bluuebunny/crossref_metadata_2025 huggingface dataset:
Orthokeratotic Bowen disease: a histopathologic, immunohistochemical and molecular study
Authors: Idriss Munir H. , Misri Rachita , Böer‐Auer Almut
Published: August 2015

Background

Some examples of Bowen disease lack the characteristic broad parakeratosis making their histopathologic diagnosis particularly difficult in small and incomplete biopsies.

Materials and Methods

The archives of our dermatopathology laboratory were searched for cases of Bowen disease with >75% orthokeratosis (orthokeratotic Bowen disease) and classic Bowen disease (>25% parakeratosis). Selected specimens were evaluated histopathologically, using immunohistochemical stains (CK10, CK7, Bcl‐2, p16 and Ki‐67) and by DNA amplification/sequencing for human papilloma virus (HPV) subtypes.

Results

Among 102 consecutive samples 14 cases of orthokeratotic Bowen disease were identified. In comparison with 24 examples of classic Bowen disease, the orthokeratotic examples occurred more frequently in female and younger patients (p = 0.04 and 0.008, respectively) but shared most of the histopathologic features of classic Bowen disease except a preserved granular layer and relative absence of the eyeliner sign (p < 0.0001 and p = 0.042, respectively). Immunohistochemical staining patterns were similar between the two groups. HPV types 11, 16 and 58 were identified from five cases of orthokeratotic Bowen disease.

Conclusion

Orthokeratotic Bowen disease is a distinct variant of squamous cell carcinoma in situ associated with HPV infection in less than half of the cases studied.
Sources of organisational resiliency during the Thailand floods of 2011: a test of the bonding and bridging hypotheses
Authors: Andrew Simon , Arlikatti Sudha , Siebeneck Laura , Pongponrat Kannapa , Jaikampan Kraiwuth
Published: August 2015

Based on the Institutional Collective Action framework, this research tests the impact of two competing hypotheses—bonding and bridging—on enhancing organisational resiliency. The bonding hypothesis posits that organisational resiliency can be achieved if an organisation works closely with others, whereas the bridging hypothesis argues that such a structure places considerable stress on an organisation and advocates for an organisation to position itself as a central actor to gain access to novel resources from a diverse set of entities to achieve resiliency. The paper analyses data gathered from semi‐structured interviews with 44 public, private, and non‐profit organisations serving communities affected by the Great Floods of 2011 in the Thai capital, Bangkok (urban), and in Pathum Thani (suburban) and Ayutthaya (rural) provinces. The findings suggest that: organisational resiliency was associated with the bridging effect; organisations in the rural province were more resilient than those in the suburban and urban centres; and private and non‐governmental organisations generally were more resilient than public sector organisations. The findings highlight the importance of fostering multi‐sector partnerships to enhance organisational resiliency for disaster response.
Classification systems of communication for use in epidemiological surveillance of children with cerebral palsy
Authors: Virella Daniel , Pennington Lindsay , Andersen Guro L , Andrada Maria da Graça , Greitane Andra , Himmelmann Kate , Prasauskiene Audrone , Rackauskaite Gija , De La Cruz Javier , Colver Allan ,   Surveillance of Cerebral Palsy in Europe Network
Published: August 2015

Aim

Children with cerebral palsy (CP) often experience communication difficulties. We aimed to identify a classification system for communication of children withCPsuitable for epidemiological surveillance.

Method

Systems to classify the communication of children withCPwere identified. The Communication Function Classification System (CFCS), Functional Communication Classification System (FCCS), and Viking Speech Scale (VSS) were chosen for further investigation and translated. They were administered to 155 children aged 4 to 13 years withCP(across all motor severity levels) from eight European countries. Children's parents/carers, speech therapists, and other health professionals applied the systems through direct observation. Other professionals applied them from case notes only. The systems were assessed for agreement, stability, ease, and feasibility of application.

Results

Test–retest stability was moderate‐to‐high forVSS(k=0.66–0.88),CFCS(k=uncomputed–0.91), andFCCS(k=0.52–0.91). Overall interrater agreement was fair to very good for every classification system.VSSachieved the best agreement between parents/carers and speech therapists.VSSwas considered the easiest instrument to apply.

Interpretation

Because of its ease of use by a range of healthcare professionals, theVSSshould be considered forCPregisters which intend to survey speech intelligibility. For a wider assessment of communication, theCFCSorFCCshould be considered.
Pattern of online communication in teaching a blended oral surgery course
Authors: Marei H. F. , Al‐Khalifa K. S.
Published: August 2015

Aim

To explore the factors that might affect the patterns of interaction amongst dental students that can be found in asynchronous online discussion fora.

Subjects and methods

It is a qualitative study that involved the participation of 71 dental students (42 male and 29 female) who belong to one academic year. Students were participated in asynchronous online discussion fora as a part of a blended oral surgery course that involved both face‐to‐face lecture and an online learning environment using the Blackboard learning management system. Qualitative analysis of students' pattern of discussion was performed using Transcript Analysis Tool.

Results

The total number of postings was 410. Sixty‐seven of 71 students participated in the discussion by writing posts, whereas all of the students had accessed all of the postings. A positive correlation between imposing vertical questions and the number of non‐referential and referential statements was observed. Regarding horizontal questions, a positive correlation was observed with the number of referential statements, whilst there was a negative correlation with the number of non‐referential statements.

Conclusion

Asynchronous online discussion fora that are integrated as a part of a whole pedagogical practice may provide an opportunity for promoting learning, especially when consideration is given to the structure of problems, timely feedback by tutors and supportive strategies within the discussion threads.
Perceived learned skills and professional development of graduates from a master in dental public health programme
Authors: Aslam S. , Delgado‐Angulo E. K. , Bernabé E.
Published: August 2015

Introduction

Assessing the impact of a training programme is important for quality assurance and further development. It also can helps with accountability and marketing purposes. This study evaluated the impact of King's College London (KCL) Master of Science programme in Dental Public Health in terms of graduates' perceived learned skills and professional development.

Methods

An online questionnaire was sent to individuals who completed successfully the KCL Master of Science programme in Dental Public Health and had a valid email address. Participants provided information on demographic characteristics, perceived learned skills (intellectual, practical and generic) and professional development (type of organisation, position in the organisation and functions performed at work before and after the programme). Learned skills' scores were compared by demographic factors in multiple linear regression models, and the distribution of responses on career development was compared using nonparametric tests for paired groups.

Results

Although all scores on learned skills were on the favourable side of the Likert scale, graduates reported higher scores for practical skills, followed by intellectual and generic skills. No differences in scores were found by sex, age, nationality or time since graduation. In terms of career development, there were significantly higher proportions of graduates working in higher education institutions and taking leadership/managerial roles in organisations as well as greater number and variety of functions at work after than before the programme.

Conclusion

This online survey shows that the programme has had a positive impact on graduates in terms of perceived learned skills and professional development.
Psychometric integrity of the Chinese Happiness Inventory among retired older people in Taiwan
Authors: Chiang Hui‐Hsun , Lin Lin , Lee Tony Szu‐Hsien
Published: August 2015

Aim

Happiness is an important indicator of mental and physical health. It has been emphasized as one kind of well‐being, and its definition varies from culture to culture. The main objective of the present study was to examine the psychometric integrity and dimensions of the Chinese Happiness Inventory (CHI) in relation to scores on Ryff's Psychological Well‐Being Scale among retired older people in Taiwan.

Methods

A cross‐sectional study was carried out at social service centers in Taipei, Taiwan. Retired adults gave informed consent from September to November 2010, and completed a package of structured questionnaires measuring happiness and psychological well‐being. Internal consistency, the factor structure of the CHI and criterion validity were assessed.

Results

Results from an exploratory factor analysis showed a three‐factor solution for the CHI. These factors were named Positive Affect, Life Satisfaction and Interpersonal Relationships. Internal consistency coefficients were 0.95 (Positive Affect), 0.91 (Life Satisfaction), 0.85 (Interpersonal Relationships) and 0.97 (total scale). The results of a canonical correlation analysis showed the presence of a strong relationship between CHI and Ryff's Psychological Well‐Being Scale (r = 0.69), and that two canonical variates could be derived from the relationship between them.

Conclusions

The results show that the CHI is a three‐dimensional scale with high reliability and validity. The construct of happiness emphasizes relationships in relation to others and environment rather than autonomy in this sample. Although the components of happiness might be similar for Positive Affect and Life Satisfaction, their weights for Interpersonal Relationships should be considered when measuring happiness in different cultures. Geriatr Gerontol Int 2016; 16: 865–872.
Molecular aspects and chemoprevention of dimethylaminoazobenzene‐induced hepatocarcinogenesis: A review
Authors: Thomas Nisha Susan , George Kiran , Namasivayam Nalini
Published: August 2015

The lipophilic azo dye dimethylaminoazobenzene (DAB) is a potent hepatocarcinogen accounted as a group‐2B carcinogen causing risk to humans. DAB is commonly used as a coloring agent in food, pharmaceuticals, beverages, soap and polishes. The exploration of DAB‐induced hepatocarcinogenesis in animal models helped to an extent to perceive the histological, biochemical and molecular mechanisms of DAB carcinogenesis and also the severity of DAB exposure to humans. In experimental animal models, it is well‐proved that the procarcinogen DAB is predominantly metabolized by cytochrome P450 enzymes giving rise to the formation of toxic electrophiles and reactive oxygen species (ROS), which further forms DNA adducts leading to the development of hepatic tumors. Recently, research evidence suggests that dietary phytochemicals and plant polyphenols are promising agents to control the incidence of DAB‐induced hepatocarcinogenesis by preventing the generation of toxic electrophiles and ROS thereby inhibiting the formation of DNA adducts. This review highlights the role of specific dietary factors, biotransformation of DAB, phenotypic and genotypic alterations, and significance of certain chemopreventive agents against DAB‐induced hepatocarcinogenesis.
Learning to teach: how a formal teaching qualification improved our practice
Authors: Lipczynska Sonya , Crowley Clare
Published: August 2015

In this article, guest writers Sonya Lipczynska and Clare Crowley from King's College London discuss the learning that occurred when they undertook a Postgraduate Certificate in Academic Practice in Higher Education (PGCAPHE). In particular, they identify how their exploration of relevant learning and teaching theory on the course helped them to evaluate their library instruction teaching practice with medical and dental students. They highlight how they made changes and improvements to the delivery of these sessions based on greater consideration of inclusivity and the characteristics of both individuals and broader student groups. They also discuss the successes of new teaching practices that they experimented with, and reflect on how they have developed as educators as a result of this.

H.S.
Predictors of the authenticity of Internet health rumours
Authors: Zhang Zili , Zhang Ziqiong , Li Hengyun
Published: August 2015

Background

The Internet is becoming an important source of health information; however, unverified health rumours may be included in health‐related search results. There is a critical need to provide health information seekers with methods that are specifically geared towards the identification of the authenticity of health rumours.

Methods

Using 453 health rumours collected from a definitive online reference of rumours in China, this study investigates which features contribute to distinguishing between true and false rumours with a logistic regression model.

Results

There are measurable differences between true and false health rumours on the Internet. The lengths of rumour headlines and statements and the presence of pictures are negatively correlated to the probability that a rumour is true, whereas a rumour is more likely to be true if it contains elements such as numbers, source cues and hyperlinks. Finally, dread health rumours are more likely to be true than wish ones.

Conclusions

Despite the growing number of studies on rumours, the identification of the authenticity of rumours has received little attention. This study proposes some rules of thumb to help online users ascertain rumour veracity and make decisions.
Analysis of NSCLC tumour heterogeneity, proliferative and 18F‐FDG PET indices reveals Ki67 prognostic role in adenocarcinomas
Authors: Del Gobbo Alessandro , Pellegrinelli Alessio , Gaudioso Gabriella , Castellani Massimo , Zito Marino Federica , Franco Renato , Palleschi Alessandro , Nosotti Mario , Bosari Silvano , Vaira Valentina , Ferrero Stefano
Published: August 2015

Aims

The role of tumour metabolic and proliferative indices in predicting non‐small‐cell lung cancer (NSCLC) patients' prognosis is unclear. We correlated fluorine 18 (18F)‐fluorodeoxyglucose (FDG)‐positron emission tomography (PET) value and Ki67 index to patients' survival, taking into account tumour heterogeneity, disease characteristics and genetic aberrations.

Methods and results

A series of 383 NSCLCs was arranged into tissue microarrays and Ki67 staining was analysed by immunohistochemistry. The maximum standardized uptake (SUVMAX) value detected by 18F‐FDG‐PET analysis was calculated over a region of interest. Large‐cell and squamous cell carcinomas had higher proliferative and metabolic activities than adenocarcinomas, and the two measures were correlated significantly. The hot‐spot Ki67 value was correlated with patients' survival and the cut‐off to discriminate patients in the survival risk groups was 20%. Ki67 hot‐spot values were greater in anaplastic lymphoma kinase (ALK) rearranged tumours. Adenocarcinomas showed the highest intratumour heterogeneity in proliferative activity and the hot‐spot Ki67 value predicted only the prognosis of patients in this group. Although tumour metabolic activity was not associated with patients' prognosis, a SUVMAX > 2 was related to nodal metastases, tumour size and grade.

Conclusions

Our results highlight how tumour heterogeneity influences evaluation of prognostic biomarkers. Our data support Ki67 evaluation to estimate NSCLC patients' prognosis, particularly for adenocarcinoma.
Advocacy networks, choice and private schooling of the poor in India
Authors: NAMBISSAN GEETHA B. , BALL STEPHEN J.
Published: August 2015

This article is about the flows of rhetorics and discourses, particularly those that advocate choice and private schooling, and the role that transnational advocacy networks play in managing and driving these flows. We explore a set of network relations between advocacy groups in the UK and the USA and local ‘choice’ advocates in India, and some of the emerging impacts of local and transnational advocacy on the politics of education and education policy in India. The network advocates school choice and private schooling as solutions to the problem of achieving universal, high‐quality primary education. Individual policy entrepreneurs are active in making these connections and circulating ideas. A complex of funding, exchange, cross‐referencing, dissemination and mutual sponsorship links the Indian choice and privatization advocacy network, and connects it to other countries in a global network for neoliberalism.
The multiplicity of citizenship: transnational and local practices and identifications of middle‐class migrants
Authors: VAN BOCHOVE MARIANNE , RUSINOVIC KATJA , ENGBERSEN GODFRIED
Published: August 2015

In this article we focus on local and transnational forms of active citizenship, understood as the sum of all political practices and processes of identification. Our study, conducted among middle‐class immigrants in Rotterdam, the Netherlands, indicates that the importance of active transnational citizenship should not be overstated. Among these immigrants, political practices are primarily focused on the local level; political practices directed to the home country appear to be quite rare. However, although transnational activities in the public sphere are rather exceptional, many immigrants do participate in homeland‐directed activities in the private sphere. If we look at processes of identification, we see that a majority of the middle‐class immigrants have a strong local identity. Many of them combine this local identification with feelings of belonging to people in their home country.
Transnational familyhood and the liquid life paths of South Americans in the UK
Authors: GIRALT ROSA MAS , BAILEY ADRIAN J.
Published: August 2015

In this article, we explore the nature of identity in the contemporary transnational family. To do this we extend lifecourse scholarship by considering Bauman's liquid modernity thesis and introducing the concept of a liquid life path. Original empirical examples drawn from our work among South American migrants and their families living in London and northern England illustrate diverse patterns of identification; everyday practices and social norms associated with maintaining split families, including parenting and remitting, coalesce around liquid life paths. We describe how these life paths turn on and reproduce a set of spatial and temporal imaginaries. We also reflect on the implications of these fluid imaginaries for our understanding of transnational familyhood.
Tangible transnational links in the houses of Italian immigrants in Melbourne
Authors: LEVIN IRIS , FINCHER RUTH
Published: August 2015

The transnational immigrant home is understood analytically, in an extensive literature, as a mobile construct that is not necessarily confined in its application to a single locale or building. The home has significant symbolic meaning for transnationals, as well as referring to their places of residence. In this study, however, we explore the physical structure of the transnational immigrant home and its materiality – the house. We examine two distinct types of homes of Italian immigrants in Melbourne – their past houses in Italy and their current houses in Melbourne. We argue that these houses form tangible links within Italian–Australian social space, and are parts of a network that constructs this transnational space. It is necessary to consider the actual materiality of such houses in order to extend the common understanding of ‘home’, seeing it not only as an abstract idea but also as a specifically located tangible structure and an active participant in the formation of transnational social spaces.
STRATEGIC THERAPY, ECLECTICISM, AND THE THERAPEUTIC RELATIONSHIP
Authors: Duncan Barry L.
Published: August 2015

Although profoundly influencing the family field by highlighting the deficiencies of pathology‐based views, strategic therapy has come under fire in two general areas: (a) adherence to a “black box” philosophy that discounts the value of intrapersonal phenomena; and (b) interventions that appear exceedingly instrumental, manipulative, and based on a position of therapist power. This article will examine these criticisms in light of the rise of eclecticism and the resurgence of the primacy of the therapeutic relationship. It will be argued that if strategic therapy is to remain viable, it must evolve to include the contributions of other models and consider the relationship context from which intervention arises.
THE PROBLEM OF STRATEGY WITHIN THE SYSTEMIC THERAPIES*
Authors: Held Barbara S.
Published: August 2015

Strategic principles, because they imply therapist power and influence, have become an object of debate within the systemic therapy movement. This article examines a variety of positions taken in that debate, focusing particularly on those expressed by the other members of the 1990 AAMFT panel “Twists and Turns in Strategic Therapy,” namely, Harold Goolishian, Insoo Berg, and Barry Duncan. By considering strategic therapy in terms of the distinction between therapeutic process and content and the distinction between realist and antirealist epistemologies, it is argued that there is more convergence among the proponents of those positions than their writings might have us believe.
Does nest predation risk affect the frequency of extra‐pair paternity in a socially monogamous passerine?
Authors: Yuta Teru , Koizumi Itsuro
Published: August 2015

While considerable variations in both the frequency of extra‐pair paternity (EPP) and the behavioral events that produce it are recognized among species, populations, individuals, and breeding attempts, the determinants of these variations are surprisingly difficult to establish. Nest predation may be one such determinant, since it is the most important source of reproductive failure, and past studies have suggested a variety of reproductive flexibilities under nest predation risk. However, despite its potentially significant effect on mating behaviors, nest predation risk has rarely been discussed in association with variations in intraspecific EPP patterns. Here, we examined the effect of naturally occurring nest predation, which varied between sites, years, and breeding attempts, on patterns of EPP in 92 broods (132 adults and 710 nestlings) of the Japanese great tit Parus major minor. We found that the frequency of extra‐pair offspring was positively correlated with the nest predation rate, along with a correlation to breeding attempts in a season, but not with other factors such as individual quality or breeding density. Under high nest‐predation risk, it may be adaptive for males to search for additional extra‐pair copulation to spread the risk of losing all offspring and to invest less in mate‐guarding, which also enables females to seek additional extra‐mating. The results of this study suggest that nest predation risk, among other factors, may significantly influence paternity allocation in birds.
Comparative demographics of a Hawaiian forest bird community
Authors: Guillaumet Alban , Woodworth Bethany L. , Camp Richard J. , Paxton Eben H.
Published: August 2015

Estimates of demographic parameters such as survival and reproductive success are critical for guiding management efforts focused on species of conservation concern. Unfortunately, reliable demographic parameters are difficult to obtain for any species, but especially for rare or endangered species. Here we derived estimates of adult survival and recruitment in a community of Hawaiian forest birds, including eight native species (of which three are endangered) and two introduced species at Hakalau Forest National Wildlife Refuge, Hawaiʻi. Integrated population models (IPM) were used to link mark–recapture data (1994–1999) with long‐term population surveys (1987–2008). To our knowledge, this is the first time that IPM have been used to characterize demographic parameters of a whole avian community, and provides important insights into the life history strategies of the community. The demographic data were used to test two hypotheses: 1) arthropod specialists, such as the ‘Akiapōlā‘auHemignathus munroi, are ‘slower’ species characterized by a greater relative contribution of adult survival to population growth, i.e. lower fecundity and increased adult survival; and 2) a species’ susceptibility to environmental change, as reflected by its conservation status, can be predicted by its life history traits. We found that all species were characterized by a similar population growth rate around one, independently of conservation status, origin (native vs non‐native), feeding guild, or life history strategy (as measured by ‘slowness’), which suggested that the community had reached an equilibrium. However, such stable dynamics were achieved differently across feeding guilds, as demonstrated by a significant increase of adult survival and a significant decrease of recruitment along a gradient of increased insectivory, in support of hypothesis 1. Supporting our second hypothesis, we found that slower species were more vulnerable species at the global scale than faster ones. The possible causes and conservation implications of these patterns are discussed.
Chemical defence in avian brood parasites: production and function of repulsive secretions in common cuckoo chicks
Authors: Trnka Alfréd , Požgayová Milica , Procházka Petr , Capek Miroslav , Honza Marcel
Published: August 2015

The use of active chemical defence against predators is relatively rare in birds. Among others, it has been reported for some members of family Cuculidae whose chicks, when threatened, expel dark foul‐smelling liquid from their cloaca. Apart from the brood parasitic great spotted cuckoo Clamator glandarius, however, this phenomenon has not yet been systematically studied in any other cuckoo species. Here we investigated the repellent behaviour in the evicting brood parasite, the common cuckoo Cuculus canorus, parasitizing the great reed warbler Acrocephalus arundinaceus. We explored whether production of secretions varies with chick age or size, and tested its presumed repellent function against various types of predators. We found that the production of secretions commenced at the age of approximately eight days, then gradually increased and decreased again shortly before fledging. Furthermore, we experimentally confirmed a more intensive repellent effect of the secretions on mammal predators than on avian predators, such as raptors and owls. The secretions have, however, no effect on corvid predators, probably because these scavengers often consume malodorous food. Further experimental studies together with phylogenetic comparative analyses are needed to elucidate the origin and function of this intriguing phenomenon both in parasitic and non‐parasitic cuckoos.
New Caledonia: a Pleistocene refugium for rain forest lineages of relict angiosperms
Authors: Pouteau Robin , Trueba Santiago , Feild Taylor S. , Isnard Sandrine
Published: August 2015

Aim

In New Caledonia, relictual angiosperm lineages are over‐represented. However, the mechanisms responsible for such a distribution remain unclear. Two key hypotheses are that: (1) the diversity reflects adaptation to ultramafic substrates that ecologically filtered plant colonists; and (2) the diversity stems from wet climatic conditions that have persisted in New Caledonia during the late Quaternary while Australia and some nearby islands experienced widespread extinction events. Here, we investigate which hypothesis better explains the disharmony of relict angiosperms in New Caledonia.

Location

New Caledonia (South West Pacific Ocean).

Methods

We built species distribution models from herbarium data to determine the environmental correlates for 60 relict angiosperm taxa. Environmental variables used to characterize habitats included vegetation, substrate, and climate variables. We then tested whether the variety of xylem conduit structures borne by New Caledonian relict angiosperms, which is expected to affect plant hydraulic capacity, was correlated with habitat preference. Finally, we analysed species prevalence on different substrates and projected habitat size and distribution to the Last Glacial Maximum (LGM).

Results

We found a clear habitat preference among relict angiosperms for rain forests located on non‐ultramafic substrates, with the exception of taxa bearing true vessels with simple perforation plates, which harboured a wider habitat breadth. We also showed that these rain forest habitats experienced a range reduction and an eastward shift during the LGM, forming two refugial areas located on the warm and rainy east coast of Grande Terre.

Main conclusions

Prevalence of relict angiosperms in habitats characterized by low evaporative demand appears to be related to xylem hydraulic limitations. The disharmony of relict angiosperms in New Caledonia therefore arose from the persistence of rain forests in the island despite global fluctuations in climate during the Quaternary that affected floras in the region. Our study offers a new model to explain why certain angiosperm families are disharmonically represented in New Caledonia.
Human papillomavirus status, anal cytology and histopathological outcome in HIV‐positive patients
Authors: Dietrich A. , Hermans C. , Heppt M.V. , Ruzicka T. , Schauber J. , Reinholz M.
Published: August 2015

Background

Human papillomavirus (HPV) are responsible for a broad spectrum of mucocutaneous infections and may cause squamous cell carcinoma following long‐standing infection . Oncogenic HPV, most commonly HPV 16, are detectable in over 90% of cervical intraepithelial neoplasia and anal intraepithelial neoplasia (AIN). Human immunodeficiency virus (HIV) infection is strongly associated with a higher prevalence of chronic HPV infection, a higher incidence of AIN and an increased risk for anal cancer (AC). In September 2013, guidelines concerning prevention, screening and treatment of AIN for patients affected by HIV were issued by the German AIDS society.

Objective

In order to validate the suggested screening procedure, we analysed data from 123 male and female patients with HIV infection that regularly present in our outpatient clinic.

Methods

Anal cytology, HPV typing and high‐resolution anoscopy (HRA) were performed.

Results

Our results show that screening by anal cytology only identifies a minority of patients with high grade AIN (AIN 3) histology. Patients with normal cytology (NILM, cytology graded negative for intraepithelial lesion or malignancy; n = 5, 29.4%), atypical squamous cells of undetermined significance (ASCUS; n = 5, 71.4%) and low grade squamous intraepithelial lesion (LSIL; n = 8, 44.5%) showed highly dysplastic lesions (AIN 2 and 3) in the histological workup more frequently than expected. Additionally, high‐grade squamous intraepithelial lesion (HSIL) was strongly associated with detection of high‐risk oncogenic HPV.

Conclusion

Anal cytology as the solitary screening tool for anal cancer fails to detect anal dysplasia in a considerable number of patients. Additionally, HPV typing and possibly further biomarkers might be applied to identify those patients with a higher risk of developing anal carcinoma, in order to monitor them more closely or directly transfer them to HRA.
Differences in patient and physician assessment of a dynamic patient reported outcome tool for chronic pruritus
Authors: Fritz F. , Blome C. , Augustin M. , Koch R. , Ständer S.
Published: August 2015

Background

Chronic pruritus is a subjective symptom, mainly measured through patient reported outcomes. Our aim is to assess two different methods regarding the change of symptoms: a visual dynamic pruritus score (vDPS) documented by patients, and a numerical value (nDPS) documented by physicians.

Methods

Inferential statistics and reliability analyses have been performed on data collected in 2013.

Results

Data of 701 patients were analysed (45.6% males, 54.4% females, mean age 60 ± 16 years). The nDPS showed less extreme and generally lower values than the vDPS. There was a slight concordance between both methods; the highest concordance was seen for no/weak change and very good reduction.

Conclusion

The difference between patient and physician assessed same score points to an important bias in pruritus assessment which has to be taken into account especially in clinical trials. Though further studies are needed, the patient‐based assessment seems to be less biased by a social desirability effect.
Inhibition of 2-methoxyestradiol glucuronidation by probenecid
Authors: Qian Yuli , Sherbini Ahmad , Matin Bahar , Zhao Yanli , Castellot John , Greenblatt David J
Published: August 2015

Objectives

2-Methoxyestradiol (2ME2), a metabolite of estradiol, has antitumour activity in vitro. However, potential clinical applicability has been limited by low oral bioavailability. Probenecid was evaluated in vitro as an inhibitor of 2ME2 glucuronidation for purposes of enhancing 2ME2 oral bioavailability.

Methods

Human liver microsomes were used to determine kinetic parameters for transformation of 2ME2 to its glucuronide metabolites (M1, M2) and inhibition of the reactions by probenecid.

Key findings

M1 and M2 formation from 2ME2 proceeded with features of substrate inhibition. Probenecid inhibited metabolite formation, with mean inhibition constant (Ki) values of 0.9 and 2.6 mM, respectively. Inhibition was reversible, with mixed competitive–non-competitive characteristics.

Conclusion

The Ki values for probenecid inhibition of 2ME2 glucuronide formation, when compared to maximum probenecid plasma concentrations anticipated clinically, indicate that probenecid co-administration has the potential to augment systemic plasma levels of 2ME2 after oral dosage in humans.
Mechanistic insight into the dramatic improvement of probucol dissolution in neutral solutions by solid dispersion in Eudragit E PO with saccharin
Authors: Higashi Kenjirou , Seo Atsunori , Egami Kiichi , Otsuka Naoya , Limwikrant Waree , Yamamoto Keiji , Moribe Kunikazu
Published: August 2015

Objectives

Solid dispersion using Eudragit E PO (EPO) improves the dissolution of poorly water-soluble drugs in acidic solutions; however, the dissolution extremely decreases in neutral solutions. In this report, ternary solid dispersions containing probucol (PBC), EPO, and saccharin (SAC) were prepared to enable high drug dissolution at neutral pH.

Methods

Cryogenic-grinding was used to obtain ternary solid dispersions. Dissolution tests at neutral pH values were conducted to confirm the usefulness of the cryogenic-ground mixture (cryo-GM). The molecular state of each component and intermolecular interactions in the ternary cryo-GM were evaluated using powder X-ray diffraction (PXRD) and 13C solid-state NMR including spin-lattice relaxation time evaluation.

Key findings

PBC dispersed in ternary cryo-GM had an improved dissolution in neutral solutions. PBC and SAC were in amorphous states in EPO polymer matrices. The weak hydrophobic interaction between PBC and EPO and the ionic bond or hydrogen bond between EPO and SAC were demonstrated. These two molecular interactions improved the dissolution of PBC in neutral solutions.

Conclusion

Preparation of ternary solid dispersion is a potential method of improving drug solubility and absorption.
Use of Hormone Testing for the Diagnosis and Evaluation of Male Hypogonadism and Monitoring of Testosterone Therapy: Application of Hormone Testing Guideline Recommendations in Clinical Practice
Authors: Muram David , Zhang Xiang , Cui Zhanglin , Matsumoto Alvin M.
Published: August 2015

Introduction

Clinical practice guidelines recommend that testosterone (T) levels be measured on ≥2 occasions to confirm a diagnosis of hypogonadism, gonadotropins be measured to determine whether hypogonadism is primary or secondary, and T levels be measured to monitor the adequacy of T therapy. However, it is not known whether hormone testing as recommended by guidelines is routinely performed in real-world clinical practice.

Aim

The aim of this study was to assess the use of hormone testing for the diagnosis and evaluation of hypogonadism and monitoring of T therapy in clinical practice.

Methods

In this retrospective cohort study of the Truven Health Marketscan® Commercial and Medicare Supplemental Insurance Databases during 2010–2012, 63,534 men over 18 years old who received T therapy and had continuous medical benefit enrollment for 1 year prior to and 6 months after T therapy initiation were included in this analysis.

Main Outcome Measures

Proportion of patients who received ≥2, 1, or no T-level determinations prior to or following T therapy initiation.

Results

Seventy-one percent of hypogonadal men had T measured at least once and 40% had ≥ 2 tests, but only 12% of men had luteinizing hormone and/or follicle-stimulating hormone levels measured prior to T therapy initiation. Following T therapy initiation, 46% had ≥1 follow-up T measurements.

Conclusions

Appropriate use of T and gonadotropin levels in clinical practice as recommended by guidelines is suboptimal, increasing the possibility of overdiagnosis of male hypogonadism, underdiagnosis of secondary hypogonadism, and inappropriate T therapy use and management. Further investigation is needed into reasons for nonadherence to guidelines for appropriate hormone testing to inform future quality improvement efforts.
Sensitivity and Specificity of the Phallometric Test for Hebephilia
Authors: Cantor James M. , McPhail Ian V.
Published: August 2015

Introduction

The phallometric test has been examined most widely in the literature with regard to its ability to detect pedophilia; however, it has become of increasing interest to clinicians and researchers to ascertain to what extent the test accurately detects hebephilia: Whereas pedophilia refers to an adult's sexual interest in prepubescent children (age 10 or younger, on average), hebephilia refers to an adult's sexual interest in pubescent children (ages 11–14, on average).

Aim

The aim of this study was to estimate the accuracy of volumetric phallometry in distinguishing pedophilic men and hebephilic men from men who are teleiophilic (primarily sexually interested in adults, age 17 or older).

Methods

A retrospective chart review was conducted on the cumulate database of a large phallometric laboratory and clinic to identify a group of 239 men who committed sexual offenses against extrafamilial adults age 17 or older and a group of 996 men who committed sexual offenses against extrafamilial children age 14 or younger, all of whom professed a greater sexual interest in adults over children.

Main Outcome Measures

The sensitivity and specificity of the phallometric test is calculated for its accuracy in distinguishing sexual preferences for children spanning various age ranges.

Results

Receiver operator characteristic curves were highly significant for each classification decision: Using its previously established cut-point of +0.25 standard deviation (SD) units, the phallometric test detected hebephilia with a sensitivity and specificity of 70.0% and 90.7%, detected pedophilia with 46.9% and 100%, and detected pedohebephilia with 75.3% and 90.7%. At a new cut-point of +0.0 SD units, the sensitivity and specificity of the test for pedophilia was 71.9% and 95.3%.

Conclusions

Volumetric phallometry significantly distinguishes teleiophilic sex offenders from each of pedophilic, hebephilic, and pedohebephilic sex offenders and can serve as a reliable diagnostic test of sexual age preference among men who deny sexual interest in children.
Dramatic increase in sea otter mortality from white sharks in California
Authors: Tinker M. Tim , Hatfield Brian B. , Harris Michael D. , Ames Jack A.
Published: August 2015

Although southern sea otters (Enhydra lutris nereis) are not considered prey for white sharks (Carcharodon carcharias), sharks do nonetheless bite sea otters. We analyzed spatial and temporal trends in shark bites on sea otters in California, assessing the frequency of shark bite wounds in 1,870 carcasses collected since 1985. The proportion of stranded sea otters having shark bites has increased sharply since 2003, and white shark bites now account for >50% of recovered carcasses. The trend was most pronounced in the southern part of the range, from Estero Bay to Point Conception, where shark bite frequency has increased eightfold. Seasonal trends were also evident: most shark‐bitten carcasses are recovered in late summer and fall; however, the period of elevated shark bite frequency has lengthened. The causes of these trends are unclear, but possible contributing factors include increased white shark abundance and/or changes in white shark behavior and distribution. In particular, the spatiotemporal patterns of shark‐bitten sea otters match increases in pinniped populations, and the increased availability of marine mammal prey for white sharks may have led to more sharks spending more time in nearshore waters utilized by both sea otters and pinnipeds.
Glycaemic control is a predictor of infection‐related hospitalization on haemodialysis patients: Miyazaki Dialysis Cohort study (MID study)
Authors: Toida Tatsunori , Sato Yuji , Nakagawa Hideto , Komatsu Hiroyuki , Kikuchi Masao , Uezono Shigehiro , Yamada Kazuhiro , Ishihara Tabito , Hisanaga Shuichi , Kitamura Kazuo , Fujimoto Shouichi
Published: August 2015

Aim

Although infection is the second leading cause of death in maintenance haemodialysis patients, the effects of glycaemic control on infection in diabetic haemodialysis patients have not yet been examined in detail. We examined the relationship between diabetes or glycemic control and infection‐related hospitalization (IRH) in haemodialysis patients.

Methods

Patients receiving maintenance haemodialysis (n = 1551, 493 diabetic patients) were enrolled in this prospective cohort study in December 2009 and followed‐up for 3 years. IRH during the follow‐up period was abstracted from medical records. Kaplan–Meier and Cox regression analyses were used to investigate the relationship between diabetes or glycaemic control and IRH.

Results

The Kaplan–Meier analysis revealed that the risk of IRH was significantly higher in haemodialysis patients with diabetes, particularly in those with poorly controlled HbA1c levels (HbA1c ≥ 7.0%), than in haemodialysis patients without diabetes. When patients with ≥HbA1c 7.0% were divided into two groups using a median value of HbA1c, the risk of IRH was significantly higher in those with the poorest glycaemic control (HbA1c ≥ 7.4%), an older age, or lower albumin levels. The multivariable‐adjusted hazard ratio for the risk of IRH was not higher in the second criteria of HbA1c (HbA1c 7.0–7.3%), but was significantly higher in the group with the poorest glycaemic control (HbA1c ≥ 7.4%) than in those in the good control criterion (HbA1c < 7.0%).

Conclusions

Although diabetes is a risk factor for IRH among maintenance haemodialysis patients, the relationship between glycaemic control and the risk of infection is not linear. Therefore, the risk of infection may increase in a manner that is dependent on the glycaemic control threshold.
Effect of colestilan on serum phosphorus in dialysis patients: A meta‐analysis of the literature
Authors: Zhang Qian , Li Ming , Chen Jing
Published: August 2015

Aim

To evaluate the efficacy and safety of colestilan as a phosphorus binder in dialysis patients, we performed a meta‐analysis of randomized controlled trials.

Methods

We retrieved studies that compared colestilan with placebo in the treatment of dialysis patients from Medline, EMBASE, the Cochrane Library and conference proceedings.

Results

Four studies were included. The treatment durations ranged from 2 to 12 weeks, median 7.5 weeks. Compared with placebo group, colestilan significantly decreased serum phosphorus (WMD, −0.22 mmol/L; 95% CI, −0.33 to −0.12, P < 0.0001), calcium phosphorus product (WMD, −0.70 mmol2/L2; 95% CI, −1.06 to −0.35, P = 0.0001), intact PTH (WMD, −5.37 pmol/L; 95% CI, −8.38 to −2.36, P = 0.0005) and LDL cholesterol (WMD, −0.78 mmol/L; 95% CI, −0.85 to −0.71, P < 0.00001). There was no significant difference in serum calcium between the two groups. Colestilan therapy increased gastrointestinal complaints significantly (OR = 4.07, 95% CI: 3.06–6.53, P < 0.00001). Sensitivity analysis was performed by excluding studies with Jadad score of three or 3 g/day colestilan, the results did not change.

Conclusions

Short‐term administration of colestilan is effective for the treatment of hyperphosphataemia in dialysis patients. Long‐term effectiveness and safety needs to be evaluated.
Characterization of the placoderm (Gnathostomata) assemblage from the tetrapod‐bearing locality of Strud (Belgium, upper Famennian)
Authors: Olive Sébastien , Clément Gaël , Daeschler Edward B. , Dupret Vincent
Published: August 2015

The placoderm fauna of the late Famennian tetrapod‐bearing locality of Strud, Belgium, is studied on the basis of historical and newly collected material. It includes the previously described antiarch Grossilepis rikiki, the groenlandaspidid Turrisaspis strudensis sp. nov. and the actinolepidoideid Phyllolepis undulata. P. undulata is thoroughly described and joins the list of the valid Phyllolepis species confidently diagnosed. A morphometrical analysis performed on the centronuchal and anterior ventrolateral plates of the Phyllolepis material demonstrates that there is only one species of Phyllolepis in Belgium (thus, Phyllolepis konincki becomes a junior synonym of P. undulata), that P. rossimontina (Pennsylvania) is a synonym of P. undulata and that the unity of the genus Phyllolepis is strongly supported, although the characterization of several species within this genus is blurred. The strong resemblance between the faunal compositions in Strud and Red Hill (Pennsylvania, USA) suggests important faunal exchanges between these regions of the Euramerica landmass.
Primary pulmonary angiosarcoma: A case report
Authors: Tanaka Hiroyuki , Yorita Kenji , Takahashi Nobuyasu , Usuma Yasuhiro , Nakamura Kunihide , Kataoka Hiroaki
Published: August 2015

Primary sarcoma is uncommon in the lung, and primary angiosarcoma is exceedingly rare. We report a case of primary pulmonary angiosarcoma of the left lung with emphasis on its growth pattern in the lung. A 48‐year‐old Japanese man was admitted to our hospital because of dyspnea on exertion. He was subsequently found to have left pleural effusion. Computed tomography shows a nodular lesion measuring 7 × 4 cm in his left lung. Obstruction of the left inferior lobar bronchus was observed, and endobronchial biopsy suggested angiosarcoma. Left pneumonectomy was performed. On macroscopic examination of the cut surface, multiple nodular lesions were observed particularly in portions around branches of pulmonary artery along bronchioles. Histological examination revealed vascular channel‐like structure with vague lumen formations by atypical polygonal or spindle‐shaped neoplastic cells. Immunohistochemically, the neoplastic cells are positive for FLI‐1, ERG, CD31 and von Willebrand factor/factor VIII‐related antigen, but not CD34. Angiosarcoma is a particularly rare form of primary pulmonary tumors, and this case report describes its unique macroscopic growth pattern in the lung.