bluuebunny/crossref_metadata_2025 huggingface dataset:
Disparities in initial presentation and treatment outcomes of diabetic foot ulcers in a public, private, and Veterans Administration hospital (在公立、私立以及退伍军人管理局医院中的糖尿病足溃疡的最初表现与治疗结果的差异)
Authors: Blumberg Sheila N. , Warren Stephen M.
Published: April 2013

Background

Disparities in diabetic foot ulcer (DFU) treatment outcomes are well described, although few studies identify risk factors contributing to disparate healing and amputation rates. In a unique academic center serving urban public, private, and veteran patients, we investigated amputation and healing rates and specific risk factors for disparate treatment outcomes.

Methods

A retrospective chart review of diabetic patients with a new diagnosis of a foot ulcer at geographically adjacent, but independent public, private, and Veterans Administration (VA) hospitals was conducted. Healing and lower extremity amputation outcomes were assessed.

Results

Across the three hospitals, 234 patients met the inclusion criteria. Patients at the VA hospital were older (mean 72.5 years; P < 0.001) and had gangrenous ulcers (mean 14.1%; P < 0.001) compared with patients in the private and public hospitals. Public hospital patients were mostly Hispanic (mean 54%; P < 0.001) with a shorter duration of diabetes (mean 12.8 years; P = 0.02), but were more poorly controlled than VA and private hospital patients (P ≤ 0.001). Prior amputation (odds ratio [OR] 1.97; P = 0.016) and non‐Caucasian race (OR 2.42; P = 0.004) increased the risk of amputation on multivariate analysis. Osteomyelitis (P = 0.0371) and gangrene (P < 0.001) are independent risk factors for amputation. Across all three hospitals, 42.3% of patients were treated by amputation (6.8% private, 12% public and 23.5% VA; P < 0.001).

Conclusion

In a single triumvirate health care system where the patient population is stratified primarily by insurance, VA patients have significantly higher amputation rates compared with patients at adjacent private and public hospitals. The VA patients are largely racial minorities with advanced DFU progression to gangrenous ulcers.
Breast cancer survival of Hispanic women in the USA is influenced by country of origin
Authors: Chakraborty Subhankar , Smith Lynette , Ganti Apar Kishor , Bonthu, Neelima , Shimizhu Tomohiro , Batra Surinder K
Published: April 2013

Aim

People of Hispanic origin comprise nearly 16 percent of the (US) population. With the growing population of Hispanics in the USA, an important epidemiological question is whether their country of origin affects survival in Hispanic women living in the USA at the time of diagnosis of breast cancer.

Methods

We searched the Surveillance Epidemiology and End Results (SEER) database for Hispanic women with a single primary breast cancer with known country of origin diagnosed between 1973 and 2008. Univariate and multivariate analyses were performed to evaluate whether the country of origin was an independent predictor of survival.

Results

In total, 48 849 female breast cancer patients of Hispanic origin were included in the SEER database. Nearly 23 percent of them had an origin in Mexico, 9 percent in South or Central America 3 percent in Puerto Rico, 2 percent in Cuba, 0.3 percent in the Dominical Republic and 3 percent in other countries, including Europe. About 60 percent of patients were identified as Hispanic by their surname or classified as Spanish/Hispanic not otherwise specified. Median survival of patients in these groups was 204, 240, 142, 169, 82.4, 115.5 and 210 months, respectively (P < 0.0001 by log–rank test). Univariate and multivariate analysis showed that the country of origin was an independent predictor of survival in Hispanic women with breast cancer.

Conclusion

The country of origin is an independent predictor of overall survival among Hispanic women diagnosed with breast cancer.
Fruit and vegetable intake and prostate cancer risk: A meta‐analysis
Authors: Meng Hongzhou , Hu Wenyi , Chen Zhaodian , Shen Yuehong
Published: April 2013

Aims

Recent reports have examined the effect of fruit and vegetable intake on the risk of prostate cancer, but the results are inconsistent. A meta‐analysis of prospective studies was conducted to arrive at quantitative conclusions about the contribution of vegetable and fruit intake to the incidence of prostate cancer.

Methods

A comprehensive, systematic search of medical literature published up to June 2012 was performed to identify relevant studies. Separate meta‐analyses were conducted for fruit and vegetable consumption. The presence of publication bias was assessed using Egger and Begg tests.

Results

In total, 16 cohort studies met the inclusion criteria and were included in the meta‐analysis. The combined adjusted relative risk comparing highest with lowest categories showed that there was no association between vegetable and fruit consumption and prostate cancer incidence. The pooled relative risk was 0.97 (95%CI 0.93, 1.01) for vegetables and 1.02 (95%CI 0.98, 1.07) for fruit. There is no heterogeneity between the studies. No publication bias was detected.

Conclusion

This meta‐analysis suggests that total fruit or vegetable consumption may not exert a protective role in the risk of prostate cancer.
The corpus‐predominant gastritis index may serve as an early marker of Helicobacter pylori‐infected patients at risk of gastric cancer
Authors: Tsai Y.‐C. , Hsiao W.‐H. , Yang H.‐B. , Cheng H.‐C. , Chang W.‐L. , Lu C.‐C. , Sheu B.‐S.
Published: April 2013

Background

To eradicate Helicobacter pylori before the occurrence of precancerous changes is important to prevent gastric carcinogenesis.

Aim

To validate whether the corpus‐predominant gastritis index (CGI) can serve as an early marker to identify the H. pylori‐infected patients at risk of gastric carcinogenesis.

Methods

This study enrolled 188 subjects, including 43 noncardiac gastric cancer patients, 63 of their first‐degree relatives and 82 sex‐ and age‐matched duodenal ulcer patients as controls. All received endoscopy to provide topographic gastric specimens to test for H. pylori infection and its related histological features, translated into the operative link on gastritis assessment (OLGA), operative link on gastric intestinal metaplasia assessment (OLGIM) stages, and the presence of CGI. Spasmolytic polypeptide‐expressing metaplasia (SPEM) was assessed by immunohistochemistry staining of trefoil factor 2.

Results

Gastric cancer patients had higher prevalence of CGI and OLGIM stage II–IV, but not OLGA stage II–IV, than the controls (P = 0.001, OR = 3.4[95% CI: 1.4–8.1] for CGI; OR = 5.0[95% CI: 2.0–12.8] for OLGIM). In patients with the combined presence of CGI and OLGIM stage II–IV, the risk of gastric cancer increased to 9.8 (P < 0.001). The first‐degree relatives of the gastric cancer patients had a higher rate of the presence of CGI, but not OLGA or OLGIM stage II–IV than the duodenal ulcer controls (P = 0.001). Of the first‐degree relatives, the presence of CGI increased the risk of SPEM (P = 0.003, OR = 5.5[95% CI: 1.8–17.0]).

Conclusion

The corpus‐predominant gastritis index, which is highly correlated to SPEM, may serve as an early marker to identify the H. pylori‐infected patients at a higher risk of gastric cancer.
Bidirectional relationships between cigarette use and spinal pain in adolescents accounting for psychosocial functioning
Authors: Gill Davinder K. , Davis Melissa C. , Smith Anne J. , Straker Leon M.
Published: April 2013

Objectives

The objective of this study was to determine the presence of possible bidirectional causal pathways between cigarette use and spinal pain in adolescents controlling for psychosocial functioning, using a prospective longitudinal research design.

Design

The data for this study was collected from a cohort of Australian adolescents at 14 (n = 1596) and 17 (n = 1291) years of age.

Methods

Multivariable logistic regression was used to assess i) if cigarette use at 14 predicted low back pain (LBP), mid back pain (MBP) or neck shoulder pain (NSP) at 17 in those adolescents without each condition at 14, and ii) if back pain only (BP), neck shoulder pain only (NSP) or comorbid BP and NSP at 14 predicted cigarette use at 17 in those adolescents who did not smoke at 14.

Results

After controlling for psychosocial factors, cigarette use at 14 predicted MBP at 17 (OR = 3.05, p = 0.049, 95% CI [1.01‐9.24]). BP only at 14 was a significant risk factor for smoking at 17 (OR = 1.84, p = 0.006, 95% CI [1.19‐2.84]) after controlling for psychosocial factors.

Conclusion

The findings indicate that there are bi‐directional relationships between cigarette use and spinal pain and that these relationships vary with pain location.

Statement of contribution

What is already known about the subject? Cigarette use, psychosocial problems and spinal pain are common in adolescents and evidence suggests bi‐directional relationships.

What does this study add?

Cigarette use, psychosocial problems and spinal pain are correlated in adolescents.

BP only at 14 years of age predicted cigarette use at 17 years of age after controlling for psychosocial factors.

Cigarette use at 14 years of age predicted mid BP at 17 years of age after controlling for psychosocial factors.
Robot‐assisted laparoscopic artificial urinary sphincter insertion in men with neurogenic stress urinary incontinence
Authors: Yates David R. , Phé Véronique , Rouprêt Morgan , Vaessen Christophe , Parra Jérôme , Mozer Pierre , Chartier‐Kastler Emmanuel
Published: April 2013

Objective

To describe for the first time the technique of robot‐assisted artificial urinary sphincter (R‐AUS) insertion in male patients with neurogenic incontinence.

Materials and Methods

From January 2011 to the present date, six patients with spinal cord injury have undergone R‐AUS insertion at our academic institution and we have prospectively collected data on pre‐, peri‐ and early postoperative outcomes.

A transperitoneal five‐port approach was used using a three‐arm standard da Vinci® robot (Intuitive Surgical, Sunnyvale, CA, USA) in a 30° reverse Trendelenburg position.

The artificial urinary sphincter (AUS) cuff was placed circumferentially around the bladder neck, the reservoir was left intra‐abdominally in a lateral vesicular space and the pump was placed in a classic scrotal position.

Results

All six patients had successful robotic implantation of the AUS.

The median patient age was 51.5 years, the median (range) operating time was 195 (175–250) min with no significant blood loss or intra‐operative complications. The median (range) length of hospital stay was 4 (4–6) days.

At a median (interquartile range) follow‐up of 13 (6–21) months, all six patients had a functioning device with complete continence.

To date, we have observed no incidence of early erosion, device infection or device malfunction.

Conclusions

Allowing for the preliminary nature of our data, R‐AUS insertion appears safe and technically feasible.

Larger studies with long‐term follow‐up and comparison with open AUS insertion are necessary before definitive statements can be made for R‐AUS in respect of complications and functional outcomes.
The European Association of Urology Robotic Urology Section (ERUS) survey of robot‐assisted radical prostatectomy (RARP)
Authors: Ficarra Vincenzo , Wiklund Peter N. , Rochat Charles Henry , Dasgupta Prokar , Challacombe Benjamin J. , Sooriakumaran Prasanna , Siemer Stefan , Suardi Nazareno , Novara Giacomo , Mottrie Alexandre
Published: April 2013

Objective

To evaluate surgeons adherence to current clinical practice, with the available evidence, for robot‐assisted radical prostatectomy (RARP) and offer a baseline assessment to measure the impact of the Pasadena recommendations. Recently, the European Association of Urology Robotic Urology Section (ERUS) supported the Pasadena Consensus Conference on best practices in RARP.

Subjects and Methods

This survey was performed in January 2012. A specific questionnaire was sent, by e‐mail, to 145 robotic surgeons who were included in the mailing‐list of ERUS members and working in different urological institutions.

Participating surgeons were invited to answer a multiple‐choice questionnaire including 24‐items evaluating the main RARP surgical steps.

Results

In all, 116 (79.4%) invited surgeons answered the questionnaire and accepted to participate to the ERUS survey.

In all, 47 (40.5%) surgeons performed >100 RARPs; 41 (35.3%) between 50 and 100, and 28 (24.1%) <50 yearly.

The transperitoneal, antegrade technique was the preferred approach.

Minimising bladder neck dissection and the use of athermal dissection of the neurovascular bundles (NVBs) were also popular.

There was more heterogeneity in the use of energy for seminal vesicle dissection, the preservation of the tips of the seminal vesicle and the choice between intra‐ and interfascial planes during the antero‐lateral dissection of the NVBs. There was also large variability in the posterior and/or anterior reconstruction steps.

Conclusions

The present study is the first international survey evaluating surgeon preferences during RARP.

Considering that the results were collected before the publication of the Pasadena recommendations, the data might be considered an important baseline evaluation to test the dissemination and effects of the Pasadena recommendations in subsequent years.
Ay allele promotes azoxymethane‐induced colorectal carcinogenesis by macrophage migration in hyperlipidemic/diabetic KK mice
Authors: Ito Kumiko , Ishigamori Rikako , Mutoh Michihiro , Ohta Toshihiro , Imai Toshio , Takahashi Mami
Published: April 2013

The incidence of colorectal cancer has been increasing and is associated with obesity and diabetes. We have found that type 2 diabetes model KK‐Ay/TaJcl (KK‐Ay) mice develop tumors within a short period after treatment with azoxymethane (AOM). However, factors that contribute to the promotion of carcinogenesis have not been clarified. Therefore, we looked at the genetic background of KK‐Ay, including two genetic characteristics of KK/TaJcl (KK) mice and C57BL/6J‐Ham‐Ay/+ (Ay) mice, compared with other non‐obese and non‐diabetic mouse strains C57BL/6J and ICR, and induced colorectal premalignant lesions, aberrant crypt foci (ACF), and tumors using AOM (150 μg/mouse/week for 4 weeks and 200 μg/mouse/week for 6 weeks, respectively). The mice with a diabetes feature, KK‐Ay and KK, developed significantly more ACF, 67 and 61 per mouse, respectively, whereas ICR, Ay, and C57BL/6J mice developed 42, 24, and 18 ACF/mouse, respectively, at 17 weeks of age. Serum insulin and triglyceride levels in KK‐Ay and KK mice were quite high compared with other non‐diabetic mouse strains. Interestingly, KK‐Ay mice developed more colorectal tumors (2.7 ± 2.3 tumor/mouse) than KK mice (1.2 ± 1.1 tumor/mouse) at 25 weeks of age, in spite of similar diabetic conditions. The colon cancers that developed in both KK‐Ay and KK mice showed similar activation of β‐catenin signaling. However, mRNA levels of inflammatory factors related to the activation of macrophages were significantly higher in colorectal cancer of KK‐Ay mice than in KK. These data indicate that factors such as insulin resistance and dyslipidemia observed in obese and diabetic patients could be involved in susceptibility to colorectal carcinogenesis. In addition, increase of tumor‐associated macrophages may play important roles in the stages of promotion of colorectal cancer.
Identifying infants at high‐risk for second‐hand smoke exposure
Authors: Hawkins S. S. , Berkman L.
Published: April 2013

Background

To examine the social determinants of infant smoke exposure and whether these associations vary by mothers' smoking status and number of children in the household.

Methods

There were 135 278 mothers from 28 states who participated in the Pregnancy Risk Assessment Monitoring System from 2000 to 2003.

Results

Overall 9.9% of mothers reported that her infant was in the same room as someone smoking for 1 or more hours per day. Among smoking households, infants with 1 or 2+ siblings were 25% and 59% more likely to be exposed to 1+ hours of second‐hand smoke daily, respectively, than infants with no siblings.

Conclusion

Infants only a few months old are being exposed to second‐hand smoke, particularly infants whose mother smokes and infants with siblings, indicating the importance of surveillance even for this young age group.
Gonadal mosaicism as a rare cause of autosomal recessive inheritance
Authors: Anazi S. , Al‐Sabban E. , Alkuraya F.S.
Published: April 2013

Autosomal recessive diseases are typically caused by the biparental inheritance of familial mutant alleles. Unusual mechanisms by which the recessiveness of a mutant allele is unmasked include uniparental isodisomy and the occurrence of a de novo chromosomal rearrangement that disrupts the other allele. Gonadal mosaicism is a condition in which a postfertilization mutation is confined to the gamete precursors and is not detected in somatic tissues. Gonadal mosaicism is known to give the impression of autosomal recessive inheritance when recurrence of an autosomal‐dominant condition among offspring of phenotypically normal parents is observed. Here, we report an extremely rare event in which maternal gonadal mosaicism for a recessive mutation in COL4A4 caused the recurrence of Alport syndrome within a consanguineous family. Such rare occurrence should be taken into account when analyzing pedigrees both for clinical and research purposes.
A novel mutation in GJA1 causing oculodentodigital syndrome and primary lymphoedema in a three generation family
Authors: Brice G , Ostergaard P , Jeffery S , Gordon K , Mortimer PS , Mansour S
Published: April 2013

Oculodentodigital syndrome (ODD; OMIM 164200) is a congenital condition with phenotypic features most commonly affecting the face, eyes, dentition and digits. The condition is caused by mutations in the GJA1 gene on chromosome 6. GJA1 codes for connexin 43, a gap junction protein important in providing cell to cell communication and is expressed in lymphatic valves. We present a patient with a clinical and molecular diagnosis of ODD and lower limb lymphoedema. Sanger sequencing of family members confirmed that the missense, p.K206R, GJA1 mutation segregated with the phenotype suggestive of causality. To our knowledge this association has not been reported previously. This is therefore the second connexin gene associated with a lymphoedema phenotype after the recent publication of GJC2 (connexin 47) as a cause of four limb lymphoedema.
Bilateral Maps for Partial Matching
Authors: van Kaick Oliver , Zhang Hao , Hamarneh Ghassan
Published: April 2013

Feature‐driven analysis forms the basis of many shape processing tasks, where detected feature points are characterized by local shape descriptors. Such descriptors have so far been defined to capture regions of interest centred at individual points. Using such regions to compare feature points can be problematic when performing partial shape matching, because the region of interest is typically defined as an isotropic neighbourhood around a point, which does not adapt to the geometry of the shape parts. We introduce the bilateral map, a local shape descriptor whose region of interest is defined by two feature points. Compared to the classical descriptor definition using a single point, the bilateral approach exploits the use of a second point to place more constraints on the selection of the spatial context for feature analysis. This leads to a descriptor where the shape of the region of interest adapts to the context of the two points, making it more refined for shape matching. In particular, we show that our new descriptor is more effective for partial matching, because potentially extraneous regions of the models are selectively ignored owing to the adaptive nature of the bilateral map. This property also renders the bilateral map partially insensitive to topological changes. We demonstrate the effectiveness of the bilateral map for partial matching via several correspondence and retrieval experiments and evaluate the results both qualitatively and quantitatively.
Effects of Immediate and Delayed Loading on Peri‐Implant Trabecular Structures: A Cone Beam CT Evaluation
Authors: Huang Yan , Van Dessel Jeroen , Liang Xin , Depypere Maarten , Zhong Weijian , Ma Guowu , Lambrichts Ivo , Maes Frederik , Jacobs Reinhilde
Published: April 2013

Purpose

To develop a method for characterizing trabecular bone microarchitecture using cone beam computed tomography (CBCT) and to evaluate trabecular bone changes after rehabilitation using immediate versus delayed implant protocols.

Materials and Methods

Six mongrel dogs randomly received 27 titanium implants in the maxillary incisor or mandibular premolar areas, following one of four protocols: (1) normal extraction socket healing; (2) immediate implant placement and immediate loading; (3) delayed implant placement and delayed loading; (4) delayed implant placement and immediate loading. The animals were euthanized at 8 weeks, and block biopsies were scanned using high resolution CBCT. Standard bone structural variables were assessed in coronal, middle, and apical levels.

Results

Coronal and middle regions had more compact, more platelike, and thicker trabeculae. Protocols (2), (3), and (4) had significantly higher values (p < 0.001) than protocol (1) for bone surface density, bone surface volume ratio, and connectivity density, while significantly lower values (p < 0.001) were found for trabecular separation and fractal dimension. However, protocols (2), (3), and (4) did not show significantly different bone remodeling.

Conclusions

Compared with normal extraction healing, the implant protocols have an improved bone structural integration. Results do not suggest a different bone remodeling pattern when a delayed versus an immediate implant protocol is used.
Sequential healing of open extraction sockets. An experimental study in monkeys
Authors: Scala Alessandro , Lang Niklaus P. , Schweikert Michael T. , de Oliveira José Américo , Rangel‐Garcia Idelmo , Botticelli Daniele
Published: April 2013

Aim

To describe the sequential healing of open extraction sockets at which no attempts to obtain a primary closure of the coronal access to the alveolus have been made.

Material and methods

The third mandibular premolar was extracted bilaterally in 12 monkeys, and no sutures were applied to close the wound. The healing after 4, 10, 20, 30, 90 and 180 days was morphometrically studied.

Results

After 4 days of healing, a blood clot mainly occupied the extraction sockets, with the presence of an inflammatory cells' infiltrate. A void was confined in the central zones of the coronal and middle regions, in continuity with the entrance of the alveoli. At 10 days, the alveolus was occupied by a provisional matrix, with new bone formation lining the socket bony walls. At 20 days, the amount of woven bone was sensibly increasing. At 30 days, the alveolar socket was mainly occupied by mineralized immature bone at different stages of healing. At 90 and 180 days, the amount of mineralized bone decreased and substituted by trabecular bone and bone marrow. Bundle bone decreased from 95.5% at 4 days to 7.6% at 180 days, of the whole length of the inner alveolar surface.

Conclusions

Modeling processes start from the lateral and apical walls of the alveolus, leading to the closure of the socket with newly formed bone within a month from extraction. Remodeling processes will follow the previous stages, resulting in trabecular and bone marrow formation and in a corticalization of the socket access.
Pseudopapillary pattern in intra‐operative squash smear preparations of central nervous system germinomas
Authors: Ates D. , Kosemehmetoglu K. , Onder S. , Soylemezoglu F.
Published: April 2013

Background

Although the morphology of central nervous system (CNS) germ cell tumours is very similar to that of gonadal germ cell tumours, some architectural changes may dominate the microscopic appearance of CNS germinomas leading to misdiagnosis at low‐power magnification.

Methods

We report five cases of CNS germinoma demonstrating delicate pseudopapillary fronds on squash smear preparations.

Results

The age of the patients ranged from 5 to 21 years (mean 14). Three were female and two male. Three patients presented with symptoms of diabetes insipidus, including polydipsia and polyuria, while absence seizures, meaningless speech, hemiparesia, weight loss, insufficient breast development, amenorrhoea and symptoms of raised intracranial pressure were also encountered depending on the location of the tumours. Tumours were located in the hypophysis in two cases and in the suprasellar region in three. During the intra‐operative pathological consultation, evenly distributed pseudopapillary or papillary structures formed the dominant pattern in the squash preparations of all cases. The neoplastic cells were characterized by pale variably vacuolated cytoplasm, pleomorphic nuclei with irregular membranes, and several prominent nucleoli. Variable numbers of small lymphocytes were also found.

Conclusion

Intracranial germinomas may commonly exhibit a pseudopapillary pattern on squash smears that may cause misdiagnosis as neoplasms with papillary morphology. Careful examination of cellular details is essential in order to reach the correct diagnosis.
Maximising the net social benefit of the construction of post‐disaster alternative housing projects
Authors: El‐Anwar Omar
Published: April 2013

The widespread destruction that follows large‐scale natural disasters, such as Hurricane Katrina in August 2005, challenges the efficacy of traditional temporary housing methods in providing adequate solutions to housing needs. Recognising these housing challenges, the Congress of the United States allocated, in 2006, USD 400 million to the Department of Homeland Security to support Alternative Housing Pilot Programs, which are intended to explore the possibilities of providing permanent and affordable housing to displaced families instead of traditional temporary housing. This paper presents a new methodology and optimisation model to identify the optimal configurations of post‐shelter housing arrangements to maximise the overall net socioeconomic benefit. The model is capable of quantifying and optimising the impacts of substituting temporary housing with alternative housing on the social and economic welfare of displaced families as well as the required additional costs of doing so. An application example is presented to illustrate the use of the model and its capabilities.
Effect of pioglitazone on body composition and bone density in subjects with prediabetes in the ACT NOW trial
Authors: Bray G. A. , Smith S. R. , Banerji M. A. , Tripathy D. , Clement S. C. , Buchanan T. A. , Henry R. R. , Kitabchi A. E. , Mudaliar S. , Musi N. , Ratner R. E. , Schwenke D. C. , Stentz F. B. , Reaven P. D. , DeFronzo R. A.
Published: April 2013

Aims

This study examined the effects of pioglitazone on body weight and bone mineral density (BMD) prospectively in patients with impaired glucose tolerance as pioglitazone (TZD) increases body weight and body fat in diabetic patients and increases the risk of bone fractures.

Methods

A total of 71 men and 163 women aged 49.3 (10.7) years [mean (s.d.)]; body mass index (BMI), 34.5 (5.9) kg/m2 were recruited at five sites for measurements of body composition by dual energy X‐ray absorptiometry at baseline and at conversion to diabetes or study end, if they had not converted.

Results

Mean follow‐up was 33.6 months in the pioglitazone group and 32.1 months in the placebo group. Body weight increased 4.63 ± 0.60 (m ± s.e.) kg in the pioglitazone group compared to 0.98 ± 0.62 kg in the PIO group (p < 0.0001). Body fat rose 4.89 ± 0.42 kg in the pioglitazone group compared to 1.41 ± 0.44 kg, (p < 0.0001) in placebo‐treated subjects. The increase in fat was greater in legs and trunk than in the arms. BMD was higher in all regions in men and significantly so in most. PIO decreased BMD significantly in the pelvis in men and women, decreased BMD in the thoracic spine and ribs of women and the lumbar spine and legs of men. Bone mineral content also decreased significantly in arms, legs, trunk and in the total body.

Conclusions

Pioglitazone increased peripheral fat more than truncal fat and decreased BMD in several regions of the body.
From gene to brain to behavior: schizophrenia‐associated variation in AMBRA1 alters impulsivity‐related traits
Authors: Heinrich Angela , Nees Frauke , Lourdusamy Anbarasu , Tzschoppe Jelka , Meier Sandra , Vollstädt‐Klein Sabine , Fauth‐Bühler Mira , Steiner Sabina , Bach Christiane , Poustka Luise , Banaschewski Tobias , Barker Gareth J. , Büchel Christian , Conrod Patricia J. , Garavan Hugh , Gallinat Jürgen , Heinz Andreas , Ittermann Bernd , Loth Eva , Mann Karl , Artiges Eric , Paus Tomáš , Lawrence Claire , Pausova Zdenka , Smolka Michael N. , Ströhle Andreas , Struve Maren , Witt Stephanie H. , Schumann Gunter , Flor Herta , Rietschel Marcella ,   The IMAGEN consortium
Published: April 2013

Recently, genome‐wide association between schizophrenia and an intronic variant in AMBRA1 (rs11819869) was reported. Additionally, in a reverse genetic approach in adult healthy subjects, risk allele carriers showed a higher medial prefrontal cortex blood oxygen level‐dependent (BOLD) response during a flanker task examining motor inhibition as an aspect of impulsivity. To test whether this finding can be expanded to further aspects of impulsivity, we analysed the effects of the rs11819869 genotype on impulsivity‐related traits on a behavioral, temperament and neural level in a large sample of healthy adolescents. We consider this reverse genetic approach specifically suited for use in a healthy adolescent sample, as these individuals comprise those who will eventually develop mental disorders in which impulsivity is implicated. Healthy adolescents from the IMAGEN study were included in the neuropsychological analysis (n = 848) and a functional magnetic resonance imaging (fMRI) task (n = 512). Various aspects of impulsivity were assessed using the Temperament and Character Inventory‐Revised, the Substance Use Risk Profile Scale, the Cambridge Cognition Neuropsychological Test Automated Battery, and the Stop Signal Task (SST) in the fMRI paradigm. On a behavioral level, increased delay aversion was observed in risk allele carriers. Furthermore, risk allele carriers showed a higher BOLD response in an orbito‐frontal target region during the SST, which declined to trend status after Family Wise Error correction. Our findings support the hypothesis that the schizophrenia‐related risk variant of rs11819869 is involved in various aspects of impulsivity, and that this involvement occurs on a behavioral as well as an imaging genetics level.
Review of diel rhythmic activities in physiological functions of scorpions
Authors: Warburg Michael R.
Published: April 2013

In this study I review the subject of biological rhythms in scorpions. This will include only some of the diel rhythmic endogenous physiological functions and not the locomotory rhythmicity, which will be dealt separately. Most studies reported here were conducted on 13 scorpion species that were studied in 39 different studies. Most of these (66.7%) were studies on a single species (Heterometrus fulvipes). Being a scorpionid, it sits and waits near its burrow not being very active, especially the females. The fact that experimenting was carried out irrespective of species diversity, gender, ecological or physiological conditions, and was usually done on animals kept in captivity for some time before the experimenting had started, is a major drawback to this kind of study. Although the main conclusion appears to be that enzymes reached their peak activity at 20.00 h, there are some exceptions showing otherwise that need further study in order to explain them.
Consulting University: A Reflection from Inside
Authors: Czarniawska Barbara , Mazza Carmelo
Published: April 2013

This paper contributes to a growing literature on the role of management consultants in the public sector by examining a sensitive area of management consulting, as exercised by university faculty members and as applied to universities. It frames the development of management consulting as an idea that originated in universities, travelled first into the private sector and then into the public sector, from country to country, and was eventually applied to universities – with problematic effects.
The Evolution of Client‐Consultant Relationships: A Situational Analysis of IT Consultancy in the Public Sector
Authors: Campagnolo Gian Marco
Published: April 2013

This research proposes a situational understanding of the role of con‐sultants. The analysis is grounded on a case from Italian local government over a ten year period. The case is one of the earliest adopters of an ERP system in the public sector. The paper extends current understanding of client‐consultant relationships by developing a specific picture of changes in the role of consultants over time. In the case analysed, multiple changes in client‐consultant relationships occurred. They were due to particular historical contingencies in the evolution of the structure of expertise in the field. The case contributes to knowledge on consultants by contrasting bilateral and instantaneous accounts of client‐consultant relationship with a perspective that overcomes the distinction between context and individual action.
More than One Way to be Happy: A Typology of Marital Happiness
Authors: Rauer Amy , Volling Brenda
Published: April 2013

This study utilized observational and self‐report data from 57 happily married couples to explore assumptions regarding marital happiness. Suggesting that happily married couples are not a homogeneous group, cluster analyses revealed the existence of three types of couples based on their observed behaviors in a problem‐solving task: (1) mutually engaged couples (characterized by both spouses' higher negative and positive problem‐solving); (2) mutually supportive couples (characterized by both spouses' higher positivity and support); and (3) wife compensation couples (characterized by high wife positivity). Although couples in all three clusters were equally happy with and committed to their marriages, these clusters were differentially associated with spouses' evaluations of their marriage. Spouses in the mutually supportive cluster reported greater intimacy and maintenance and less conflict and ambivalence, although this was more consistently the case in comparison to the wife compensation cluster, as opposed to the mutually engaged cluster. The implications of these typologies are discussed as they pertain to efforts on the part of both practitioners to promote marital happiness and repair marital relations when couples are faced with difficulties.
What does S‐palmitoylation do to membrane proteins?
Authors: Blaskovic Sanja , Blanc Mathieu , van der Goot F. Gisou
Published: April 2013

S‐palmitoylation is post‐translational modification, which consists in the addition of a C16 acyl chain to cytosolic cysteines and which is unique amongst lipid modifications in that it is reversible. It can thus, like phosphorylation or ubiquitination, act as a switch. While palmitoylation of soluble proteins allows them to interact with membranes, the consequences of palmitoylation for transmembrane proteins are more enigmatic. We briefly review the current knowledge regarding the enzymes responsible for palmitate addition and removal. We then describe various observed consequences of membrane protein palmitoylation. We propose that the direct effects of palmitoylation on transmembrane proteins, however, might be limited to four non‐mutually exclusive mechanistic consequences: alterations in the conformation of transmembrane domains, association with specific membrane domains, controlled interactions with other proteins and controlled interplay with other post‐translational modifications.
Predicting lower bound damage curves for high‐strength low‐alloy steels
Authors: Münstermann S. , Schruff C. , Lian J. , Döbereiner B. , Brinnel V. , Wu B.
Published: April 2013

Hindered by the distinctive toughness requirements of the current European standards, the high‐strength low‐alloy (HSLA) steels are rarely applied to the pressure vessels industry. The reason is that the design rules specified by the standards define local plastic deformation as limit state. This results in an over‐conservative application of materials. To achieve an effective, economical and energy‐efficient use of HSLA steels, a strain‐based criterion, the damage curve, which considers crack initiation instead of the beginning of plastic deformation as limit state, is proposed in this study for the improved design rules. In the view of the interaction of microstructure and mechanical properties of materials, the new design rule is derived on the basis of the correlation of microstructural features of HSLA steels with the micromechanical damage models. The experimental verification of the result is furthermore investigated with sufficient agreement so that the general applicability of the procedure can be expected. However, further studies for a reliable parameter calibration are necessary.
Climate change scenarios experiments predict a future reduction in small pelagic fish recruitment in the Humboldt Current system
Authors: Brochier Timothée , Echevin Vincent , Tam Jorge , Chaigneau Alexis , Goubanova Katerina , Bertrand Arnaud
Published: April 2013

The Humboldt Current System (HCS) sustains the world′s largest small pelagic fishery. While a cooling of this system has been observed during recent decades, there is debate about the potential impacts of rising atmospheric CO2 concentrations on upwelling dynamics and productivity. Recent studies suggest that under increased atmospheric CO2 scenarios the oceanic stratification may strongly increase and upwelling‐favorable winds may remain nearly constant off Peru and increase off Chile. Here we investigate the impact of such climatic conditions on egg and larval dispersal phases, a key stage of small pelagic fish reproduction. We used larval retention rate in a predefined nursery area to provide a proxy for the recruitment level. Numerical experiments are based on hydrodynamics downscaled to the HCS from global simulations forced by pre‐industrial (PI), 2 × CO2 and 4 × CO2 scenarios. A biogeochemical model is applied to the PI and 4 × CO2 scenarios to define a time‐variable nursery area where larval survival is optimum. We test two distinct values of the oxycline depth that limits larval vertical distribution: One corresponding to the present‐day situation and the other corresponding to a shallower oxycline potentially produced by climate change. It appeared that larval retention over the continental shelf increases with enhanced stratification due to regional warming. However, this increase in retention is largely compensated for by a decrease of the nursery area and the shoaling of the oxycline. The underlying dynamics are explained by a combination of stratification effects and mesoscale activity changes. Our results therefore show that future climate change may significantly reduce fish capacity in the HCS with strong ecological, economic and social consequences.
Effects of simulated drought on the carbon balance of Everglades short‐hydroperiod marsh
Authors: Malone Sparkle L. , Starr Gregory , Staudhammer Christina L. , Ryan Michael G.
Published: April 2013

Hydrology drives the carbon balance of wetlands by controlling the uptake and release of CO2 and CH4. Longer dry periods in between heavier precipitation events predicted for the Everglades region, may alter the stability of large carbon pools in this wetland's ecosystems. To determine the effects of drought on CO2 fluxes and CH4 emissions, we simulated changes in hydroperiod with three scenarios that differed in the onset rate of drought (gradual, intermediate, and rapid transition into drought) on 18 freshwater wetland monoliths collected from an Everglades short‐hydroperiod marsh. Simulated drought, regardless of the onset rate, resulted in higher net CO2 losses net ecosystem exchange (NEE) over the 22‐week manipulation. Drought caused extensive vegetation dieback, increased ecosystem respiration (Reco), and reduced carbon uptake gross ecosystem exchange (GEE). Photosynthetic potential measured by reflective indices (photochemical reflectance index, water index, normalized phaeophytinization index, and the normalized difference vegetation index) indicated that water stress limited GEE and inhibited Reco. As a result of drought‐induced dieback, NEE did not offset methane production during periods of inundation. The average ratio of net CH4 to NEE over the study period was 0.06, surpassing the 100‐year greenhouse warming compensation point for CH4 (0.04). Drought‐induced diebacks of sawgrass (C3) led to the establishment of the invasive species torpedograss (C4) when water was resupplied. These changes in the structure and function indicate that freshwater marsh ecosystems can become a net source of CO2 and CH4 to the atmosphere, even following an extended drought. Future changes in precipitation patterns and drought occurrence/duration can change the carbon storage capacity of freshwater marshes from sinks to sources of carbon to the atmosphere. Therefore, climate change will impact the carbon storage capacity of freshwater marshes by influencing water availability and the potential for positive feedbacks on radiative forcing.
The biogeography of stream bacteria
Authors: Lear Gavin , Washington Vidya , Neale Martin , Case Brad , Buckley Hannah , Lewis Gillian
Published: April 2013

Aim

The extent to which bacterial communities exhibit biogeographic patterns in their distribution remains unclear. We examined the relative influence of factors including geographic distance, latitude, elevation and catchment land use on the distribution and taxon richness of stream bacterial communities across New Zealand.

Location

Bacterial communities were collected from biofilm growing on submerged rocks in 244 streams. Sample sites spanned a north–south gradient of over 970 km, an elevational gradient of c. 750 m and were collected from a variety of catchment types across New Zealand.

Methods

We used automated ribosomal intergenic spacer analysis, a DNA fingerprinting technique, to characterize the structure and taxon richness of each bacterial community. Key attributes relating to sample location, upstream catchment land use and a suite of additional environmental parameters were collected for every site using GIS procedures. Univariate correlations between measures of bacterial community structure and latitude, elevation and distance were examined. Variance partitioning was then used to assess the relative importance of purely spatial factors versus catchment land use and environmental attributes for determining bacterial community structure and taxon richness.

Results

Bacterial taxon richness was related to the geographic location of the sample site, being significantly greater at latitudes closer to the equator and reduced at higher elevations. We observed distance decay patterns in bacterial community similarity related to geographic distance and latitudinal distance, but not to elevational distance. Overall, however, bacterial community similarity and taxon richness was more closely related to variability in catchment land use than to climatic variability or geographic location.

Main conclusion

Our data suggest that stream biofilm communities across New Zealand are more influenced by catchment land use attributes than by dispersal limitation.
Age–gender differences in the reaction times of ankle muscles
Authors: Hong Junghwa , Kim Ji‐Won , Chung Hong‐Young , Kim Hyo‐Hee , Kwon Yuri , Kim Chul‐Seung , Ho Ye‐Ji , Eom Gwang‐Moon , Jun Jae‐Hoon , Park Byung Kyu
Published: April 2013

Aim

Reaction times of the hip abductor were reported to be longer in elderly women than in elderly men, and this was suggested to be related to mediolateral balance performance. The aim of the present study was to investigate the effects of age and gender on the reaction performance of ankle muscles, which have predominant roles in anterioposterior balance control.

Methods

A total of 40 elderly subjects and 40 young subjects (even number of men and women) carried out a series of isometric plantarflexions and dorsiflexions, as forcefully and quickly as possible, in response to auditory stimulus. Surface electromyogram at the dorsiflexor and plantarflexor were recorded, together with foot plantar force. Premotor time, motor time and total reaction time derived from the experimental data were compared between age groups and genders by two‐way anova.

Results

Both dorsiflexor and plantarflexor showed similar reaction performance. Premotor time increased with age with no gender difference. Motor time increased with age in women and not in men, resulting in longer motor time in elderly women than in elderly men. Total reaction time was dominated by premotor time, so that it was longer in the elderly with no gender difference.

Conclusion

Although age‐related elongation of motor time was greater in women, total reaction time was not different between the genders. This may be related to no gender difference in anterioposterior balance performance. Geriatr Gerontol Int 2014; 14: 94–99.
Antiviral therapy after curative treatment of hepatitis B/C virus‐related hepatocellular carcinoma: A systematic review of randomized trials
Authors: Sun Ping , Yang Xiao , He Rui‐Qing , Hu Qing‐Gang , Song Zi‐Fang , Xiong Jun , Zheng Qi‐Chang
Published: April 2013

Aim

Available published work on the benefit of adjuvant antiviral therapy after curative treatment of hepatocellular carcinoma (HCC) reports controversial results. The objective of this systematic review was to evaluate the effect of adjuvant antiviral therapy on recurrence and survival after curative treatment of HCC.

Methods

We conducted an extensive search strategy. All randomized controlled trials comparing adjuvant antiviral therapy versus placebo or no treatment were considered for this review. Results were expressed as hazard ratio for time‐to‐event outcomes with 95% confidence intervals using RevMan 5.

Results

We included nine trials (three of low risk of bias and six of unclear risk of bias) with 954 patients. All the included studies used conventional interferon (IFN) as adjuvant antiviral therapy; none of them used pegylated IFN or nucleoside analogs. There were significant improvements for recurrence‐free survival and overall survival in the adjuvant IFN group compared with the control group. Subgroup analysis also showed a significant difference favoring IFN therapy in hepatitis C virus (HCV)‐related HCC patients, but for hepatitis B virus (HBV)‐related patients, the difference failed to reach statistical significance. A dose reduction was needed in 28.3% of patients and discontinuation of IFN therapy happened in 8.2% of patients due to moderate to severe side‐effects.

Conclusion

Our study suggested potential benefits of adjuvant IFN therapy following curative treatment of HCC, especially for HCV‐related HCC. Further high‐quality randomized controlled trials of more effective adjuvant antiviral regimens, either used alone or in combination, for virus‐related HCC, especially HBV‐related HCC, are needed.