bluuebunny/crossref_metadata_2025 huggingface dataset:
Is there a limit to transanal endoscopic surgery? A comparative study between standard and technically challenging indications among 168 consecutive patients
Authors: Saget A. , Maggiori L. , Petruciani N. , Ferron M. , Panis Y.
Published: May 2015

Aim

To assess the surgical outcome of transanal endoscopic surgery (TES) for rectal neoplasms in technically challenging indications.

Method

All patients who underwent TES for a rectal neoplasm from 2007 to 2014 were included. Technically challenging indications included a tumour with (i) diameter ≥ 5 cm, (ii) involving ≥ 50% of the rectal circumference and (iii) located ≥ 10 cm from the anal verge. Patients were divided into three groups according to how many of these features they had, as follows: Group 1, none; Group 2, one; Group 3, two or more.

Results

Of the 168 patients (80 benign and 88 malignant tumours) included in the study, 73 (44%) were in Group 1, 46 (27%) in Group 2 and 49 (29%) in Group 3. There was no difference between Group 1 and Group 2 with regard to peritoneal perforation (P = 0.210), severe postoperative morbidity (P = 0.804), length of hospital stay (P = 0.444), incomplete resection (P = 0.441), piecemeal resection (P = 0.740), locoregional recurrence (P = 0.307) and long‐term symptomatic rectal stenosis (P = 0.076). Conversely Group 3 showed significantly impaired results compared with Group 1 with regard to peritoneal perforation (P = 0.003), piecemeal resection (P = 0.005), incomplete resection (P = 0.025), locoregional recurrence (P = 0.035) and long‐term symptomatic rectal stenosis (P < 0.001), but no difference in severe postoperative morbidity (P = 0.328).

Conclusion

Transanal endoscopic surgery for rectal neoplasms appears to be safe and effective, even in patients presenting with a technically challenging tumours. Although the short‐ and long‐term outcomes after TES are worse in patients with highly challenging tumours, nevertheless the technique should still be considered in patients at high risk of requiring a proctectomy.
The Cognitive Social Network in Dreams: Transitivity, Assortativity, and Giant Component Proportion Are Monotonic
Authors: Han Hye Joo , Schweickert Richard , Xi Zhuangzhuang , Viau‐Quesnel Charles
Published: May 2015

For five individuals, a social network was constructed from a series of his or her dreams. Three important network measures were calculated for each network: transitivity, assortativity, and giant component proportion. These were monotonically related; over the five networks as transitivity increased, assortativity increased and giant component proportion decreased. The relations indicate that characters appear in dreams systematically. Systematicity likely arises from the dreamer's memory of people and their relations, which is from the dreamer's cognitive social network. But the dream social network is not a copy of the cognitive social network. Waking life social networks tend to have positive assortativity; that is, people tend to be connected to others with similar connectivity. Instead, in our sample of dream social networks assortativity is more often negative or near 0, as in online social networks. We show that if characters appear via a random walk, negative assortativity can result, particularly if the random walk is biased as suggested by remote associations.
Effect of food intake on left and right ventricular systolic tissue Doppler measurements
Authors: Dieden Anna , Gårdinger Ylva , Hlebowicz Joanna , Björgell Ola , Dencker Magnus
Published: May 2015

Systolic tissue Doppler measurements (s′) have been used to measure the velocity in myocardial motion and are a valuable tool for evaluating the systolic function of the left and right ventricles. Digestion of food is known to significantly alter hemodynamics and may therefore affect s′. The effect of food intake on s′ parameters has not yet been studied. We assessed whether s′ is affected by food intake. Nineteen healthy subjects aged 26·2 ± 4·2 years were investigated. s′ was measured with pulsed tissue Doppler imaging in the right and left ventricles before the subjects ate a standardized meal and also 30 and 110 min after the meal. Three measurements were taken in each projection, and a mean value was calculated for each. s′ increased significantly (P<0·05) from fasting to 30 min after food intake in every measured site except in the left inferolateral wall (P = 0·15, NS). Several, but not all, variables returned to base value 110 min after food intake. This study shows that food intake affects the tissue Doppler variables used to evaluate systolic heart function. Further studies are needed in older healthy subjects and older subjects with various cardiovascular diseases.
Near infrared spectroscopy for frontal lobe oxygenation during non‐vascular abdominal surgery
Authors: Sørensen Henrik , Grocott Hilary P. , Secher Niels H.
Published: May 2015

Purpose

Cerebral deoxygenation, as determined by near infrared spectroscopy (NIRS), seems to predict postoperative complications following cardiac surgery. We identify the type of non‐vascular abdominal surgery associated with cerebral deoxygenation and/or hyperoxygenation, how such deviations affect patient outcome, and whether maintained cerebral oxygenation improves outcome.

Methods

A systematic literature search was performed on PubMed, EMBASE, Web of Science and Clinicaltrials.gov.

Results

A total of 901 patients from 24 publications are described. A decrease in NIRS (>15% relative to baseline) manifested with reverse Trendelenburg's positioning and in 24% (median) of especially elderly patients undergoing open surgery and demonstrated a correlation to hospital stay (LOS). However, if cerebral deoxygenation was reversed promptly, improved postoperative cognitive function (28 versus 26; mini‐mental state examination) and reduced LOS (14 versus 23 days) were seen. Also, during liver transplantation (LTx), impaired cerebral autoregulation (25%), cerebral deoxygenation in the anhepatic phase (36%) and cerebral hyperoxygenation with reperfusion of the grafted liver (14%) were identified by NIRS and could lead to adverse neurological outcome, that is seizures, transient hemiparesis and stroke.

Conclusion

NIRS seems important for predicting neurological complications associated with LTx. Also, surgery in reverse Trendelenburg's position and in other types of abdominal surgery about one‐fourth of the patients are subjected to episodes of cerebral deoxygenation that seems to predict a poor outcome. Although there are currently only few studies available for patients going through abdominal surgery, the available evidence points to that it is an advantage to maintain the NIRS‐determined cerebral oxygenation.
Anything to Stay Alive: The Challenges of a Campaign for an Experimental Drug
Authors: Geffen Nathan
Published: May 2015

Drug‐resistant tuberculosis (TB) has a high mortality rate. Most medicines used to treat it are poorly tested and have terrible side effects. Activists have campaigned for patients with drug‐resistant TB to have access to experimental drugs, particularly one called bedaquiline, before these have been approved by regulatory authorities such as the Food and Drug Administration (FDA) in the United States (US) and the Medicines Control Council (MCC) in South Africa. Some activists have also campaigned for bedaquiline to be approved by regulatory authorities before testing of the drug is completed. These campaigns raise ethical concerns about whether patients should be offered experimental, unapproved, medicines for the treatment of life‐threatening illnesses, and if authorities should approve drugs for life‐threatening illnesses when vital questions about safety and efficacy remain outstanding.
Parasitism of a native Hawaiian stream fish by an introduced nematode increases with declining precipitation across a natural rainfall gradient
Authors: Gagne Roderick B. , Blum Michael J.
Published: May 2015

Climate change can promote disease emergence if shifting conditions favour infection of native fauna by introduced parasites and pathogens. In Hawai'i, climate warming is predicted to reduce net precipitation and surface flow in streams, which in turn could increase parasitism of native stream fishes by non‐native parasites. In this study, we utilised a natural precipitation gradient across the Hamakua coast on the island of Hawai'i to assess the relationship between precipitation and infection of Awaous stamineus, a native amphidromous goby, by the introduced nematode Camallanus cotti. We found that the abundance, intensity and prevalence of C. cotti in A. stamineus increased with declining rainfall. Our results also show that parasitism tracks precipitation patterns across the archipelago and that parasitism increases even with moderate decreases in rainfall. As the Hamakua coast precipitation gradient represents a proxy for predicted climate‐driven reductions in precipitation, these findings suggest that infection of native Hawaiian fishes by introduced parasites will increase if climate conditions change as expected. Our findings also suggest that parasitism may be exacerbated by other factors that reduce surface flow, including water extraction for agricultural and urban uses. If so, then adaptive management of minimum flow standards in Hawai'i and elsewhere could improve the well‐being of at‐risk native fishes by alleviating parasitism under current and future climate conditions.
Canopy interactions and physical stress gradients in subtidal communities
Authors: Bennett Scott , Wernberg Thomas , de Bettignies Thibaut , Kendrick Gary A. , Anderson Robert J. , Bolton John J. , Rodgers Kirsten L. , Shears Nick T. , Leclerc Jean‐Charles , Lévêque Laurent , Davoult Dominique , Christie Hartvig C.
Published: May 2015

Species interactions are integral drivers of community structure and can change from competitive to facilitative with increasing environmental stress. In subtidal marine ecosystems, however, interactions along physical stress gradients have seldom been tested. We observed seaweed canopy interactions across depth and latitudinal gradients to test whether light and temperature stress structured interaction patterns. We also quantified interspecific and intraspecific interactions among nine subtidal canopy seaweed species across three continents to examine the general nature of interactions in subtidal systems under low consumer pressure. We reveal that positive and neutral interactions are widespread throughout global seaweed communities and the nature of interactions can change from competitive to facilitative with increasing light stress in shallow marine systems. These findings provide support for the stress gradient hypothesis within subtidal seaweed communities and highlight the importance of canopy interactions for the maintenance of subtidal marine habitats experiencing environmental stress.
Metabolic syndrome in female migraine patients is associated with medication overuse headache: a clinic‐based study in China
Authors: He Z. , Dong L. , Zhang Y. , Kong Q. , Tan G. , Zhou J.
Published: May 2015

Background and purpose

Migraine and metabolic syndrome have been reported to coexist to a marked degree, especially in women migraine patients, but the relationship between these two conditions is still unclear. This study was performed to evaluate the association of headache characteristics and its comorbidities with metabolic syndrome (MetS) and its components in female migraine patients.

Methods

A total of 142 women with migraine who fulfilled the criteria of the International Classification of Headache Disorders 2nd edition were recruited in a neurological outpatient department in China. The characteristics of migraine and its comorbidities (analgesic use, psychiatric disorders and disability) were assessed with a detailed questionnaire. Anthropometrics, blood biochemistry and transcranial Doppler sonography were used for metabolic measurements and vascular function.

Results

Of 142 participants, 70.4% had one or more metabolic abnormalities and 12.0% had MetS. After adjustment for age, residence, body mass index, waist‐to‐height ratio, smoking and drinking history, chronic migraine in women patients was associated with MetS [odds ratio (OR) = 5.342, P = 0.032], but when the chronic migraine patients were comorbid with medication overuse headache (MOH), the risk for MetS increased significantly (OR = 12.68, P = 0.007). In addition, MOH was associated with abdominal obesity and hypertension amongst the components of MetS (OR = 4.205 and 3.234, P = 0.043 and 0.039, respectively).

Conclusions

Our study may suggest that chronic migraine is associated with MetS, especially when it is comorbid with analgesic overuse. MOH may be the risk factor for MetS in female migraine patients and associated with abdominal obesity and hypertension.
Non‐motor symptoms burden in treated and untreated early Parkinson's disease patients: argument for non‐motor subtypes
Authors: Zis P. , Martinez‐Martin P. , Sauerbier A. , Rizos A. , Sharma J. C. , Worth P. F. , Sophia R. , Silverdale M. , Chaudhuri K. Ray
Published: May 2015

Background and purpose

Non‐motor symptoms (NMSs) occurring at an early stage of Parkinson's disease (PD) may impair quality of life more than motor symptoms. This study aimed to evaluate the severity of overall NMS profile and burden of NMSs in early PD patients, treated (time since confirmed diagnosis of 5 years or less) or drug naive (DN).

Methods

Cross‐sectional data from an ongoing multicentre study (16 sites) were obtained and specifically an NMS data set from validated scales was analysed in treated and DN PD patients.

Results

A full data set was available in 234 unique early PD patients. Of them, there were 170 treated (63.5% males, mean age 68.2 years) and 64DN patients (64.1% males, mean age 66.5 years). Compared to DN patients the time since confirmed diagnosis was significantly longer in treated PD patients (1.9 years vs. 3.7 years, P < 0.001). Fatigue (57.7%), urinary urgency (57.1%), nocturia (55.3%), memory difficulties (51.2%) and urinary frequency (48.8%) were the most prevalent NMSs amongst treated PD, whereas DN PD reported most frequently sadness (57.8%), fatigue (57.8%), lightheadedness (53.1%), memory difficulties (48.4%) and urinary urgency (46.9%).

Conclusions

Our results suggest that NMSs are dominant in the untreated and early phase of PD causing a considerable burden. This warrants investigation of the issue of NMS subtyping within PD.
Familial neonatal seizures in 36 families: Clinical and genetic features correlate with outcome
Authors: Grinton Bronwyn E. , Heron Sarah E. , Pelekanos James T. , Zuberi Sameer M. , Kivity Sara , Afawi Zaid , Williams Tristiana C. , Casalaz Dan M. , Yendle Simone , Linder Ilan , Lev Dorit , Lerman‐Sagie Tally , Malone Stephen , Bassan Haim , Goldberg‐Stern Hadassa , Stanley Thorsten , Hayman Michael , Calvert Sophie , Korczyn Amos D. , Shevell Michael , Scheffer Ingrid E. , Mulley John C. , Berkovic Samuel F.
Published: May 2015

Objective

We evaluated seizure outcome in a large cohort of familial neonatal seizures (FNS), and examined phenotypic overlap with different molecular lesions.

Methods

Detailed clinical data were collected from 36 families comprising two or more individuals with neonatal seizures. The seizure course and occurrence of seizures later in life were analyzed. Families were screened for KCNQ2, KCNQ3, SCN2A, and PRRT2 mutations, and linkage studies were performed in mutation‐negative families to exclude known loci.

Results

Thirty‐three families fulfilled clinical criteria for benign familial neonatal epilepsy (BFNE); 27 of these families had KCNQ2 mutations, one had a KCNQ3 mutation, and two had SCN2A mutations. Seizures persisting after age 6 months were reported in 31% of individuals with KCNQ2 mutations; later seizures were associated with frequent neonatal seizures. Linkage mapping in two mutation‐negative BFNE families excluded linkage to KCNQ2, KCNQ3, and SCN2A, but linkage to KCNQ2 could not be excluded in the third mutation‐negative BFNE family. The three remaining families did not fulfill criteria of BFNE due to developmental delay or intellectual disability; a molecular lesion was identified in two; the other family remains unsolved.

Significance

Most families in our cohort of familial neonatal seizures fulfill criteria for BFNE; the molecular cause was identified in 91%. Most had KCNQ2 mutations, but two families had SCN2A mutations, which are normally associated with a mixed picture of neonatal and infantile onset seizures. Seizures later in life are more common in BFNE than previously reported and are associated with a greater number of seizures in the neonatal period. Linkage studies in two families excluded known loci, suggesting a further gene is involved in BFNE.
Do Yellow‐Bellied Marmots Perceive Enhanced Predation Risk When they are Farther from safety? An experimental study
Authors: Monclús Raquel , Anderson Alexandra M. , Blumstein Daniel T.
Published: May 2015

Whereas there are many studies of the time allocated to antipredator vigilance while animals forage, the vast majority of these studies remain correlative. This is potentially problematic because a variety of factors other than variation in perceived risk might influence putative antipredator behaviors such as time allocated to vigilance and foraging. We conducted an experimental study of yellow‐bellied marmot (Marmota flaviventris) antipredator behavior while marmots foraged at a replicated set of feeding stations established 1, 5, 10, and 20 m from their main burrows. Marmots appeared to perceive a reduced risk of predation when they foraged in the presence of other marmots; they allocated more time to foraging and decreased the time allocated to vigilance. When they foraged farther from their burrows, marmots initiated foraging after a substantially greater amount of time, tended to increase the frequency of their bouts of vigilance, and decreased the duration of each bout. Yearling marmots took less time to begin foraging than adults. Marmot flight initiation distance at our feeding trays was independent of the distance they foraged away from the burrow. Taken together, these experimental results demonstrate that marmots' perceptions of risk increased with distance to the burrow and decreased when other individuals were within 10 m of them while they foraged.
Bioinformatics approach for choosing the correct reference genes when studying gene expression in human keratinocytes
Authors: Beer Lucian , Mlitz Veronika , Gschwandtner Maria , Berger Tanja , Narzt Marie‐Sophie , Gruber Florian , Brunner Patrick M. , Tschachler Erwin , Mildner Michael
Published: May 2015

Reverse transcription polymerase chain reaction (qRT‐PCR) has become a mainstay in many areas of skin research. To enable quantitative analysis, it is necessary to analyse expression of reference genes (RGs) for normalization of target gene expression. The selection of reliable RGs therefore has an important impact on the experimental outcome. In this study, we aimed to identify and validate the best suited RGs for qRT‐PCR in human primary keratinocytes (KCs) over a broad range of experimental conditions using the novel bioinformatics tool ‘RefGenes’, which is based on a manually curated database of published microarray data. Expression of 6 RGs identified by RefGenes software and 12 commonly used RGs were validated by qRT‐PCR. We assessed whether these 18 markers fulfilled the requirements for a valid RG by the comprehensive ranking of four bioinformatics tools and the coefficient of variation (CV). In an overall ranking, we found GUSB to be the most stably expressed RG, whereas the expression values of the commonly used RGs, GAPDH and B2M were significantly affected by varying experimental conditions. Our results identify RefGenes as a powerful tool for the identification of valid RGs and suggest GUSB as the most reliable RG for KCs.
Heat shock protein 90: a pathophysiological factor and novel treatment target in autoimmune bullous skin diseases
Authors: Tukaj Stefan , Zillikens Detlef , Kasperkiewicz Michael
Published: May 2015

The chaperone heat shock protein 90 (Hsp90), a cell stress‐inducible molecule that regulates activity of many client proteins responsible for cellular growth, differentiation and apoptosis, has been proposed as an important therapeutic target in patients with malignancies. More recently, its active participation in (auto)immune processes has been recognized as evidenced by amelioration of inflammatory disease pathways through pharmacological inhibition of Hsp90 in rodent models of autoimmune encephalomyelitis, rheumatoid arthritis and systemic lupus erythematosus. Based on own current research results, this viewpoint essay provides important insights that Hsp90 is also involved as a notable pathophysiological factor in autoimmune blistering dermatoses including epidermolysis bullosa acquisita, bullous pemphigoid and possibly dermatitis herpetiformis. The observed in vitro, ex vivo and in vivo efficacy of anti‐Hsp90 treatment in experimental models of autoimmune bullous diseases and its underlying multimodal anti‐inflammatory mechanisms of interference with key contributors to autoimmune‐mediated blister formation supports the introduction of selective non‐toxic Hsp90 inhibitors into the clinical setting for the treatment of patients with these disorders.
Atorvastatin and fenofibrate combination induces the predominance of the large HDL subclasses and increased apo AI fractional catabolic rates in New Zealand white rabbits with exogenous hypercholesterolemia
Authors: Flores‐Castillo Cristobal , Zamora‐Pérez Juan Á. , Carreón‐Torres Elizabeth , Arzola‐Paniagua Angélica , Aguilar‐Salinas Carlos , López‐Olmos Victoria , Fragoso José M. , Luna‐Luna María , Rodríguez‐Pérez José M. , Franco Martha , Vargas‐Alarcón Gilberto , Pérez‐Méndez Óscar
Published: May 2015

The anti‐atherogenic properties of high‐density lipoproteins (HDLs) may be related to their structure and metabolism. The HDL physicochemical characteristics that determine their plasma clearance during treatment with statins and fibrates are not well understood. In this study, we analyzed HDL‐apo AI fractional catabolic rates (FCRs), size distributions, and the lipid composition of the HDL subclasses in New Zealand white rabbits with exogenous dyslipidemia that received low doses of atorvastatin and fenofibrate. Hypercholesterolemia decreased only partially with the combination of both drugs. HDL size distribution shifted toward larger particles among the groups of rabbits that received atorvastatin, fenofibrate, or their combination, compared with both the control group and the dyslipidemic group. The HDL subclasses were significantly rich in cholesterol in each of the groups compared with controls. The structural changes noted in the HDL subclasses were not associated with impaired plasma paraoxonase‐1 (PON1) activity. The groups receiving monotherapy and the drug combination group were all associated with a higher apo AI FCR value compared with both the dyslipidemic rabbits and the control group. In conclusion, the combination of atorvastatin and fenofibrate induced a more favorable HDL subclass profile than did the individual use of these drugs. Similarly, the apo AI FCR values were augmented in every group receiving drug treatment (either monotherapy or combination therapy) in the setting of hypercholesterolemia. The anti‐atherogenic properties of HDLs, excluding their capacity to bind PON1, may be enhanced by the structural and metabolic modifications induced by the combination of atorvastatin and fenofibrate.
Phosphate binder pill burden, patient‐reported non‐adherence, and mineral bone disorder markers: Findings from the DOPPS
Authors: Fissell Rachel B. , Karaboyas Angelo , Bieber Brian A. , Sen Ananda , Li Yun , Lopes Antonio A. , Akiba Takashi , Bommer Jürgen , Ethier Jean , Jadoul Michel , Pisoni Ronald L. , Robinson Bruce M. , Tentori Francesca
Published: May 2015

Because of multiple comorbidities, hemodialysis (HD) patients are prescribed many oral medications, including phosphate binders (PBs), often resulting in a high “pill burden.” Using data from the international Dialysis Outcomes and Practice Patterns Study (DOPPS), we assessed associations between PB pill burden, patient‐reported PB non‐adherence, and levels of serum phosphorus (SPhos) and parathyroid hormone (PTH) using standard regression analyses. The study included data collected from 5262 HD patients from dialysis units participating in the DOPPS in 12 countries. PB prescription ranged from a mean of 7.4 pills per day in the United States to 3.9 pills per day in France. About half of the patients were prescribed at least 6 PB pills per day, and 13% were prescribed at least 12 PB pills per day. Overall, the proportion of patients who reported skipping PBs at least once in the past month was 45% overall, ranging from 33% in Belgium to 57% in the United States. There was a trend toward greater PB non‐adherence and a higher number of prescribed PB pills per day. Non‐adherence to PB prescription was associated with high SPhos (>5.5 mg/dL) and PTH (>600 pg/mL). Adherence to PB is a challenge for many HD patients and may be related to the number of PB pills prescribed. Prescription of a simplified PB regimen could improve patient adherence and perhaps improve SPhos and PTH levels.
Antimicrobial Susceptibility‐Guided Therapy Versus Empirical Concomitant Therapy for Eradication of Helicobacter pylori in a Region with High Rate of Clarithromycin Resistance
Authors: Cosme Angel , Lizasoan Jacobo , Montes Milagrosa , Tamayo Esther , Alonso Horacio , Mendarte Usua , Martos Maider , Fernández‐Reyes María , Saraqueta Cristina , Bujanda Luis
Published: May 2015

Background

Nonbismuth quadruple (concomitant) regimen is recommended for first‐line empirical Helicobacter pylori (HP) eradication treatment when clarithromycin resistance is more than 15–20%. Our objective was to evaluate the efficacy and tolerability of concomitant versus antimicrobial susceptibility‐guided treatment in an area with high rates of clarithromycin resistance.

Methods

Three hundred consecutive HP‐infected patients received antimicrobial susceptibility‐guided therapy or empirical concomitant therapy for 10 days. The concomitant regimen was omeprazole (20 mg/12 hour), amoxicillin (1 g/12 hour), clarithromycin (500 mg/12 hour), and metronidazole (500 mg/12 hour) (OACM). Patients diagnosed by culture received one of three combinations of antibiotics based on susceptibility results: omeprazole, amoxicillin, and clarithromycin (OAC); omeprazole, amoxicillin, and levofloxacin (OAL); or omeprazole, amoxicillin, and metronidazole (OAM), at the aforementioned doses (and 500 mg/12 hour in the case of levofloxacin). Eradication was confirmed with a 13C urea breath test, 6 weeks after treatment. Adverse events and adherence were assessed with questionnaires and reviewing medication sachets.

Results

The mean age was 50 years, 59% were women, and 14% had peptic ulcers. Concomitant and antimicrobial susceptibility‐guided eradication rates were, respectively, 87% and 94% by intention‐to‐treat (p = .08) and 89% and 95% (p = .08) per protocol per‐protocol analysis. Adverse effects were reported in 31% of patients on OACM and 15% of those on susceptibility‐guided therapy (p < .05).

Conclusions

For HP eradication in a region with high rates of multiple drug resistance, antimicrobial susceptibility‐guided therapy is more effective than empirical concomitant therapy.
Holotranscobalamin Levels in Children with Helicobacter Pylori Infection
Authors: Afyoncu Oguz , Gursel Orhan , Atay Avni , Kurekci Emin , Balamtekin Necati , Hasimi Adnan , Ozguven Mehmet A. , Ozcan Okan
Published: May 2015

Background

The purpose of this study was to evaluate the association between vitamin B12 levels and Helicobacter Pylori infection and to examine the clinical usefulness of holotranscobalamin (holoTC) measurement in children.

Materials and Methods

Thirty patients between 6 and 15 years of age, who were diagnosed as H. pylori infected by C14 urea breath test, and 26 controls were enrolled in the study. Tests for complete blood count, serum vitamin B12 and folate, plasma total homocysteine, and holoTC levels were performed in each patient in the study and control groups.

Results

Mean plasma holoTC concentrations were significantly lower in children with H. pylori infection before treatment (median 23.7 pmol/L (12.9–37.1 pmol/L)) versus after treatment (median 38.2 pmol/L (21.2–61.4 pmol/L)) and controls (median 36.1 pmol/L (12.6–58.7 pmol/L)).

Conclusions

The findings of our study suggest that H. pylori infection has a reversible negative effect on vitamin B12 status reflected in a decreased level of plasma holoTC that normalizes upon treatment of the infection, while no change is observed in total plasma vitamin B12.
Low expression of B‐cell‐associated protein 31 in human primary hepatocellular carcinoma correlates with poor prognosis
Authors: Tan Ning , Liu Qinyi , Liu Xiaojia , Gong Zhiwei , Zeng Yonglian , Pan Guangdong , Xu Qing , He Songqing
Published: May 2015

Aims

The aim of the present study was to investigate the prognostic value of B‐cell associated protein 31 (BAP31) in human primary hepatocellular carcinoma (HCC).

Methods and results

BAP31 levels were evaluated by immunohistochemistry on tissue microarrays. The integral optical density, representing the expression level of BAP31 in each tissue sample, was calculated with image‐pro plus. Immunohistochemical analysis of BAP31 levels in 74 paired HCC tissues and peritumoral non‐cancerous tissues showed that BAP31 expression was significantly higher in HCC tumour tissues (P = 0.025). The prognostic value of BAP31 in HCC was evaluated in 234 cases in a training cohort and in 63 cases in a validation cohort. The expression level of BAP31 was significantly correlated with overall survival (OS) in both the training cohort and the validation cohort. The lower the level of BAP31 expression in HCC tissue, the poorer the prognosis. Univariate and multivariate analyses showed that the expression level of BAP31 in HCC was an independent prognostic factor for OS in both the training cohort and the validation cohort.

Conclusions

BAP31 expression is an independent prognostic factor for OS of patients with postoperative HCC, and low expression levels of BAP31 in HCC may indicate poor outcomes of HCC patient after surgical resection.
HLA‐B*38:55Q: a new alternatively expressed allele identified in a three‐generation Italian family
Authors: Fusco C. , Azzarone R. , Penta R. , Canossi A. , Di Iulio B. , Toriello M. , Auriemma L. , Pagano M. , Poggi V. , Papola F.
Published: May 2015

The new allelic variant HLA‐B*38:55Q differs from the closest related B*38:01:01 by one nucleotide substitution at position 373 in exon 3 (TGC>CGC). This results in a difference of one amino acid at residue 101 of the HLA‐B heavy chain, from a neutral‐polar Cys to a basic‐polar Arg, thus impairing disulphide bridge formation in the alpha‐2 domain. This alteration of the secondary structure probably affects the maturation of the heavy chain and the level of surface expression, making the HLA‐B*38:55Q undetectable by standard serological typing.
Assessing nonvitamin K antagonist oral anticoagulants (NOACs) in the laboratory
Authors: Gosselin R. C. , Adcock D. M.
Published: May 2015

Nonvitamin K antagonist oral anticoagulants (NOACs) are being used with increasing frequency due to their safety profile, ease of use, and given that therapeutic monitoring is not required. As these agents have only recently been FDA approved, their effect on routine and specialty coagulation assays is not well appreciated. This article discusses NOAC effect on routine coagulation assays and whether these assays can be used to estimate drug concentration as well as which assays are suitable to quantitate drug concentration in plasma. Also reviewed is the use of manufactured drug calibrators to determine reagent responsiveness and the effect of these agents on various special coagulation assays.
Pearls and pitfalls in factor inhibitor assays
Authors: Adcock D. M. , Favaloro E. J.
Published: May 2015

The proper performance and interpretation of factor inhibitor assays is a critical role for the hemostasis laboratory. Both false‐positive and false‐negative inhibitor assays may be reported, leading to serious patient mismanagement. Knowledge and recognition of common causes of both false‐positive and negative‐results can aid in the identification of these potential pitfalls. Safeguards to reporting accurate factor inhibitor assays include initial characterization of the sample, using the Nijmegen modification, properly performing and interpreting an incubated mixing test in conjunction, and performing two dilutions for each dependent dilution in the factor inhibitor assay.
Challenging hemostasis scenarios in pediatric patients – two case studies
Authors: Moser K. A. , Puetz J.
Published: May 2015

Pediatric patients differ from adult patients in many clinical situations, and disorders of hemostasis and thrombosis are no exception. The current article presents clinical and laboratory features of two cases in which pediatric patients are evaluated for bleeding disorders. Discussion of the cases focuses on practical considerations for laboratorians. Review of these case studies highlights selected common and esoteric issues in pediatric hemostasis testing.
Quality of factor XI activity testing in North American Specialized Coagulation Laboratories
Authors: Zantek N. D. , Hsu P. , Meijer P. , Smock K. J. , Plumhoff E. A. , Refaai M. A. , Van Cott E. M.
Published: May 2015

Introduction

The performance of factor XI activity (FXI) by laboratories in the North American Specialized Coagulation Laboratory Association proficiency testing program was analyzed.

Methods

Over 10 years (2003–2013), 80 samples were distributed; 33–55 laboratories participated per exercise providing 3833 total responses. Analysis was performed on numeric results and qualitative classification of results.

Results

The sample FXI levels ranged from 3.8 to 154.0 IU/dL. The overall interlaboratory average coefficient of variation (CV%) was 17.5%; the CV was higher for a sample with low (3.8 IU/dL) FXI. Results were correctly classified as abnormal (100%) for a sample with 3.8 IU/dL FXI and normal/borderline normal (97.7%) for 45 samples with 80 to < 140 IU/dL FXI. The classification was heterogeneous for samples with FXI of 50 to < 80 IU/dL. Six specimens were repeat‐tested from 2007 to 2013. The mean FXI was not significantly different in laboratories using the same method on both exercises, suggesting good intralaboratory precision over time. Univariate analysis of data from 2011 to 2012 did not find a consistent significant difference among the activators, analyzers, calibrators, and FXI‐deficient plasmas.

Conclusion

Laboratories generally performed well in assessment of FXI based on interlaboratory precision when FXI >30 IU/dL and on classification of samples with very low or normal FXI.
Ultrasound‐guided micropercutaneous nephrolithotomy in pediatric patients with kidney stones
Authors: Bodakçi Mehmet Nuri , Penbegul Necmettin , Dağgülli Mansur , Dede Onur , Utangaç Mehmet Mazhar , Hatipoglu Namık Kemal , Sancaktutar Ahmet Ali
Published: May 2015

Objective

To present the outcomes of ultrasound‐guided micropercutaneous nephrolithotomy for the treatment of renal stones in pediatric patients.

Methods

Ultrasound‐guided micropercutaneous nephrolithotomy was carried out on 25 pediatric patients from June 2012 to October 2014. Micropercutaneous nephrolithotomy surgery was completed without the use of fluoroscopy in 19 patients. Medical records were retrieved from our institutional database and retrospectively reviewed. Percutaneous puncture was carried out by an “all‐seeing needle” in seven patients and by a 14‐G intravenous cannula in 18 patients. After entering to the collecting system through an “all‐seeing needle” or by Microsheath, the calculus was fragmented using a 273‐micron holmium yttrium aluminium garnet laser. After the stone was fragmented to the smallest pieces possible, the operation was terminated.

Results

Single access was obtained in all patients using ultrasound guidance. The average age of the patients was 4.12 ± 5.33 years. The mean stone size was 13.45 ± 3.11 mm. The mean operative time was 51.45 ± 30.69 min. The mean duration of hospitalization was 3.18 ± 1.77 days. Treatment success was 92%. Two patients had residual fragments after the procedure; these patients were followed conservatively. A total of three minor complications were observed and all of them were managed conservatively.

Conclusions

To our knowledge, this is the first study of ultrasound‐guided micropercutaneous nephrolithotomy in the pediatric population. Our findings suggest that micropercutaneous nephrolithotomy can be safely carried out with ultrasound guidance in children by experienced hands, allowing to minimize risks associated with radiation exposure in this patient population.
Technostress creators and job outcomes: theorising the moderating influence of personality traits
Authors: Srivastava Shirish C. , Chandra Shalini , Shirish Anuragini
Published: May 2015

Although prior research has examined the influence of technostress creators on job outcomes, insights into the influence of personality traits on the perceptions of technostress creators and their consequent impacts on job outcomes are rather limited. Such insights would enable a deeper understanding about the effects of individual differences on salient job‐related outcomes. In this research, by leveraging the distinctions in personality traits offered by the big five personality traits in the five‐factor model and grounding the research in the transactional model of stress and coping, we theorise the moderating influence of personality traits on the relationships between technostress creators and job outcomes, namely job burnout and job engagement. Specifically, the study theorises the mechanisms through which each of the specific personality traits openness‐to‐experience, neuroticism, agreeableness, conscientiousness and extraversion interacts with technostress creators to differently influence job burnout and job engagement. We test the proposed model in a field study based on a survey of senior organisational managers who regularly use information and communication technologies for executing professional tasks. Although technostress creators are generally associated with negative job outcomes, our results also show that for individuals with certain personality traits, technostress creators may result in positive job outcomes. The study thus contributes to the technostress literature, specifically by incorporating the salient role of individual differences. The study also provides insights for managers who should pay special attention to allocating specific job roles to employees with particular personality traits in order to optimise job‐related outcomes.
Inkjet Printing of Microporous Silica Gas Separation Membranes
Authors: Bram Martin , Dornseiffer Jürgen , Hoffmann Jan , van Gestel Tim , Meulenberg Wilhelm A. , Stöver Detlev
Published: May 2015

Inkjet printing was applied to manufacture silica‐based gas separation membranes, which were coated on a pore‐graduated alumina substrate with a mesoporous γ‐alumina interlayer. A silica sol diluted by 1‐propanol was used to print the membrane layer followed by thermal treatment in a rapid thermal processing furnace. The membrane thickness was varied between 30 and 110 nm by conducting one, two, and three coating steps. In the latter case, H2 permeance in the range of 2.0 × 10−8–3.3 × 10−8 mol/s·m2·Pa combined with H2/CO2 selectivities in the range of 15–25 were achieved, proving the concept that inorganic gas separation membranes can be successfully processed by inkjet printing.
Retrograde pyelonephritis and lumbar spondylitis as a result of Salmonella typhi in a type 2 diabetes patient with neurogenic bladder
Authors: Fukuda Tatsuya , Bouchi Ryotaro , Minami Isao , Ohara Norihiko , Nakano Yujiro , Nishitani Rie , Murakami Masanori , Takeuchi Takato , Akihisa Momoko , Fujita Masamichi , Izumiyama Hajime , Hashimoto Koshi , Yoshimoto Takanobu , Ogawa Yoshihiro
Published: May 2015

We present a case of a 62‐year‐old diabetic woman with acute pyelonephritis and spondylitis caused by Salmonella typhi. She was admitted to Tokyo Medical Dental University Hospital, Tokyo, Japan, because of unconsciousness and was diagnosed with sepsis by retrograde pyelonephritis as a result of Salmonella typhi. Antibiotics treatment was immediately started; however, she subsequently developed lumbar spondylitis, and long‐term conservative treatment with antibiotics and a fixing device were required. This is the first report of a diabetic patient who developed retrograde urinary tract infection with Salmonella typhi, followed by sepsis and spondylitis. The infection could be a result of diabetic neuropathy, presenting neurogenic bladder and hydronephrosis. The patient was successfully treated with antibiotics and became asymptomatic with normal inflammatory marker levels, and no clinical sign of recurrence was observed in the kidney and spine at 4 months.
Two Gonostomatid Ciliates from the Soil of Lombardia, Italy; including Note on the Soil Mapping Project
Authors: Bharti Daizy , Kumar Santosh , La Terza Antonietta
Published: May 2015

Two gonostomatid ciliates, Gonostomum paronense n. sp. and G. strenuum, isolated from the soil sample of paddy field, Lombardia, Italy, were investigated using live observation and protargol impregnation. Gonostomum paronense n. sp. is mainly characterized by a tailed body, frontoventral cirri arranged in pairs, and presence of pretransverse and transverse cirri. Morphologically and morphometrically, the new species is similar to Gonostomum namibiense in having a tailed body and frontoventral cirral pairs; however, it differs mainly in the number of frontoventral cirral pairs (seven vs. three). Phylogenetic analyses based on the SSU rDNA sequences show that the new species is more closely related to G. namibiense than to G. strenuum, supporting the morphological classification based on the cirral pattern and the tailed body. However, due to the poor nodal support and absence of gene sequence of the type species Gonostomum, a more robust phylogeny of this group still remains unresolved. The biometric data of the Italian population of Gonostomum strenuum overlap with those from other known populations. Both species were collected from the industrial area of Parona, in the framework of the “Soil Mapping, Lombardia” project in which, for the first time in Italy, soil ciliates were used as bioindicators of soil quality.
Oral cancer awareness and knowledge among residents in the Oporto city, Portugal
Authors: Monteiro Luís Silva , Warnakulasuriya Saman , Cadilhe Suzana , Sousa Duarte , Trancoso Pedro Ferreira , Antunes Luís , Salazar Filomena , Pacheco José Júlio
Published: May 2015

Objective

To assess the awareness and knowledge on oral cancer in a general population of Oporto city, in Portugal.

Methods

Face‐to‐face interviews were performed with 1116 individuals, resident in the city of Oporto. Participants' socio‐demographic information, lifestyle habits and awareness, knowledge and beliefs on oral cancer were ascertained.

Results

Breast cancer was the most mentioned being as heard of (69.8%), while oral cancer was one of the least heard of (23.7%). Tobacco was identified as a risk factor by 54.8% of individuals and this knowledge was associated with their education level (P < 0.001), dentist visits (P = 0.026), and tobacco consumption (P < 0.001). Fewer subjects (24.6%) referred to alcohol as a risk factor, and this knowledge was associated with their education level (P = 0.020) and dentist visits (P = 0.002). More than half the subjects (58.8%) could not identify any sign or symptom of oral cancer.

Conclusion

There is a general lack of awareness on oral cancer among this Oporto population. Higher education level and better oral health care were significant factors that identified individuals with a better awareness and knowledge of oral cancer, suggesting that educational measures could be useful for the prevention and early diagnosis of oral cancer in the Portuguese population.
Midwives in Medical Student and Resident Education and the Development of the Medical Education Caucus Toolkit
Authors: Radoff Kari , Natch Amy , McConaughey Edie , Salstrom Jan , Schelling Karen , Seger Suzanne
Published: May 2015

Midwives have been involved formally and informally in the training of medical students and residents for many years. Recent reductions in resident work hours, emphasis on collaborative practice, and a focus on midwives as key members of the maternity care model have increased the involvement of midwives in medical education. Midwives work in academic settings as educators to teach the midwifery model of care, collaboration, teamwork, and professionalism to medical students and residents. In 2009, members of the American College of Nurse‐Midwives formed the Medical Education Caucus (MECA) to discuss the needs of midwives teaching medical students and residents; the group has held a workshop annually over the last 4 years. In 2014, MECA workshop facilitators developed a toolkit to support and formalize the role of midwives involved in medical student and resident education. The MECA toolkit provides a roadmap for midwives beginning involvement and continuing or expanding the role of midwives in medical education. This article describes the history of midwives in medical education, the development and growth of MECA, and the resulting toolkit created to support and formalize the role of midwives as educators in medical student and resident education, as well as common challenges for the midwife in academic medicine. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.
Neonatal Treatment with a Pegylated Leptin Antagonist Induces Sexually Dimorphic Effects on Neurones and Glial Cells, and on Markers of Synaptic Plasticity in the Developing Rat Hippocampal Formation
Authors: López‐Gallardo M. , Antón‐Fernández A. , Llorente R. , Mela V. , Llorente‐Berzal A. , Prada C. , Viveros M. P.
Published: May 2015

The present study aimed to better understand the role of the neonatal leptin surge, which peaks on postnatal day (PND)9–10, on the development of the hippocampal formation. Accordingly, male and female rats were administered with a pegylated leptin antagonist on PND9 and the expression of neurones, glial cells and diverse markers of synaptic plasticity was then analysed by immunohistochemistry in the hippocampal formation. Antagonism of the actions of leptin at this specific postnatal stage altered the number of glial fibrillary acidic protein positive cells, and also affected type 1 cannabinoid receptors, synaptophysin and brain‐derived neurotrophic factor (BDNF), with the latter effect being sexually dimorphic. The results indicate that the physiological leptin surge occurring around PND 9–10 is critical for hippocampal formation development and that the dynamics of leptin activity might be different in males and females. The data obtained also suggest that some but not all the previously reported effects of maternal deprivation on hippocampal formation development (which markedly reduces leptin levels at PND 9–10) might be mediated by leptin deficiency in these animals.