bluuebunny/crossref_metadata_2025 huggingface dataset:
Home-Based Multidisciplinary Rehabilitation following Hip Fracture Surgery: What Is the Evidence?
Authors: Donohue Kathleen , Hoevenaars Richelle , McEachern Jocelyn , Zeman Erica , Mehta Saurabh
Published: December 2013

Objective. To determine the effects of multidisciplinary home rehabilitation (MHR) on functional and quality of life (QOL) outcomes following hip fracture surgery.Methods. Systematic review methodology suggested by Cochrane Collboration was adopted. Reviewers independently searched the literature, selected the studies, extracted data, and performed critical appraisal of studies. Summary of the results of included studies was provided.Results. Five studies were included. Over the short-term, functional status and lower extremity strength were better in the MHR group compared to the no treatment group (NT). Over the long-term, the MHR group showed greater improvements in balance confidence, functional status, and lower extremity muscle strength compared to NT group, whereas the effect on QOL and mobility was inconsistent across the studies. Several methodological issues related to study design were noted across the studies.Conclusion. The MHR was found to be more effective compared to the NT in improving functional status and lower extremity strength in patients with hip fracture surgery. Results of this review do not make a strong case for MHR due to high risk of bias in the included studies. Further research is required to accurately characterize the types of disciplines involved in MHR and frequency and dosage of intervention.
Penetration of Milk-Derived Antimicrobial Peptides into Phospholipid Monolayers as Model Biomembranes
Authors: Barzyk Wanda , Rogalska Ewa , Więcław-Czapla Katarzyna
Published: December 2013

Three antimicrobial peptides derived from bovine milk proteins were examined with regard to penetration into insoluble monolayers formed with 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) or 1,2-dipalmitoyl-sn-glycero-3-phospho-rac-(1-glycerol) sodium salt (DPPG). Effects on surface pressure (Π) and electric surface potential (ΔV) were measured,Πwith a platinum Wilhelmy plate andΔVwith a vibrating plate. The penetration measurements were performed under stationary diffusion conditions and upon the compression of the monolayers. The two type measurements showed greatly different effects of the peptide-lipid interactions. Results of the stationary penetration show that the peptide interactions with DPPC monolayer are weak, repulsive, and nonspecific while the interactions with DPPG monolayer are significant, attractive, and specific. These results are in accord with the fact that antimicrobial peptides disrupt bacteria membranes (negative) while no significant effect on the host membranes (neutral) is observed. No such discrimination was revealed from the compression isotherms. The latter indicate that squeezing the penetrant out of the monolayer upon compression does not allow for establishing the penetration equilibrium, so the monolayer remains supersaturated with the penetrant and shows an under-equilibrium orientation within the entire compression range, practically.
The Anxiolytic Effect of Aromatherapy on Patients Awaiting Ambulatory Surgery: A Randomized Controlled Trial
Authors: Ni Cheng-Hua , Hou Wen-Hsuan , Kao Ching-Chiu , Chang Ming-Li , Yu Lee-Fen , Wu Chia-Che , Chen Chiehfeng
Published: December 2013

The aim of this study was to determine if aromatherapy could reduce preoperative anxiety in ambulatory surgery patients. A total of 109 preoperative patients were randomly assigned to experimental (bergamot essential oil) and control (water vapor) conditions and their responses to the State Trait Anxiety Inventory and vital signs were monitored. Patients were stratified by previous surgical experience, but that did not influence the results. All those exposed to bergamot essential oil aromatherapy showed a greater reduction in preoperative anxiety than those in the control groups. Aromatherapy may be a useful part of a holistic approach to reducing preoperative anxiety before ambulatory surgery.
Arc Interference Behavior during Twin Wire Gas Metal Arc Welding Process
Authors: Ye Dingjian , Hua Xueming , Wu Yixiong
Published: December 2013

In order to study arc interference behavior during twin wire gas metal arc welding process, the synchronous acquisition system has been established to acquire instantaneous information of arc profile including dynamic arc length variation as well as relative voltage and current signals. The results show that after trailing arc (T-arc) is added to the middle arc (M-arc) in a stable welding process, the current of M arc remains unchanged while the agitation increases; the voltage of M arc has an obvious increase; the shape of M arc changes, with increasing width, length, and area; the transfer frequency of M arc droplet increases and the droplet itself becomes smaller. The wire extension length of twin arc turns out to be shorter than that of single arc welding.
Molecular Diagnosis of Periprosthetic Joint Infection by Quantitative RT‐PCR of Bacterial 16S Ribosomal RNA
Authors: Lee Mel S. , Chang Wen-Hsin , Chen Su-Chin , Hsieh Pang-Hsin , Shih Hsin-Nung , Ueng Steve W. N. , Lee Gwo-Bin
Published: December 2013

The diagnosis of periprosthetic joint infection is sometimes straightforward with purulent discharge from the fistula tract communicating to the joint prosthesis. However it is often difficult to differentiate septic from aseptic loosening of prosthesis because of the high culture‐negative rates in conventional microbiologic culture. This study used quantitative reverse transcription polymerase chain reaction (RT‐qPCR) to amplify bacterial 16S ribosomal RNA in vitro and in 11 clinical samples. The in vitro analysis demonstrated that the RT‐qPCR method was highly sensitive with the detection limit of bacterial 16S rRNA being 0.148 pg/μl. Clinical specimens were analyzed using the same protocol. The RT‐qPCR was positive for bacterial detection in 8 culture‐positive cases (including aerobic, anaerobic, and mycobacteria) and 2 culture‐negative cases. It was negative in one case that the final diagnosis was confirmed without infection. The molecular diagnosis of bacterial infection using RT‐qPCR to detect bacterial 16S rRNA around a prosthesis correlated well with the clinical findings. Based on the promising clinical results, we were attempting to differentiate bacterial species or drug‐resistant strains by using species‐specific primers and to detect the persistence of bacteria during the interim period before the second stage reimplantation in a larger scale of clinical subjects.
Future of Management of Multiple Sclerosis in the Middle East: A Consensus View from Specialists in Ten Countries
Authors: Aljumah Mohammed , Alroughani Raed , Alsharoqi I. , Bohlega Saeed A. , Dahdaleh Maurice , Deleu Dirk , Esmat Khaled , Khalifa Ahmad , Sahraian Mohammad A. , Szólics Miklós , AlTahan Abdulrahman , Yamout Bassem I. , Rieckmann Peter , Daif Abdulkader
Published: December 2013

The prevalence of multiple sclerosis (MS) is now considered to be medium-to-high in the Middle East and is rising, particularly among women. While the characteristics of the disease and the response of patients to disease-modifying therapies are generally comparable between the Middle East and other areas, significant barriers to achieving optimal care for MS exist in these developing nations. A group of physicians involved in the management of MS in ten Middle Eastern countries met to consider the future of MS care in the region, using a structured process to reach a consensus. Six key priorities were identified: early diagnosis and management of MS, the provision of multidisciplinary MS centres, patient engagement and better communication with stakeholders, regulatory body education and reimbursement, a commitment to research, and more therapy options with better benefit-to-risk ratios. The experts distilled these priorities into a single vision statement: “Optimization of patient-centred multidisciplinary strategies to improve the quality of life of people with MS.” These core principles will contribute to the development of a broader consensus on the future of care for MS in the Middle East.
It Is Not Always Necessary to Do Axillary Dissection for T1 and T2 Breast Cancer—Point
Authors: Morrow Monica
Published: December 2013

Axillary lymph node dissection (ALND) has been a part of breast cancer management since the 1900s. The idea that axillary metastases do not require surgical removal is a repudiation of the Halstedian concept of breast cancer biology, yet multiple prospective randomized studies show that the incidence of nodal recurrence in patients not having ALND is substantially lower than expected, based on the incidence of axillary metastases in patients having ALND, and survival does not differ based on axillary treatment. Avoidance of axillary dissection significantly reduces the morbidity of breast cancer surgery. As the use of systemic therapy has increased and targeted therapies have become available, the incidence of axillary recurrence in patients not having dissection has decreased to approximately 1% at 5 years, making routine axillary dissection difficult to justify. ALND is no longer standard management for patients with T1 and T2, clinically node-negative cancers undergoing breast-conserving therapy and found to have a positive sentinel node, and can also be avoided in patients with these tumor features having mastectomy if the need for postmastectomy radiotherapy is clear with the finding of a positive sentinel node. Cancer Res; 73(24); 7151–4. ©2013 AACR.
Instrumental Exams Performance Can Be a Contributing Factor to the Delay in Diagnosis of Migraine
Authors: Viticchi Giovanna , Bartolini Marco , Falsetti Lorenzo , Dolcini Jacopo , Cerqua Raffaella , Luzzi Simona , Provinciali Leandro , Silvestrini Mauro
Published: December 2013

Background: Diagnostic delay is a recognized drawback for a correct management of migraine patients. The aim of this study was to investigate the possible relationship among number and type of examinations performed and diagnostic delay in migraine diagnosis. Methods: We enrolled 500 subjects referred to our Headache Center for a migraine without aura. We analyzed the relationship among diagnostic delay, number of examinations performed and performance of each single test by a Cox regression model and an ordinal logistic regression model. Results: Each individual exam increased a diagnostic delay of at least 12 months (p < 0.05, Cox regression model). Brain CT as the first diagnostic approach had a reduced risk of delay of more than 5 years (OR 0.632, 95% CI 0.71-0.56, p < 0.05, ordinal regression model). Conclusions: The number of instrumental examinations seems to significantly influence the diagnostic delay. This aspect contributes to increase health care costs, the risk of pain chronicization and pharmacological treatment misuse.
Effects of Uric Acid Levels on Outcome in Severe Ischemic Stroke Patients Treated with Intravenous Recombinant Tissue Plasminogen Activator
Authors: Lee Sang-Hwa , Heo Sung Hyuk , Kim Jun-Hyun , Lee Dokyung , Lee Ji Sung , Kim Young Seo , Kim Hyun Young , Koh Seong-Ho , Chang Dae-Il
Published: December 2013

Uric acid (UA) has been known to be a neuroprotective antioxidant because of its free radical scavenger activity. We studied the influence of UA in patients with acute ischemic stroke after thrombolytic therapy. Two hundred eighteen consecutive patients treated with intravenous thrombolysis were included in this analysis. We analyzed the relationship between serum UA levels obtained at the emergency department and clinical outcomes. Early improvement and excellent functional outcomes were measured using the National Institutes of Health Stroke Scale (NIHSS) 24 h after onset and the modified Rankin scale after 3 months. There was no significant relationship between serum UA levels and early improvement or excellent functional outcome in the total patients (p = 0.583 and p = 0.082, respectively). However, in patients with severe baseline stroke deficits (NIHSS score ≥15), higher-tertile UA levels were significantly associated with excellent functional outcomes (p = 0.003). Excellent functional outcomes in patients with severe baseline disability might have a significant association with serum UA levels particularly in men but not in women (p = 0.007 in men and p = 0.621 in women). Increased serum UA levels might be associated with better outcomes in ischemic stroke patients treated with intravenous thrombolysis, but the effectiveness of UA can differ by initial stroke severity and gender.
Worsening of Wilson Disease following Penicillamine Therapy
Authors: Kalita Jayantee , Kumar Vijay , Chandra Satish , Kumar Bishwanath , Misra Usha Kant
Published: December 2013

Background: Penicillamine is a standard therapy for Wilson disease (WD) but some patients have paradoxical worsening. Predictors of such deterioration have not been evaluated. This study documents frequency and predictors of deterioration following treatment in WD. Methods: 59 consecutive patients with neurologic WD and 4 asymptomatic siblings were prospectively evaluated. Their clinical, laboratory, ultrasound abdomen and cranial MRI findings with and without worsening were compared. Patients were treated with oral penicillamine and/or zinc and followed up at 1, 3 and 6 months or earlier if needed. Deterioration was defined by >10% worsening in baseline Burke-Fahn-Marsden score or appearance of new neurological sign. Results: Patients' median age was 13 years and 13 were females. 19 patients (30.2%) worsened following treatment; 10 within 1 month, 7 in 1-3 months, and 2 after 3 months of treatment. Deterioration was associated with drooling, leukopenia, thrombocytopenia, splenomegaly and evidence of chronic liver disease. None of the asymptomatic patients following zinc therapy deteriorated. Conclusions: In the deteriorating group, withdrawal of penicillamine resulted in improvement/stabilization in 11 patients, 2 improved by trientine therapy and 4 continued to deteriorate till 3 months. 30.2% patients with WD deteriorated following penicillamine, especially those with chronic liver disease, leukopenia and thrombocytopenia.
A Database and Website for Molecular Defects of the GH-IGF Axis: www.growthgenetics.com
Authors: Rosenfeld Ron G. , von Stein Thorsten
Published: December 2013

Background/Aims: Over the last decade, multiple molecular defects of the GH-IGF axis have been identified and characterized, greatly expanding our appreciation of the genotypic and phenotypic variability of endocrine growth disorders. Methods: In an effort to address the growing complexity of molecular defects and their characteristic phenotypes, a Growth Genetics Consortium was established in 2008, with the goal of developing a repository of case information on all patients with genetic variations in the GH-IGF axis. A database was established, along with a publicly accessible website (www.growthgenetics.com), with registration open to all potential users. Results: The genes currently available in the database include GHR, Stat5b, IGF1, IGF2, IGFALS and IGF1R. The data collected include clinical details, auxology, family history, laboratory data, identified molecular defects and, if relevant, treatment information. Conclusions: It is planned for the database and website to eventually include all identified genes in the GH-IGF axis.
Arterial Spin Labeling Perfusion MRI in Children and Young Adults with Previous Ischemic Stroke and Unilateral Intracranial Arteriopathy
Authors: Bulder Marcel M.M. , Bokkers Reinoud P.H. , Hendrikse Jeroen , Kappelle L. Jaap , Braun Kees P.J. , Klijn Catharina J.M.
Published: December 2013

Background: Little is known about cerebral blood flow (CBF) in young patients with ischemic stroke caused by an intracranial arteriopathy. Arterial spin labeling (ASL) perfusion is a noninvasive technique for measuring CBF. We aimed to investigate whether, in young patients with unilateral intracranial arteriopathy and previous ischemic stroke, CBF is compromised in noninfarcted brain areas of the symptomatic hemisphere and whether this is related to the severity of the arteriopathy. Methods: Patients aged 5-50 years, with previous middle cerebral artery (MCA) territory infarction and a unilateral intracranial arteriopathy, underwent magnetic resonance imaging (MRI), MR angiography and pseudocontinuous ASL perfusion MRI. We assessed the severity of stenosis of arteries that fed the symptomatic MCA territory, quantified CBF in the noninfarcted cortex of both MCA territories and generated CBF maps for visual CBF interpretation. Results: A total of 17 patients were included (median age 29 years, range 5-49, 29% male). We found a similar median quantified CBF in the symptomatic and asymptomatic MCA territories (86 ml·100 g-1·min-1). CBF maps showed hypoperfusion in the symptomatic MCA territory in 59% of patients compared to 18% based on quantified CBF. Patients with a severe arteriopathy more often showed hypoperfusion on CBF maps than patients with a mild arteriopathy. In 53% of patients, small foci of increased signal intensity were visible on CBF maps around an area of hypoperfusion, indicating vascular artifacts. In these patients, we found large intraindividual variation in the quantified CBF in the symptomatic hemisphere. In 47% of patients, the visual interpretation of perfusion did not correspond with the quantified CBF. Conclusions: This study shows that more than half of young patients with previous ischemic stroke in the MCA territory and a unilateral intracranial arteriopathy have hypoperfusion in the noninfarcted cortex of the symptomatic hemisphere when CBF is visually assessed using a CBF map, in particular in patients with a severe arteriopathy. In the same patients, quantification of CBF shows hypoperfusion in the symptomatic hemisphere in only 18%. This discrepancy is caused by labeled blood within the arteries that has not yet reached the tissue at the time of imaging. Visual assessment can show hypoperfusion, while the quantified CBF in a similar region appears higher when the intravascular labeled blood is included in the region of interest. Further research should focus on elucidating whether cerebral perfusion deficits in young stroke patients with intracranial arteriopathy might help to identify patients who are at risk of poor outcome or stroke recurrence.
Sal k 5, a Member of the Widespread Ole e 1-Like Protein Family, Is a New Allergen of Russian Thistle (Salsola kali) Pollen
Authors: Castro L. , Mas S. , Barderas R. , Colás C. , García-Sellés J. , Barber D. , Rodríguez R. , Villalba M.
Published: December 2013

Background:Salsola kali is an Amaranthaceae weed with important repercussions for pollinosis in temperate areas. Ole e 1-like members are relevant allergens in pollen from different species. We aimed to characterize and produce as recombinant allergen S. kali Ole e 1-like protein. Methods: The natural allergen was purified at homogeneity after three chromatographic steps. Specific cDNA was sequenced and expressed in Pichia pastoris yeast. Structural relationships of natural and recombinant forms were carried out by 2D electrophoresis and spectroscopic analyses. Its immunological relevance was analyzed by ELISA and immunoblotting using an IgG antiserum and monoclonal antibodies specific to Ole e 1, as well as sera from 57 allergic patients recruited from two Spanish regions where this pollinosis is frequent. Results: The purified allergen, Sal k 5, is an acidic glycoprotein of 151 amino acid residues and 17,628 Da of molecular mass. Its amino acid sequence exhibits 68 and 32% identity with the allergens of Che a 1 and Ole e 1, respectively. The recombinant protein was correctly processed and its structural and immunologic equivalence to the natural form was proven. A sensitization frequency between 30 and 40% was observed in pollinic patients from the center and east coast of Spain. Conclusions: Sal k 5 is a member of the Ole e 1-like protein family which can be considered an important allergen from S. kali. Its inclusion in diagnosis protocols would allow the accurate defining of patients allergic to this pollen.
Trends in Stroke Treatment and Outcome between 1995 and 2010: Observations from Riks-Stroke, the Swedish Stroke Register
Authors: Appelros Peter , Jonsson Fredrik , Åsberg Signild , Asplund Kjell , Glader Eva-Lotta , Åsberg Kerstin Hulter , Norrving Bo , Stegmayr Birgitta , Terént Andreas ,   for the Riks-Stroke Collaboration
Published: December 2013

Background: Continuous changes in stroke treatment and care, as well as changes in stroke characteristics, may alter stroke outcome over time. The aim of this paper is to describe time trends for treatment and outcome data, and to discuss if any such changes could be attributed to quality changes in stroke care. Methods: Data from Riks-Stroke, the Swedish stroke register, were analyzed for the time period of 1995 through 2010. The total number of patients included was 320,181. The following parameters were included: use of computed tomography (CT), stroke unit care, thrombolysis, medication before and after the stroke, length of stay in hospital, and discharge destination. Three months after stroke, data regarding walking, toileting and dressing ability, as well social situation, were gathered. Survival status after 7, 27 and 90 days was registered. Results: In 1995, 53.9% of stroke patients were treated in stroke units. In 2010 this proportion had increased to 87.5%. Fewer patients were discharged to geriatric or rehabilitation departments in later years (23.6% in 2001 compared with 13.4% in 2010), but more were discharged directly home (44.2 vs. 52.4%) or home with home rehabilitation (0 vs. 10.7%). The need for home help service increased from 18.2% in 1995 to 22.1% in 2010. Regarding prevention, more patients were on warfarin, antihypertensives and statins both before and after the stroke. The functional outcome measures after 3 months did improve from 2001 to 2010. In 2001, 83.8% of patients were walking independently, while 85.6% were independent in 2010. For toileting, independence increased from 81.2 to 84.1%, and for dressing from 78.0 to 80.4%. Case fatality (CF) rates after 3 months increased from 18.7% (2001) to 20.0% (2010). This trend is driven by patients with severe strokes. Conclusions: Stroke outcomes may change over a relatively short time period. In some ways, the quality of care has improved. More stroke patients have CT, more patients are treated in stroke units and more have secondary prevention. Patients with milder strokes may have benefited more from these measures than patients with severe strokes. Increased CF rates for patients with severe stroke may be caused by shorter hospital stays, shorter in-hospital rehabilitation periods and lack of suitable care after discharge from hospital.
Late-Onset Capsular Block Syndrome: Unusually Delayed Presentation
Authors: Rana Mrinal , Jiang Li , Ilango Balasubramaniam , Yang Yit
Published: December 2013

Capsular block syndrome (CBS) has been known to occur as a rare complication of cataract surgery with continuous curvilinear capsulorhexis and a posterior-chamber lens implant. Typically, it presents with reduced vision in the early postoperative period and is characterised by a forward displacement of the posterior-chamber intra-ocular lens and an accumulation of intra-capsular opaque material. Management of CBS is usually by Nd:YAG laser capsulotomy. In this report, we describe a unique case of very-delayed-onset CBS with good visual acuity, occurring 8 years after surgery. It was treated successfully with surgical removal of the opaque material.
Impaired Hyperemic Myocardial Blood Flow Is Associated With Inducibility of Ventricular Arrhythmia in Ischemic Cardiomyopathy
Authors: Rijnierse Mischa T. , de Haan Stefan , Harms Hendrik J. , Robbers Lourens F. , Wu LiNa , Danad Ibrahim , Beek Aernout M. , Heymans Martijn W. , van Rossum Albert C. , Lammertsma Adriaan A. , Allaart Cornelis P. , Knaapen Paul
Published: December 2013

Background—

Risk stratification for ventricular arrhythmias (VAs) is important to refine selection criteria for primary prevention implantable cardioverter defibrillator therapy. Impaired hyperemic myocardial blood flow (MBF) is associated with increased mortality rate in ischemic and nonischemic cardiomyopathy, which may be attributed to electric instability inducing VAs. The aim of this pilot study was to assess whether hyperemic MBF impairment may be related with VA inducibility in patients with ischemic cardiomyopathy.

Methods and Results—

Thirty patients with ischemic cardiomyopathy referred for primary prevention implantable cardioverter defibrillator implantation were prospectively included (26 men; 65±8 years old; left ventricular ejection fraction, 29±6%). [
15
O]H
2
O positron-emission tomography was performed to quantify resting MBF, hyperemic MBF, and coronary flow reserve. Left ventricular dimensions, function, and scar burden were assessed with cardiovascular magnetic resonance imaging. An electrophysiological study was performed to test VA inducibility. Positive electrophysiological study patients (n=12) showed reduced hyperemic MBF (1.25±0.30 versus 1.66±0.38 mL·min
−1
·g
−1
;
P
<0.01) and coronary flow reserve (1.59±0.49 versus 2.12±0.48;
P
<0.01) compared with electrophysiological study negative patients (n=18). In electrophysiological study positive patients, the number of scar segments >75% transmurality was higher (
P
<0.05), although scar size and border zone did not differ. Receiver-operating characteristic curve analysis indicated that impaired hyperemic MBF (area under the curve, 0.84; 95% confidence intervals [0.69–0.99]) and coronary flow reserve (area under the curve, 0.77; 95% confidence intervals [0.57–0.96]) were associated with VA inducibility.

Conclusions—

In this pilot study, impaired hyperemic MBF and coronary flow reserve were associated with VA inducibility in patients with ischemic cardiomyopathy. These results are hypothesis generating for a potential role of quantitative positron-emission tomography perfusion imaging in risk stratification for VAs.
Airflow Obstruction, Lung Function, and Incidence of Atrial Fibrillation
Authors: Li Jingjing , Agarwal Sunil K. , Alonso Alvaro , Blecker Saul , Chamberlain Alanna M. , London Stephanie J. , Loehr Laura R. , McNeill Ann Marie , Poole Charles , Soliman Elsayed Z. , Heiss Gerardo
Published: December 2013

Background—

Reduced low forced expiratory volume in 1 second (FEV
1
) is reportedly associated with an increased risk of atrial fibrillation (AF). Extant reports do not provide separate estimates for never smokers or for blacks, who incongruously have lower AF incidence than whites.

Methods and Results—

We examined 15 004 middle-aged blacks and whites enrolled in the Atherosclerosis Risk in Communities (ARIC) cohort study. Standardized spirometry data were collected at the baseline examination. Incident AF was identified from the first among the following:
International Classification of Diseases
codes for AF on hospital discharge records or death certificates or 12-lead ECGs performed during 3 triennial follow-up visits. Over an average follow-up of 17.5 years, a total of 1691 participants (11%) developed new-onset AF. The rate of incident AF was inversely associated with FEV
1
in each of the 4 race and sex groups. After multivariable adjustment for traditional cardiovascular disease risk factors and height, hazard ratios of AF comparing the lowest with the highest quartile of FEV
1
were 1.37 (95% confidence interval, 1.02–1.83) for white women, 1.49 (95% confidence interval, 1.16–1.91) for white men, 1.63 (95% confidence interval, 1.00–2.66) for black women, and 2.36 (95% confidence interval, 1.30–4.29) for black men. The above associations were observed across all smoking status categories. Moderate/severe airflow obstruction (FEV
1
/forced vital capacity <0.70 and FEV
1
< 80% of predicted value) was also associated with higher AF incidence.

Conclusions—

In this large population-based study with a long-term follow-up, reduced FEV
1
and obstructive respiratory disease were associated with a higher AF incidence after adjustment for measured confounders.
Treatment of Acute Venous Thromboembolism With Dabigatran or Warfarin and Pooled Analysis
Authors: Schulman Sam , Kakkar Ajay K. , Goldhaber Samuel Z. , Schellong Sebastian , Eriksson Henry , Mismetti Patrick , Christiansen Anita Vedel , Friedman Jeffrey , Le Maulf Florence , Peter Nuala , Kearon Clive
Published: December 2013

Background—

Dabigatran and warfarin have been compared for the treatment of acute venous thromboembolism (VTE) in a previous trial. We undertook this study to extend those findings.

Methods and Results—

In a randomized, double-blind, double-dummy trial of 2589 patients with acute VTE treated with low-molecular-weight or unfractionated heparin for 5 to 11 days, we compared dabigatran 150 mg twice daily with warfarin. The primary outcome, recurrent symptomatic, objectively confirmed VTE and related deaths during 6 months of treatment occurred in 30 of the 1279 dabigatran patients (2.3%) compared with 28 of the 1289 warfarin patients (2.2%; hazard ratio, 1.08; 95% confidence interval [CI], 0.64–1.80; absolute risk difference, 0.2%; 95% CI, −1.0 to 1.3;
P
<0.001 for the prespecified noninferiority margin for both criteria). The safety end point, major bleeding, occurred in 15 patients receiving dabigatran (1.2%) and in 22 receiving warfarin (1.7%; hazard ratio, 0.69; 95% CI, 0.36–1.32). Any bleeding occurred in 200 dabigatran (15.6%) and 285 warfarin (22.1%; hazard ratio, 0.67; 95% CI, 0.56–0.81) patients. Deaths, adverse events, and acute coronary syndromes were similar in both groups. Pooled analysis of this study RE-COVER II and the RE-COVER trial gave hazard ratios for recurrent VTE of 1.09 (95% CI, 0.76–1.57), for major bleeding of 0.73 (95% CI, 0.48–1.11), and for any bleeding of 0.70 (95% CI, 0.61–0.79).

Conclusion—

Dabigatran has similar effects on VTE recurrence and a lower risk of bleeding compared with warfarin for the treatment of acute VTE.

Clinical Trial Registration—

URL:
www.clinicaltrials.gov
. Unique identifiers: NCT00680186 and NCT00291330.
Mechanisms With Clinical Implications for Atrial Fibrillation–Associated Remodeling: Cathepsin K Expression, Regulation, and Therapeutic Target and Biomarker
Authors: Fujita Masaya , Cheng Xian Wu , Inden Yasuya , Shimano Masayuki , Yoshida Naoki , Inoue Aiko , Yamamoto Toshihiko , Takeshita Kyosuke , Kyo Seifuku , Taguchi Noriko , Shi Guo‐Ping , Kuzuya Masafumi , Okumura Kenji , Murohara Toyoaki
Published: December 2013

Background

The cysteine protease cathepsin K (CatK) has been implicated in the pathogenesis of cardiovascular disease. We sought to determine the link between atrial fibrillation (
AF
) and plasma CatK levels and to investigate the expression of and therapeutic target for CatK in vivo and in vitro.

Methods and Results

Plasma CatK and extracellular matrix protein peptides (intact procollagen type I of N‐terminal propeptide; carboxyl‐terminal telopeptide of type I collagen [
ICTP
]) were measured in 209 consecutive patients with
AF
(paroxysmal
AF
, 146; persistent
AF
, 63) and 112 control subjects. In addition, the regulation of CatK expression was investigated in vivo and vitro. Patients with
AF
had higher plasma CatK and
ICTP
levels than did control subjects. Patients with persistent
AF
had higher levels of plasma CatK and
ICTP
than did patients with paroxysmal
AF
. CatK was correlated with
ICTP
concentration and left atrial diameter in all subjects. In rabbits, superoxide production, CatK activity, fibrosis, and the levels of atrial tissue angiotensin
II
, angiotensin type 1 receptor, gp91phox, phospho‐p38 mitogen‐activated protein kinase, and CatK were greater in those with tachypacing‐induced
AF
than in controls, and these changes were reversed with angiotensin type 1 receptor antagonist. Olmesartan and mitogen‐activated protein kinase inhibitor decreased the CatK expression induced by angiotensin
II
in rat neonatal myocytes.

Conclusions

These data indicated that increased plasma CatK levels are linked with the presence of
AF
. Angiotensin type 1 receptor antagonist appears to be effective in alleviating atrial fibrosis in a rabbit
AF
model, partly reducing angiotensin type 1 receptor‐p38mitogen‐activated protein kinase‐dependent and ‐independent CatK activation, thus preventing AF.
Efficiency of Conscious Access Improves with Coupling of Slow and Fast Neural Oscillations
Authors: Nakatani Chie , Raffone Antonino , van Leeuwen Cees
Published: December 2013

Global workspace access is considered as a critical factor for the ability to report a visual target. A plausible candidate mechanism for global workspace access is coupling of slow and fast brain activity. We studied coupling in EEG data using cross-frequency phase–amplitude modulation measurement between delta/theta phases and beta/gamma amplitudes from two experimental sessions, held on different days, of a typical attentional blink (AB) task, implying conscious access to targets. As the AB effect improved with practice between sessions, theta–gamma and theta–beta coupling increased generically. Most importantly, practice effects observed in delta–gamma and delta–beta couplings were specific to performance on the AB task. In particular, delta–gamma coupling showed the largest increase in cases of correct target detection in the most challenging AB conditions. All these practice effects were observed in the right temporal region. Given that the delta band is the main frequency of the P3 ERP, which is a marker of global workspace activity for conscious access, and because the gamma band is involved in visual object processing, the current results substantiate the role of phase–amplitude modulation in conscious access to visual target representations.
Psorodonotus venosus group (Orthoptera, Tettigoniidae; Tettigoniinae): geometric morphometry revealed two new species in the group
Authors: KAYA SARP , KORKMAZ E. MAHİR , ÇIPLAK BATTAL
Published: December 2013

Psorodonotus (Orthoptera, Tettigoniidae) includes 11 species distributed in Caucasus, Anatolia and Balkans. Although its present taxonomy is problematic, mainly three species groups can be distinguished; (i) The Specularis Group, (ii) The Caucasicus Group and (iii) The Venosus Group. Our recent studies on the genus have revealed presence of two new species in the last species group. Morphology of the species group studied both qualitatively and quantitatively using linear metric data of pronotum, tegmina and hind femur, and geometric data of male cerci and ovipositor. Morphological data were accompanied by data obtained from male calling song. Morphological and song data were produced from six different populations from North and Eastern part of Turkey: (1) Hakkari, (2) Tendürek, (3) Giresun, (4) Artvin, (5) Kars and (6) Ağrı. Qualitative and quantitative morphology, either linear-metric or geometric, suggest last three population as members of the same unit, but each of other three as different units. Song data are also largely in support of the morphological results. Necessary illustrations were provided to document results visually. Following conclusions were made: (1) the Artvin, Kars and Ağrı populations represent typical P. venosus and the Giresun population P. rugulosus, (2) each of the Hakkari and Tendürek populations represents a new species and P. hakkari sp. n. and P. tendurek sp. n. described by comparing with other members of P. venosus group, (3) P. rugulosus, P. hakkari sp. n. and P. tendurek sp. n. differ from P. venosus mainly by the longer cerci (extend to or beyond end of abdomen) and indistinct tubercles on surface of pronotal disc in female. P. rugulosus and P. tendurek sp. n. are also similar by sharing presence of two loud elements in a syllable (one in P. venosus, song of P. hakkari sp. n. is not available). But, similarities in phenotype are in conflict with relationships suggested by genetic data.
Cambarus (C.) hatfieldi, a new species of crayfish (Decapoda:Cambaridae) from the Tug Fork River Basin of Kentucky, Virginia and West Virginia, USA
Authors: Loughman Zachary J. , FAgundo Raquel A. , Lau Evan , Welsh Stuart A. , Thoma Roger f.
Published: December 2013

Cambarus (Cambarus) hatfieldi is a stream-dwelling crayfish that appears to be endemic to the Tug Fork River system of West Virginia, Virginia, and Kentucky. Within this region, it is prevalent in all major tributaries in the basin as well as the Tug Fork River’s mainstem. The new species is morphologically most similar to Cambarus sciotensis and Cambarus angularis. It can be differentiated from C. sciotensis by its squamous, subtrinagular chelae compared to the elongate triangular chelae of C. sciotensis; its shorter palm length/palm depth ratio (1.9) compared to C. sciotensis (2.3); and a smaller areola length/total carapace length ratio (30.4% vs.36.5% respectively). Cambarus hatfieldi can be differentiated from C. angularis by its smaller areola length/total carapace length ratio (30.4% vs. 36.7% respectively); a smaller rostrum width/rostral length ratio (59.4% vs. 67.2% respectively); its rounded abdominal pleura as compared to the subtruncated pleura of C. angularis; the length of the central projection and mesial process of C. hatfieldi which both extend to the margin of the gonopod shaft or slightly beyond the margin compared to the central projection of C. sciotensis and C. angularis where both extend well beyond the margin of the gonopod shaft.
A new genus and species of Vartini (Hemiptera: Cicadellidae: Deltocephalinae) from Africa
Authors: ZAHNISER JAMES N.
Published: December 2013

A new genus and species of the leafhopper tribe Vartini are described.  Afrovarta angelae gen. & sp. nov. are described based on specimens from Ghana, Cameroon, and Gabon.
Exploratory High-Resolution Climate Simulations using the Community Atmosphere Model (CAM)
Authors: Bacmeister Julio T. , Wehner Michael F. , Neale Richard B. , Gettelman Andrew , Hannay Cecile , Lauritzen Peter H. , Caron Julie M. , Truesdale John E.
Published: December 2013

Extended, high-resolution (0.23° latitude × 0.31° longitude) simulations with Community Atmosphere Model versions 4 and 5 (CAM4 and CAM5) are examined and compared with results from climate simulations conducted at a more typical resolution of 0.9° latitude × 1.25° longitude. Overall, the simulated climate of the high-resolution experiments is not dramatically better than that of their low-resolution counterparts. Improvements appear primarily where topographic effects may be playing a role, including a substantially improved summertime Indian monsoon simulation in CAM4 at high resolution. Significant sensitivity to resolution is found in simulated precipitation over the southeast United States during winter. Some aspects of the simulated seasonal mean precipitation deteriorate notably at high resolution. Prominent among these is an exacerbated Pacific “double ITCZ” bias in both models. Nevertheless, while large-scale seasonal means are not dramatically better at high resolution, realistic tropical cyclone (TC) distributions are obtained. Some skill in reproducing interannual variability in TC statistics also appears.
Social Media for Selection? Validity and Adverse Impact Potential of a Facebook-Based Assessment
Authors: Van Iddekinge Chad H. , Lanivich Stephen E. , Roth Philip L. , Junco Elliott
Published: December 2013

Recent reports suggest that an increasing number of organizations are using information from social media platforms such as Facebook.com to screen job applicants. Unfortunately, empirical research concerning the potential implications of this practice is extremely limited. We address the use of social media for selection by examining how recruiter ratings of Facebook profiles fare with respect to two important criteria on which selection procedures are evaluated: criterion-related validity and subgroup differences (which can lead to adverse impact). We captured Facebook profiles of college students who were applying for full-time jobs, and recruiters from various organizations reviewed the profiles and provided evaluations. We then followed up with applicants in their new jobs. Recruiter ratings of applicants’ Facebook information were unrelated to supervisor ratings of job performance (rs = −.13 to –.04), turnover intentions (rs = −.05 to .00), and actual turnover (rs = −.01 to .01). In addition, Facebook ratings did not contribute to the prediction of these criteria beyond more traditional predictors, including cognitive ability, self-efficacy, and personality. Furthermore, there was evidence of subgroup difference in Facebook ratings that tended to favor female and White applicants. The overall results suggest that organizations should be very cautious about using social media information such as Facebook to assess job applicants.
Advantages and Challenges of Distributing Leadership in Middle-Level Schools
Authors: Grenda J. Patrick , Hackmann Donald G.
Published: December 2013

This multiple-site case study examined distributed leadership practices of three middle school principals, using observations, interviews, and document analysis. Findings disclosed that the principals built on the interdisciplinary teaming structure to develop empowering organizational structures that promoted democratic governance. Employing distributed practices, they identified teacher leaders to guide curriculum, professional development, and building management. While utilizing the teaming structure to facilitate building-wide decision making, the principals also found that distributing leadership across several individuals sometimes created challenges for communications accuracy.
The Implications of Physical Injury on Otovestibular and Cognitive Symptomatology following Blast Exposure
Authors: Johnson Christopher M. , Perez Colleen F. , Hoffer Michael E.
Published: December 2013

Objective

Identify a potential difference in the spectrum of otovestibular and cognitive symptoms in blast‐exposed patients comparing individuals with or without significant extremity injuries.

Study Design

Case series with chart review.

Setting

A military tertiary care medical center.

Subjects and Methods

All new patient referrals for otovestibular evaluation after a blast injury or exposure were identified in the electronic medical record. One hundred consecutive patients meeting these criteria were studied. Data including presence of severe extremity injuries, diagnosis of mild traumatic brain injury, symptoms of imbalance, vertigo, headache, tympanic membrane perforation, hearing loss, and tinnitus were collected and analyzed.

Results

Of 100 patients included, 38 suffered severe extremity injuries. Those patients with severe extremity injuries were more likely to suffer from tympanic membrane perforations (58% vs 23%, P <. 001, odds ratio [OR], 4.71, 95% confidence interval [CI], 1.96‐11.33) and hearing loss (53% vs 23%, P =. 002, OR, 3.81, 95% CI, 1.59‐9.11). However, those without severe extremity injuries were more likely to suffer from imbalance (79% vs 32%, P <. 001, OR, 8.17, 95% CI, 3.26‐20.44) and vertigo (47% vs 2%, P <. 001, OR, 32.52, 95% CI, 4.19‐252.07) and more likely to have been diagnosed with a mild traumatic brain injury following blast exposure (66% vs 26%, P <. 001, OR, 5.47, 95% CI, 2.24‐13.36).

Conclusion

Blast‐exposed individuals who sustained severe extremity injuries reported significantly fewer cognitive and vestibular symptoms. In the aftermath of a blast, those who can walk away may have still sustained a significant injury. Specifically, they may suffer more long‐term cognitive and vestibular symptoms than those with severe physical injuries.
Validity of European Position Paper on Rhinosinusitis Disease Control Assessment and Modifications in Chronic Rhinosinusitis
Authors: Snidvongs Kornkiat , Heller Gillian Z. , Sacks Raymond , Harvey Richard J.
Published: December 2013

Objectives

To develop a chronic rhinosinusitis (CRS) disease control staging system that predicts patient and physician opinion. This involved exploring the predictive capacity of the proposed European Position Paper on Rhinosinusitis (EPOS) 2012 staging system and other potential scoring systems based on patient symptoms and objective criteria.

Study Design

Prospective study.

Setting

Tertiary hospitals.

Subjects and Methods

Adults CRS patients undergoing sinus surgery were prospectively enrolled from a tertiary clinic. The Sino‐Nasal Outcome Test 22, endoscopy score, and systemic medication were recorded at 6 and 12 months. A physician and patient report of their condition as either “controlled,”“partly controlled,” or “uncontrolled” was also recorded. Ordinal regression was used for modeling a staging system. The EPOS criteria and various combinations were assessed. Kappa agreements between the staging systems and patient/physician reports were analyzed.

Results

One hundred six patients were assessed. Nasal obstruction (P =. 02), endoscopic mucosal inflammation (P <. 001), and thick and/or purulent discharge (P =. 01) associated with progress reports. A modified staging system of Nasal Obstruction, Systemic medication used, and Endoscopic inflammation (NOSE) was selected on predictive strengths. The EPOS and NOSE had significant agreement with physician's (k = 0.29, P <. 01, and k = 0.45, P <. 01) and patient's report (k = 0.18, P =. 01, and k = 0.32, P <. 01).

Conclusions

The disease control assessment by EPOS has slight agreement with patients and a physician. A simpler NOSE system using nasal obstruction, mucosa, and discharge is proposed.
Single-Level and Multilevel Mediation Analysis
Authors: Tofighi Davood , Thoemmes Felix
Published: December 2013

Mediation analysis is a statistical approach used to examine how the effect of an independent variable on an outcome is transmitted through an intervening variable (mediator). In this article, we provide a gentle introduction to single-level and multilevel mediation analyses. Using single-level data, we demonstrate an application of structural equation modeling (SEM) in estimating mediation models with multiple mediators and multiple outcomes. We also describe the estimation and interpretation of a 2→1→1 multilevel mediation model in which the first, second, and third numbers correspond to the measurement levels of the independent, mediator, and outcome variables, respectively. We present two numerical examples that use simulated data based on published studies in adolescence research to demonstrate how to specify, estimate, and interpret the results of single-level and multilevel mediation analyses to answer key research questions. We briefly discuss underlying assumptions required to make a valid causal interpretation of a mediation analysis.
Objectifying Media
Authors: Galdi Silvia , Maass Anne , Cadinu Mara
Published: December 2013

Across two studies, we investigated the hypothesis that exposure to objectifying television in which women are shown as sexual objects increases the likelihood of harassing conduct. In both studies ( Ns = 141; 120), male participants were exposed to one of the three TV clips in which women were portrayed (a) as sexual objects (objectifying TV), (b) in professional roles, or (c) excluded (a nature documentary). Study 1 showed that men exposed to objectifying TV reported greater proclivity to engage in sexual coercion and manifested more gender-harassing behavior than participants in the other conditions. Study 2 further demonstrated that exposure to objectifying TV increased participants’ conformity to masculine gender role norms, which, in turn, mediated the relation between experimental condition and gender harassment. Together, the two studies suggest that media content plays a central role in activating harassment-related social norms, which in turn encourage or inhibit harassing conduct.