bluuebunny/crossref_metadata_2025 huggingface dataset:
Preventive and remedial application of etanercept attenuate monocrotaline‐induced pulmonary arterial hypertension
Authors: Zhang Ling‐ling , Lu Jie , Li Meng‐tao , Wang Qian , Zeng Xiao‐feng
Published: February 2014

Aim

To evaluate the efficacy of etanercept (ETN) on monocrotaline (MCT)‐induced pulmonary arterial hypertension (PAH) in rats.

Methods

A PAH rat model was induced by intraperitoneal injection (i.p.) of MCT (60 mg/kg) once and ENT therapy (2.5 mg/kg twice a week i.p.) was initiated on the day following MCT injection (prevention protocol) or after PAH is established (remedial protocol) for 2 weeks. The mean pulmonary arterial pressure (mPAP) was measured using a right heart catheterization technique; quantitative determination of lung small artery blood wall thickening observed by hematoxylin and eosin staining; the expression of tumor necrosis factor (TNF)‐α and interleukin (IL)‐6 in the rat lung tissues were determined using immunohistochemistry.

Results

Both preventive (12.53 ± 3.8 vs. model control 28.67 ± 7.57 mmHg, P < 0.01) and remedial (35.95 ± 20.29 vs. model control 66.17 ± 24.29 mmHg, P < 0.01) applications of ETN could significantly reduce mPAP. We obtained similar results when using the R‐value to assess the efficacy of ETN in two treatment groups (preventive groups, 0.273 ± 0.018 vs. 0.203 ± 0.036, P < 0.01; remedial groups, 0.227 ± 0.031 vs. 0.124 ± 0.008, P < 0.01). The immunohistochemistry staining showed that there were strong expressions of TNF‐α and IL‐6 in the lung tissues of model groups and decreased expression in both treatment groups.

Conclusion

Treatment with TNF‐α antagonism ETN prevented and reversed MCT‐induced PAH by reducing inflammatory cell infiltration. Our results suggest a critical role of TNF‐α and inflammation in MCT‐induced PAH progression and targeting the inflammatory environment might be a potential means of PAH treatment.
Diagnosis and surgical treatment of esophageal carcinoma with coexistent intrathoracic vascular malformations
Authors: Niu Zhong‐Xi , Gao Qiang , Peng Jun , Shi Hui , Chen Long‐Qi
Published: February 2014

Background

The anomaly of intrathoracic large vessels might not only compress the esophagus resulting in dysphagia, but also hinder esophagectomy, even leading to uncontrolled massive hemorrhaging. This paper reviews our experience of seven patients with this diagnosis and their treatment.

Methods

From January 2007 through January 2012, among patients admitted with esophageal carcinoma, there were seven patients confirmed to have coexisted intrathoracic vascular anomalies. They were six men and one woman, aged 52 to 63 (mean 58.42). The vascular anomalies included aberrant right subclavian artery (ARSA) in three cases, post‐aortic left innominate vein (PALIV) in two cases, and one case each of right aortic arch (RAA) and pseudoaneurysm of aortic isthmus (PAAI). Their diagnosis, surgical strategy, and outcome were reviewed.

Results

The vascular anomalies were missed by esophagography and endoscopy, but all identified by enhanced chest computed tomography (CT). Surgery was planned according to the anatomic features of the anomalies. ARSA did not need special management. RAA underwent left thoracotomy in order to dissect the aortopulmonary arterial ligament and to facilitate the mobilization of the esophagus. PAAI had preoperative aortic stenting to prevent unexpected aortic rupture. Prophylactic ligation of thoracic duct was performed on all patients and no postoperative chylothorax was documented.

Conclusions

The coexistence of intrathoracic vascular malformations with esophageal carcinoma is rare, but easily missed in routine X‐ray and endoscopy. Enhanced chest CT must be performed to confirm. Surgery should be designed individually in consideration of the anatomic features of the vascular anomalies. A routine prophylactic ligation of the thoracic duct is recommended.
Genetic Relationship Between Predisposition for Binge Alcohol Consumption and Blunted Sensitivity to Adverse Effects of Alcohol in Mice
Authors: Fritz Brandon M. , Cordero Kristy A. , Barkley‐Levenson Amanda M. , Metten Pamela , Crabbe John C. , Boehm Stephen L.
Published: February 2014

Background

Initial sensitivity to ethanol (EtOH) and the capacity to develop acute functional tolerance (AFT) to its adverse effects may influence the amount of alcohol consumed and may also predict future alcohol use patterns. The current study assessed sensitivity and AFT to the ataxic and hypnotic effects of EtOH in the first replicate of mice (HDID‐1) selectively bred for high blood EtOH concentrations (BECs) following limited access to EtOH in the Drinking in the Dark (DID) paradigm.

Methods

Naïve male and female HDID‐1 and HS/Npt mice from the progenitor stock were evaluated in 3 separate experiments. In Experiments 1 and 2, EtOH‐induced ataxia was assessed using the static dowel task. In Experiment 3, EtOH‐induced hypnosis was assessed by using modified restraint tubes to measure the loss of righting reflex (LORR).

Results

HDID‐1 mice exhibited reduced initial sensitivity to both EtOH‐induced ataxia (p < 0.001) and hypnosis (p < 0.05) relative to HS/Npt mice. AFT was calculated by subtracting the BEC at loss of function from the BEC at recovery (Experiments 1 and 3) or by subtracting BEC at an initial recovery from the BEC at a second recovery following an additional alcohol dose (Experiment 2). The dowel test yielded no line differences in AFT, but HS/Npt mice developed slightly greater AFT to EtOH‐induced LORR than HDID‐1 (p < 0.05).

Conclusions

These results suggest that HDID‐1 mice exhibit aspects of blunted ataxic and hypnotic sensitivity to EtOH which may influence their high EtOH intake via DID, but do not display widely different development of AFT. These findings differ from previous findings with the high alcohol‐preferring (HAP) selected mouse lines, suggesting that genetic predisposition for binge, versus other forms of excessive alcohol consumption, is associated with unique responses to EtOH‐induced motor incoordination.
Brains online: structural and functional correlates of habitual Internet use
Authors: Kühn Simone , Gallinat Jürgen
Published: February 2014

In the past decades, the Internet has become one of the most important tools to gather information and communicate with other people. Excessive use is a growing concern of health practitioners. Based on the assumption that excessive Internet use bears resemblance with addictive behaviour, we hypothesized alterations of the fronto‐striatal network in frequent users. On magnetic resonance imaging scans of 62 healthy male adults, we computed voxel‐based morphometry to identify grey matter (GM) correlates of excessive Internet use, assessed by means of the Internet Addiction Test (IAT) and functional connectivity analysis and amplitude of low‐frequency fluctuation (ALFF) measures on resting state data to explore the functional networks associated with structural alterations. We found a significant negative association between the IAT score and right frontal pole GM volume (P < 0.001, family wise error corrected). Functional connectivity of right frontal pole to left ventral striatum was positively associated with higher IAT scores. Furthermore, the IAT score was positively correlated to ALFF in bilateral ventral striatum. The alterations in the fronto‐striatal circuitry associated with growing IAT scores could reflect a reduction of top‐down modulation of prefrontal areas, in particular, the ability to maintain long‐term goals in face of distraction. The higher activation of ventral striatum at rest may indicate a constant activation in the context of a diminished prefrontal control. The results demonstrate that excessive Internet use may be driven by neuronal circuits relevant for addictive behaviour.
Corrective osteotomy for procurvatum deformity caused by distal femoral physeal fracture malunion stabilised with String‐of‐Pearls locking plates: results in two dogs and a review of the literature
Authors: Kim SE , Lewis DD
Published: February 2014

Background

This report describes the treatment of severe procurvatum because of distal femoral physeal fracture malunion in two skeletally immature dogs.

Case reports

Both dogs presented with severe right hindlimb lameness and markedly reduced stifle extension at less than 5 months of age. Severe distal femoral procurvatum and mild‐to‐moderate femoral shortening secondary to distal femoral physeal fracture malunion were evident on radiographs. The sagittal plane deformities were addressed with a caudal opening‐wedge osteotomy in one dog and cranial closing wedge ostectomy in the other dog. String‐of‐Pearls locking plates were used to stabilise the osteotomies. Functional stifle extension range of motion and femoral length were improved post surgery in both dogs. Explantation of the plates was required in both dogs because of local soft tissue irritation. Both dogs had excellent outcomes based on subjective and objective measures (pressure sensitive walkway, force platform analysis) when assessed at skeletal maturity.

Conclusions

Corrective osteotomy stabilised with String‐of‐Pearls locking plates is a viable treatment option for improving limb function in dogs with severe procurvatum deformities caused by distal femoral physeal fracture malunion.
Intravenous Lipid Emulsion Improves Recovery Time and Quality from Isoflurane Anaesthesia: A Double‐Blind Clinical Trial
Authors: Li Qian , Yang Di , Liu Jin , Zhang Han , Zhang Jingyu
Published: February 2014

Recovery time and quality after general anaesthesia is important for patient safety. This study aimed to determine whether intravenous lipid emulsion could improve recovery profiles from isoflurane anaesthesia in adult patients undergoing laparoscopic cholecystectomy. Sixty‐six patients were enrolled. After anaesthesia induction, inspired isoflurane concentration was adjusted to maintain stable vital signs and the suitable conditions for operation. At the end of the operation, the isoflurane was discontinued, and either 2 ml/kg 30% lipid emulsions or 0.9% saline solution was administered intravenously. The time to eye opening, extubation and exit from the operation room was recorded, and the quality of recovery from anaesthesia was assessed. Sixty patients completed the study. The median time to eye opening and exit from the operation room was significantly shorter in the lipid emulsion group than in the saline group [15.5 (interquartile range 9.0) versus 20.0 (10.0) min., p = 0.01; 19.5 (8.3) versus 23.6 (6.3) min., p = 0.04, respectively], whereas the median time to extubation did not show any noticeable difference. The quality of recovery was better in the lipid emulsion group than that of the saline solution group with respect to drowsiness visual analogue scale score (p < 0.01), Observer's Assessment of Alertness/Sedation score (p < 0.01), Mini‐Mental State Examination score (p = 0.04) and Modified Aldrete Post Anaesthesia Recovery score (p = 0.03). No serious adverse events were observed during the study period. In conclusion, intravenous lipid emulsion may effectively improve the recovery time and quality from isoflurane anaesthesia for laparoscopic cholecystectomy.
Methodological capacity within the field of “educational technology” research: an initial investigation
Authors: Bulfin Scott , Henderson Michael , Johnson Nicola F. , Selwyn Neil
Published: February 2014

The academic study of educational technology is often characterised by critics as methodologically limited. In order to test this assumption, the present paper reports on data collected from a survey of 462 “research active” academic researchers working in the broad areas of educational technology and educational media. The paper explores their familiarity and expertise with various methods of data collection and analysis. Data from the survey highlight a preference for relatively basic forms of descriptive research, coupled with a lack of capacity in advanced quantitative data collection and analysis. The paper concludes with some directions for “methodological capacity building” to broaden the use of methods in educational technology research.
Advances in the understanding of cancer immunotherapy
Authors: Shore Neal D.
Published: February 2014

The principal role of the immune system is to prevent and eradicate pathogens and infections. The key characteristics or features of an effective immune response include specificity, trafficking, antigen spread and durability (memory). The immune system is recognised to have a critical role in controlling cancer through a dynamic relationship with tumour cells. Normally, at the early stages of tumour development, the immune system is capable of eliminating tumour cells or keeping tumour growth abated; however, tumour cells may evolve multiple pathways over time to evade immune control. Immunotherapy may be viewed as a treatment designed to boost or restore the ability of the immune system to fight cancer, infections and other diseases. Immunotherapy manifests differently from traditional cancer treatments, eliciting delayed response kinetics and thus may be more effective in patients with lower tumour burden, in whom disease progression may be less rapid, thereby allowing ample time for the immunotherapy to evolve. Because immunotherapies may have a different mechanism of action from traditional cytotoxic or targeted biological agents, immunotherapy techniques have the potential to combine synergistically with traditional therapies.
A new treatment for retroperitoneal fibrosis: initial experiences of using Seprafilm® to wrap the ureter
Authors: Kamihira Osamu , Hirabayashi Tsuyoki , Yamaguchi Asaomi , Hirabayashi Hiroki , Moriya Yoshie , Fukatsu Akitoshi , Yoshikawa Yoko , Matsuura Osamu , Kimura Kyosuke
Published: February 2014

Objective

To confirm the efficacy of using Seprafilm® (Genzyme Corp., Cambridge, MA, USA) for wrapping the ureter to treat the ureteric stenosis caused by retroperitoneal fibrosis (RPF).

Patients and Methods

Between August 2010 and September 2012, 11 ureters in eight patients with RPF (seven males and one female, mean age 65 years) were treated. The mean (range) length of the narrow segment of the ureter was 30 (10–90) mm. During surgery, after having been released from adhesive tissue, the stenotic segment of the ureter was wrapped with Seprafilm to isolate it from the surrounding tissue. A radiographic follow‐up was performed every 6 months using computed tomography, i.v. pyelography and/or 99mTc‐mercapto‐acetylglycyl‐glycyl‐glycine (99mTc‐MAG3) renal scintigraphy.

Results

For the unilateral operations, the mean estimated blood loss was 39 mL, and the mean operating time was 154 min. All ureters were isolated from the fibrotic tissue and wrapped with Seprafilm successfully without major complications. During the mean follow‐up period of 17 months, no ureteric restenoses were observed in the affected sides, but new stenosis occurred in the contralateral side of the ureter in one patient.

Conclusions

Although the follow‐up period is still limited, we believe that the use of Seprafilm has the potential to become an effective option in the treatment of ureteric stenosis caused by RPF, when the omentum cannot be used. To establish the relative advantages of using Seprafilm over performing a standard omental wrap, further experimentation will be required to compare the two techniques.
Syn‐sedimentary salt diapirism as a control on fluvial‐system evolution: an example from the proximal Permian Cutler Group, SE Utah, USA
Authors: Venus Joanne H. , Mountney Nigel P. , McCaffrey William D.
Published: February 2014

Loading of subsurface salt during accumulation of fluvial strata can result in halokinesis and the growth of salt pillows, walls and diapirs. Such movement may eventually result in the formation of salt‐walled mini‐basins, whose style of architectural infill may be used to infer both the relative rates of salt‐wall growth and sedimentation and the nature of the fluvial‐system response to salt movement. The Salt Anticline Region of the Paradox Basin of SE Utah comprises a series of elongate salt‐walled mini‐basins, arranged in a NW‐trending array. The bulk of salt movement occurred during deposition of the Permian Cutler Group, a wedge of predominantly quartzo‐feldspathic clastic strata comprising sediment derived from the Uncompahgre Uplift to the NE. The sedimentary architecture of selected mini‐basin fills has been determined at high resolution through outcrop study. Mini‐basin centres are characterized by multi‐storey fluvial channel elements arranged into stacked channel complexes, with only limited preservation of overbank elements. At mini‐basin margins, thick successions of fluvial overbank and sheet‐like elements dominate in rim‐syncline depocentres adjacent to salt walls; many such accumulations are unconformably overlain by single‐storey fluvial channel elements that accumulated during episodes of salt‐wall breaching. The absence of gypsum clasts suggests that sediment influx was high, preventing syn‐sedimentary surface exposure of salt. Instead, fluvial breaching of salt‐generated topography reworked previously deposited sediments of the Cutler Group atop growing salt walls. Palaeocurrent data indicate that fluvial palaeoflow to the SW early in the history of basin infill was subsequently diverted to the W and ultimately to the NW as the salt walls grew to form topographic barriers. Late‐stage retreat of the Cutler fluvial system coincided with construction and accumulation of an aeolian system, recording a period of heightened climatic aridity. Aeolian sediments are preserved in the lees of some salt walls, demonstrating that halokinesis played a complex role in the differential trapping of sediment.
Do richness and rarity hotspots really matter for orchid conservation in light of anticipated habitat loss?
Authors: Crain Benjamin J. , Tremblay Raymond L.
Published: February 2014

Aim

The aim of this analysis was to identify strategies that will maximize efficiency and effectiveness in conservation planning. As many orchids are threatened with extinction for various reasons, our primary objective was to combine hotspots analyses with stochastic extinction modelling to highlight possible conservation priorities for Lepanthes spp. (Orchidaceae) based on patterns of richness, rarity and threat. Our subsequent objective was to identify potential conservation surrogates and variables that are the best predictors of extinction probabilities. The ultimate goal was to determine which factors should be emphasized in conservation planning to prevent species extinctions.

Location

Latin America; the Caribbean.

Methods

We used herbarium records and ArcGIS to map the distribution of Lepanthes spp. and to identify hotspots of richness and rarity. We forecasted extinction patterns with Koopowitz's stochastic extinction model and calculated extinction probabilities in each country. We used a randomForest regression model in R to assess the importance of richness, rarity and threat for explaining extinction probabilities.

Results

Hotspots of Lepanthes richness and rarity occurred in north‐western South America and southern Central America and largely overlapped with each other. The highest extinction probabilities occurred in northern Central America, Haiti and Ecuador, and generally, hotspots of richness and rarity did not correspond with patterns of threat. Habitat loss was the most important variable for explaining extinction probabilities, followed by measures of rarity.

Main conclusions

Conservation efforts will be most efficient in richness and rarity hotspots, and because they overlap, rarity hotspots could act as surrogates for protecting overall Lepanthes diversity. Hotspots rarely occurred in the most threatened areas, and therefore, conservation efforts are more urgent in non‐hotspot areas. Conservation efforts will be most effective if they combine ex situ strategies in locations with high habitat conversion rates with reservation strategies in rarity and richness hotspots, particularly where they overlap.
Spatio‐temporal marine conservation planning to support high‐latitude coral range expansion under climate change
Authors: Makino Azusa , Yamano Hiroya , Beger Maria , Klein Carissa J. , Yara Yumiko , Possingham Hugh P.
Published: February 2014

Aim

Increasing sea‐surface temperatures (SST) have resulted in poleward range expansions of scleractinian corals and declines in their core ranges. These changes may provide management opportunities for the long‐term persistence of corals, but spatial prioritization rarely considers and anticipates these changes. We developed a spatio‐temporal conservation plan that accommodates future coral range expansions based on projections of futureSST. Our spatial planning approach is particularly useful in places with limited information about species distributions. Our aims were to (1) identify areas that consistently remain important for conservation through time and (2) determine the differences between priorities for conservation that account for potential coral range expansions and those that ignore them.

Location

Japan.

Methods

We developed spatial planning approaches using predicted coral habitat distributions for current conditions, the near future and the distant future. Using theMarxan conservation planning software, we designed conservation plans for scenarios that incorporated different types of spatial and temporal connections. Spatial connections are physical connections between adjacent and nearby areas, whereas temporal connections connect planning areas throughout time.

Results

We found that protecting areas important for current and future coral habitat distributions is possible by prioritizing places that are consistently important through time. A spatially and temporally cohesive plan was accomplished with only a 14% increase in the overall reserve system costs, compared with reserve systems ignoring future coral habitat distributions. The attributes of priority areas (e.g. locations, outside boundary length and size) were substantially different when we varied the types of connections.

Main conclusions

This study demonstrated that areas with highest conservation priority now will not necessarily be optimal when planning for future change, such as coral range expansions. Furthermore, we showed that incorporating spatio‐temporal connections into spatial prioritization achieves objectives of simultaneously conserving corals in the current climate and facilitating their expansions asSSTrises.
FORECASTING CRUDE OIL PRICE MOVEMENTS WITH OIL‐SENSITIVE STOCKS
Authors: CHEN SHIU‐SHENG
Published: February 2014

This paper uses monthly data from 1984:M10 to 2012:M8 to show that oil‐sensitive stock price indices, particularly those in the energy sector, have strong power in predicting nominal and real crude oil prices at short horizons (1‐month‐ahead predictions), using both in‐ and out‐of‐sample tests. In particular, the forecasts based on oil‐sensitive stock price indices are able to outperform significantly the no‐change forecasts. For example, using the NYSE Arca (AMEX) oil index as a predictor, the 1‐month‐ahead forecasts for nominal crude oil prices reduce the mean squared prediction error by between 22% (for the West Texas Intermediate oil price) and 28% (for the Dubai oil price). Moreover, we find that the directional forecast based on the AMEX oil index is significantly better than a 50:50 coin toss. The novelty of this analysis is that it proposes a new and valuable predictor that both reflects timely market information and is readily available for forecasting the spot oil price.(JEL G17, Q43, Q47, C53)
AN ESTIMATE OF THE AGE DISTRIBUTION'S EFFECT ON CARBON DIOXIDE EMISSIONS
Authors: LUGAUER STEVEN , JENSEN RICHARD , SADLER CLAYTON
Published: February 2014

We estimate the age distribution's impact on carbon dioxide emissions from 1990 to 2006 by exploiting demographic variation in a panel of 46 countries. To eliminate potential bias from endogeneity or omitted variables, we instrument for the age distribution in a country's current population with lagged birth rates, and the regressions control for total population, total output, and country and year fixed effects. Carbon dioxide emissions increase with the share of the population aged 35 to 49 years, and this result is statistically significant and quantitatively large. (JEL Q4, J1)
VOTING FOR INCOME‐IMMISERIZING REDISTRIBUTION IN THE MELTZER–RICHARD MODEL
Authors: BARNETT RICHARD C. , BHATTACHARYA JOYDEEP , BUNZEL HELLE
Published: February 2014

This paper argues that income received via redistributive transfers, unlike labor income, requires no direct sacrifice of leisure; this makes it attractive to many voters even if it leaves them poorer. This point is made within the classic Meltzer and Richard (1981) model wherein heterogeneous voters evaluate an income‐redistribution program that finances a lump‐sum transfer to all via a distorting income tax. The political‐equilibrium policy under majority rule is the tax most preferred, utility‐wise, by the median voter. Ironically, this voter, and many poorer voters, may support a redistribution policy that leaves them poorer in income terms but with higher utility. (JEL H2, E6, D72)
GENDER DIFFERENCES IN EXPERIMENTAL WAGE NEGOTIATIONS
Authors: DITTRICH MARCUS , KNABE ANDREAS , LEIPOLD KRISTINA
Published: February 2014

We examine behavioral gender differences and gender pairing effects in a laboratory experiment with face‐to‐face alternating‐offers wage bargaining. Our results suggest that gender differences in bargaining behavior are role‐dependent. We find that women obtain worse bargaining outcomes than men when they take on the role of employees, but not when they act as employers. Differences in bargaining outcomes can be explained by the bargaining parties' initial offers and counteroffers. We do not find evidence for behavioral differences between men and women in the process of alternating offers after first offers and counteroffers are made.(JEL J16, C78, C91)
THE IMPACT OF RESTAURANT CALORIE LABELS ON FOOD CHOICE: RESULTS FROM A FIELD EXPERIMENT
Authors: ELLISON BRENNA , LUSK JAYSON L. , DAVIS DAVID
Published: February 2014

Using field experiment data, we compare the effectiveness of calorie labels to a “fat tax” at reducing calories ordered. Results from a structural model of consumer demand show that numeric labels did not influence food choice, but symbolic traffic light labels caused restaurant patrons to select lower‐calorie menu items; thus, adding a traffic light symbol could enhance the effectiveness of the numeric calorie label (as currently proposed by the Food and Drug Administration). Additionally, our model projects that labels can both reduce intake more than a 10% tax on high‐calorie items and a 10% subsidy on low‐calorie items. (JEL Q18, I18)
Consensus on domains, formation objectives and contents in cariology for undergraduate dental students in Colombia
Authors: Martignon S. , Marín L. M. , Pitts N. , Jácome‐Liévano S.
Published: February 2014

Objective

To achieve a consensus for an undergraduate cariology teaching curriculum between Colombian dental schools in line with the 2015 Global Alliance for a Cavity‐Free Future goal: ‘90% of dental schools adopting the current caries paradigm’.

Materials and methods

First phase: Four‐regional 2‐day workshops were conducted with 4 representative teachers (cariology, clinics, basic‐science, public health and specialisations) from each of the 24‐ACFO schools (Colombian Dental Schools Association) as follows: Presentations: ‐Main Colombian cariology teaching barriers, ‐Caries and public health current paradigms; ‐Schools' cariology teaching descriptions; ‐European Cariology Curriculum. Five main‐domain subgroup discussions: (i) the knowledge base; (ii) risk assessment, diagnosis and synthesis; (iii) decision‐making, preventive non‐surgical therapy; (iv) decision‐making, surgical therapy; and (v) evidence‐based cariology in clinical and public health practice, to adapt domains, objectives and contents to Colombian curriculum, public health and national health system needs. These 4‐regional plus 24‐school consensuses sent 1 month afterwards were adapted into a preliminary document. 2nd‐phase: 10 peer review by national faculty in cariology, and 10 curriculum, basic sciences, research, clinical management and public health experts. School participants and deans reviewed the draft document and suggestions were discussed and adapted into a final consensus document officially presented to the academic community at the ACFO National‐Research‐Meeting (September, 2012).

Results

24 schools and 92 teachers participated. The Colombian Cariology Curriculum was agreed by 23 schools. It positioned public health into one domain. A general focus on social determination was included, and more relevance was given to fluorosis than erosion.

Conclusions

A consensus on cariology teaching for undergraduate dental students was achieved in Colombia and work to promote its adoption has commenced.
Effects of local negative feedbacks on the evolution of species within metacommunities
Authors: Loeuille Nicolas , Leibold Mathew A.
Published: February 2014

Local negative feedbacks occur when the occupation of a site by a species decreases the subsequent fitness of related individuals compared to potential competitors. Such negative feedbacks can enhance diversity by changing the spatial structure of the environment. The conditions, however, involve dispersive, environmental and evolutionary processes in complex interactive ways. We introduce a model that accounts for four mechanisms: colonisation‐competition‐extinction ecological dynamics, evolutionary dynamics, local negative feedbacks and environmental averaging. Three qualitatively distinct dynamics are possible, one dominated by specialists, another dominated by generalists and an intermediate situation exhibiting taxon cycles. We discuss how metacommunity diversity, macro‐ecological patterns and environmental patterning are linked to the three qualitative dynamics. The model provides classical shapes for morph‐abundance distributions, or diversity‐area relationships. Diversity can be high when specialists dominate or when taxon cycles happen. Finally, local negative feedbacks often yield fine‐grain environments for taxon cycle dynamics and coarse‐grain environments when generalists dominate.
Spontaneous electroencephalographic changes in a castration model as an indicator of nociception: A comparison between donkeys and ponies
Authors: Grint N. J. , Johnson C. B. , Clutton R. E. , Whay H. R. , Murrell J. C.
Published: February 2014

Reasons for performing study

Donkeys are believed to be less demonstrative of pain than ponies. Research into comparative sensory processing between these species is required to elucidate these behavioural differences.

Objectives

To compare changes in the electroencephalogram (EEG) recorded during castration between donkeys and ponies.

Study design

Prospective clinical study.

Methods

Six ponies and 6 donkeys were castrated under halothane anaesthesia after acepromazine premedication and thiopental anaesthetic induction. Markers were inserted into the EEG recording at the time of skin incision (skin) and emasculation (emasc) for both testicles (T1 and T2) during a closed castration. Raw EEG data were analysed and the EEG variables median frequency (F50), total power (Ptot) and spectral edge frequency (F95) derived using standard techniques. Baseline values of F50, Ptot and F95 for each animal were used to calculate the percentage change from baseline at T1skin, T2skin, T1emasc and T2emasc.

Results

Decreased F50 values relative to baseline were observed in 4 ponies and 2 donkeys across all castration time points. In the remaining animals, the F50 value increased compared with baseline. Both donkey and pony groups showed an overall decrease in Ptot values compared with baseline at T1skin, but the magnitude of the decrease was significantly less (P = 0.004) in ponies than in donkeys. Donkeys demonstrated an overall greater increase (P = 0.05) in F95 values at T1skin relative to baseline compared with ponies.

Conclusions

Electroencephalographic responses to the noxious stimulus of castration were noted in both donkeys and ponies. Donkeys demonstrated a greater change in Ptot in response to castration than ponies; thus, donkeys appear to demonstrate a cerebral cortical response to a noxious stimulus that is similar to or greater than that in ponies, suggesting that their subtle behavioural expression of pain is not due to a difference in cortical processing of noxious sensory stimuli.
Changes in the radioactive cesium concentrations of grasslands during the first year after the Fukushima Daiichi Nuclear Power Plant accident in east Japan
Authors: Yamamoto Yoshito , Shibuya Takeshi , Hirano Kiyoshi , Shindo Kazumasa , Mashiyama Hideto , Fujisawa Tamotsu , Nakamura Michinaga , Tozawa Yoshiro , Miyaji Hirotake , Nakao Seiji , Togamura Yasuko
Published: February 2014

Radioactive cesium (Cs) concentration of vegetation and soil was monitored in grasslands in seven farms located at a distance ranging from 90 to 180 km from the Fukushima nuclear power plant during seven months following the reactor meltdown in March 2011. The monitored sites included six sown meadows used to produce hay or silage, three sown pastures and one native pasture used for cattle grazing. The radioactive Cs concentrations of the soil ranged from 264–1593 Bq kg−1 dry matter (DM). The radioactive Cs concentrations in vegetation (aboveground parts of dominant grasses) were high with values ranging from 639–19 823 Bq kg−1 DM for the meadows, 949–7161 Bq kg−1 DM for the sown pastures and 5088–358 549 Bq kg−1 DM for the native pasture. Although the radioactive Cs concentrations tended to decrease over time in most grasslands, there was no clear decreasing trend for grassland soils low in exchangeable potassium concentration and clay content. The transfer of radioactive Cs from soil to herbage tended to be lower in soils with higher exchangeable potassium concentration and clay content. Detailed measurements in one meadow showed highest radioactive Cs concentration in surface litter, followed by standing dead and live plant material. Approximately, 71, 21 and 7% of radioactive Cs in the meadows were present in the soil, litter and standing dead material, respectively. Further regular monitoring of radioactive Cs concentration in grasslands in the affected areas surrounding the nuclear power plant is required to amend the existing guidelines regarding livestock feeding.
A Correction on Coastal Heads for Groundwater Flow Models
Authors: Lu Chunhui , Werner Adrian D. , Simmons Craig T. , Luo Jian
Published: February 2014

We introduce a simple correction to coastal heads for constant‐density groundwater flow models that contain a coastal boundary, based on previous analytical solutions for interface flow. The results demonstrate that accurate discharge to the sea in confined aquifers can be obtained by direct application of Darcy's law (for constant‐density flow) if the coastal heads are corrected to ((α + 1)/α)hs − B/2α, in which hs is the mean sea level above the aquifer base, B is the aquifer thickness, and α is the density factor. For unconfined aquifers, the coastal head should be assigned the value . The accuracy of using these corrections is demonstrated by consistency between constant‐density Darcy's solution and variable‐density flow numerical simulations. The errors introduced by adopting two previous approaches (i.e., no correction and using the equivalent fresh water head at the middle position of the aquifer to represent the hydraulic head at the coastal boundary) are evaluated. Sensitivity analysis shows that errors in discharge to the sea could be larger than 100% for typical coastal aquifer parameter ranges. The location of observation wells relative to the toe is a key factor controlling the estimation error, as it determines the relative aquifer length of constant‐density flow relative to variable‐density flow. The coastal head correction method introduced in this study facilitates the rapid and accurate estimation of the fresh water flux from a given hydraulic head measurement and allows for an improved representation of the coastal boundary condition in regional constant‐density groundwater flow models.
Immune activation despite suppressive highly active antiretroviral therapy is associated with higher risk of viral blips in HIV‐1‐infected individuals
Authors: Zoufaly A , Kiepe JG , Hertling S , Hüfner A , Degen O , Feldt T , Schmiedel S , Kurowski M , van Lunzen J
Published: February 2014

Objectives

Viral blips are thought to represent random biological variations around a steady state of residual HIV viraemia and to lack clinical significance. We aimed to assess the association of immune activation and the occurrence of blips.

Methods

HIV‐infected patients from our out‐patient cohort who developed a blip after having been on fully suppressive highly active antiretroviral therapy (HAART) for at least 180 days were matched with patients without blips according to duration of complete viral suppression (CVS), age, sex and Centers for Disease Control and Prevention (CDC) stage. Frequencies of CD3+, CD3+CD4+, CD3+CD8+, CD3+HLA‐DR+, CD4+CD45RA+, CD16+CD56+CD3− and CD19+ cells, as well as C‐reactive protein (CRP) levels and clinical parameters, were included in conditional logistic regression models. Adherence to HAART was assessed by measuring prescribed nonnucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI) plasma levels in a sample of 57 patients.

Results

Eighty‐two patients with viral blip were matched with 82 controls from the same cohort. The mean age was 47.2 years [standard deviation (SD) 12.1 years], 80.5% of patients were male and 42.7% had CDC stage C disease. Viral blips occurred after a median of 14 months [interquartile range (IQR) 8–34 months] of CVS. In the logistic regression, activated CD3+HLA‐DR+ lymphocytes [odds ratio (OR) 1.25 per 100 cells/μL; 95% confidence interval (CI) 1.02–1.54; P = 0.03] were significantly associated with blips and there was a trend for an association of longer time on HAART with blips (OR 1.31 per year; 95% CI 0.96–1.78; P = 0.09). No between‐group difference regarding subtherapeutic drug levels was found (P = 0.46).

Conclusions

The occurrence of viral blips after suppressive HAART was associated with elevated markers of T‐cell activation. Blips may identify a subset of patients with higher immune activation and increased risk for HIV disease progression.
HIV‐associated neurocognitive disorder in HIV‐infected Koreans: the Korean NeuroAIDS Project
Authors: Ku NS , Lee Y , Ahn JY , Song JE , Kim MH , Kim SB , Jeong SJ , Hong K‐W , Kim E , Han SH , Song JY , Cheong HJ , Song YG , Kim WJ , Kim JM , Smith DM , Choi JY
Published: February 2014

Objectives

HIV‐associated neurocognitive disorder (HAND) is an independent predictor of early mortality and is associated with many difficulties in activities of daily living. We sought to determine the prevalence of and risk factors for HAND in HIV‐infected Koreans. In addition, we investigated the performance of screening tools and components of neuropsychological (NP) tests for diagnosing HAND.

Methods

HIV‐infected patients were enrolled consecutively from two different urban teaching hospitals in Seoul, South Korea between March 2012 and September 2012. Participants completed a detailed NP assessment of six cognitive domains commonly affected by HIV. The Frascati criteria were used for diagnosing HAND. Four key questions, the International HIV Dementia Scale (IHDS) and Montreal Cognitive Assessment (MoCA)‐K were also assessed as potential tools for screening for HAND.

Results

Among the 194 participants, the prevalence of HAND was 26.3%. Asymptomatic neurocognitive impairment and minor neurocognitive disorder accounted for 52.9 and 47.1% of the patients with HAND, respectively. In multivariate analysis, haemoglobin (Hb) level ≤ 13 g/dL (P = 0.046) and current use of a protease inhibitor‐based regimen (P = 0.031) were independent risk factors for HAND. The sensitivity and specificity of the IHDS were 72.6 and 60.8%, and those of MoCA‐K were 52.9 and 73.4%, respectively. The IHDS (P < 0.001) and MoCA‐K (P < 0.001) were both useful for screening for HAND. Among NP tests, the sensitivity and specificity of the Grooved Pegboard Test were 90.2 and 72.0%, and those of the Wisconsin Card Sorting Test were 61.2 and 84.4%, respectively.

Conclusions

HAND is a prevalent comorbidity in HIV‐infected Koreans. Active screening and diagnosis with effective tools, such as the IHDS, MoCA‐K and Grooved Pegboard Test, could be used to identify this important complication.
Emergency department lengths of stay: characteristics favouring a delay to the admission decision as distinct from a delay while awaiting an inpatient bed
Authors: Perimal‐Lewis L. , Ben‐Tovim D. I. , Li J. Y. , Hakendorf P. H. , Thompson C. H.
Published: February 2014

Background

A prolonged stay for a patient within the emergency department (ED) can adversely affect the outcome of their ensuing hospital admission.

Aims

To investigate the characteristics of those eventual general medical hospital inpatients who stay in the ED awaiting a decision to be admitted and then await a bed.

Methods

Data from Flinders Medical Centre's patient journey database were analysed. The analysis was carried out on 19 476 patients admitted as an emergency under the General Medicine units.

Results

A less urgent Australian Triage Scale category significantly prolonged triage‐to‐admit time but did not affect boarding time. The decision to admit a patient took 29% longer for patients who presented to the ED outside of working hours. However, a decision to admit taken outside working hours meant the boarding time was over 3 h shorter than if the decision had been taken inside working hours. For every additional patient in the ED at the time of presentation, the admission decision was delayed by about half a minute. Every additional patient in the ED at the time of an admission decision increased boarding time by almost 10 min.

Conclusion

Outside of working hours, patients presenting to ED have longer triage‐to‐admit times while patients for admission have shorter boarding times. ED congestion delays admission decisions only slightly and prolongs patients' boarding times to a greater extent. Strategies to reduce the time patients spend in ED should differ depending on whether a decision to admit the patient has been reached.
Spontaneous pneumothorax; a multicentre retrospective analysis of emergency treatment, complications and outcomes
Authors: Brown S. G. A. , Ball E. L. , Macdonald S. P. J. , Wright C. , McD Taylor D.
Published: February 2014

Background

Spontaneous pneumothorax can be managed initially by observation, aspiration or chest drain insertion.

Aims

To determine the clinical features of spontaneous pneumothorax in patients presenting to the emergency department (ED), interventions, outcomes and potential risk factors for poor outcomes after treatment.

Methods

Retrospective chart review from ED of three major referral and two general hospitals in Australia of presentations with primary spontaneous pneumothorax (PSP) or secondary spontaneous pneumothorax (SSP). Main outcomes were prolonged air leak (>5 days) and pneumothorax recurrence within 1 year.

Results

We identified 225 people with PSP and 98 with SSP. There were no clinical tension pneumothoraces with hypotension. Hypoxaemia (haemoglobin oxygen saturation measured by pulse oximetry ≤92%) occurred only in SSP and in older patients (age >50 years) with PSP. Drainage was performed in 150 (67%) PSP and 82 (84%) SSP. Prolonged air leak occurred in 16% (95% confidence interval 10–23%) of PSP and 31% (21–42%) of SSP. Independent risk factors for prolonged drainage were non‐asthma SSP and pneumothorax size >50%. Complications were recorded in 11% (7.5–16%) of those having drains inserted. Recurrences occurred in 5/91 (5%, 1.8–12%) of those treated without drainage versus 40/232 (17%, 13–23%) of those treated by drainage, of which half occurred in the first month after drainage.

Conclusion

Pneumothorax drainage is associated with substantial morbidity including prolonged air leak. As PSP appears to be well tolerated in younger people even with large pneumothoraces, conservative treatment in this subgroup may be a viable option to improve patient outcomes, but this needs to be confirmed in a clinical trial.
Factors associated with paediatric dentists’ perception of dental pain in pre‐schoolers: a mixed‐methods study
Authors: Daher Anelise , Costa Márcia , Costa Luciane R.
Published: February 2014

Background

Children dental pain recognition is pointed as a priority in paediatric dentistry, but little is known about dentists’ perception of pre‐schoolers’ dental pain.

Aim

To understand paediatric dentists’ viewpoint on dental pain (toothache) in pre‐schoolers and to identify the associated factors.

Design

Mixed‐methods with two phases: (i) preliminary qualitative study (focus group of paediatric dentists), with responses analysed by content analysis and (ii) quantitative survey (self‐administered questionnaire answered by 223 paediatric dentists), with the main outcome ‘perception’ assessed as ‘feel or not prepared’ to identify a pre‐schooler with dental pain. Triangulation was used to discuss the results of each approach.

Results

(i) Paediatric dentists can observe dental pain in pre‐schoolers when there are normative signs; this pain is related to the changes in a child's behaviour and in dental planning. (ii) Participants were 40.1 ± 8.4 years old, 17.1 ± 8.3years since graduation, 65.9% did not feel prepared to identify a pre‐schooler with dental pain. This feeling of unpreparedness was associated with younger specialists (P = 0.01) and less time since graduation (P < 0.01). Triangulation showed a convergence of the qualitative and quantitative approaches.

Conclusion

Noticing dental pain in pre‐schoolers was associated with specialists’ experience and the need for visible signs; dentists do not always feel completely prepared to recognise pain in pre‐schoolers.