bluuebunny/crossref_metadata_2025 huggingface dataset:
Combining Coronary with Carotid and Cerebrovascular Angiography Using Prospective ECG Gating and Iterative Reconstruction with 256‐slice CT
Authors: Zhang Jin‐Ling , Liu Bai‐Lu , Zhao Yan‐Ming , Liang Hong‐Wei , Wang Guo‐Kun , Wan Yong , Huang Ya‐Hua , Shen Bao‐Zhong
Published: November 2014

Objective

To investigate the image quality and radiation dose of combined coronary and carotid/cerebrovascular angiography with ECG gating and iterative reconstruction using 256‐slice CT compared with the findings with the two examinations performed separately.

Patients and Methods

One hundred sixty‐five consecutive patients underwent a single‐injection single‐pass combination of coronary and carotid/cerebrovascular CT angiography (group A), coronary CT angiography alone (group B), or carotid/cerebrovascular CT angiography alone (group C). We assessed the image quality of the combined and separate examinations and calculated the respective effective radiation doses. We evaluated the differences in the proportions of image quality grade between the combination and single‐examination groups. Diagnostic performance of the combined scanning for detecting significant vascular stenosis has been compared with reference digital subtraction angiography (DSA) in the patient subgroup of group A.

Results

There was no significant difference in age, body mass index (BMI), or gender distribution among the 3 groups (all P > 0.05). But there was significant difference in scan length, DLP, and effective dose among the 3 groups (all P < 0.05). There were no significant differences in the effective radiation dose of coronary scanning between groups A and B (P > 0.05), while the effective radiation dose of carotid/cerebrovascular scanning in group A was significantly lower than that in group C (P < 0.05), and the total effective radiation dose in group A were relatively low (2.21 ± 1.38 mSv). The differences of the proportion of carotid/cerebrovascular image quality grades between groups A and C were not significant (P > 0.05). In a subgroup of group A of 30 patients with DSA, combined computed tomographic angiography successfully detected 56 coronary stenosis on per‐segment basis, and 62 stenosis on carotid and cerebral artery. The sensitivity, specificity, positive and negative predictive value (NPV) of coronary stenosis were 91.80%, 95.60%, 87.50% and 97.21%, respectively. The sensitivity, specificity, positive and NPV of carotid/cerebrovascular stenosis were 93.55%, 94.68%, 92.06% and 95.70%, respectively.

Conclusion

Combination of coronary and carotid/cerebrovascular angiography with 256‐slice CT scanner with prospective ECG gating and iterative reconstruction produces diagnostic‐quality images of the coronary, carotid, and cerebrovascular systems in a single examination, using less contrast medium and a lower radiation dose than when the two examinations are performed separately. This novel technique has high accuracy in detecting significant stenosis in one image setting.
Effect of acotiamide on gastric emptying in healthy adult humans
Authors: Zai Hiroaki , Matsueda Kei , Kusano Motoyasu , Urita Yoshihisa , Saito Youichi , Kato Hiroki
Published: November 2014

Background

Acotiamide is a first‐in‐class drug that is used to treat functional dyspepsia (FD). It is considered that acotiamide acts as an antagonist on muscarinic autoreceptors in the enteric nervous system and inhibits acetylcholinesterase activity. We examined the effect of acotiamide on gastric emptying in healthy adult humans.

Materials and methods

Twelve healthy adult males were enrolled in this double‐blind crossover study. Acotiamide or placebo was administered orally in the 12 subjects 30 min before ingestion of a nutritional liquid meal (400 Kcal/400 mL). Six of the 12 participants took 100 mg of acotiamide or placebo, and six of the 12 participants took 300 mg of acotiamide or placebo in a double‐blind crossover fashion. All subjects underwent measurement of gastric emptying by the 13C breath test.

Results

After the meal with placebo was ingested, the %dose/h curve ascended. The %dose/h curve after a meal with 100 or 300 mg of acotiamide ascended in an identical manner compared with the results with placebo. No significant differences were observed at any studied time point, and there were no significant changes in gastric emptying parameters (gastric emptying coefficient, t‐1/2ex and t‐lag ex).

Conclusions

A single administration of 100 or 300 mg of acotiamide did not affect gastric emptying after a liquid meal in healthy adult humans. Acotiamide has profound effects on restoring delayed gastric emptying and impaired accommodation in patients with FD but may have no effect on gastric emptying in healthy subjects. Such pharmacological actions have not been observed in previous gastroprokinetic studies.
DPPIV (CD26) as a novel stem cell marker in Ph+ chronic myeloid leukaemia
Authors: Valent Peter , Sadovnik Irina , Ráčil Zdeněk , Herrmann Harald , Blatt Katharina , Cerny‐Reiterer Sabine , Eisenwort Gregor , Lion Thomas , Holyoake Tessa , Mayer Jiří
Published: November 2014

The concept of leukaemic stem cells (LSCs) has been developed to explain the complex cellular hierarchy and biology of leukaemias and to screen for pivotal targets that can be employed to improve drug therapies through LSC eradication in these patients. Some of the newly discovered LSC markers seem to be expressed in a disease‐specific manner and may thus serve as major research tools and diagnostic parameters. A useful LSC marker in chronic myeloid leukaemia (CML) appears to be CD26, also known as dipeptidylpeptidase IV. Expression of CD26 is largely restricted to CD34+/CD38− LSCs in BCR/ABL1+ CML, but is not found on LSCs in other myeloid or lymphoid neoplasms, with the exception of lymphoid blast crisis of CML, BCR/ABL1p210+ acute lymphoblastic leukaemia, and a very few cases of acute myeloid leukaemia. Moreover, CD26 usually is not expressed on normal bone marrow (BM) stem cells. Functionally, CD26 is a cytokine‐targeting surface enzyme that may facilitate the mobilization of LSCs from the BM niche. In this article, we review our current knowledge about the biology and function of CD26 on CML LSCs and discuss the diagnostic potential of this new LSC marker in clinical haematology.
Electrochemical impedance spectroscopy in understanding the influence of ultrasonic dental scaling on the dental structure–dental filling interface
Authors: Andrei Mihai , Pirvu Cristian , Demetrescu Ioana
Published: November 2014

The purpose of this study was to investigate the effect of ultrasonic scaling on teeth restored with a light‐cured resin. Ultrasonic scaling is a very popular periodontal therapy among dentists, and used for the removal of dental plaque and calculus in order to reduce and eliminate inflammation. Given the fact that most ultrasonic devices are used at high frequencies to perform scaling, undesirable consequences, such as loss of adhesion and increase in surface roughness, may occur in teeth that have been restored with light‐cured resins. Electrochemical impedance spectroscopy (EIS) and scanning electron microscopy were used to investigate the effects of ultrasonic treatments at the dental material–hard dental tissue interface. After ultrasonic scaling, EIS measurements were performed on a human tooth that had been restored with a light‐cured resin filling. The data were analyzed and the influence of ultrasound was shown after visualization of the hard dental tissues and the dental material as equivalent electrical circuits. The study revealed, through EIS measurements, that ultrasonic scaling affected the resistance of the light‐cured resin filling and dentin, whereas the enamel was affected only slightly. Scanning electron microscopy revealed an increase in roughness of the dental material.
Multiple skeletal metastases from a penile squamous cell carcinoma in a horse
Authors: Nelson B. B. , Edmondson E. F. , Sonis J. M. , Frank C. B. , Valdés‐Martínez A. , Leise B. S.
Published: November 2014

A 21‐year‐old gelding with ventral abdominal and preputial oedema was evaluated for right hindlimb lameness. Partial phallectomy had been performed 3 years prior for treatment of squamous cell carcinoma. Regional analgesia did not localise the source of lameness and nuclear scintigraphy was recommended. The results of the scan revealed severe increased radiopharmaceutical uptake in the proximal femur. Radiographic and ultrasound examinations were inconclusive. The horse was discharged with recommendations of stall confinement and a 2 week course of nonsteroidal anti‐inflammatory drugs. Four weeks later the horse presented for an inability to elevate his neck and persistent hindlimb lameness. The owner elected humane euthanasia. Post mortem examination revealed metastatic squamous cell carcinoma in the proximal femur and fifth cervical vertebrae consistent with metastasis from the penile squamous cell carcinoma. To the authors’ knowledge, multiple site bone metastasis of squamous cell carcinoma has not been reported previously in the horse.
Short Selling and Firm Operating Performance
Authors: Deshmukh Sanjay , Gamble Keith Jacks , Howe Keith M.
Published: November 2014

While it is well known that short selling predicts future negative stock price performance, it has not been established whether short selling predicts future negative operating performance. We find that firms in the top decile of increases in short interest (an increase of about four percentage points) experience a 21% subsequent decline in operating performance relative to matched control firms. The greater the increase in short interest, the larger the decline in operating performance. The results are robust to alternative performance measures and to sample splits based on firm size. These results suggest that short interest may reflect private information about firm fundamentals rather than other factors that may drive stock price changes.
Pharmacokinetics, phenotype and product choice in haemophilia B: how to strike a balance?
Authors: Berntorp E. , Dolan G. , Hermans C. , Laffan M. , Santagostino E. , Tiede A.
Published: November 2014

At the 7th Annual Congress of the European Association for Haemophilia and Allied Disorders (EAHAD) held in Brussels, Belgium, in February 2014, Pfizer sponsored a satellite symposium entitled:“Pharmacokinetics, phenotype and product choice in haemophilia B: How to strike a balance?”Co‐chaired by Cedric Hermans (Cliniques Universitaires Saint Luc, Brussels, Belgium) and Mike Laffan (Imperial College, London, UK), the symposium provided an opportunity to debate whether pharmacokinetic (PK) parameters are good surrogates for clinical efficacy for haemophilia B in clinical practice, consider the perceptions and evidence of disease severity, and examine how these considerations can inform approaches to balancing the potential risks and benefits of the currently available treatment options for haemophilia B. PK parameters are routinely measured in clinical practice and are a requirement of regulatory bodies to demonstrate the clinical efficacy of products; however, the relationship between measured PK parameters and clinical efficacy is yet to be determined, an issue that was debated by Gerry Dolan (University Hospital, Queen's Medical Centre, Nottingham, UK) and Erik Berntorp (Lund University, Malmö Centre for Thrombosis and Haemostasis, Malmö, Sweden). Elena Santagostino (Universita degli Studi di Milano, Milano, Italy) reviewed how differing perceptions on the severity of haemophilia B compared with haemophilia A may have an impact on clinical decision‐making. Finally, Andreas Tiede (Hannover Medical School, Hannover, Germany), examined the considerations for balancing the potential risks and benefits of the currently available treatment options for haemophilia B. Although the pathophysiology of haemophilia B has been widely studied and is largely understood, continued investigation and discussion around the optimal management course and appropriate therapeutic choice is warranted.
Late Holocene coral reef environment recorded in Tridacnidae shells from archaeological sites in Okinawa‐jima, subtropical southwestern Japan
Authors: Asami Ryuji , Konishi Mika , Tanaka Kentaro , Uemura Ryu , Furukawa Masahide , Shinjo Ryuichi
Published: November 2014

Seasonally resolved records of carbon and oxygen isotopic composition (δ18O) in fossil shells of giant clams (Tridacnidae) recovered from the Kogachibaru Shell Mound (26°26′N, 127°49′E) and the Second Aragusuku‐Shichabaru Ruin (26°18′N, 127°46′E) in Okinawa‐jima, southwestern Japan, were investigated to reconstruct subtropical coral reef environments of the past. The samples, mainly composed of aragonite shells with limited amounts of diagenetically‐altered calcite cements, were selected for geochemical analyses. The radiocarbon dating of the samples for stable isotope analyses yields about 4000 yr cal. BP for the Kogachibaru Shell Mound and about 1900–1700 yr cal. BP for the Second Aragusuku‐Shichabaru Ruin, respectively, that correspond to the early and middle Shell Mound periods in Okinawa‐jima. These show good agreement with the respective ages inferred from excavation. The shell δ18O values roughly show seasonal variations, coincident with the occurrence of annual growth bands. Applying corrections for the effect of diagenetic alteration, the averages of annual, summer, and winter δ18O values of fossil shells were significantly lower (by 0.1–0.7‰) than those of aragonite theoretically precipitated in present‐day coral reef water of Okinawa‐jima. These results demonstrate that annual mean seawater temperature and salinity at the sites where the Tridacnida spp. lived were about 1–3°C higher and/or about 1–2 lower than at present. This variation cannot be fully explained by global climate change, sea level change, and topographic growth of coral reef. Therefore, it is likely that the giant clams lived in extremely small and/or closed coral‐reef lagoons with less water circulation where seawater is highly susceptible to insolation‐induced temperature increase and input of fresh water; the effect could be enhanced by the fisheries lifestyle that stonewalling would be constructed at shallow waters through the use of tidal variation during the early and middle Shell Mound period in Okinawa‐jima.
Effect of ozone treatment on physicochemical properties of waxy rice flour and waxy rice starch
Authors: Ding Wenping , Wang Yuehui , Zhang Wei , Shi Yongcheng , Wang Donghai
Published: November 2014

The effect of ozone treatment on physicochemical properties of waxy rice flour and waxy rice starch was investigated. Results showed that ozone treatment increased the pasting viscosity of waxy rice flour. Compared with untreated waxy rice flour, the peak viscosities of waxy rice flour for 0.5, 1 and 2 h of ozone treatments were increased by 27.4%, 32.8% and 45.5%, respectively. The alpha‐amylase in waxy rice flour was inactivated during the treatment. The gelatinisation temperature and enthalpy of waxy rice flour were kept unchanged after the treatment. For waxy rice starch, pasting viscosity, swelling power and molecular weight were increased after 0.5 h of treatment, but decreased as treatment time extended. The ozone treatment decreased gelatinisation temperature and enthalpy of waxy rice starch.
Effect of proteins on the formation of starch–lipid complexes during extrusion cooking of wheat flour with the addition of oleic acid
Authors: De Pilli Teresa , Legrand Jack , Derossi Antonio , Severini Carla
Published: November 2014

The formation of starch–lipid complexes plays an important role in extruded products. The effect of gluten proteins on thermal conditions at which the starch–lipid complexes formed during extrusion cooking of wheat flour with the addition of oleic acid was evaluated, considering wheat starch as a reference. The presence of gluten proteins in wheat flour extrudates brought about a reduction of the formation of starch–lipid complexes compared to blend of wheat starch and oleic acid extruded at the same operating conditions (melting enthalpy: 0.4 vs. 1.6 kJ kg−1). Moreover, the lubricant effect of oleic acid observed during extrusion of wheat starch (low values of specific mechanical energy and residence time) was not found during extrusion of wheat flour with addition of oleic acid because of the interaction between gluten proteins and oleic acid. This research points out the importance of proteins on biopolymer modifications and their effect on extrudate quality.
Dynamic monitoring of the shelf life of Cobia (Rachycentron canadum): a study on the applicability of a smart photochromic indicator
Authors: Brizio Ana P. B. R. , Gonzaga Junior Marcondes A. , dos Santos Fogaça Fabíola H. , Prentice Carlos
Published: November 2014

To ensure the marketing of fresh fish‐based products, it is necessary to develop fast methods that assess its freshness in real time. This study therefore evaluated the applicability of a photochromic time–temperature indicator (TTI) to monitor the time and temperature history during the period of validity of the whole fish of the cobia specimen stored in ice. The TTI response was both visibly interpreted as well as adaptable to measurement using suitable equipment. The results showed that the smart indicator activated during 6 s of ultraviolet light showed a similar rate of deterioration of the analysed product visual response, proving to be a dynamic shelf life indicator that can assure consumers the ultimate quality point of the entire cobia easily, cheaply and accurately.
Chronic obstructive pulmonary disease case finding by community pharmacists: a potential cost-effective public health intervention
Authors: Wright David , Twigg Michael , Thornley Tracey
Published: November 2014

Objectives

This study aims to pilot a community pharmacy chronic obstructive pulmonary disease (COPD) case finding service in England, estimating costs and effects.

Methods

Patients potentially at risk of COPD were screened with validated tools. Smoking cessation was offered to all smokers identified as potentially having undiagnosed COPD. Cost and effects of the service were estimated.

Key findings

Twenty-one community pharmacies screened 238 patients over 9 months. One hundred thirty-five patients were identified with potentially undiagnosed COPD; 88 were smokers. Smoking cessation initiation provided a project gain of 38.62 life years, 19.92 quality-adjusted life years and a cost saving of £392.67 per patient screened.

Conclusions

COPD case finding by community pharmacists potentially provides cost-savings and improves quality of life.
Characteristics favouring a delayed disposition decision in the emergency department
Authors: Perimal‐Lewis L. , Hakendorf P. H. , Thompson C. H.
Published: November 2014

Background

The working hours of a hospital affects efficiency of care within the emergency department (ED). Understanding the influences on ED time intervals is crucial for process redesign to improve ED patient flow.

Aim

To assess characteristics that affect patients' transit through an ED.

Methods

Retrospective cohort study from 2004 to 2010 of 268 296 adult patients who presented to the ED of an urban tertiary‐referral Australian teaching hospital.

Results

After adjustment for Australasian Triage Scale (ATS) category, every decade increase in age meant patients spent an additional 2 min in the ED waiting to be seen (P < 0.001) and an extra 29‐min receiving treatment (P < 0.001). For every additional 10 patients in the ED, the ‘waiting time’ (WT) phase duration increased by 20 min (P < 0.001) and the ‘Assessment and Treatment Time’ (ATT) phase duration increased by 26 min (P < 0.001). When patients arrived outside working hours, the WT phase duration increased by 20 min (P < 0.001). When seen outside working hours, the ATT phase duration increased by 34.5 min (P < 0.001).

Conclusion

Extrinsic to the patients themselves and in addition to ED overcrowding, the working hours of the hospital affected efficiency of care within the ED. Not only should the whole of the hospital be involved in improving efficient and safe transit of patients through an ED, but the whole of the day and every day of the week deserve attention.
Echocardiographic and electrocardiographic findings in patients with obesity hypoventilation syndrome
Authors: Alawami M. , Mustafa A. , Whyte K. , Alkhater M. , Bhikoo Z. , Pemberton J.
Published: November 2014

Background

Obesity is a risk factor for both sleep‐related breathing disorders (SRBD), including obesity hypoventilation syndrome (OHS) and cardiovascular diseases (CVD). The development of CVD in patients with SRBD is usually attributed to the fact that most patients are obese in addition to conventional cardiovascular risk factors.

Aims

This study aims to measure the prevalence of certain CVD in patients with OHS in the Auckland region and highlight the importance of the effects of SRBD on the heart.

Methods

A dataset of all patients with a formal diagnosis of OHS that were under active follow up was compiled from Auckland District Health Board Sleep Disordered Breathing Service. Clinical notes were retrospectively reviewed for echocardiogram reports, blood pressure measurements and electrocardiograms.

Results

Forty‐seven patients were included in the present study. The median age was 60 years, 24 were female (51%), 20 (42.5%) had diabetes, mean HbA1C was 53.5 mmol/mol, mean systolic blood pressure was 127 mmHg, mean body mass index was 49 kg/m2, mean forced expiratory volume in 1 s was 1.7 L, mean estimated glomerular filtration was 71 mL/min/1.73 m2 and there was anti‐hypertensive use in 31 (65.9%) patients. Thirty‐three patients had poor quality echocardiography views (70.2%). Left ventricular systolic and diastolic function was impaired in 8 (25%) and 18 (60%) respectively. Right ventricular dysfunction and pulmonary hypertension was present in 19 (63.3%) and 13 (52%) respectively. Sixteen patients (34%) had recurrent atrial or ventricular arrhythmias.

Conclusion

There appears to be a high prevalence of right ventricular impairment, pulmonary hypertension, left ventricle hypertrophy, diastolic dysfunction and arrhythmias in patients with OHS. These findings would appear to be higher than expected in obese patients without OHS. A larger prospective matched cohort study would be needed to confirm the clinical significance of these findings.
Hyponatraemia at hospital admission is a predictor of overall mortality
Authors: Balling L. , Gustafsson F. , Goetze J. P. , Dalsgaard M. , Nielsen H. , Boesgaard S. , Bay M. , Kirk V. , Nielsen O. W. , Køber L. , Iversen K.
Published: November 2014

Background

Hyponatraemia is a prognostic marker of increased mortality and morbidity in selected groups of hospitalised patients. The aim of the present study was to examine the prevalence and prognostic significance of hyponatraemia at hospital admission in an unselected population with a broad spectrum of medical and surgical diagnoses.

Methods

Consecutive patients >40 years of age admitted to a general district hospital in Greater Copenhagen between 1 April 1998 and 31 March 1999. Median follow‐up time was 5.16 years (range 0–4372 days). Plasma sodium measurements were available in 2960 patients, and hyponatraemia defined as P‐Na+ <137 mmol/L at hospital admission was present in 1105 (37.3 %) patients.

Results

One‐year mortality was higher for hyponatraemic patients than for normonatraemic patients: 27.5% versus 17.7%. Moreover, hyponatraemia was an independent predictor of short and long‐term all‐cause mortality after 1 year and after the entire observation period respectively: hazard ratio (HR) 1.6 (95 % confidence interval (CI) 1.4–1.9, P < 0.0001) and HR 1.4 (95 % CI 1.3–1.6, P < 0.0001). Patients with hyponatraemia had longer hospitalisations than patients with normonatraemia: 7.6 (±0.38) days vs 5.6 (±0.21) days, P < 0.001. There was no interaction between hyponatraemia at admission and any admission diagnoses (P > 0.05 for all interaction analyses).

Conclusion

Hyponatraemia is associated with increased all‐cause mortality and longer admission length independently of diagnosis and clinical variables.
Acute effects of different degrees of ultra‐endurance exercise on systemic inflammatory responses
Authors: Comassi M. , Vitolo E. , Pratali L. , Del Turco S. , Dellanoce C. , Rossi C. , Santini E. , Solini A.
Published: November 2014

Background

Intense physical stress might promote inflammatory responses, whereas a regular physical exercise has positive influence. Little is known on the acute metabolic and inflammatory responses to different levels of strenuous exercise in trained athletes.

Aim

To compare the short‐term effect of two different ultra‐endurance competitions on the inflammatory profile in male triathletes.

Methods

We studied 14 Ironman (IR) and 13 Half Ironman (HIR) before and after their own specific race. We assessed body composition and measured blood cells, lipids, iron metabolism and plasma levels of some acute‐phase cytokines and inflammatory markers.

Results

After the race, IR showed reduced total body water and fat‐free mass, not related with the duration of exercise, and increased white cells and platelets; high‐density lipoprotein levels also increased. IR, but not HIR, showed reduced iron levels, increased ferritin and transferrin, reduced % saturated transferrin. HIR showed higher basal interleukin (IL)‐6, tumour necrosis factor (TNF)‐α, IL‐10, IL‐1β than IR; however, the post‐performance rise was greater in IR. Irisin increased only in HIR and osteocalcin decreased in IR. In the whole study group, delta of white blood cells was directly related with delta of monocyte chemoattractant protein 1, and Δ ferritin was inversely related with Δosteocalcin.

Conclusions

A single ultra‐endurance competition induces an inflammatory response depending on the duration of physical effort, with increased acute‐phase cytokines, and an altered iron metabolism. Irisin, whose biological meaning is still uncertain, seems to be associated with acute variations of some metabolic parameters.
Doping in sport: effects, harm and misconceptions
Authors: Birzniece V.
Published: November 2014

Doping in sport is a widespread problem not just among elite athletes, but even more so in recreational sports. In scientific literature, major emphasis is placed on doping detection, whereas detrimental effects of doping agents on athletes' health are seldom discussed. Androgenic anabolic steroids are well known for their positive effects on muscle mass and strength. Human growth hormone also increases muscle mass, although the majority of that is an increase in extracellular fluid and not the functional muscle mass. In recreational athletes, growth hormone does not have major effect on muscle strength, power or aerobic capacity, but stimulates anaerobic exercise capacity. Erythropoietin administration increases oxygen‐carrying capacity of blood improving endurance measures, whereas systemic administration of beta‐adrenergic agonists may have positive effect on sprint capacity, and beta‐adrenergic antagonists reduce muscle tremor. Thus, there are certain drugs that can improve selective aspects of physical performance. However, most of the doping agents exert serious side‐effects, especially when used in combination, at high doses and for a long duration. The extent of long‐term health consequences is difficult to predict, but likely to be substantial, especially when gene doping is considered. This review summarises the main groups of doping agents used by athletes, with the main focus on their effects on athletic performance and adverse effects.
Trends in the incidence of intensive care unit invasive mechanical ventilation and subsequent 2‐year survival in very elderly New Zealanders
Authors: Tripp D. G. , Purdie G. , Hicks P.
Published: November 2014

Background

The number of elderly in the general population is growing. There are therefore implications for the provision of intensive care unit (ICU) care to elderly patients.

Aim

Our aim was to determine the incidence of ICU invasive mechanical ventilation (IMV), long‐term outcomes of patients treated with IMV, and trends in these variables over a 10‐year period in New Zealand, with a focus on very elderly patients (aged 80 years and over).

Methods

Analysis of New Zealand public hospital discharge data from July 1999 to June 2010, with linked long‐term mortality data. Transfers or readmissions to different hospitals were linked using a national unique patient identifier.

Results

There were 58 003 patients treated with IMV in a New Zealand ICU. Of these patients, 6.6% were very elderly. Population rates of ICU IMV declined or were static over all age groups. The 2‐year mortality rate ranged from 15% in patients aged 16–39 years to 52% in the very elderly. The 2‐year mortality rates for the very elderly were highest for acute medical patients (78%), followed by acute surgical admissions (46%) and elective admissions (35%). The 2‐year mortality rate for all patients declined over the study period, and declined or was static for all age groups and admission types. In the very elderly, the standardised mortality ratio of patients surviving at 1 year who survived their second year after admission, compared with the age‐matched general population, was lower than all other age groups.

Conclusion

For very elderly patients over the period 1999–2009, the population rate of IMV was static and 2‐year mortality declined.
Toddlers’ Responses to Infants’ Negative Emotions
Authors: Nichols Sara R. , Svetlova Margarita , Brownell Celia A.
Published: November 2014

Early developments in toddlers’ responses to adults’ distress have been extensively examined, but less work has been directed to young children's responses to other children in distress. In the current study, we examined 12‐, 18‐, and 24‐month‐old children's (N = 71) behavioral and affective responses to a crying infant (doll) present in the room with the child. A comparison condition included a contented, neutral infant to contrast with the crying infant so as to disambiguate social interest from distress‐specific responding. Results showed that 12‐month‐olds were neither particularly interested in nor concerned about the infant, although they did discriminate between conditions. In contrast, 18‐ and 24‐month‐olds were socially interested and attentive to the infant, but 24‐month‐olds exhibited greater affective concern to the crying infant than did 18‐month‐olds. Children at all three ages were also mildly distressed themselves by the infant's crying, and this did not decline over the second year. Both girls and children without siblings were more interested in the infant; no effects were found for gender, daycare experience, or siblings on affective concern.
The Potential for Utilizing the Seed Crop Amaranth (Amaranthusspp.) in East Africa as an Alternative Crop to Support Food Security and Climate Change Mitigation
Authors: Alemayehu F. Reta , Bendevis M. A. , Jacobsen S.‐E.
Published: November 2014

The projected growth in global food demand has resulted in increased attention towards underutilized crops with the potential to improve global food security and ability to mitigate adverse effects of climate changes. Changing consumer demands in favour of more nutritiously balanced and organically grown crops have added to the interest in species such as amaranth. Promoting the consumption and cultivation of amaranth could be valuable due to its unique nutrient composition and inherent tolerance of drought and other stress factors. Due to current and predicted effects of climate changes, these attributes are becoming increasingly important. Amaranth is a source of high quality protein, as well as dietary fibre and lipids rich in unsaturated fatty acids. The seeds contain desirable levels of minerals, vitamins for human diets, in addition to other bioactive components such as phytosterols, squalene, fagopyritols, saponins and polyphenols. Amaranth is currently in demand by specific consumer groups, such as high‐performance athletes, malnourished children, and people suffering from diabetes and coeliac disease. Even so, there are few detailed analyses available concerning the potential for using amaranth to improve and support agricultural productivity in developing countries. The present review has assessed the promotion and improvement of amaranth production in East Africa to hold subtstantial potential for benefitting small‐holder farmers in Africa, by providing a stable source of income and food for subsistence farmers, while also mitigating the impact of climate change through the prospect of supporting the establishment of food and nutritional security.
Formation of Bi2ZnB2O7 Nanocrystals in ZnO–Bi2O3–B2O3 Glass Induced by Femtosecond Laser
Authors: Liu Zhao , Zeng Huidan , Ji Xiaoming , Ren Jing , Chen Guorong , Ye Junyi , Dai Ye , Cheng Ya
Published: November 2014

We report on the formation of Bi2ZnB2O7 crystal structures with designated patterns in ZnO–Bi2O3–B2O3 glass by femtosecond laser direct writing. The crystallization mechanism in glass is investigated by crystallization kinetics analysis and simulation of the three‐dimensional temperature field distribution. The crystallized regions show larger third‐order optical nonlinearity than the unirradiated region in glass by Z‐scan technique. This finding is of great potential in application of nonlinear optical integrated devices and development of new nonlinear materials.
Heterozygosity at a single locus explains a large proportion of variation in two fitness‐related traits in great tits: a general or a local effect?
Authors: García‐Navas V. , Cáliz‐Campal C. , Ferrer E. S. , Sanz J. J. , Ortego J.
Published: November 2014

In natural populations, mating between relatives can have important fitness consequences due to the negative effects of reduced heterozygosity. Parental level of inbreeding or heterozygosity has been also found to influence the performance of offspring, via direct and indirect parental effects that are independent of the progeny own level of genetic diversity. In this study, we first analysed the effects of parental heterozygosity and relatedness (i.e. an estimate of offspring genetic diversity) on four traits related to offspring viability in great tits (Parus major) using 15 microsatellite markers. Second, we tested whether significant heterozygosity–fitness correlations (HFCs) were due to ‘local’ (i.e. linkage to genes influencing fitness) and/or ‘general’ (genome‐wide heterozygosity) effects. We found a significant negative relationship between parental genetic relatedness and hatching success, and maternal heterozygosity was positively associated with offspring body size. The characteristics of the studied populations (recent admixture, polygynous matings) together with the fact that we found evidence for identity disequilibrium across our set of neutral markers suggest that HFCs may have resulted from genome‐wide inbreeding depression. However, one locus (Ase18) had disproportionately large effects on the observed HFCs: heterozygosity at this locus had significant positive effects on hatching success and offspring size. It suggests that this marker may lie near to a functional locus under selection (i.e. a local effect) or, alternatively, heterozygosity at this locus might be correlated to heterozygosity across the genome due to the extensive ID found in our populations (i.e. a general effect). Collectively, our results lend support to both the general and local effect hypotheses and reinforce the view that HFCs lie on a continuum from inbreeding depression to those strictly due to linkage between marker loci and genes under selection.
The need for evidence‐based public health response in disasters
Authors: Mahapatra Prasanta
Published: November 2014

Aim

Broad outline of this paper was presented at the Evidence Aid Symposium, on 20 Sep 2014, at Hyderabad, India, before the 22nd Cochrane Colloquium.

Methods

Survey of the field and review of literature.

Results

Response to disasters is usually vulnerable to myths and misconceptions. Effective healthcare response requires evidence and information to meet various and often unpredictable eventualities. The knowledge base should facilitate rapid assessment of adverse health outcomes, availability healthcare infrastructure, appropriate organizational strategies, and selection of feasible medical interventions to deal with any given disaster. Most rapid surveys have to adopt some stratification and a cluster sampling design for representativeness. Qualitative research methods are useful to study organizational challenges. Adequate and accurate description of the context is important for interpretation of organization behavior studies. Testing efficacy of medical interventions by randomized trials is usually difficult, unless feasible study designs are planned in advance and ready for execution at short notice. A lot of disaster healthcare research literature is based on surveys and case studies, as these are more feasible. Hence, systematic reviews ought to rate the level of evidence from qualitative studies and adequately summarize the context of case studies.

Conclusions

Research on health response to disaster has picked up momentum only recently in the 21st century. There is also a need to develop disaster healthcare research capacities to address regional vulnerabilities. Generating evidence is not enough. Concerted societal action is needed to sensitize, train, and equip adequate human resources to fill in various key emergency medical and public health roles when disaster strikes.
Minimum initial service package (MISP) for sexual and reproductive health in disasters
Authors: Lisam Suchitra
Published: November 2014

Background

This paper is based on a presentation given at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India. The paper provides background about how the sexual and reproductive health (SRH) got conceived as a humanitarian health response that adopts human right approach, based on core principles driven by needs of adolescent girls and women, and having respect for their values, ethics and morals.

Methodology

Good practices across nations documented by Inter‐Agency Working Groups (IAWGs) on Reproductive Health in Humanitarian Crisis has supported the provision of essential SRH care services to adolescent girls and women in humanitarian crisis and in disasters. Secondary desk review is used to document the lessons learnt and good practices followed and documents for SRH.

Objective

These essential SRH care services are to be provided as “Minimum Initial Service Package (MISP)” for implementation at the outset of disaster. The Sphere Humanitarian Charter and Minimum Standards in Disaster Response incorporated the MISP for SRH as a minimum standard of care in disaster response with a goal to reduce mortality, morbidity and disability among populations affected by crises, particularly women and girls. Disaster prone countries are expected to roll out MISP to improve humanitarian response and emergency preparedness systems.

Result

The East Europe and Central Asia (EECA) region including India have rolled out MISP starting from 2011 (EECA) and from 2013‐2014 onwards in India across cities such as Chennai, Patna, Bhubaneshwar, Kolkata, Faridabad and Calcutta. Across India, through these national and state level trainings, nearly 600 people from NGOs, institutions, and government agencies were developed as national level trainers and resource persons for MISP who could advocate for RH in emergencies, apply core techniques provided in the MISP, apply coordination skills for the implementation of MISP and develop an action plan to integrate RH and Gender Based Violence (GBV) into Disaster Management Plans of respective agencies.

Conclusion

The way forward includes focusing on MISP distance learning module, integration of MISP in Health action plans, and integration into national disaster preparedness and contingency planning of respective agencies and departments and building capacity at various levels.
Effects of epidural neostigmine and clonidine in labor analgesia: A systematic review and meta‐analysis
Authors: Zhang Ning , Xu Ming‐jun
Published: November 2014

Aim

To evaluate the effect and quality of epidural neostigmine and clonidine added to initial spinal analgesia in labor analgesia.

Methods

A systematic search was conducted in the Medline, Embase, Cochrane Library and China National Knowledge Infrastructure electronic databases. Case–control studies reporting epidural administration of neostigmine and clonidine for labor analgesia were retrieved. For continuous variables, mean differences (MD) and 95% confidence intervals (CI) were calculated; for binary classification variables, odds ratio (OR) and risk ratios (RR) with their 95% CI were analyzed.

Results

A total of four case–control studies, including 280 parturients, were identified in this meta‐analysis. The results showed that epidural clonidine and neostigmine significantly prolonged initial analgesia (MD = 37.79, 95% CI = 9.37–66.21, P = 0.0.009) and reduced hourly local anesthetics and opioid administration (MD = −5.49, 95% CI = −6.78, −4.21, P < 0.0001). There was no significant difference in total duration of labor, mode of delivery (cesarean section rate or instrumental delivery rate) and Apgar scores of the neonates in the two groups.

Conclusion

Epidural administration of neostigmine and clonidine, following the spinal injection of local anesthetic, has a stronger analgesic effect in managing labor pain and reduces hourly anesthetic consumption. No obvious adverse reactions were found.
Embolization for post‐partum rupture of ovarian artery aneurysm: Case report and review
Authors: Sakaguchi Isao , Ohba Takashi , Ikeda Osamu , Yamashita Yasuyuki , Katabuchi Hidetaka
Published: November 2014

Spontaneous rupture of an ovarian artery aneurysm most commonly presents with abdominal pain in a multiparous woman in the early post‐partum period. Aneurysms of the ovarian artery have been reported in the published work very infrequently. In our case, a 31‐year‐old multiparous woman experienced sudden left lower quadrant abdominal pain on the second post‐partum day. Angiography showed rupture of a left ovarian artery aneurysm, which was successfully embolized using gelatin sponge particles. The patient resumed menstruation 3 months after the embolization and concurrently conceived, ultimately giving birth at term without complications. Interventional radiology appears to be a highly safe and effective technique for diagnosis and management of a ruptured ovarian artery aneurysm with minimal risk of impairing subsequent fertility.
Annual report of the Committee on Gynecologic Oncology, the Japan Society of Obstetrics and Gynecology
Authors: Yamagami Wataru , Aoki Daisuke
Published: November 2014

The Japan Society of Obstetrics and Gynecology collects and analyzes annual data on gynecologic cancers from member institutions. Here we present the Patient Annual Report for 2012 and the Treatment Annual Report for 2006. Data on 7028 patients with cervical cancer, 8217 with endometrial cancer, 5140 with ovarian cancer and 1725 with ovarian borderline tumor for whom treatment was initiated in 2012 were summarized in the Patient Annual Report. Data on the prognosis of 2699 patients with cervical cancer, 3243 with endometrial cancer and 1898 with ovarian cancer for whom treatment was initiated in 2006 were analyzed in the Treatment Annual Report. In the Patient Annual Report for 2012, stage I accounted for 55.4%, stage II for 23.0%, stage III for 11.0% and stage IV for 10.6% of all patients with cervical cancer. Stage I accounted for 72.2%, stage II for 7.0%, stage III for 13.4% and stage IV for 7.3% of all patients with endometrial cancer. Stage I accounted for 43.1%, stage II for 9.2%, stage III for 29.7% and stage IV for 7.2% of all patients with ovarian cancer. In the Treatment Annual Report for 2006, the 5‐year overall survival rates for patients with cervical cancer were 92.9% for stage I, 74.6% for stage II, 55.3% for stage III and 24.3% for stage IV. The equivalent rates for patients with endometrial cancer were 96.3%, 92.7%, 80.6% and 35.8%, respectively; and those for patients with ovarian surface epithelial–stromal tumors were 90.6%, 82.9%, 48.7% and 40.9%, respectively.
Potential proton beam therapy for recurrent endometrial cancer in the vagina
Authors: Yanazume Shintaro , Arimura Takeshi , Kobayashi Hiroaki , Douchi Tsutomu
Published: November 2014

Proton beam radiotherapy mainly has been used in the gynecological field in patients with cervical cancer. The efficacy of proton beam therapy in patients with recurrent endometrial cancer has not yet been determined. A 77‐year‐old endometrial cancer patient presented with recurrence in the vagina without distant metastasis following hysterectomy. A hard mass measuring 6 cm originated from the apex of the vagina, surrounded the vaginal cavity, and infiltrated the proximal and distal vagina. The patient received proton beam radiotherapy using a less invasive particle treatment system while minimizing the dose to the surrounding normal tissues. The dose to the planning target volume was 74 Gy (relative biological effectiveness) with 37 fractions. The patient was treated with 150–210‐MeV proton beams for 53 days. Proton beam therapy led to the disappearance of tumors without any complications except for grade 1 cystitis although evidence of further complications is not available past our 6‐month follow‐up period. Proton beam therapy may become a useful treatment modality for recurrent endometrial cancer as well as cervical uterine cancer.
Re‐expression ofLactotransferrin, a candidate tumor suppressor inactivated by promoter hypermethylation, impairs the malignance of oral squamous cell carcinoma cells.
Authors: Zhang Jie , Ling Tianyou , Wu Hanjiang , Wang Kai
Published: November 2014

Background

Lactotransferrin(LTF) has been confirmed to act as a tumor suppressor in multiple cancers; however, its roles in oral squamous cell carcinoma (OSCC), one of malignant head and neck carcinomas, has not been explored.

Methods

Here, the expression ofLTFinOSCCtissues andTCA8113 cells was detected withRT‐PCR, qPCR, andIHC. And the correlation betweenLTFexpression andOSCCmetastasis was assessed.MS‐PCRwas performed to reveal the methylation status in promoter regions ofLTFboth inOSCCtissue samples and cells. The influences of 5‐Aza‐Cdc treatment to the methylation status and expression levels ofLTFwere also analyzed. At last, the functions ofLTFinOSCCprogression were demonstrated byMTTanalysis, clone formation assay, and cell cycle analysis inTCA8113 cells with forced ectopic expression ofLTF.

Results

LTFshowed a low or null expression pattern inOSCCtissues and cells, at least partially, due to the hypermethylated status in promoter regions for 5‐Aza‐Cdc, a methyltransferase inhibitor, could restore the expression ofLTFinTCA8113 cells. And the expression level ofLTFexhibited a negative correlation withOSCCmetastasis.

Conclusions

Re‐expression ofLTFinhibited the growth, proliferation, as well as cell cycle progression ofTCA8113 cells. In conclusion, hypermethylation contributes much toLTFinactivation inOSCC. AndLTFcan partially reverse the malignant phenotypes ofOSCCcells and may be served as a potential target for diagnosis and therapy ofOSCCin future.