bluuebunny/crossref_metadata_2025 huggingface dataset:
Assembly of root‐associated bacteria communities: interactions between abiotic and biotic factors
Authors: Dean Sarah L , Farrer Emily C , Porras‐Alfaro Andrea , Suding Katharine N , Sinsabaugh Robert L
Published: July 2014

Nitrogen (N) deposition in many areas of the world is over an order of magnitude greater than it would be in absence of human activity. We ask how abiotic (N) and biotic (plant host and neighborhood) effects interact to influence root‐associated bacterial (RAB) community assembly. Using 454 pyrosequencing, we examinedRABcommunities from two dominant alpine tundra plants,Geum rossiiandDeschampsia cespitosa, under control,Naddition andD. cespitosaremoval treatments, implemented in a factorial design. We hypothesized that host would have the strongest effect onRABassembly, followed byN, then neighbor effects.

The most dominant phyla wereProteobacteria(mostlyGammaproteobacteria),Actinobacteria,BacteroidetesandAcidobacteria. We foundRABcommunities were host specific, with only 17% overlap in operational taxonomic units. Host effects on composition were over twice as strong asNeffects.D. cespitosa RABdiversity declined withN, whileG. rossii RABdid not.D. cespitosaremoval did not influenceG. rossii RABcommunity composition, butG. rossii RABdiversity declined withNonly whenD. cespitosawas absent.

We conclude thatRABof both hosts are sensitive toNenrichment, andRABresponse toNis influenced by host identity and plant neighborhood.
Right Ventricular Electrical and Mechanical Synchronization by Properly Timed Septal Pacing in a Patient with Right Bundle Branch Block and First Degree AV Block—A Case Report
Authors: Siliste Calin , Suran Maria‐Claudia‐Berenice , Margulescu Andrei‐Dumitru , Vinereanu Dragos
Published: July 2014

We present a case of near‐normalization of the QRS by septal pacing in a patient with dual‐chamber pacemaker and underlying complete right bundle branch block and first degree atrioventricular block. The right ventricular mechanical synchronization suggested by the ECG was validated as such by strain echo. To the best of our knowledge, this is the first time it has been shown that the narrowing of the QRS corresponds to mechanical synchronization in a case of this seldom‐recognized phenomenon.
Association between Resolution of Fragmented QRS and Response to Cardiac Resynchronization Therapy
Authors: Celikyurt Umut , Karauzum Kurtulus , Sahin Tayfun , Agacdiken Aysen , Vural Ahmet , Ural Dilek
Published: July 2014

Background

Cardiac resynchronization therapy (CRT) has been recommended for patients with symptomatic heart failure and a wide QRS. Fragmented QRS (fQRS) on a 12‐lead electrocardiography (ECG) has been shown to predict cardiac events. We aimed to investigate the relationship between resolution of fQRS and response to CRT.

Methods

Sixty‐seven consecutive patients (38 men, mean age 65 ± 11) with left bundle branch block and fQRS on ECG undergoing CRT were studied. The presence of fQRS was assessed using standardized criteria. Echocardiographic response to CRT was defined by a ≥15% reduction in left ventricular end‐systolic volume (LVESV) and resolution of fQRS was defined as decrease in number of leads with fQRS on ECG at 6 months follow‐up.

Results

Thirty‐nine patients (58%) had response to CRT. LVESV significantly decreased from 150 ± 64 to 100 ± 48 in responders (P = 0.001). There was not any significant decrease in nonresponders (LVESV; from 157 ± 70 to 153 ± 66, P = 0.45). The number of leads with fQRS was decreased from 4.4 ± 1.8 to 1.7 ± 1.6 in responder patients (P < 0.001). The number of leads with fQRS was not significantly changed in nonresponders. (4.2 ± 2.2 vs. 5.1 ± 2.4, P = 0.06). In multivariate analysis, significant associates of response to CRT was evaluated adjusting for etiology of cardiomyopathy, baseline QRS width, left ventricular ejection fraction, number of leads with fQRS and resolution of fQRS. Resolution of fQRS was the only predictor of response to CRT (OR 0.018, 95% CI, 0.004–0.083, P < 0.001).

Conclusions

After adjusting for potential confounders, resolution of fQRS, is associated with response to CRT.
Characterization of large deletions in the DHCR7 gene
Authors: Lanthaler B. , Hinderhofer K. , Maas B. , Haas D. , Sawyer H. , Burton‐Jones S. , Carter K. , Suri M. , Witsch‐Baumgartner M.
Published: July 2014

Pathogenic variants in the DHCR7 gene cause Smith–Lemli–Opitz syndrome (SLOS), a defect of cholesterol biosynthesis resulting in an autosomal recessive congenital metabolic malformation disorder. In approximately 4% of patients, the second mutation remains unidentified. In this study, 12 SLOS patients diagnosed clinically and/or by elevated 7‐dehydrocholesterol (7‐DHC) have been investigated by customized multiplex ligation‐dependent probe amplification (MLPA) analysis, because only one DHCR7 sequence variant has been detected. Two unrelated patients of this cohort carry different large deletions in the DHCR7 gene. One patient showed a deletion of exons 3–6. The second patient has a deletion of exons 1 and 2 (non‐coding) and lacks the major part of the promoter. These two patients show typical clinical and biochemical phenotypes of SLOS. Second disease‐causing mutations are p.(Arg352Trp) and p.(Thr93Met), respectively. Deletion breakpoints were characterized successfully in both cases. Such large deletions are rare in the DHCR7 gene but will resolve some of the patients in whom a second mutation has not been detected.
Genetic epidemiology of tooth agenesis in Japan: a population‐ and family‐based study
Authors: Machida J. , Nishiyama T. , Kishino H. , Yamaguchi S. , Kimura M. , Shibata A. , Tatematsu T. , Kamamoto M. , Yamamoto K. , Makino S. , Miyachi H. , Shimozato K. , Tokita Y.
Published: July 2014

Tooth agenesis is one of the most common congenital anomalies in humans. However, the etiology of tooth agenesis remains largely unclear, as well as evidence base useful for genetic counseling. Therefore, we estimated the prevalence and sibling recurrence risk, and investigated agenetic patterns systematically. Tooth agenesis was classified into two subtypes: hypodontia (one to five missing teeth) and oligodontia (six or more missing teeth). The prevalence of these two subtypes were 6.8% [95% confidence interval (CI): 6.1–7.7%] and 0.1% (95% CI: 0.04–0.3%), respectively, and sibling recurrence risk of these were 24.5% (95% CI: 13.8–38.3%) and 43.8% (95% CI: 26.4–62.3%), respectively. This result suggests that the severe phenotype, oligodontia, might be mostly transmitted in a dominant fashion. Using a simple statistical modeling approach, our data were found to be consistent with a bilateral symmetry model, meaning that there was equal probability of missing teeth from the right and left sides.
Young People as Moral Beings: Childhood, Morality and Inter‐Generational Relationships
Authors: Britton Joanne
Published: July 2014

This article uses the work of Goffman to explore how a group of older children presented a moral self in a study of inter‐generational relationships. By reflecting critically on their own behaviour and that of other young people and adults, they presented themselves as morally competent agents, whilst questioning the taken‐for‐granted moral competence of adults. Their presentation of a moral self involved portraying themselves as moral beings, whilst acknowledging that they are also moral becomings. The findings highlight how the embedded authority and associated moral accountability of adults in relation to children militate against recognising children's moral agency.
Is C‐reactive protein useful in prognostication for colorectal cancer? A systematic review
Authors: Pathak S. , Nunes Q. M. , Daniels I. R. , Smart N. J.
Published: July 2014

Aim

With the advent of several different therapeutic strategies to manage the different stages of colorectal cancer, it would be beneficial to allow substratification of patients into groups who are most likely to benefit from costly interventions. The purpose of this review is to analyse the evidence from several retrospective studies examining the prognostic significance of C‐reactive protein (CRP).

Method

A literature search was performed using PubMed, Embase, Cochrane Library, CINAHL and Google Scholar databases to identify studies that analysed CRP and its prognostic significance in all stages of operable colorectal cancer. The primary end‐points of interest were overall survival and disease‐free survival.

Results

In all, 205 studies were identified by the search. Twelve involving 1705 patients fulfilled the inclusion criteria and were included. Three of the included studies including 305 patients considered Stage IV colorectal cancer and the impact of CRP on survival. Overall survival and disease‐free survival were shorter in the presence of an elevated preoperative CRP in local and advanced colorectal cancer.

Conclusion

CRP may be useful for prognosis in patients with primary and metastatic colorectal cancer, but currently there is insufficient evidence to justify its routine use. Further well‐designed prospective studies are needed to validate its role in substratification of patients for consideration of (neo)adjuvant therapies.
Comparing Data Sets: Implicit Summaries of the Statistical Properties of Number Sets
Authors: Morris Bradley J. , Masnick Amy M.
Published: July 2014

Comparing datasets, that is, sets of numbers in context, is a critical skill in higher order cognition. Although much is known about how people compare single numbers, little is known about how number sets are represented and compared. We investigated how subjects compared datasets that varied in their statistical properties, including ratio of means, coefficient of variation, and number of observations, by measuring eye fixations, accuracy, and confidence when assessing differences between number sets. Results indicated that participants implicitly create and compare approximate summary values that include information about mean and variance, with no evidence of explicit calculation. Accuracy and confidence increased, while the number of fixations decreased as sets became more distinct (i.e., as mean ratios increase and variance decreases), demonstrating that the statistical properties of datasets were highly related to comparisons. The discussion includes a model proposing how reasoners summarize and compare datasets within the architecture for approximate number representation.
The amino acid response to a mixed meal in patients with type 2 diabetes: effect of sitagliptin treatment
Authors: Muscelli E. , Frascerra S. , Casolaro A. , Baldi S. , Mari A. , Gall W. , Cobb J. , Ferrannini E.
Published: July 2014

Aims

Amino acid (AA) metabolism is altered in type 2 diabetes (T2D), and fasting levels of α‐hydroxybutyrate (α‐HB), a biomarker for insulin resistance, have been suggested to track AA metabolism. We investigated the changes in AA and α‐HB induced by a mixed‐meal tolerance test (MTT) and the effects of sitagliptin treatment.

Methods

Forty‐seven T2D patients [56 ± 7 years, body mass index (BMI) 29.9 ± 4.2 kg/m2] were randomized to sitagliptin (100 mg/day, 6 weeks) or placebo. Seven age‐ and BMI‐matched non‐diabetic subjects served as control (CT).

Results

During a 5‐h MTT, branched‐chain AA (BCAA) peaked earlier in T2D than CT [75(25) vs. 62(3) mmol/l·h over 2 h, median(interquartile range), p = 0.05], and rose higher [5‐h increment: 31(23) vs. 19(24) mmol/l·h, p = 0.05]. Fasting α‐HB was higher [7.5(2.7) vs. 5.9(1.3) µg/ml, p = 0.04 T2D vs. CT], and its meal‐induced increments were larger [24(99) vs. −41(86) µg/ml·h, p = 0.006]. Plasma non‐esterified fatty acids (NEFA) declined during MTT, but their increments were greater in patients (53 ± 16 vs. 35 ± 10 mEq/l·h, p = 0.005). Compared to placebo, both BCAA [−6.4(21.1) vs. 0.0(48.0) mmol/l·h, p = 0.01] and α‐HB increments [−114(250) vs. 114(428) µg/ml·h, p = 0.002] decreased with sitagliptin, and meal‐induced NEFA suppression was improved. Changes in BCAA and α‐HB were reciprocally related to changes in insulin sensitivity (ρ = −0.37 and −0.43, p ≤ 0.01).

Conclusions

T2D is associated with a hyperaminoacidaemic response to MTT, which circulating α‐HB levels track. Sitagliptin‐induced glycaemic improvement was associated with reductions in BCAA and α‐HB excursions and better NEFA suppression, in parallel with improved insulin sensitivity, confirming that α‐HB is a readout of metabolic overload.
Psychological and cognitive impairment of long‐term migrators to high altitudes and the relationship to physiological and biochemical changes
Authors: Gao Y.‐X. , Li P. , Jiang C.‐H. , Liu C. , Chen Y. , Chen L. , Ruan H.‐Z. , Gao Y.‐Q.
Published: July 2014

Background and purpose

The present study aimed to examine how long‐term migration to high‐altitude regions affects mentality and cognition, and the correlation with various physiological and biochemical changes.

Methods

The WHO Neurobehavioral Core Test Battery, Raven's Standard Progressive Matrices (RSPM) and Pittsburgh Sleep Quality Index questionnaire were used to assess 141 young male subjects who lived in plain regions and 217 young male subjects who had migrated to a 4500 m high‐altitude region and lived there for 1–5 years. Arterial oxyhemoglobin saturation, cerebral tissue oxygenation indices (TOIs), serum S100B and brain‐derived neurotrophic factor (BDNF) were also measured.

Results

Long‐term migrators to a high‐altitude region exhibited exacerbated mood disorders, retarded color discrimination ability, decreased visual memory capacity, and impaired perceptual motor skill and motion stability. In addition, the migrators exhibited lower RSPM scores and lower sleep quality. Further analyses revealed significant correlations between sleep quality and cerebral TOIs, mood and sleep quality, mood and certain cognitive functions, mood and serum BDNF levels, and RSPM scores and serum S100B levels.

Conclusions

Long‐term living at high altitudes causes significant impairment of psychological and cognitive function. Cerebral hypoxic extent, sleep quality and biochemical dysfunction are major influencing factors.
Generalizing the use of geographical weights in biodiversity modelling
Authors: Mellin C. , Mengersen K. , Bradshaw C. J. A. , Caley M. J.
Published: July 2014

Aim

Determining how ecological processes vary across space is a major focus in ecology. Current methods that investigate such effects remain constrained by important limiting assumptions. Here we provide an extension to geographically weighted regression in which local regression and spatial weighting are used in combination. This method can be used to investigate non‐stationarity and spatial‐scale effects using any regression technique that can accommodate uneven weighting of observations, including machine learning.

Innovation

We extend the use of spatial weights to generalized linear models and boosted regression trees by using simulated data for which the results are known, and compare these local approaches with existing alternatives such as geographically weighted regression (GWR). The spatial weighting procedure (1) explained up to 80% deviance in simulated species richness, (2) optimized the normal distribution of model residuals when applied to generalized linear models versus GWR, and (3) detected nonlinear relationships and interactions between response variables and their predictors when applied to boosted regression trees. Predictor ranking changed with spatial scale, highlighting the scales at which different species–environment relationships need to be considered.

Main conclusions

GWR is useful for investigating spatially varying species–environment relationships. However, the use of local weights implemented in alternative modelling techniques can help detect nonlinear relationships and high‐order interactions that were previously unassessed. Therefore, this method not only informs us how location and scale influence our perception of patterns and processes, it also offers a way to deal with different ecological interpretations that can emerge as different areas of spatial influence are considered during model fitting.
A pore‐scale investigation of the dynamic response of saturated porous media to transient stresses
Authors: Huber C. , Su Y.
Published: July 2014

The dynamical response of saturated porous media to transient stresses is complex because of the coupling between the solid and fluid phases. Over the last three decades, theoretical models have emerged and they predict that the transient response of porous media to pore‐pressure fluctuations depends only on a single dimensionless number. This single parameter represents the ratio of the forcing frequency to a characteristic frequency of the medium. Although theoretical models for the frequency dependence of the effective permeability of the medium have successfully predicted the response of porous media at high frequency observed in laboratory and numerical experiments, they rely on assumptions that limit their applicability to homogeneous media and narrow pore‐size distributions. We use pore‐scale flow simulations with four different porous media topologies to study the effect of pore geometry and pore‐size distribution on the dynamic response to transient pore‐pressure forcing. We find a good agreement with published theoretical work for all but one medium that exhibits the broadest pore‐size distribution and therefore the largest degree of pore‐scale heterogeneity. Our results suggest the presence of a resonance peak at high frequency where the discharge, and therefore the effective permeability, is significantly amplified compared to their value around the resonant frequency. We suggest two interpretations to explain resonance. At the continuum scale, a finite speed of pore‐pressure propagation during transients requires the addition of a correction term to Darcy's law. We derive a hyperbolic mass conservation equation that admits resonance under certain conditions. This model can explain the peak observed for one medium but fails to explain the absence of resonance displayed by the three other media. The second interpretation, motivated by the different pore‐size distribution for the texture where resonance is observed, calls for pore‐scale processes and heterogeneous pore‐pressure distribution among primary and secondary flow pathways.
Evolution of sediment permeability during burial and subduction
Authors: Daigle H. , Screaton E. J.
Published: July 2014

We assembled a data set of permeability measurements from 317 subduction zone and reference site samples worldwide made over nearly 25 years of scientific drilling. This data set allowed us to examine the influence of grain size, structural domain, and measurement type on permeabilities ranging from 10−21 to 10−14 m2. We found that porosity–permeability behavior is a function of clay‐size fraction, which is consistent with previous work. Sediments within the slope, accretionary prism, and fault‐zone structural domains are strongly affected by shearing, which alters the permeability behavior with burial. Consolidation, flow‐through, and transient pulse decay measurements all provide comparable results. Measurements of horizontal and vertical permeability show significant cm‐scale permeability anisotropy (ratio of horizontal to vertical permeability >10) in the slope and accretionary prism structural domains, further indicating shear deformation in these domains. Laboratory consolidation trends match large‐scale (102 m) field trends in structural domains with negligible shear, but tend to underestimate the rate of permeability reduction with porosity loss where shear is significant. Comparison with downhole measurements shows that permeability is controlled by higher‐permeability (>10−15 m2) layers at the meter to tens of meters scale, while wireline formation tester measurements closely match laboratory results. Sediments from the underthrust and reference structural domains exhibit similar porosity–permeability trends, which suggests that shallow subduction (total burial <1 km) does not significantly alter the porosity–permeability behavior of incoming sediments. Comparison with measurements of deeper analog data from 14 passive‐margin samples show that porosity–permeability trends are maintained through burial and diagenesis to porosities <10%, suggesting that behavior observed in shallow samples is informative for predicting behavior at depth following subduction.
Ethics Experts as an Instrument of Technocratic Governance: Evidence from EU Medical Biotechnology Policy
Authors: Littoz‐Monnet Annabelle
Published: July 2014

This article challenges the assumption that ethics committees introduce democratic control in policy areas where scientific expertise and ethical concerns collide. The claim is that politicians or bureaucrats are likely to resort to the use of ethical expertise when they face a specific type of dilemma: the impossibility, on the one hand, of yielding a consensus on controversial value‐based issues via the democratic route and the need, on the other, to legitimize controversial policy choices in these areas. The article examines this dynamic with regard to the European Union's medical biotechnology policy, a contested policy domain where ethical specialists are awarded expert status. The article finds that establishing ethical experts as a new category of expertise alongside scientific experts actually bolsters the technocratic domain in areas where it is contested, thus reinforcing the authority of experts and bureaucrats in the policy process, rather than democratic control.
Measurement of liver stiffness as a non‐invasive method for diagnosis of non‐alcoholic fatty liver disease
Authors: Yoshioka Kentaro , Hashimoto Senju , Kawabe Naoto
Published: July 2014

Non‐alcoholic fatty liver disease (NAFLD) is one of the major causes of liver disease worldwide. To detect early stages of NAFLD and start treatment or to monitor the changes in trials of new drugs, non‐invasive diagnostic methods are needed, such as biochemical markers or liver stiffness measurement (LSM). LSM with transient elastography (TE) and acoustic radiation force impulse (ARFI) has been shown to be useful in NAFLD, although the cut‐off values have varied among reports. Magnetic resonance elastography and real‐time tissue elastography also can be useful for the diagnosis of NAFLD, although the number of studies is limited. Fibrosis is absent in 8–40% of patients with non‐alcoholic steatohepatitis (NASH), making it difficult to diagnose NASH by LSM because LSM is usually associated with fibrotic stage. The presence of inflammation or hepatocyte ballooning may affect LSM and aid the diagnosis of NASH without fibrosis. However, obesity significantly increases the failure of LSM and its interference is more conspicuous in TE than in ARFI. The newly implemented XL probe of TE has overcome the difficulty to some degree. Nonetheless, the effects of obesity, hepatocyte ballooning, steatosis and inflammation on LSM values have not yet been adequately investigated, although they are likely to affect LSM values. Further studies are needed to establish the clinical utility of LSM in NAFLD.
Vancomycin‐associated drug reaction with eosinophilia and systemic symptoms syndrome
Authors: Young S. , Ojaimi S. , Dunckley H. , Douglas M. W. , Kok J. , Fulcher D. A. , Lin M.‐W. , Swaminathan S.
Published: July 2014

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially life‐threatening multi‐system disorder characterised by the delayed onset of fever, rash and internal organ involvement following the administration of a drug. We report three definite cases of vancomycin‐associated DRESS syndrome occurring and review the literature regarding this syndrome.
Eltrombopag for resistant immune thrombocytopenia secondary to chronic lymphocytic leukaemia
Authors: Jolliffe E. , Romeril K.
Published: July 2014

Autoimmune manifestations are a common occurrence with chronic lymphocytic leukaemia (CLL). We describe a case of CLL‐associated immune thrombocytopenia (ITP) that had a loss of response to standard treatment for ITP. The thrombopoeitin receptor agonist, eltrombopag, was successfully used preoperatively to increase the platelet count to a safer level, in this instance to facilitate laparoscopic splenectomy.
Interferon‐gamma release assays and the diagnosis of tuberculosis: have they found their place?
Authors: Darby J. , Black J. , Buising K.
Published: July 2014

Tuberculosis (TB) remains an important issue in Australia with more than 85% of active cases contributed by overseas‐born persons. Other risk groups include older Australians who acquired TB in the past and indigenous people. Immune suppression is an emerging risk factor for TB, particularly due to the expanding group of conditions for which potent immunosuppressive therapies is now used. Screening for latent TB is recommended in many risk groups including recent contacts of those with transmissible TB, those undergoing immune suppressive therapy, recently arrived refugees or migrants from high‐risk countries and indigenous people with high rates of TB in the local community. Interferon‐gamma release assay (IGRA) has now been available for several years for the diagnosis of latent TB. It is now used in many clinical situations, and despite the rapid rate of new publications, there are still gaps in our knowledge. This paper reviews the current role of interferon‐gamma release assay in various situations, to determine its place in current practice and to explore where uncertainties exist.
Cyberbullying: Implications for the Psychiatric Nurse Practitioner
Authors: Carpenter Lindsey M. , Hubbard Grace B.
Published: July 2014

Purpose

The purpose of this article is to inform and educate psychiatric nurse practitioners about the pervasiveness of the rapidly increasing problem of cyberbullying.

Review of Literature

As more children and adolescents obtain access to the Internet, mobile devices, and social networking sites, the exposure to bullying in the virtual format increases. Cyberbullying is a growing public health concern and can affect mental health and school performance. Cyberbullying often results in a range of psychiatric symptoms and has been linked to suicide attempts and completions.

Conclusions

The psychiatric nurse practitioner is uniquely prepared to provide a range of interventions for patients, families, and communities who have experienced cyberbullying.
Severe hepatic injury associated with different statins in patients with chronic liver disease: A nationwide population‐based cohort study
Authors: Chang Chia‐Hsuin , Chang Yi‐Cheng , Lee Yen‐Chieh , Liu Ying‐Chun , Chuang Lee‐Ming , Lin Jou‐Wei
Published: July 2014

Background and Aim

The hepatotoxicity of statins in patients with chronic liver diseases remains unclear. In this study, we aimed to estimate the risk of severe hepatic injury associated with different statins in patients with chronic liver disease.

Methods

A nationwide population‐based cohort study was conducted by analyzing the Taiwan National Health Insurance database. A total of 37 929 subjects with chronic liver disease who started statin therapy were identified during the period of January 1, 2005 to December 31, 2009. Outcome was defined as hospitalization due to liver injury.

Results

During a total of 118 772 person‐years of follow‐up, 912 incident cases of hospitalization due to hepatic injury are identified. The incidence rate was 2.95, 2.49, 2.92, 1.94, 2.65, and 2.52 per 100 000 person‐days for atorvastatin, lovastatin, fluvastatin, pravastatin, simvastatin, and rosuvastatin initiators, respectively. Overall, there was no difference in the incidence associated with different statins. However, when each statin was further categorized to high (≧ 0.5 defined daily dose) or low (< 0.5 defined daily dose) mean daily dose, only high‐dose atorvastatin was significantly associated with increased risk of hospitalization due to hepatic injury (hazard ratio, 1.62; 95% confidence interval, 1.29, 2.03) as compared with low‐dose atorvastatin.

Conclusion

The overall incidence of hospitalization due to severe hepatic injury was low among statin initiators with chronic liver disease. Only high‐dose atorvastatin was associated with increased risk.
Repeated stereotactic ablative radiotherapy using CyberKnife for patients with hepatocellular carcinoma
Authors: Lo Cheng‐Hsiang , Huang Wen‐Yen , Lin Kuen‐Tze , Lin Miao‐Jung , Lin Te‐Pao , Jen Yee‐Min
Published: July 2014

Background and Aim

This study aimed to evaluate the outcomes and toxicities of repeated stereotactic ablative radiotherapy (SABR) in hepatocellular carcinoma (HCC).

Methods

Fourteen HCC patients with local recurrence (18 lesions) after liver SABR received repeated radiotherapy with SABR using CyberKnife. No patients experienced radiation‐induced liver disease after the first SABR course. The median first SABR dose was 41 Gy (range, 34–60 Gy); the median second SABR dose, 40 Gy (range, 25–50 Gy); and the median interval, 12.9 months. Local recurrence was divided into in‐field recurrence and out‐field recurrence.

Results

Objective responses were observed in 11 tumors (61.1%), including five tumors (27.8%) with complete responses. Intrahepatic out‐field failure was the main cause of treatment failure (7 of 14 patients). In‐field failure had developed in 1 of 18 tumors (5.6%), resulting in a 2‐year in‐field failure‐free rate of 88.2%. The median time to progression was 14.0 months, with 1‐ and 2‐year progression‐free survival rates of 68.6% and 42.9%, respectively. One‐ and two‐year overall survival rates were 76% and 59.1%, respectively. Of the 14 patients, one developed radiation‐induced liver disease and three showed progression of the Child‐Turcotte‐Pugh class after the second SABR course. Other toxicities were generally mild and tolerable.

Conclusion

Repeated SABR in selected HCC patients is feasible with acceptable toxicity.
Serological markers associated with disease behavior and response to anti‐tumor necrosis factor therapy in ulcerative colitis
Authors: Kevans David , Waterman Matti , Milgrom Raquel , Xu Wei , Van Assche Gert , Silverberg Mark
Published: July 2014

Background and Aim

Information is limited on the relationship between serological markers and disease behavior and anti‐tumor necrosis factor‐α (anti‐TNF) therapy response in ulcerative colitis (UC). This study aimed to determine the association between serological markers and unfavorable UC behavior defined as need for colectomy or UC‐related hospitalization. The association between serological markers and requirement for and outcome of anti‐TNF therapy was also evaluated.

Methods

Two hundred thirty patients were studied. Requirement for colectomy, UC‐related hospitalization, and anti‐TNF therapy were documented. Response to anti‐TNF therapy at 1 year and rates of therapy discontinuation were recorded. Titers of perinuclear anti‐neutrophil cytoplasmic antibodies (pANCAs), anti‐Saccharomyces cerevisiae antibody (ASCA), and antibody to Escherichia Coli outer membrane porin (anti‐OmpC) were determined. Antibody reference ranges were used to dichotomize subjects into seropositive and seronegative groups. Where multiple tests were performed, P‐values were Bonferroni corrected (pcorr).

Results

Extensive colitis was associated with requirement for colectomy and UC‐related hospitalization, HR 7.7 (95% confidence interval [CI] 1.9–32.2) pcorr = 0.03 and HR 2.7 (95% CI 1.5–4.6), pcorr = 0.006, respectively. No serological variable was associated with unfavorable UC behavior. Anti‐OmpC positivity was associated with a lack of response to anti‐TNF therapy at 1 year (odds ratio 0.14 [95% CI 0.03–0.60], pcorr = 0.04) and increased likelihood of therapy discontinuation (HR 2.2 [95% CI 1.1–4.7], P = 0.03).

Conclusion

Extensive colitis is associated with unfavorable disease course in UC. Anti‐OmpC holds promise as a biomarker of anti‐TNF therapy response in UC; however, prospective studies are required before it can be incorporated into routine clinical practice.
A single non‐invasive model to diagnose non‐alcoholic fatty liver disease (NAFLD) and non‐alcoholic steatohepatitis (NASH)
Authors: Otgonsuren Munkhzul , Estep Michael J. , Hossain Nayeem , Younossi Elena , Frost Spencer , Henry Linda , Hunt Sharon , Fang Yun , Goodman Zachary , Younossi Zobair M.
Published: July 2014

Background and Aim

Non‐alcoholic steatohepatitis (NASH) is the progressive form of non‐alcoholic fatty liver disease (NAFLD). A liver biopsy is considered the “gold standard” for diagnosing/staging NASH. Identification of NAFLD/NASH using non‐invasive tools is important for intervention. The study aims were to: develop/validate the predictive performance of a non‐invasive model (index of NASH [ION]); assess the performance of a recognized non‐invasive model (fatty liver index [FLI]) compared with ION for NAFLD diagnosis; determine which non‐invasive model (FLI, ION, or NAFLD fibrosis score [NFS]) performed best in predicting age‐adjusted mortality.

Methods

From the National Health and Nutrition Examination Survey III database, anthropometric, clinical, ultrasound, laboratory, and mortality data were obtained (n = 4458; n = 861 [19.3%] NAFLD by ultrasound) and used to develop the ION model, and then to compare the ION and FLI models for NAFLD diagnosis. For validation and diagnosis of NASH, liver biopsy data were used (n = 152). Age‐adjusted Cox proportional hazard modeling estimated the association among the three non‐invasive tests (FLI, ION, and NFS) and mortality.

Results

FLI's threshold score > 60 and ION's threshold score > 22 had similar specificity (FLI = 80% vs ION = 82%) for NAFLD diagnosis; FLI < 30 (80% sensitivity) and ION < 11 (81% sensitivity) excluded NAFLD. An ION score > 50 predicted histological NASH (92% specificity); the FLI model did not predict NASH or mortality. The ION model was best in predicting cardiovascular/diabetes‐related mortality; NFS predicted overall or diabetes‐related mortality.

Conclusions

The ION model was superior in predicting NASH and mortality compared with the FLI model. Studies are needed to validate ION.
Comparison of multi‐ and single‐frequency bioelectrical impedance analysis with dual‐energy X‐ray absorptiometry for assessment of body composition in post‐menopausal women: effects of body mass index and accelerometer‐determined physical activity
Authors: Gába A. , Kapuš O. , Cuberek R. , Botek M.
Published: July 2014

Background

Bioelectric impedance analysis (BIA) is commonly used in research to assess body composition. However, studies that validate the accuracy of BIA exclusively in post‐menopausal women are lacking. The main purpose of the present study was to evaluate the agreement of multi‐frequency (MF)‐BIA and single‐frequency (SF)‐BIA with dual‐energy X‐ray absorptiometry (DXA) in the estimation of fat mass (FM) and fat‐free mass (FFM) among post‐menopausal women with variation in body mass index (BMI) and physical activity (PA).

Methods

FM and FFM were estimated by BIA and DXA in 146 post‐menopausal women with a mean (SD) age of 62.8 (5.2) years. PA was determined by an accelerometer.

Results

The mean (SD) difference between MF‐BIA and DXA was −1.8 (1.8) kg (P = 0.08) and 1.3 (1.8) kg (P = 0.01) for FM and FFM, respectively. SF‐BIA provided a significantly lower estimate of FM [−2.0 (2.2) kg; P = 0.04] and a higher estimate of FFM [1.8 (2.4) kg; P < 0.01] compared to DXA. MF‐BIA provided significantly better estimates of FM and FFM with narrower limits of agreement than SF‐BIA in obese and insufficiently active subjects. In other BMI and PA groups, both BIA devices showed a similar deviation from DXA.

Conclusions

BIA tends to underestimate FM and overestimate FFM relative to DXA. MF‐BIA appears to be a more appropriate method for the assessment of body composition than SF‐BIA in post‐menopausal woman with BMI >30 kg/m2 and in those who are insufficiently active.
Psychopathic Sexuality: The Thin Line Between Fantasy and Reality
Authors: Visser Beth A. , DeBow Victoria , Pozzebon Julie A. , Bogaert Anthony F. , Book Angela
Published: July 2014

In two studies, we explored the relations between psychopathic traits and sexual fantasy content. In Study 1, we rated content themes in the fantasy narratives of 195 men and women recruited at a Canadian university. In Study 2, we administered a sexual fantasy questionnaire to a sample of 355 Canadian undergraduate students. In Study 1, we found that psychopathic traits predicted themes of anonymous, uncommitted, and nonromantic sexual activity after controlling for participant sex. In Study 2, we found that psychopathy added to the prediction of self‐reported engagement in unrestricted, dominant, submissive, deviant, and adventurous sexual activity, even after controlling for participant sex and level of fantasizing about that activity. Furthermore, an interaction between psychopathy and level of fantasizing was observed for unrestricted and deviant sexual behavior, such that participants who reported high levels of fantasizing about these sexual themes were more likely to engage in that behavior if they also reported high levels of psychopathic traits. These findings suggest that psychopathy is related not only to interest in particular sexual behaviors, but also to whether individuals will translate these fantasized behaviors into reality.
Low serum level of 1,25(OH)2D is associated with chronic periodontitis
Authors: Antonoglou G. N. , Knuuttila M. , Niemelä O. , Raunio T. , Karttunen R. , Vainio O. , Hedberg P. , Ylöstalo P. , Tervonen T.
Published: July 2014

Background and Objectives

Vitamin D has been studied primarily for its involvement in calcium and phosphate absorption and bone metabolism. The active form of vitamin D—1,25(OH)2D—has also been investigated for its immune modulatory properties. We explored associations between serum levels of 25(OH)D and 1,25(OH)2D and periodontal health.

Subjects and Methods

This case–control study included 55 subjects with chronic periodontitis (cases) and 30 periodontally healthy subjects (controls). Their serum levels of 25(OH)D, 1,25(OH)2D, ultrasensitive C‐reactive protein and high‐density lipoprotein cholesterol were determined. Associations between vitamin D and periodontal health status were studied using logistic regression analysis.

Results

A statistically significant association was found between serum 1,25(OH)2D level and periodontal health status; in that subjects with a low 1,25(OH)2D were more likely to belong to the periodontitis group (OR = 0.97, 95% CI = 0.95–1.00). There was practically no association between 25(OH)D level and periodontal health status.

Conclusion

In this case–control study low serum 1,25(OH)2D level appeared to be associated with periodontitis, which was in line with the previously reported associations between serum 1,25(OH)2D levels and other inflammatory diseases. Whether this association is causal in nature, remains to be confirmed in future studies.
The Political Cosmology of Prison Poetics: Khāqānī of Shirwān on Muslim–Christian Difference
Authors: Gould Rebecca
Published: July 2014

This essay examines the political cosmology fostered by the medieval Persian prison poem, specifically in the oeuvre of Khāqānī of Shirwān (d. 1199), in relation to this genre's cosmopolitan geography. I focus in particular on how Khāqānī's Christian Qasīda (ode) negotiated 12th‐century Islamic attitudes towards non‐Muslim religious minorities, particularly Christians of varying ethnic, racial, and cultural backgrounds. An important document in the history of Muslim–Christian relations, Khāqānī's text was one of many Persian prison poems (habsīyyāt) that elaborated a new conception for the role of poetry in the political economy of medieval Islamic societies. In simultaneously presenting the incarcerated poet as a faithful Muslim and as a metonym for Jesus Christ, Khāqānī's prison poetics reconceived the fault lines of religious and ethnic difference.
Noradrenergic Mechanisms Controlling Urethral Smooth and Striated Muscle Function in Urethral Continence Reflex in Rats
Authors: FURUTA Akira , SUZUKI Yasuyuki , KIMURA Shouji , ASANO Kouji , EGAWA Shin , YOSHIMURA Naoki
Published: July 2014

Objectives

To investigate the role of noradrenergic pathways in the urethral continence reflex during abdominal compression in rats.

Methods

Under urethane anesthesia, urethral baseline pressure (UBP) and urethral pressure response (UPR) during momentary abdominal compression using a 100 g weight was measured using a transurethral microtransducer‐tipped catheter placed at the middle urethra in Sprague–Dawley female rats. Following intravenous (i.v.) application of hexamethonium or α‐bungarotoxin to block urethral smooth or striated muscle function, respectively, the effects of terazosin, an α1‐adrenoceptor (AR) antagonist (0.3 mg/kg, i.v.), medetomidine, an α2‐AR agonist (0.3 mg/kg, i.v.) or nisoxetine, a norepinephrine reuptake inhibitor (1 mg/kg, i.v.) followed by terazosin on UBP and UPR were examined.

Results

After hexamethonium pretreatment, terazosin did not alter UBP or UPR, whereas medetomidine significantly decreased UPR by 28% without UBP changes. Nisoxetine significantly increased UPR by 64%, which was eliminated by terazosin, but UBP was not altered by nisoxetine. After α‐bungarotoxin pretreatment, UBP and UPR were significantly decreased by terazosin or medetomidine. Nisoxetine induced significant increases in UBP and UPR by 16 and 15%, respectively, which were antagonized by terazosin.

Conclusion

These results suggest that: the baseline activity and reflex contraction of urethral smooth muscle are decreased by α1‐AR inhibition or α2‐AR stimulation; the reflex contraction of urethral striated muscle is decreased by α2‐AR stimulation, but not by α1‐AR inhibition; and nisoxetine increases baseline and reflex activity of smooth muscle in addition to striated muscle reflex activity by α1‐AR stimulation. These findings will be useful to understand nerve‐mediated urethral closure mechanisms.
Comparison of adrenaline auto‐injector devices: Ease of use and ability to recall use
Authors: Robinson M. N. , Dharmage S. C. , Tang M. L. K.
Published: July 2014

Background

A limited number of adrenaline auto‐injectors are currently available. Epipen and Anapen are available in Australia, New Zealand, UK and parts of Europe and Asia. Few studies have compared the performance of these devices.

Objective

To compare the intuitiveness of use of these devices. A secondary aim was to compare the ability to recall the use of each device after a period of 3 months.

Method

A random sample of 100 subjects naïve to both the EpiPen and Anapen were recruited from staff and families attending Royal Children's Hospital, Melbourne Australia. Subjects were randomized to Anapen (n = 53) or EpiPen (n = 47) and asked to demonstrate use of a ‘trainer’ device (i) prior to and (ii) after receiving training in its correct use. A subset (n = 32) participated in a follow‐up study to evaluate (iii) the ability to recall correct use of each device.

Results

Most subjects correctly demonstrated all steps in use of the EpiPen and Anapen both prior to (89% vs. 79%, p = 0.17) and after training on use (100% vs. 100%). However, after 3 months, significantly more participants correctly demonstrated use of EpiPen (87%) compared to Anapen (35%) (p = 0.003) and critical errors that would likely result in failure to administer adrenaline were more common with Anapen (59% vs. 13%, p = 0.01).

Conclusion

Most study participants correctly demonstrated the use of both devices without prior training. There was greater attrition in correct use of Anapen compared to EpiPen over time. Critical errors in administration were more likely with Anapen than EpiPen.
Functional capacity after pediatric liver transplantation: A pilot study
Authors: Maria da Silva Rosângela , Brunow de Carvalho Werther , Johnston Cíntia , Borba de Castro Mariela , Manta Ferreira Israel , Patti Camilla L. , Anthero de Azevedo Ramiro , Miziara Gonzalez Adriano , Moura Linhares Marcelo , Augusto Salzedas‐Netto Alcides
Published: July 2014

The prospective cross‐sectional study investigated the 6MWT performance in pediatric group of liver transplant recipients (6–17 yr, median post‐transplantation time of 22 months) and compared to the normal values obtained in healthy children as well as evaluated the reproducibility of the 6MWT. We analyzed the relationship between walked distance and the 6MWw, distance walked × body weight) with the anthropometric, clinical, and pulmonary functions. In post‐transplanted group, the average walked distance was significantly shorter compared with control (687 ± 80 m vs. 511 ± 72 m, p < 0.001). The calculated ICC coefficient confirmed the reproducibility among tests. The Pearson correlation revealed that only walked distance in the 6MWT was moderately correlated with tidal volume. Conversely, the 6MWw was significantly correlated with age, weight, height, BMI, FVC, PEF rate, and volume expiratory. According to multiple regression analysis, age, VE and FVC factors explained 80% of the variance in the 6MWw. In conclusion, the pediatric liver transplant recipients' performance in the 6MWT is significantly lower than the values for healthy children of the same age. Notably, the 6MWw may provide relevant information, constituting an additional parameter in the determination of functional capacity.
Natural Resource Exports, Fiscal Policy Volatility and Growth
Authors: Bleaney Michael , Halland Håvard
Published: July 2014

The combination of poor institutions and erratic macroeconomic policy, as measured by the volatility of fiscal policy, is associated with slower growth. We show that macroeconomic policy is more erratic in countries that are rich in natural resources, especially minerals and fuels, and in those that receive large aid inflows. Poor institutions also play a role. Although Africa is a major receiver of aid and exporter of natural resources, this is not purely an African phenomenon. Output volatility is not associated with slower growth after controlling for institutions and the volatility of fiscal policy.
Access to reeds and mat making in the lower Volta basin of Ghana
Authors: Ayivor Jesse Sey
Published: July 2014

This paper explores the origins of pressures on reeds and sedges used for mat making in the lower Volta basin of Ghana, and their impact on the socially embedded system which dictates access to reed fields. Data for the study were collected through field work employing participatory rural appraisal methods in 18 communities, involving 152 mat weavers. The findings showed that the mat‐weaving industry has contributed immensely in providing poor women a means of livelihood but reed marshes in the basin have reduced in recent years due to hydrological changes in the area caused by the damming of the Volta upstream. The decline in the availability of reed is exerting immense pressure on this once freely available resource, thus inducing landlords to impose a price on the rights of entry into marshlands by reed collectors. The imposition of these charges affected the very people that the mat‐weaving industry is targeted to help. The study recommends the local and central government to play a more active role and civil society groups to broaden the livelihood base of women living in this region.
A new human leukocyte antigen class I allele: HLA‐A*11:125
Authors: Zheng J. W. , Guo Z. H. , Jiang Y. Q. , Yang J. H. , Xie J. H. , Sun Y. , Tang Q. J. , Xiang D.
Published: July 2014

HLA‐A*11:125 allele differs from A*11:01:01 by one nucleotide substitution at nt 140 from T to C.