bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacotherapy for Neurocognitive Disorders Based on the Hypothesis of Endogenous Appearance of Anticholinergic Activity
Authors: Hosoi Misa , Hori Koji , Konishi Kimiko , Tani Masayuki , Tomioka Hiroi , Kitajima Yuka , Akashi Norihisa , Inamoto Atsuko , Kurosawa Kenzo , Yuda Hajime , Hanashi Takahiro , Ouchi Hiromi , Hachisu Mitsugu
Published: June 2015

We previously proposed the hypothesis of endogenous anticholinergic activity (AA) in Alzheimer's disease (AD). According to this hypothesis, the downregulation of acetylcholine seen in AD is associated with upregulation/hyperactivity of N-methyl-D-aspartate receptor (NMDAR). The hyperactivation of NMDAR then induces inflammation, which, in turn, causes AA to appear endogenously. Based on this hypothesis, we commented that cholinesterase inhibitors (ChEIs) are ‘preventative' therapy for AD and NMDAR antagonists are the true ‘treatment' for AD. We also noted that ChEIs, such as donepezil, could treat delirium. Moreover, we proposed measuring serum anticholinergic activity in patients, particularly AD patients, in out-of-hospital pharmacies to monitor the anticholinergic burden for targeted treatment.
Demonstrating the Role of Anticholinergic Activity in a Mood Disorder
Authors: Hori Koji , Konishi Kimiko , Hanashi Takahiro , Tani Masayuki , Tomioka Hiroi , Kitajima Yuka , Akashi Norihisa , Inamoto Atsuko , Kurosawa Kenzo , Hasegawa Sayaka , Izuno Takuji , Kikuchi Nodoka , Hosoi Misa , Hachisu Mitsugu
Published: June 2015

We report a case of a 54-year-old woman presenting with amnesia, apathy, work-related difficulties and mental stress. At presentation, her Mini-Mental State Examination score was 27 and her serum anticholinergic activity (SAA) was positive without medication or recent physical illnesses. In addition, magnetic resonance imaging revealed mild atrophy of the frontal and temporal lobes, with a relatively intact hippocampus. Consequently, we diagnosed mild cognitive impairment due to Alzheimer's disease and prescribed a cholinesterase inhibitor (donepezil, 10 mg/day); her SAA fully disappeared and clinical symptoms partially resolved. Addition of duloxetine coupled with environmental adjustments caused her cognitive function to return to a normal level, so we diagnosed pseudodementia due to depression. In this case, we believe that the simultaneous cholinergic burden and mental stress led to positive SAA, which made it reasonable to prescribe a cholinesterase inhibitor to ameliorate the associated acetylcholine hypoactivity. We believe that it is essential to recognize the importance of prescribing a cholinesterase inhibitor for specific patients, even those with pseudodementia, to control their clinical symptoms. Moreover, SAA might be a useful biomarker for identifying this subgroup of patients. We propose that anticholinergic activity appears endogenously in mood disorders (depression and bipolar disorder) and set out our rationalization for this hypothesis.
Plasma Cholinesterase Activity in Alzheimer's Disease
Authors: Hosoi Misa , Hori Koji , Konishi Kimiko , Tani Masayuki , Tomioka Hiroi , Kitajima Yuka , Akashi Norihisa , Inamoto Atsuko , Minami Sousuke , Izuno Takuji , Umezawa Kaori , Horiuchi Kentaro , Hachisu Mitsugu
Published: June 2015

Cholinesterase inhibitors (ChEIs) are not allowed to be prescribed in combination, which means that we need to select 1 of 3 ChEIs for use in a patient with Alzheimer's disease (AD). However, there is no quantitative analysis on the differences between these agents. In this article, we propose that plasma cholinesterase activity (pChE) could be used as the standard for differentiating between rivastigmine (Riv) and donepezil (Don) in the management of AD. To date, we have treated 6 patients with Riv 18 mg and 5 patients with Don 5 mg. The pChE is related to low-grade inflammation associated with AD, diabetes mellitus and lipid metabolic dysfunction. Moreover, low pChE is related to liver dysfunction. The pChE must be kept under control. We speculated that Riv is the most appropriate therapy for patients with relatively high pChE, whereas Don is best reserved for those AD patients with relatively low pChE.
Ginkgo biloba Extract Inhibits Platelet Activation via Inhibition of Akt
Authors: Shiyong Ye , Yijia Xiang , Peng Zhong , Chong Liu , Wuming Hu , Linchun Lv , Chunlai Zeng
Published: June 2015

Ginkgo biloba extract (GBE) contains flavone glycosides and terpenoids. It can modify vasomotor function, reduce the adhesion of blood cells to the endothelium, and inhibit the activation of platelets, and therefore plays an important role in the treatment of a variety of cardiovascular and neurological disorders. However, the molecular mechanism underlying its significant anticoagulation activity is largely unknown. In this study, we found that GBE adenosine diphosphate, collagen, and U4 (U46619) induced platelet aggregation in both platelet-rich plasma and washed platelets. GBE could reduce the adhesion of platelets to a collagen-coated surface and platelet spreading on fibrinogen. The treatment with GBE significantly inhibited the phosphorylation of Akt, suggesting that its inhibition of platelet activation might be mediated by attenuation of the PI3K/Akt pathway.
Peripheral Perfusion Index Predicts Hypotension during Fluid Withdrawal by Continuous Veno-Venous Hemofiltration in Critically Ill Patients
Authors: Klijn Eva , Groeneveld A.B. Johan , van Genderen Michel E. , Betjes Michiel , Bakker Jan , van Bommel Jasper
Published: June 2015

Aim: Peripheral perfusion may predict harmful hypovolemic hypotension during fluid withdrawal by continuous veno-venous hemofiltration (CVVH) in critically ill patients with acute kidney injury. Methods: Twenty-three critically ill AKI patients were subjected to progressive fluid withdrawal. Systemic hemodynamics and peripheral perfusion index (PPI) by pulse oximetry, forearm-to-fingertip skin temperature gradient (Tskin-diff) and tissue oxygen saturation (StO2, near infra-red spectroscopy) were measured. Results: Most hemodynamic values decreased with fluid withdrawal, particularly in the hypotensive group, except for stroke volume (SV) and cardiac output, which decreased to a great extent in the non-hypotensive patients. Increases in systemic vascular resistance (SVR) were less in hypotension. Baseline pulse pressure and PPI were lower in hypotensive (n = 10) than non-hypotensive patients and subsequent PPI values paralleled SV decreases. A baseline PPI ≤0.82 AU predicted hypotension with a sensitivity of 70%, and a specificity of 92% (AUC 0.80 ± 0.11, p = 0.004). Conclusion: Progressive fluid withdrawal during CVVH is poorly tolerated in patients with less increases in SVR. The occurrence of hypotension can be predicted by low baseline PPI.
Safety and Efficacy of Mechanical Thrombectomy Using Stent Retrievers in the Endovascular Treatment of Acute Ischaemic Stroke: A Systematic Review
Authors: Puñal-Riobóo Janet , Atienza Gerardo , Blanco Miguel
Published: June 2015

Background: The treatment of choice for acute ischaemic stroke is the intravenous administration of recombinant tissue plasminogen activator within 3-4.5 h of symptom onset. However, the use of a thrombolytic would be limited by its narrow therapeutic window and contraindications. As a result, in recent years, techniques such as mechanical thrombectomy have emerged, which employ thrombus retrieval devices, such as stent retrievers (Solitaire™, Trevo® or Revive™), whose safety and efficacy in the endovascular treatment of acute ischaemic stroke is analysed in this article. Methods: A systematic literature search was undertaken until March 2015. The quality of evidence was assessed according to the GRADE methodology. A meta-analysis of the results of randomised controlled trials (RCTs) was performed, and the weighted average for the case series' sample size was calculated (Review Manager v5.2 and SPSS v19). Results: Seventeen primary studies (2 RCTs, Solitaire™ and Trevo® vs. Merci®, and 15 case series) were selected. The RCT results show that stent retrievers have a safety profile similar to the Merci® device. However, both Solitaire™ and Trevo® achieved a higher recanalisation success rate (OR, 4.56; 95% CI, 2.63-7.90; p < 0.00001) and appropriate clinical outcome at 90 days (OR, 2.54; 95% CI, 1.52-4.25; p < 0.0004), although the 90-day mortality rate was similar in both groups (OR, 0.75; 95% CI, 0.17-3.37; p = 0.70). Conclusions: Stent retrievers appear to be safe and effective devices, achieving high recanalisation rates and good clinical outcomes in the endovascular treatment of patients with acute ischaemic stroke due to the occlusion of intracranial arteries in comparison with the clot retriever Merci®.
Developmental Dynamic Analysis of the Excreted Microbiome of Chickens Using Next-Generation Sequencing
Authors: Lim Sooyeon , Cho SooHyun , Caetano-Anolles Kelsey , Jeong Seok Geun , Oh Mi Hwa , Park Beom Young , Kim Hyun Jung , Cho Seoae , Choi Sang Ho , Ryu Sangryeol , Lee Ju-Hoon , Kim Heebal , Ham Jun Sang
Published: June 2015

Poultry contamination can be largely attributed to the presence of chicken feces during the production process. Fecal contamination is often found in raw chicken products sold for human consumption. Quantitative analysis of the fecal microbial community of chickens using next-generation sequencing techniques is the focus of this study. Fecal samples were collected from 30 broiler chickens at two time points: days 1 and 35 of development. 454 pyrosequencing was conducted on 16S rRNA extracted from each sample, and microbial population dynamics were investigated using various automated bioinformatics pipelines. Diversity of the microbial community at the genus level increased during the 5-week growth period. Despite this growth, only a few dominant bacteria groups (over 80%) were identified in each fecal sample, with most groups being unique and only a few were shared between samples. Population analysis at the genus level showed that microbial diversity increased with chicken growth and development. Classification and phylogenetic analysis of highly represented microbes (over 1%) clearly showed high levels of sequence similarity between groups such as Firmicutes and Proteobacteria. These results suggest that the chicken fecal excreted microbiome is a dynamic system with a differentiated population structure that harbors a highly restricted number of higher taxa.
Demographic and Technical Risk Factors of 30-Day Stroke, Myocardial Infarction, and/or Death in Standard- and High-Risk Patients Who Underwent Carotid Angioplasty and Stenting
Authors: Borhani Haghighi Afshin , Yousefi Samaneh , Bahramali Ehsan , Kokabi Safoora , Heydari Seyed Taghi , Shariat Abdolhamid , Nikseresht Alireza , Ashjazadeh Nahid , Izadi Sadegh , Petramfar Peyman , Poursadegh Maryam , Rahimi Jaberi Abbas , Emami Sajjad , Agheli Hamid , Nemati Reza , Yaghoubi Ehsan , Abdi Mohammad Hosein , Panahandeh Majid , Heydari Moslem , Safari Anahid , Basir Marziyeh , Cruz-Flores Salvador , Edgell Randal
Published: June 2015

Background: Carotid angioplasty and stenting (CAS) is an accepted treatment to prevent stroke in patients with carotid artery stenosis. The purpose of this study is to identify risk factors for major complications after CAS. Materials and Methods: This is a prospective study that was conducted at Shiraz University of Medical Sciences in southern Iran from March 2011 to June 2014. Consecutive patients undergoing CAS were enrolled. Both standard- and high-risk patients for endarterectomy were enrolled. Demographic data, atherosclerotic risk factors, site of stenosis, degree of stenosis, and data regarding technical factors were recorded. Thirty-day stroke, myocardial infarction, and/or death were considered as the composite primary outcomes of the study. Results: A total of 251 patients were recruited (mean age: 71.1 ± 9.6 years; male: 65.3%). Of these, 178 (70.9%) were symptomatic, 73 (29.1%) were diabetic, 129 (51.4%) were hyperlipidemic, 165 (65.7%) were hypertensive, and 62 (24.7%) patients were smokers. CAS was performed for left internal carotid artery (ICA) in 113 (45.4%) patients. Fourteen (5.6%) patients had sequential bilateral stenting. Mean stenosis of operated ICA was 80.2 ± 13.8%. An embolic protection device was used in 203 (96.2%) patients. Pre- and postdilation were performed in 39 (18.5%) and 182 (86.3%) patients, respectively. Composite outcomes were observed in 3.6% of patients (3.2% stroke, 0% myocardial infarction, and 1.2% death). Left-sided lesions and the presence of diabetes mellitus were significantly associated with poor short-term outcome (p = 0.025 and p = 0.020, respectively). Conclusion: There was a higher risk of short-term major complications in diabetic patients and for left carotid artery intervention.
The Entity Mapper: A Data Visualization Tool for Qualitative Research Methods
Authors: Luther Anne
Published: June 2015

In recent years, data visualization is increasingly being used to represent complex information and is mostly embedded in quantitative investigations. This article introduces an open source software tool for visualizing data that has been prestructured following qualitative research methods. The article goes on to summarize research material on current data visualization strategies in qualitative research. An example shows how the new software can be used to construct a visual data analysis through quantitative metadata and qualitative results.
Century of Light Shines for Twenty-Five Years
Authors: Pallas Jim
Published: June 2015

Jim Pallas, an artist who pioneered the use of technology in art, collaborated with computer sage Rene Vega and programmer Randy Mims in 1979 to create Century of Light, one of the earliest interactive public sculptures. In this article, Pallas describes an earlier struggle to incorporate technology into sculpture, the selection process that led to this, his first public commission and the collaborative process. Sited within a pedestrian mall in downtown Detroit, the sculpture sensed viewers’ movements, sounds and light. Unfortunately, the sculpture was located in an ill-conceived plaza. Although the city administration mismanaged the site and allowed the sculpture to be destroyed 25 years later, the electronics and program were rescued and remain intact.
Pro-Tanto Obligations and Ceteris-Paribus Rules
Authors: Frederick Danny
Published: June 2015

I summarize a conception of morality as containing a set of rules which hold ceteris paribus and which impose pro-tanto obligations. I explain two ways in which moral rules are ceteris-paribus, according to whether an exception is duty-voiding or duty-overriding. I defend the claim that moral rules are ceteris-paribus against two qualms suggested by Luke Robinson’s discussion of moral rules and against the worry that such rules are uninformative. I show that Robinson’s argument that moral rules cannot ground pro-tanto obligations is unsound, because it confuses an absolute reason for an obligation with a reason for an absolute obligation, and because it overlooks the possibility that priority rules may be rules for ordering pro-tanto obligations rather than rules for eliminating contenders for the status of absolute obligation.
Love and (Polygamous) Marriage?
Authors: Crookston Emily M.
Published: June 2015

Opponents of same-sex marriage suggest that legalizing same-sex marriage will start a slide down a “slippery-slope” leading to the legalization of all kinds of salacious family arrangements including polygamy. In this paper, I argue that because previous attempts by liberal political theorists to combat such slippery-slope arguments have been unsuccessful, there are two options left open to political liberals. Either one could embrace polygamy as a logically consistent implication of extending civil liberties to same-sex couples or one could find a new strategy for blocking the slide down the slope. I take the second option arguing that we ought to devise a harm principle for domestic partnerships. Once this principle has been established, it becomes clear that the risk of exploitation for those potentially occupying the multiple side of the marriage is sufficient reason to reject polygamous marriage arrangements. I conclude that, contrary to appearances, holding both (a) same-sex marriage is permissible and (b) polygamous marriage is impermissible is at the same time consistent and consistently liberal.
Tetracyclus hinziae (Bacillariophyta), a new species from the central Cascade Mountains (WA, USA)
Authors: Bishop Ian , Spaulding Sarah
Published: June 2015

Here we describe a new freshwater diatom species from the Cascade Mountain Range in Washington State, including observations of living cells and chloroplast structure. The species represents the fourth known extant species within the genus, as most species of Tetracyclus Ralfs are extinct. The new species can be distinguished from other Tetracyclus species and Diatoma mesodon Kützing by its lanceolate-elliptical shape, apiculate ends, small size, rimoportula placement, and distinct septa pattern. The distribution of the new taxon is currently catchments within the Mt. Baker-Snoqualmie National Forest and Mount Rainier National Park, and is found in greatest abundance in aerophilous, moss and liverwort habitats in first- and second-order streams.
Allium marmoratum (Amaryllidaceae), a new species of section Falcatifolia from Chimgan Massif, Eastern Uzbekistan
Authors: Seregin Alexey P.
Published: June 2015

The former Soviet republics of Middle Asia are an important area of Allium Linnaeus (1753: 294) diversity. The latest checklist by Khassanov (2008) recorded 244 species and subspecies. At least 18 new species were described from Kazakhstan, Kyrgyzstan, Uzbekistan, and Tajikistan afterwards (Lazkov 2008, Fritsch 2009, Fritsch & Friesen 2009, Khassanov & Tojibaev 2009, 2010, Khassanov et al. 2009, 2011, 2013, Sennikov & Lazkov 2013, Tojibaev et al. 2014 , Seregin et al. 2015). Due to the high number of extremely rare local endemics, Allium species of this region are still underexplored. For instance, some collections in many herbaria are still remaining unnamed or bear provisional identifications.
A taxonomic revision of the Neotropical spider genus Xiruana Brescovit 1997 (Araneae: Anyphaenidae, Anyphaeninae)
Authors: OLIVEIRA LUIZ FERNANDO M. , BRESCOVIT ANTONIO D.
Published: June 2015

The genus Xiruana Brescovit, 1997 is currently composed of four South American species: X. gracilipes (Keyserling) from Brazil, Bolivia and Argentina, X. affinis (Mello-Leitão) from Brazil, X. hirsuta (Mello-Leitão) from Venezuela, Brazil, Paraguay, Argentina and Uruguay, and X. tetraseta (Mello-Leitão) from Venezuela, Brazil and Paraguay. Of these, the last three are redescribed in this paper, including the first description of the females of X. hirsuta and X. tetraseta. Additionally, we describe thirteen new species: Xiruana pocone n. sp. from Brazil, Paraguay and Argentina; X. bifida n. sp. from Brazil and Paraguay; X. aymara n. sp. from Bolivia; X. cocha n. sp. from Peru; X. fiebrigi n. sp. from Paraguay, and X. ajuricaba n. sp., X. tribarrense n. sp., X. guaia n. sp., X. jaboticabal n. sp., X. minacu n. sp., X. tapirape n. sp., X. lusitania n. sp., X. silarae n. sp., all endemic to Brazil. The known geographical distribution of all species here presented is mapped.
First record of a living species of the genus Janulum (Class Demospongiae)
in the Southern Hemisphere
Authors: KELLY MICHELLE , ERPENBECK DIRK , MORROW CHRISTINE , SOEST ROB VAN
Published: June 2015

A new species of the enigmatic sponge genus Janulum de Laubenfels, 1936 was discovered recently on the Louisville Seamount Chain, in International Waters to the east of New Zealand; two small specimens were found encrusting the interstices of the stony coral Solenosmilia variabilis Duncan at a depth of 1200–1600 m. Janulum imago sp. nov., is described and compared with the genus type J. spinispiculum (Carter, 1876) from the North Atlantic. Janulum was also recorded from the Late Eocene Oamaru Diatomite of southern New Zealand in 1892, but was misidentified as genus Plocamia Schmidt (Order Poecilosclerida Topsent, Family Microcionidae Carter). Fossil species Janulum princeps sp. nov. is also described herein and represents the first record of this North Atlantic-Arctic Ocean genus in the Southern Hemisphere. The validity of J. filholi (Topsent, 1890), the second and only other North Atlantic species currently assigned to Janulum, is considered in the context of J. spinispiculum and the new species J. imago sp. nov.
Thumb-pads up—a new species of thick-thumbed bat from Sumatra (Chiroptera: Vespertilionidae: Glischropus)
Authors: Csorba Gábor , Görföl Tamás , Wiantoro Sigit , Kingston Tigga , Bates Paul J. J. , Huang Joe Chun-Chia
Published: June 2015

To date, three species of the genus Glischropus are recognized from the Indomalayan zoogeographic region—G. bucephalus from the Indochinese subregion, G. tylopus from the Sundaic subregion (Peninsular Thailand and Malaysia, Borneo, Sumatra, Moluccas) and G. javanus, restricted to Java. The investigation of the holotype and three topotype specimens of G. batjanus supported the view that the name was previously correctly regarded as the junior subjective synonym of G. tylopus. During review of material recently collected in southwestern Sumatra, Indonesia, one specimen of a yet undescribed species of Thick-thumbed bat was identified. G. aquilus n. sp. markedly differs from its congeners by its dark brown pelage, nearly black ear and tragus, and in skull proportions. The phylogenetic analysis based on cytb sequences also supports the specific distinctness of G. aquilus n. sp. Its discovery brings the count to 88 species of bats known from Sumatra.
The description of a new species Polymastigos javaensis n.sp. (Annelida: Capitellidae) from the Segara Anakan mangroves, Central Java, Indonesia
Authors: PAMUNGKAS JOKO
Published: June 2015

A new species, Polymastigos javaensis n. sp., is described from sandy clay sediment (0-30 cm depth) of the Segara Anakan mangroves. The species is described based on the distribution of capillaries and hooks, and the form of the prostomium, thorax, abdomen, lateral organs, genital pores, branchiae and pygidium. Methyl green staining pattern was applied to examine the similarity between the material of this study and Green’s material. Polymastigos javaensis n. sp. is the second species belonging to the genus Polymastigos, after P. reishi Green, 2002. It differs from P. reishi in the form of abdominal segments and hooks, and the methyl green staining pattern. A key to distinguish the two species is provided in this paper.
Responses of Tropical Deep Convection to the QBO: Cloud-Resolving Simulations
Authors: Nie Ji , Sobel Adam H.
Published: June 2015

Observational studies suggest that the stratospheric quasi-biennial oscillation (QBO) can modulate tropical deep convection. The authors use a cloud-resolving model with a limited domain, representing a convective column in the tropics, to study the mechanisms of this modulation. The large-scale circulation is parameterized using the weak temperature gradient (WTG) approximation, under which the parameterized large-scale vertical motion acts to relax the horizontal-mean temperature toward a specified reference profile. Temperature variations typically seen in easterly and westerly phases are imposed in the upper troposphere and lower stratosphere of this reference profile. The responses of convection are studied over different sea surface temperatures, holding the reference temperature profile fixed. This can be thought of as studying the response of convection to the QBO over different “relative SSTs” and also corresponds to different equilibrium precipitation rates in the control simulation. The equilibrium precipitation rate shows slight increases in response to a QBO easterly phase temperature perturbation over small SST anomalies and strong decreases over large SST anomalies, and vice versa for the QBO westerly phase perturbation. A column moist static energy budget analysis reveals that the QBO modulates the convective precipitation through two pathways: it changes the high-cloud properties and thus the column radiative cooling, and it alters the shape of the large-scale vertical motion and thus the efficiency of energy transport by the large-scale flow. The nonmonotonicity of the precipitation response with respect to relative SST results from the competition of these two effects.
Temporal Dynamics of Anxiety Phenotypes in a Dental Pulp Injury Model
Authors: Shang Lin , Xu Tian-Le , Li Fei , Su Jiansheng , Li Wei-Guang
Published: June 2015

Background

Accumulating clinical and preclinical evidence indicates that chronic pain is often comorbid with persistent low mood and anxiety. However, the mechanisms underlying pain-induced anxiety, such as its causality, temporal progression, and relevant neural networks are poorly understood, impeding the development of efficacious therapeutic approaches.

Results

Here, we have identified the sequential emergence of anxiety phenotypes in mice subjected to dental pulp injury (DPI), a prototypical model of orofacial pain that correlates with human toothache. Compared with sham controls, mice subjected to DPI by mechanically exposing the pulp to the oral environment exhibited significant signs of anxiogenic effects, specifically, altered behaviors on the elevated plus maze (EPM), novelty-suppressed feeding (NSF) tests at 1 but not 3 days after the surgery. Notably, at 7 and 14 days, the DPI mice again avoided the open arm, center area, and novelty environment in the EPM, open field, and NSF tests, respectively. In particular, DPI-induced social phobia and increased repetitive grooming did not occur until 14 days after surgery, suggesting that DPI-induced social anxiety requires a long time. Moreover, oral administration of an anti-inflammatory drug, ibuprofen, or an analgesic agent, ProTx-II, which is a selective inhibitor of NaV1.7 sodium channels, both significantly alleviated DPI-induced avoidance in mice. Finally, to investigate the underlying central mechanisms, we pharmacologically blocked a popular form of synaptic plasticity with a GluA2-derived peptide, long-term depression, as that treatment significantly prevented the development of anxiety phenotype upon DPI.

Conclusions

Together, these results suggest a temporally progressive causal relationship between orofacial pain and anxiety, calling for more in-depth mechanistic studies on concomitant pain and anxiety disorders.
Physician burnout: can we make a difference together?
Authors: Siedsma Matthew , Emlet Lillian
Published: June 2015

Expanded abstract

Citation

West CP, Dyrbye LN, Rabatin JT, Call TG, Davidson JH, Multari A, Romanski SA, Hellyer JMH, Sloan JA, Shanafelt TF. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. JAMA Intern Med. 2014;174:527–33.

Background

Despite the documented prevalence and clinical ramifications of physician distress, few rigorous studies have tested interventions to address the problem.

Methods

Objective: To test the hypothesis that an intervention involving a facilitated physician small-group curriculum would result in improvement in well-being.

Design: A randomized clinical trial of practicing physicians. Additional data were collected on nontrial participants responding to annual surveys timed to coincide with the trial surveys.

Setting: Department of Medicine at the Mayo Clinic in Rochester, Minnesota between September 2010 and June 2012.

Participants: The study involved 74 practicing physicians in the Department of Medicine and 350 nontrial participants responding to annual surveys.

Interventions: The intervention involved 19 biweekly facilitated physician discussion groups incorporating elements of mindfulness, reflection, shared experience, and small-group learning for 9 months. Protected time (1 hour of paid time every other week) for participants was provided by the institution.

Outcomes: Meaning in work, empowerment and engagement in work, burnout, symptoms of depression, quality of life, and job satisfaction were assessed using validated metrics.

Results

Empowerment and engagement at work increased by 5.3 points in the intervention arm vs. a 0.5-point decline in the control arm by 3 months after the study (P = .04), an improvement sustained at 12 months (+5.5 vs. +1.3 points; P = .03). Rates of high depersonalization at 3 months had decreased by 15.5 % in the intervention arm vs. a 0.8 % increase in the control arm (P = .004). This difference was also sustained at 12 months (9.6 % vs. 1.5 % decrease; P = .02). No statistically significant differences in stress, symptoms of depression, overall quality of life, or job satisfaction were seen. In additional comparisons including the nontrial physician cohort, the proportion of participants strongly agreeing that their work was meaningful increased 6.3 % in the study intervention arm but decreased 6.3 % in the study control arm and 13.4 % in the nonstudy cohort (P = .04). Rates of depersonalization, emotional exhaustion, and overall burnout decreased substantially in the trial intervention arm, decreased slightly in the trial control arm, and increased in the nontrial cohort (P = .03, P = .007, and P = .002 for each outcome, respectively).

Conclusions

An intervention for physicians based on a facilitated small-group curriculum improved meaning and engagement in work and reduced depersonalization, with sustained results 12 months after the study.
Transferring genomics to the clinic: distinguishing Burkitt and diffuse large B cell lymphomas
Authors: Sha Chulin , Barrans Sharon , Care Matthew A. , Cunningham David , Tooze Reuben M. , Jack Andrew , Westhead David R.
Published: June 2015

Background

Classifiers based on molecular criteria such as gene expression signatures have been developed to distinguish Burkitt lymphoma and diffuse large B cell lymphoma, which help to explore the intermediate cases where traditional diagnosis is difficult. Transfer of these research classifiers into a clinical setting is challenging because there are competing classifiers in the literature based on different methodology and gene sets with no clear best choice; classifiers based on one expression measurement platform may not transfer effectively to another; and, classifiers developed using fresh frozen samples may not work effectively with the commonly used and more convenient formalin fixed paraffin-embedded samples used in routine diagnosis.

Methods

Here we thoroughly compared two published high profile classifiers developed on data from different Affymetrix array platforms and fresh-frozen tissue, examining their transferability and concordance. Based on this analysis, a new Burkitt and diffuse large B cell lymphoma classifier (BDC) was developed and employed on Illumina DASL data from our own paraffin-embedded samples, allowing comparison with the diagnosis made in a central haematopathology laboratory and evaluation of clinical relevance.

Results

We show that both previous classifiers can be recapitulated using very much smaller gene sets than originally employed, and that the classification result is closely dependent on the Burkitt lymphoma criteria applied in the training set. The BDC classification on our data exhibits high agreement (~95 %) with the original diagnosis. A simple outcome comparison in the patients presenting intermediate features on conventional criteria suggests that the cases classified as Burkitt lymphoma by BDC have worse response to standard diffuse large B cell lymphoma treatment than those classified as diffuse large B cell lymphoma.

Conclusions

In this study, we comprehensively investigate two previous Burkitt lymphoma molecular classifiers, and implement a new gene expression classifier, BDC, that works effectively on paraffin-embedded samples and provides useful information for treatment decisions. The classifier is available as a free software package under the GNU public licence within the R statistical software environment through the link http://www.bioinformatics.leeds.ac.uk/labpages/softwares/ or on github https://github.com/Sharlene/BDC.
Cartilage in facet joints of patients with ankylosing spondylitis (AS) shows signs of cartilage degeneration rather than chondrocyte hypertrophy: implications for joint remodeling in AS
Authors: Bleil Janine , Sieper Joachim , Maier Rene , Schlichting Uwe , Hempfing Axel , Syrbe Uta , Appel Heiner
Published: June 2015

Introduction

In ankylosing spondylitis (AS), joint remodeling leading to joint ankylosis involves cartilage fusion. Here, we analyzed whether chondrocyte hypertrophy is involved in cartilage fusion and subsequent joint remodeling in AS.

Methods

We assessed the expression of chondrocyte hypertrophy markers runt-related transcription factor 2 (Runx2), type X collagen (COL10), matrix metalloproteinase 13 (MMP13), osteocalcin and beta-catenin and the expression of positive bone morphogenic proteins (BMPs) and negative regulators (dickkopf-1 (DKK-1)), sclerostin, (wingless inhibitory factor 1 (wif-1)) of chondrocyte hypertrophy in the cartilage of facet joints from patients with AS or osteoarthritis (OA) and from autopsy controls (CO) by immunohistochemistry. Sex determining region Y (SRY)-box 9 (Sox9) and type II collagen (COL2) expression was assessed as indicators of chondrocyte integrity and function.

Results

The percentage of hypertrophic chondrocytes expressing Runx2, COL10, MMP13, osteocalcin or beta-catenin was significantly increased in OA but not in AS joints compared to CO joints. Frequencies of sclerostin-positive and DKK-1-positive chondrocytes were similar in AS and CO. In contrast, wif-1- but also BMP-2- and BMP-7-expressing and Sox9-expressing chondrocytes were drastically reduced in AS joints compared to CO as well as OA joints whereas the percentage of COL2-expressing chondrocytes was significantly higher in AS joints compared to CO joints.

Conclusions

We found no evidence for chondrocyte hypertrophy within hyaline cartilage of AS joints even in the presence of reduced expression of the wnt inhibitor wif-1 suggesting that chondrocyte hypertrophy is not a predominant pathway involved in joint fusion and remodeling in AS. In contrast, the reduced expression of Sox9, BMP-2 and BMP-7 concomitantly with induced COL2 expression rather point to disturbed cartilage homeostasis promoting cartilage degeneration in AS.
From Artist to Martyr: On Commemorating Ahmed Basiony
Authors: Ramadan Dina A.
Published: June 2015

Thirty-two-year-old multimedia artist Ahmed Basiony was one of the earliest martyrs of the 2011 Egyptian uprisings. Shortly after his death his work was selected for the Egyptian pavilion at the fifty-fourth Venice Biennale. This article questions the choice of Basiony as a representative on a national pavilion. It also examines some of the curatorial choices made in the presentation of Basiony’s work. It argues that the emphasis on the artist’s martyrdom throughout the exhibition restricts our reading of his work to the tragic events leading to his untimely death. This article also suggests that in the 2011 Egyptian pavilion exhibition we can see the earliest manifestations of the now well-established counterrevolution, as the Ministry of Culture—a representative of “deep” state—seeks to assert itself as the continued sponsor of cultural production, as well as the guardian of martyrs and their memorialization.
Yema Djamila Sahraoui
Authors: Bedjaoui Ahmed
Published: June 2015

Filmmaker Djamila Sahraoui is a product of the feminization of Algerian cinema that became dominant in the last decade of the twentieth century. More than thirty years since novelist Assia Djebar came onto the scene with her feminist stance, Algerian women are finally rendering representations of Algerian society different from those of their male counterparts. Considering her three earlier documentaries, one finds recurring themes that also run through Sahraoui’s latest film, Yema, including violence against women, the urgent need to resist, and the Kabyle landscape with its olive groves and wild mountains.

Yema is a film about the struggles being waged around the world and throughout history by men who aim to conquer. Vincent Ostria has called this into question in his review for the magazine Les InRocks; however, I would argue that Djamila Sahraoui’s film, seen through the Islamic experience, belongs to a universal discourse, much like the Greek tragedies the filmmaker has compared it to.
Avaliação de pré-natal por indicador de qualidade
Authors: Haack Bassani Débora Cristina , Derlan Camila Braga , Chaves Jéssica , Kanitz Luís , Dipp Thaíse , Ghignatti Bianca , Koeep Janine , Possuelo Lia
Published: June 2015

Introdução: A constante avaliação da qualidade do pré-natal favorece a identificação de problemas de saúde e o desempenho da equipe de saúde. O objetivo do estudo foi avaliar a qualidade dos registros nas Carteiras das Gestantes que se internam na maternidade do Hospital Santa Cruz e, por meio desse registro, evidenciar a atenção pré-natal recebida pelas gestantes. Métodos: Trata-se de um estudo quantitativo e transversal. As informações foram coletadas das carteirinhas e dos prontuários das gestantes no período de janeiro a junho de 2014. Os dados foram coletados mediante a análise das carteiras de gestante, com aplicação de um instrumento padronizado (Formulário de Captação de dados). A análise e o processamento dos dados foram realizados no programa SPSS 22.0. Resultados: Houve o predomínio de mulheres entre 31 a 36 anos, 30,6% (57) da amostra. A maioria iniciou o pré-natal no primeiro trimestre, com seis ou mais consultas. Os exames para hemoglobina e hematócrito alcançaram percentual de 34,9% (65) correspondente a duas solicitações em momentos distintos, de acordo com o Programa de Humanização do Pré-natal e Nascimento. A glicemia em jejum, em sua maioria, foi requisitada em uma consulta. O VDRL foi solicitado em uma consulta assim como a urina tipo um, ficando abaixo do preconizado. 31,2% (58) da amostra não haviam realizado os exames citados anteriormente. Conclusão: Com base neste estudo, pôde-se constatar que muitas carteiras provenientes do serviço básico de saúde necessitavam de melhor preenchimento, e que as gestantes que realizaram pré-natal em clínicas particulares possuíam dados insuficientes.
Representação social de sujeitos alcoolistas acerca da atração e da dependência do uso de álcool
Authors: Da Silva Silvio Eder Dias , Da Cunha Natacha Mariana Farias , Vasconcelos Esleane Vilela , Alves Poliana dos Santos , Vasques Jéssica S tephanie da Silva , Araújo Jeferson Santos , Freitas Karina de Oliveira
Published: June 2015

Introdução: O consumo de álcool está relacionado a vários fatores sendo considerados fatores de risco, sem restrição de classe, idade ou sexo. A família, o meio de interação social e as propagandas são três de vários fatores que podem influenciar o consumo de bebidas alcoólicas. O risco familiar e grupo de envolvimentos são considerados importantes critérios de vulnerabilidade ao alcoolismo. Este estudo objetivou conhecer a representação social do alcoolista sobre a de sua dependência química e analisar as implicações dessa representação social para o cuidado de si. Metodologia: É um estudo é do tipo descritivo e exploratório, com base na Teoria das Representações Sociais, realizado em um Centro de Atenção Psicossocial - Álcool e Drogas, em Belém-PA, com 31 sujeitos que estavam em tratamento por dependência química. Resultados: Com a análise dos dados obtivemos resultados de duas unidades temáticas: A influência parental no interesse pelo alcoolismo que mostra o meio familiar como importante influenciador para que o sujeito inicie a beber e Fatores que influenciaram o alcoolismo na adolescência em que se mostram as características da adolescência como influenciador da experimentação do álcool. Conclusão: Durante as entrevistas, pôde-se entender que, desde o início de suas vidas, os sujeitos que se tornaram alcoólatras estiveram expostos a um meio social com integrantes alcoolista, que gerou entusiasmo para uma vida cotidiana voltada para o uso do álcool; os depoimentos expressam que a família e o período da adolescência configuraram importantes fatores para sua realidade atual.
Níveis de colinesterase como marcador de risco de distúrbios neurológicos em agentes de endemias
Authors: Lima Estelita Pereira , Esmeraldo Arthur Rafhael Amorim Alves , Costa Clarisse Estácio Trummer Leandro , Virgulino Renata Rocha , Franca Rafael Janoca , Lima Antonia Máximo de
Published: June 2015

Introdução: Alguns inseticidas utilizados em saúde pública inibem as colinesterases, levando ao acúmulo de acetilcolina nas terminações nervosas, provocando alterações no sistema nervoso central. Objetivos: Avaliar o padrão de normalidade dos níveis de colinesterase de agentes de endemias de duas Microrregionais de Saúde do Ceará. Métodos: Levantamento de dados em duas unidades do Laboratório Central de Saúde Pública (LACEN), referentes a dosagens de colinesterase de 81 agentes de endemias das 20ª e 21ª Microrregionais de Saúde, medidas entre os anos de 2014 e 2015. Os agentes eram procedentes de seis municípios, nomeados em A e B (21ª Microrregional); C, D, E e F (20ª Microrregional). Resultados: Os agentes de A encontravam-se com um nível de colinesterase médio de 7.460,8 U/L (±1.232,2 U/L), e os de B, 6.941,6 (±1.122,3 U/L). Os níveis colinérgicos dos agentes da 20ª Microrregional variavam de 3.406 U/L a 12.108 U/L, com média de 8.318 U/L (±2.334 U/L). Nove homens apresentavam alteração nos níveis colinérgicos, sendo cinco com valores abaixo do limite inferior de normalidade (4.620 U/L), quatro, acima do limite superior (11.500 U/L) e ¼ deles apresentava um nível de 4.470 U/L, uma diferença de apenas 150 unidades para a taxa mínima de normalidade. Conclusões: Constataram-se alterações nos níveis de colinesterase de 11,1% dos agentes, e aproximação do valor limítrofe inferior de normalidade em 25% dos casos, indicando a necessidade de monitoramento desses níveis e conhecimento do estado de saúde desses trabalhadores.
Legal Standards of Retirement Insurance and the Russian Actuarial Pension Plans
Authors: Zakharov Mikhail
Published: June 2015

The author considers the basic content of international instruments and the ILO Convention on minimum standards of social security and the need to take them into account in the Russian insurance pension legislation. In Russia, a higher minimum standard insurance for old age pensions is set without sufficient grounds and additional conditions for awarding such pension have been introduced, which will lead to the deprivation of the right to pension for many citizens. The author also assesses a special technique for determining the earnings replacement rate by pension suggested for Russia which does not coincide with the rules defined by the Convention, which leads to its ungrounded overrating.
Prospects of the Russian Legislation Improvement in the Sphere of Responsibility of the Government of the Russian Federation
Authors: Mamitova Nataliya , Chepus Aleksey
Published: June 2015

It is an obvious fact that under the conditions of major changes and reforming in political, legal, economic and other spheres of functioning of the Russian state, the issues of degree and levels of governmental liability to civil society for the adopted decisions come to the fore. That is why this article analyzes perspectives of parliamentary responsibility of the government, its legislative enforcement and legal regulation. The article proves that the current Russian legislation often contains the norms that are characterized by instability and inconsistency, formalizing the issues of government responsibility before the parliament; in practice, the parliament supervisory powers, carried out in relation to the government activity, look quite inconsistent. Therefore the authors offer their vision of the solution of the abovementioned problems with the aim of formation of well thought out scientific basis and development of this important constitutional law institute.
Contract System: Main Problems of Law Enforcement and Ways of their Overcoming
Authors: Byelyayeva Olga
Published: June 2015

The author analyzes institutional and practical shortcomings of the Law on contract system, in particular, legal status of pseudo-customers, examination, information disclosure, warranty obligations, the Blacklist of suppliers. The author draws the conclusion on uselessness of tightening the legislation in relation to public procurement. The author considers “conditional application of the law” to be unacceptable: the applicable law is chosen depending on the background of the origin of money. The author suggests cancellation of the institute of examining contract performance results; and establishment of accurate differentiation of contractual and post-contractual obligations. The article notes truncated application of information disclosure norms and bad regulation of the Blacklist of suppliers. The author arrives at the conclusion of uselessness of tightening the legislation in relation to procurements.
Legal Regime of Reclaimed and Improved Lands
Authors: Pysheva Elena
Published: June 2015

Reclaimed and improved lands hold a special place in the land system of the Russian Federation, which determines the specifics of their legal regime.The article explores the legal nature and content of the legal regime for such lands, identifies their differences. The author gives her own definition of the legal regime of lands. The author notes that the legal regime of the reclaimed land and land plots that form part of those lands is highly differentiated. Therefore the author indicates factors that influence this regime. And it is hydro-technical and agroforestry activities performed on those lands that produce the greatest changes in their legal regime. If lands plots that form part of any land category, are recognized as reclaimed lands, it leads to tightening of the legal regime, because these lands need to comply with strict environmental requirements. Reclaimed lands are particularly vulnerable, especially those that form part of the agricultural zones of settlement lands; that is why the legal mechanism for their protection and conservation was established. The author points out to general deterioration of their ecological state, reduction of land and proposes solutions to these problems through legal means.
Confiscation as Necessary Response to Acquisitive Crime
Authors: Golovanova Natalya
Published: June 2015

This article is dedicated to the issues of foreign successful experience in legislative regulation of asset forfeiture mechanisms resulting from offenses. Modern states increasingly use different types of confiscation to deprive criminals of any proceeds derived from their offenses. It can be confiscation with criminal conviction, non-conviction based confiscation in rem. Application of civil procedure methods transfers the burden of proof to the defendant. Though confiscation in rem cannot replace criminal forfeiture. The author concludes that at the present time there occurs transformation of different types of confiscation, their enhancement. Particular emphasis is laid on extended confiscation. This type of confiscation allows using similar methods which are used in civil proceedings. Under the influence of international laws extended confiscation is implemented and used in the European criminal law on a large scale, which demonstrates tendencies to unification. On the basis of the analysis of the legislation on forfeiture of illicit assets in several countries in recent years (Great Britain, Australia), the author concludes that there are significant changes in the traditional approach to this institution. One can say that the scope of the institution expands and undergoes modifications in various jurisdictions. Extended confiscation of an offender’s assets, if the crime was committed out of selfish motives, is a fair public response. It is necessary to introduce this type of confiscation in Russia.