings that differentiate these two disorders.

Methods

A cross‐sectional study was performed including 14 patients with MS with cavitary lesions and 14 patients with VWMD. Two neuroradiologists retrospectively reviewed the MRI including at least T1‐, T2‐ and fluid‐attenuated inversion recovery weighted images.

Results

The main differences included ovoid lesions perpendicular to the lateral ventricle, punctate isolated juxtacortical lesions (both 100% in MS versus 0% in VWMD) and symmetrical infratentorial hyperintensities (0% in MS versus 50% in VWMD). Other statistically significant differences included midbrain (79% in MS versus 29% in VWMD) and thalamus lesions (71% vs. 7%) as well as extensive external capsule involvement (29% vs. 86%) and extensive corpus callosum lesions (64% vs. 100%). Cavitary lesions usually had periventricular predominance in MS (36% vs. 0%) whereas they were more frequently anterior in VWMD (0% in MS versus 57% in VWMD).

Conclusion

Despite many similar MRI findings, our results suggest that a careful analysis of the morphology and the location of the lesions is helpful to differentiate these distinct disorders.
Vascular plants promote ancient peatland carbon loss with climate warming
Authors: Walker Tom N. , Garnett Mark H. , Ward Susan E. , Oakley Simon , Bardgett Richard D. , Ostle Nicholas J.
Published: January 2016

Northern peatlands have accumulated one third of the Earth's soil carbon stock since the last Ice Age. Rapid warming across northern biomes threatens to accelerate rates of peatland ecosystem respiration. Despite compensatory increases in net primary production, greater ecosystem respiration could signal the release of ancient, century‐ to millennia‐old carbon from the peatland organic matter stock. Warming has already been shown to promote ancient peatland carbon release, but, despite the key role of vegetation in carbon dynamics, little is known about how plants influence the source of peatland ecosystem respiration. Here, we address this issue using in situ 14C measurements of ecosystem respiration on an established peatland warming and vegetation manipulation experiment. Results show that warming of approximately 1 °C promotes respiration of ancient peatland carbon (up to 2100 years old) when dwarf‐shrubs or graminoids are present, an effect not observed when only bryophytes are present. We demonstrate that warming likely promotes ancient peatland carbon release via its control over organic inputs from vascular plants. Our findings suggest that dwarf‐shrubs and graminoids prime microbial decomposition of previously ‘locked‐up’ organic matter from potentially deep in the peat profile, facilitating liberation of ancient carbon as CO2. Furthermore, such plant‐induced peat respiration could contribute up to 40% of ecosystem CO2 emissions. If consistent across other subarctic and arctic ecosystems, this represents a considerable fraction of ecosystem respiration that is currently not acknowledged by global carbon cycle models. Ultimately, greater contribution of ancient carbon to ecosystem respiration may signal the loss of a previously stable peatland carbon pool, creating potential feedbacks to future climate change.
Reterritorializing the global knowledge economy: an analysis of geopolitical assemblages of higher education
Authors: MOISIO SAMI , KANGAS ANNI
Published: January 2016

In this article, we analyse the geopolitics of higher education, which we understand as an assemblage through which the functioning of the ‘borderless’ and ‘deterritorializing’ dynamics of the global knowledge economy are respatialized. Discourses, objects and bodies constitute a geopolitical assemblage. We scrutinize in particular the geopolitical discourse of the knowledge economy, the construction of material and immaterial learning environments as one of its governmental technologies as well as the subjectification of individuals as specific kinds of professional citizens. We concretize this with an enquiry into the set of recent university reforms in Finland and the ways in which these contribute to the formation of transnational citizenship.
A profile of inactive information seekers on influenza prevention: a survey of health care workers in Central Kentucky
Authors: Kim Sujin , Real Kevin
Published: January 2016

Objective

This study developed a profile of inactive information seekers by characterising how they are different from active seekers, identifying possible determinants of inactive seekers and understanding characteristics of frequently asked influenza‐related questions.

Methods

A survey and follow‐up interviews were conducted between December 2010 and January 2011. A total of 307 health care workers in three hospitals in Central Kentucky (USA) are included.

Results

Four study groups were formed based on their information‐seeking and vaccination uptake status: (1) Inactive Seekers with Vaccination (N = 141); (2) Inactive Seekers without Vaccination (N = 49); (3) Active Seekers with Vaccination (N = 107); and (4) Active Seekers without Vaccination (N = 10).

Inactive Seekers without Vaccination are found to be least responsive to health outcomes. Inactive Seeker groups do not prefer to use sources such as Internet or family/friends. In predicting inactive seekers, Information Needs and Knowledge Perception made significant contributions to prediction. The most frequently asked questions included information about survival duration of influenza virus (N = 25) followed by the incubation period for influenza (N = 24).

Conclusion

Profiling inactive seekers can serve as a way to better design customised influenza information sources and services for health care workers, thus giving hospitals through medical libraries additional tools to reduce the spread of influenza.
The Anti-Incumbent Effects of Conditional Cash Transfer Programs
Authors: Corrêa Diego Sanches , Cheibub José Antonio
Published: January 2016

Scholars concur that conditional cash transfer (CCT) programs have a strong proincumbent effect among beneficiaries. Although no study has properly focused on the overall effect of cash transfers on incumbents' national vote shares, most scholars have deduced that this effect is positive; i.e., that cash transfers lead to the expansion of incumbents' electoral bases. This article analyzes survey data from nearly all Latin American countries and confirms that beneficiaries of CCT programs are more likely to support incumbents. However, it also shows that CCT programs may induce many voters who were previously incumbent supporters to vote for the opposition. As a consequence, the overall impact of cash transfers on incumbents' vote shares is indeterminate; it depends on the balance between both patterns of behavioral changes among voters. This study is the first to report evidence that cash transfer programs may have significant anti-incumbent effects.
Explaining disjunct distributions in the flora of southern South America: evolutionary history and biogeography of Myrceugenia (Myrtaceae)
Authors: Murillo‐A José C. , Stuessy Tod F. , Ruiz Eduardo
Published: January 2016

Aim

Past climatic and geological events can be used to interpret present distributions of organisms. We use chronological and spatial analyses of the species of Myrceugenia in southern South America to help explain their present distribution.

Location

Southern South America (Argentina, Brazil, Chile, Paraguay and Uruguay).

Methods

Chronological analyses were completed for the tribe Myrteae (Myrtaceae) using two nuclear DNA sequences and for the genus Myrceugenia using four chloroplast and two nuclear sequences. A biogeographical analysis of Myrceugenia was carried out. Based on calibration points from fossils and estimations, a relaxed molecular clock was used to estimate divergence times and rates of speciation within each lineage. Ancestral states were reconstructed through Bayesian analysis.

Results

The chronogram implies that tribe Myrteae diversified at the end of the Cretaceous, but that the majority of the individual lineages originated more recently. Myrceugenia diverged into four lineages during the early Miocene. Three of these lineages diversified in Chile, with dispersal to the north and south of the country plus a recent dispersal to the Juan Fernández archipelago. The fourth lineage diversified through vicariant events in south‐eastern Brazil. The ancestors of Blepharocalyx, Myrceugenia fernandeziana and Luma are very ancient lineages that originated between the Palaeocene and Eocene, and which have remained stable with little or no subsequent diversification.

Main conclusions

The estimated age for diversification of tribe Myrteae is consistent with the known fossil evidence from southern South America. The distribution of Myrceugenia may be explained by a combination of three events occurring in the early–middle Miocene: uplift of the Andes, a rain‐shadow effect and a marine transgression. These events may also have led to disjunct distributions in several other genera in southern South America.
Staged versus Simultaneous Thoracoscopic Hybrid Ablation for Persistent Atrial Fibrillation Does Not Affect Time to Recurrence of Atrial Arrhythmia
Authors: RICHARDSON TRAVIS D. , SHOEMAKER M. BENJAMIN , WHALEN S. PATRICK , HOFF STEVEN J. , ELLIS CHRISTOPHER R.
Published: January 2016

Staged versus Simultaneous Hybrid AF Ablation

Introduction

Totally thoracoscopic (TT) epicardial ablation combined with endocardial catheter ablation is an emerging treatment for persistent AF. The effects of timing of the TT and endocardial portion on AT/AF recurrence are not known.

Methods

We retrospectively analyzed patients undergoing TT staged versus simultaneous hybrid AF ablation at our institution. Arrhythmia‐free outcome was compared using time to recurrence (AF or AT greater than 30 seconds after a 3‐month blanking period from endocardial ablation) at 12 months. All subjects had continuous ILR or PM monitoring.

Results

Eighty‐three patients (52 same‐day, 31 staged) underwent TT hybrid AF ablation. Recurrence was observed in 23 (29%) patients at a median time of 147 days (IQR 91,238). In univariate analysis, a staged approach significantly increased the likelihood of detecting incomplete PVI (OR 6 [95% CI 2–17] P = 0.001). However, only longstanding persistent AF (LSP‐AF) status predicted recurrence (HR 4 [95% CI 1.4–12] P = 0.01). Neither a staged approach (HR 1.0 [95% CI 0.4–2.4] P = 0.9), nor detection of incomplete PVI (HR 0.9 [95% CI 0.4–2.3] P = 0.8) predicted time to first AF/AT recurrence.

Conclusions

Staged hybrid ablation of AF significantly increases the likelihood of discovering incomplete PVI at the time of endocardial mapping versus a same‐day procedure. However, the staged approach did not improve time to first AT/AF recurrence.
Spatial Relation Between Left Atrial Anatomical Contact Areas and Circular Activation in Persistent Atrial Fibrillation
Authors: NAKAHARA SHIRO , YAMAGUCHI TAKANORI , HORI YUICHI , ANJO NAOFUMI , HAYASHI AKIKO , KOBAYASHI SAYUKI , KOMATSU TAKAAKI , SAKAI YOSHIHIKO , FUKUI AKIRA , TSUCHIYA TAKESHI , TAGUCHI ISAO
Published: January 2016

Atrial Anatomical Contact Area and Circular Activation

Introduction

Atrial low‐voltage zones (LVZs) may be related to maintenance of atrial fibrillation (AF). The influence of left atrial (LA) contact areas (CoAs) on reentrant or rotor‐like sources maintaining AF has not been investigated.

Methods and Results

Forty patients with persistent AF (PsAF) were analyzed. Three representative CoA regions in the LA (ascending aorta: anterior wall; descending aorta: left inferior pulmonary vein; and vertebrae: posterior wall) were visualized by enhanced CT. Using circular catheters, the LVZs (<0.5 mV) were assessed after restoration of SR, and local activation mapping and frequency domain analyses were performed after induction of AF. Circular activation during AF was visually defined as sites with ≥2 rotations by serial electrograms encompassing >80% of the mean AF cycle length. A pivot was defined as the core of the localized circular activation. Anterior (39/40 patients, 98%), left pulmonary vein antrum (27/40, 68%), and posterior (19/40, 48%) CoAs were identified, and 80% (68/85) of those sites were overlapped by or close (<3 mm) to LVZs. Thirty‐six (90%) patients demonstrated circular activation (3.1±1.7 sites/patients) along with significantly higher organized dominant frequencies (6.3 ± 0.5 Hz, regularity‐index: 0.26 [0.23–0.41]) within the LA, and the average electrogram amplitude of those pivots was 0.30 mV (0.18–0.52). Of those sites, 55% (66/120) were located at or close to CoA regions. Catheter ablation including of LVZs neighboring CoAs terminated AF in 9 (23%) patients.

Conclusions

External anatomical structures contacting the LA may be related to unique conduction properties in diseased myocardium necessary for PsAF maintenance.
The Modified Reasons for Smoking Scale: factorial structure, validity and reliability in pregnant smokers
Authors: De Wilde Katrien Sophie , Tency Inge , Boudrez Hedwig , Temmerman Marleen , Maes Lea , Clays Els
Published: January 2016

Rationale, aims and objectives

Smoking during pregnancy can cause several maternal and neonatal health risks, yet a considerable number of pregnant women continue to smoke. The objectives of this study were to test the factorial structure, validity and reliability of the Dutch version of the Modified Reasons for Smoking Scale (MRSS) in a sample of smoking pregnant women and to understand reasons for continued smoking during pregnancy.

Methods

A longitudinal design was performed. Data of 97 pregnant smokers were collected during prenatal consultation. Structural equation modelling was performed to assess the construct validity of the MRSS: an exploratory factor analysis was conducted, followed by a confirmatory factor analysis.Test–retest reliability (<16 weeks and 32–34 weeks pregnancy) and internal consistency were assessed using the intraclass correlation coefficient and the Cronbach's alpha, respectively. To verify concurrent validity, Mann–Whitney U‐tests were performed examining associations between the MRSS subscales and nicotine dependence, daily consumption, depressive symptoms and intention to quit.

Results

We found a factorial structure for the MRSS of 11 items within five subscales in order of importance: tension reduction, addiction, pleasure, habit and social function. Results for internal consistency and test–retest reliability were good to acceptable. There were significant associations of nicotine dependence with tension reduction and addiction and of daily consumption with addiction and habit.

Conclusions

Validity and reliability of the MRSS were shown in a sample of pregnant smokers. Tension reduction was the most important reason for continued smoking, followed by pleasure and addiction. Although the score for nicotine dependence was low, addiction was an important reason for continued smoking during pregnancy; therefore, nicotine replacement therapy could be considered. Half of the respondents experienced depressive symptoms. Hence, it is important to identify those women who need more specialized care, which can include not only smoking cessation counselling but also treatment for depression.