bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients newly diagnosed with ulcerative colitis receive earlier treatment in surgical clinics
Authors: Ward S. T. , Li K. K. , Trivedi P. J. , Hejmadi R. K. , Suggett N. , Iqbal T. , Ismail T.
Published: May 2013

Aim

The diagnosis and treatment of ulcerative colitis (UC) is traditionally the realm of gastroenterologists. However, the symptoms of UC overlap with those of bowel cancer and patients may be initially referred to colorectal surgery clinics. The aims of this study were to define which specialty most frequently diagnoses UC and to determine if there were differences in management between the two specialities.

Method

The demographics, presenting symptoms and clinical management of patients with newly diagnosed UC were determined and compared by speciality clinic of initial referral. Histopathology reports and clinic letters were reviewed to identify patients newly diagnosed with UC at a large university teaching hospital from January 2007 to January 2012.

Results

Patients were more commonly referred to colorectal surgeons (74 vs 41 patients) than gastroenterologists. Patients referred to gastroenterology were younger (36.0 vs 59.6 years, P < 0.01) but there were no significant differences in gender, presenting symptoms or disease extent. Rigid sigmoidoscopy ± biopsy was more commonly performed in colorectal clinic (93.2 vs 31.7%, P < 0.01). There was a significantly shorter delay in starting disease‐specific treatment for those patients referred initially to colorectal surgery (13.8 vs 33.6 days, P = 0.01). Performing rigid sigmoidoscopy in clinic was associated with starting disease‐specific treatment at this visit.

Conclusion

Patients with first presentation UC are more commonly seen in colorectal surgery clinics where rigid sigmoidoscopy is more frequently undertaken, allowing earlier commencement of UC treatment.
Persisting anorectal dysfunction after rectal cancer surgery
Authors: Maris A. , Penninckx F. , Devreese A. M. , Staes F. , Moons P. , Van Cutsem E. , Haustermans K. , D'Hoore A.
Published: May 2013

Aim

Sphincter‐saving rectal cancer management affects anorectal function. This study evaluated persisting anorectal dysfunction and its impact on patients' well‐being.

Method

Seventy‐nine patients with a follow‐up of 12–37 (median 22) months and 79 age‐ and sex‐matched control subjects completed questionnaires.

Results

The median number of diurnal bowel movements was three in patients and one in controls (P < 0.0001). Nocturnal defaecation occurred in 53% of patients. The median Vaizey score was 8 in patients and 4 in controls (P < 0.0001). Urgency without incontinence was reported by 47% of patients and 49% of controls (P = 0.873), soiling by 28% of patients and 3% of controls (P < 0.0001), incontinence for flatus by 73% of patients and 49% of controls (P = 0.0019), and incontinence for solid stools by 16% of patients and 4% of controls (P = 0.0153). Incontinence of liquid stools occurred in 17 of 20 patients and in one of five controls who had liquid stools (P = 0.0123). Incontinence for gas, liquid or solid stool occurred once or more weekly in 47%, 19% and 6% of patients respectively. Evacuation difficulties were reported by 98% of patients, but also by 77% of controls. Neoadjuvant radio(chemo)therapy adversely affected defaecation frequency and continence. Incontinence was associated with severe discomfort in 50% of patients, severe anxiety in 40% and severe embarrassment in 48%.

Conclusion

Anorectal dysfunction is a frequent problem after management of rectal cancer with an impact on the well‐being of patients.
Functional evaluation of a novel tooth agenesis‐associated bone morphogenetic protein 4 prodomain mutation
Authors: Huang Yanyu , Lu Yongbo , Mues Gabriele , Wang Suzhen , Bonds John , D'Souza Rena
Published: May 2013

The detection of gene mutations in patients with congenitally missing teeth is not very complicated; however, proving causality is often quite difficult. Here, we report the detection of a substitution mutation, A42P, within the prodomain of bone morphogenetic protein 4 (BMP4) in a small family with tooth agenesis and describe a functional alteration that may be responsible for the tooth phenotype. As BMP4 is essential for the development of teeth and also for many other organs, it would be of considerable interest to find a BMP4 mutation that is associated only with tooth agenesis. Our in vitro investigations revealed that the A42P mutation neither affected processing and secretion of BMP4 nor altered functional properties, such as the induction of alkaline phosphatase or signaling through Smad1/5/8 phosphorylation by the mature BMP4 ligand. However, immunofluorescence staining revealed that the prodomains of BMP4 which harbor the A42P substitution form fibrillar structures around transfected cells in culture and that this fibrillar network is significantly decreased when mutant prodomains are expressed. Our finding suggests that in vivo, BMP4 prodomain behavior might also be altered by the mutation and could influence storage or transport of mature BMP4 in the extracellular matrix of the developing tooth.
Various irrigation protocols for final rinse to improve bond strengths of fiber posts inside the root canal
Authors: Bitter Kerstin , Hambarayan Ani , Neumann Konrad , Blunck Uwe , Sterzenbach Guido
Published: May 2013

Irrigation after post space preparation and its effects on the bond strength of different adhesive strategies are still an issue of interest. The aim of the present study was to investigate the effects of various irrigation protocols (IPs) on the push‐out bond strengths of fiber posts. One‐hundred and fifty extracted human anterior teeth were divided into three groups (n = 50 each) and endodontically treated. The post space was irrigated before post placement using the following five IPs in each group: IP1 (control): 5 ml of distilled water; IP2: 5.25% sodium hypochlorite (NaOCl) applied with passive ultrasonic irrigation (PUI); IP3: 1% NaOCl applied with PUI; IP4: 18% ethylenediaminetetracetic acid (EDTA) followed by 5.25% NaOCl; and IP5: 2% chlorhexidine (CHX). Fiber posts placement in each group was performed using three different adhesive strategies. A self‐etch adhesive system revealed higher bond strength (16.2 ± 6.9 MPa) compared with an etch‐and‐rinse adhesive (8.5 ± 4.2 MPa) and a self‐adhesive resin cement (9.2 ± 4.7 MPa). The use of 18% EDTA/5.25% NaOCl increased the bond strength of the self‐adhesive resin cement. Conversely, this IP decreased the bond strength for the etch‐and‐rinse adhesive system, whilst 1% NaOCl enhanced the bond strength for the same system. Consequently, each adhesive strategy may need to be adapted to a specific IP.
Bioguidage search of active compounds from Waltheria indica L. (Malvaceae) used for asthma and inflammation treatment in Burkina Faso
Authors: Zongo Frank , Ribuot Christophe , Boumendjel Ahcène , Guissou Innocent
Published: May 2013

Waltheria indica is used in traditional pharmacopeia in Burkina Faso for the treatment of asthma and conditions of inflammation. To evaluate its pharmacological properties and isolate the active compounds, a study through a bioguided phytochemical approach was conducted. This search was guided by a two‐level investigation. First, we evaluated the impact of various fractions on the activity of enzymes involved in smooth muscle contraction (PDE4A1α) and inflammatory processes (PLA2, 5‐LOX). Second, we investigated the inhibitory effect of fractions on isolated rat trachea. The initial hydroalcoholic extract from roots of W. indica (HA), n‐hexane fraction (F1), dichloromethane fraction (F2), ethyl acetate fraction (F3), residuary fraction (F4) reduced enzyme activity of PDE4A1α (inhibition of 22–42% at 50 μg/mL), 5‐LOX (60–80% at 10 μg/mL), and PLA2 (42–94% at 100 μg/mL). On isolated rat trachea, only HA, F3, and fractions obtained from F3 by chromatography on silica gel column, using dichloromethane/methanol, dose dependently inhibited contraction induced by acetylcholine. IC50 was 1051 μg/mL for HA and comprised between 181 and 477 μg/mL for F3 and its fractions. The most active fractions were purified and led to the identification of (‐)‐epicatechin. (‐)‐epicatechin from W. indica dose dependently inhibited PLA2 (IC50 = 154.7 μm) and 5‐LOX (IC50 = 15.8 μm). In conclusion, both inhibition of PDE4A1α, 5‐LOX, and PLA2 activities and rat trachea relaxation by W. indica validate its use in traditional management of asthma and other conditions of inflammation. These effects should be, at least in part, attributed to the presence of (‐)‐epicatechin in roots of W. indica.
Outcomes of non‐surgical periodontal treatment by dental hygienists in training: impact of site‐ and patient‐level factors
Authors: Preshaw PM , Holliday R , Law H , Heasman PA
Published: May 2013

Objectives

To investigate the site‐ and patient‐level factors that impact on the response to non‐surgical periodontal therapy in patients with chronic periodontitis.

Methods

A retrospective evaluation of clinical outcomes following non‐surgical periodontal therapy delivered by dental hygienists in training was undertaken. Case notes from 195 patients with chronic periodontitis were reviewed and clinical data pre‐ and post‐treatment abstracted. Patients were categorized as ‘responders’ or ‘non‐responders’ according to defined outcome criteria, and the relationship between clinical and demographic variables and treatment outcomes was assessed.

Results

Overall, there was a good response to the periodontal treatment. At deep sites (those with pretreatment probing depth ≥5 mm), the mean probing depth reduction was 1.6 ± 0.9 mm. Seventy‐one (36%) patients were classified as non‐responders (indicating that at least 30% of their deep sites did not improve by at least 2 mm following treatment). The non‐responding group contained a significantly greater proportion of smokers (28%) than the responding group (16%). Plaque scores did not differ significantly between responders or non‐responders either pre‐ or post‐treatment. Regression analyses indicated that smoking status (odds ratio, OR: 2.04), mean pretreatment probing depth (OR: 1.49) and percentage of deep sites ≥5 mm at pretreatment (OR: 1.02) were significantly associated with response to treatment.

Conclusion

This study supports the benefits of non‐surgical therapy in the treatment of chronic periodontitis by dental hygienists in training. Better responses to treatment tend to be observed in non‐smokers and in those with less advanced periodontitis at baseline.
DEFINING THE CULTURE AND ATTITUDE TOWARDS DIETARY MANAGEMENT ACTIONS IN PEOPLE UNDERGOING HAEMODIALYSIS
Authors: Onbe Hiromi , Oka Michiyo , Shimada Mikiko , Motegi Emiko , Motoi Yuji , Okabe Ayako
Published: May 2013

Objectives

The present study was designed to clarify the structure of culture and the three components of attitude in a desirable attitude toward dietary management actions in outpatient haemodialysis patients who are in the maintenance phase of treatment.

Methods

The participants in the study included nine patients undergoing chronic maintenance haemodialysis who have received guidance related to diet and had good test results. Ethnography, by means of participant observation and semi‐structured interviews, was chosen as the research method.

Findings

Desirable attitude of haemodialysis patients in dietary management actions was found to have a chronological progression in one of the components of attitude: propensity of behaviour. Change in behaviour was influenced by affect and cognition. At the base of the structure of attitude lay three factors: valuing cooking with seasonal ingredients and creating special meals for seasonal occasions; family draws near, shows care and gives support; and belief in information perceived to be good for the health, which was influenced by three components of attitude: affect, cognition, and propensity of behaviour, as well as culture.

Conclusion

Participants continue to value the food culture that they grew up with, which involves their affect towards, and cognition of, dietary management.
EXPLORING THE VIEWS OF PATIENTS NOT ON THE TRANSPLANT WAITING LIST: A QUALITATIVE STUDY
Authors: Lawrence Christopher , Sharma Shivani , Da Silva‐Gane Maria , Fletcher Ben C. , Farrington Ken
Published: May 2013

Background

Not all patients are suitable for kidney transplantation; however, little is known about the views and attitudes of patients who are not on the waiting list for transplantation.

Objective

This study aimed to determine the views and attitudes of patients who are not on the waiting list regarding the process of transplant allocation.

Methods

A grounded theory approach was used to develop theories from patient views, opinions and attitudes. Patients receiving dialysis, and not on the waiting list at a United Kingdom renal unit were identified by the renal counsellor and invited to take part. Five patients formed a focus group to enable construction of an interview schedule. Patients (n = 10, different from those in the focus group) were interviewed until themes became saturated. Interview transcripts generated conceptual categories.

Results

Seven conceptual categories emerged regarding access to transplantation. Patients experience emotions of loss relating to transplantation exacerbated by restrictions imposed by dialysis. Patients find coping mechanisms, accept their situation and trust that clinical decisions were equitable.

Conclusions

Patients trust their carers and support an efficacy argument when considering scarce resources. Communication should be improved to ensure clarity and understanding of clinical decisions.
The Reaction Mechanism and Kinetics of α‐BN Powder in Wet Air at 1273 K
Authors: Hou Xinmei , Yu Ziyou , Chen Zhiyuan , Chou Kuo‐Chih , Zhao Baojun
Published: May 2013

The reaction behavior of α‐Boron nitride (BN) powder in wet air was investigated at 1273 K using thermogravimetric (TG) analysis, X‐ray diffraction (XRD), and mass spectrometry. Scanning electron microscopy and electron probe X‐ray microanalysis (EPMA) were used to analyze the morphological and elemental development of the sample. The results show that the reaction process consists of two stages: the oxidation of BN powder to form B2O3 and the further reaction of B2O3 with H2O. In the first stage, the oxidation reaction occurs very quickly and can be described by Chou's model. In the second stage, the reaction rate followed the linear rate law.
Sintering of Multilayered Porous Structures: Part II–Experiments and Model Applications
Authors: Ni De Wei , Olevsky Eugene , Esposito Vincenzo , Molla Tesfaye T. , Foghmoes Søren P. V. , Bjørk Rasmus , Frandsen Henrik L. , Aleksandrova Elena , Pryds Nini
Published: May 2013

Experimental analyses of shrinkage and distortion kinetics during sintering of bilayered porous and dense gadolinium‐doped ceria Ce0.9Gd0.1O1.95−δ structures are carried out, and compared with the theoretical models developed in Part I of this work. A novel approach is developed for the determination of the shear viscosities ratio of the layer fully dense materials. This original technique enables the derivation of all the input parameters for the bilayer sintering modeling from one set of optical dilatometry measurements, including the conversion between real and specific times of sintering, the layers’ relative sintering intensity, and the shear viscosities ratio of the layer fully dense materials. These optical dilatometry measurements are conducted simultaneously for each individual layer and for a symmetric trilayered porous structure based on the two layers utilized in the bilayered system. The obtained modeling predictions indicate satisfactory agreement with the results of sintering of a bilayered cerium–gadolinium oxide system in terms of distortion and shrinkage kinetics.
Spark Plasma Sintered HA‐Fe3O4‐Based Multifunctional Magnetic Biocomposites
Authors: Bajpai Indu , Balani Kantesh , Basu Bikramjit
Published: May 2013

Although HA is highly biocompatible, one of the major disadvantages of HA include the lack of antibacterial property. In an earlier study, we demonstrated the potential role of magnetic field stimulation on bactericidal property in vitro. Following this, it was hypothesized that antibacterial property can be realized if bacteria are grown on magnetic biocomposites in vitro. In addressing this issue, this study demonstrates the development of HA‐Fe3O4‐based magnetic substrate with multifunctional properties. For this purpose, HA‐xFe3O4 (x: 10, 20 and 40 wt%) powder compositions were sintered using uniquely designed spark plasma sintering conditions (three stage sintering with final holding temperature of 1050°C for 5 min). A saturation magnetization of 24 emu/g is measured with HA‐40%Fe3O4. Importantly, all the HA‐Fe3O4 composites demonstrated bactericidal property by rupturing the membrane of Escherichia coli bacteria, while supporting cell growth of metabolically active human fetal osteoblast cells over 8 d culture. A systematic decrease in bacterial viability with Fe3O4 addition is consistent with a commensurate increase in reactive oxygen species (ROS).
Pragmatic deficits and social impairment in children with ADHD
Authors: Staikova Ekaterina , Gomes Hilary , Tartter Vivien , McCabe Allyssa , Halperin Jeffrey M.
Published: May 2013

Background

Impaired social functioning has been well documented in individuals with attention‐deficit/hyperactivity disorder (ADHD). Existing treatments for ADHD are effective for managing core symptoms, but have limited effectiveness at improving social skills, suggesting that social deficits in ADHD may not be directly related to core symptoms of the disorder. Language problems are also common in ADHD, with accumulating evidence of pragmatic language difficulties. Pragmatic deficits are associated with social impairment in several neurodevelopmental disorders. This study systematically examined pragmatic language functioning in children with ADHD and whether social impairment in ADHD is mediated by pragmatic deficits.

Method

Sixty‐three children (28 ADHD; 35 typically developing), ages 7–11 years, underwent a comprehensive assessment of pragmatic language, including parent ratings, standardized tests, and a narrative task. Parents also rated children's social skills on the Social Skills Improvement System.

Results

Children with ADHD had poorer pragmatic language skills relative to peers across all measures, even after controlling for general language abilities. Furthermore, pragmatic abilities as measured by parent ratings, mediated the relation between ADHD and social skills.

Conclusions

Pragmatic language skills are impaired in many children with ADHD and may partially account for high rates of social impairment. Implications for treatment and possible prevention of social problems in children with ADHD are discussed.
Nutrition self‐efficacy assessment: development of a questionnaire and evaluation of reliability in African‐American and Latino children
Authors: Sharma S. , Roberts L. , Fleming S.
Published: May 2013

Background

We aimed to develop tools that could be reliably used to evaluate self‐efficacy for consuming vegetables and low‐sugar foods and beverages for African American and Latino children living in inner‐city communities.

Methods

A total of 112 children, aged 8–11 years, identified by a parent as being either African‐American or Latino, were recruited and administered questionnaires. Internal consistency, a measure of reliability, was assessed by calculating the Cronbach's alpha of test scores.

Results

Cronbach's alpha exceeded the threshold of acceptability of 0.70 for the Authors' Vegetables Self‐Efficacy Index, and all three Low‐Sugar Self‐Efficacy Indices, including the Reference Index, the Authors' Low‐Sugar Food and Beverage Index, and the Low‐Sugar Beverages Index.

Conclusions

We present internally consistent tools that could be reliably used to evaluate self‐efficacy for consuming vegetables and low‐sugar foods and beverages in 8–11‐year‐old African‐American and Latino children from low socio‐economic communities.
Developing an interactive portion size assessment system (IPSAS) for use with children
Authors: Foster E. , Hawkins A. , Simpson E. , Adamson A. J.
Published: May 2013

Novel methods of assessing dietary intake are required to reduce the participant burden in dietary surveys, improve participation rates and thereby improve the representativeness of the sample and minimise the impact of measuring dietary intake on a subject's food intake during the recording period. One method of reducing the burden placed on participants in recording dietary intake is to replace weighing of foods with estimation of portion size using tools such as food photographs. The interactive portion size assessment system (IPSAS) is an interactive portion size assessment system for use in assessing portion sizes of foods consumed by children aged 18 months to 16 years. The system is computer‐based and is designed to be administered during an interview for a food diary or 24‐h recall. The portion sizes depicted are age‐specific and based on the weights of foods served to children during the UK National Diet and Nutrition Surveys. The system displays digital images of food used to estimate the amount of each food served to the child and the amount of any food left over. Foods are categorised within the system using a three‐tier structure. Twenty‐seven food group icons are used with two further drop‐down menus to select first the food group, then the food category and, finally, the actual food product. Each food is linked to UK food composition codes and all photographs are linked to the weight of the food depicted. Nutritional output is via a companion database. The present study describes the development of the IPSAS and the structure of the system.
Reproducibility and relative validity of a brief quantitative food frequency questionnaire for assessing fruit and vegetable intakes inNorth‐African women
Authors: Landais E. , Gartner A. , Bour A. , McCullough F. , Delpeuch F. , Holdsworth M.
Published: May 2013

Background

In the context of a rapidly increasing prevalence of noncommunicable diseases, fruit and vegetables could play a key preventive role. To date, there is no rapid assessment tool available for measuring the fruit and vegetable intakes ofNorth‐African women. The present study aimed to investigate the reproducibility and relative validity of an eight‐item quantitativefoodfrequencyquestionnaire that measures the fruit and vegetable intakes (FV‐FFQ) ofMoroccan women.

Methods

During a 1‐week period, 100 women, living in the city ofRabat,Morocco (aged 20–49 years) completed the shortFV‐FFQtwice: once at baseline (FV‐FFQ1) and once at the end of the study (FV‐FFQ2). In the mean time, participants completed three 24‐h dietary recalls. All questionnaires were administered by interviewers. Reproducibility was assessed by computing Spearman's correlation coefficients,intraclasscorrelation (ICC) coefficients andkappa statistics. Relative validity was assessed by computingWilcoxon signed‐rank tests andSpearman's correlation coefficients, as well as by performingBland–Altman plots.

Results

In terms of reproducibility,Spearman's correlation coefficient was 0.56;ICCcoefficient was 0.68; and weightedkappa was 0.35. In terms of relative validity, compared with the three 24‐h recalls, theFV‐FFQslightly underestimated mean fruit and vegetable intakes (−10.9%;P = 0.006); Spearman's correlation coefficient was 0.69; at the individual level, intakes measured by theFV‐FFQwere between 0.39 and 2.19 times those measured by the 24‐h recalls.

Conclusions

The brief eight‐itemFV‐FFQis a reliable and relatively valid tool for measuring mean fruit and vegetable intakes at the population level, although this is not the case at the individual level.
Hypoosmotic and glutamate‐induced swelling of bipolar cells in the rat retina: comparison with swelling of Müller glial cells
Authors: Vogler Stefanie , Grosche Antje , Pannicke Thomas , Ulbricht Elke , Wiedemann Peter , Reichenbach Andreas , Bringmann Andreas
Published: May 2013

Regulation of cellular volume is of great importance to avoid changes in neuronal excitability resulting from a decrease in the extracellular space volume. We compared the volume regulation of retinal glial (Müller) and neuronal (bipolar) cells under hypoosmotic and glutamate‐stimulated conditions. Freshly isolated slices of the rat retina were superfused with a hypoosmotic solution (60% osmolarity; 4 min) or with a glutamate (1 mM)‐containing isoosmotic solution (15 min), and the size changes of Müller and bipolar cell somata were recorded. Bipolar cell somata, but not Müller cell somata, swelled under hypoosmotic conditions and in the presence of glutamate. The hypoosmotic swelling of bipolar cell somata might be mediated by sodium flux into the cells, because it was not observed under extracellular sodium‐free conditions, and was induced by activation of metabotropic glutamate receptors and sodium‐dependent glutamate transporters. The glutamate‐induced swelling of bipolar cell somata was mediated by sodium chloride flux into the cells induced by activation of NMDA‐ and non‐NMDA glutamate receptors, glutamate transporters, and voltage‐gated sodium channels. The glutamate‐induced swelling of bipolar cell somata was abrogated by adenosine and γ‐aminobutyric acid, but not by vascular endothelial growth factor and ATP. The data may suggest that Müller cells, in contrast to bipolar cells, possess endogenous mechanisms which tightly regulate the cellular volume in response to hypoosmolarity and prolonged glutamate exposure. Inhibitory retinal transmission may regulate the volume of bipolar cells, likely by inhibition of the excitatory action of glutamate.
A Distinct Strain of Cowpea mild mottle virus Infecting Soybean in India
Authors: Yadav Manoj K. , Biswas Kajal K. , Lal Sanjay K. , Baranwal Virendra K. , Jain Rakesh K.
Published: May 2013

Soybean crops showing systemic mottling, mosaic and leaf deformation were observed at high disease incidences (25.1–71.0%) in the kharif season of 2011 and 2012 in the experimental farm of the Indian Agricultural Research Institute (IARI), New Delhi. Symptomatic soybean leaves contained flexuous particles (650 × 12 nm), suggesting an infection by a Carlavirus. The causal virus was characterized as a strain of Cowpea mild mottle virus (CPMMV) on the basis of mechanical inoculation, whitefly transmission, seed transmission and sequencing of the viral genome. This is the first report of natural infection by a distinct strain of CPMMV in soybean in India.
Phylogenetic clustering and overdispersion for alpine plants along elevational gradient in the Hengduan Mountains Region, southwest China
Authors: LI Xin‐Hui , ZHU Xin‐Xin , NIU Yang , SUN Hang
Published: May 2013

To better understand the elevational pattern of phylogenetic structure shown by alpine taxa and the underlying causes, we analyzed the phylogenetic structure of each elevational belt of alpine plants in the Hengduan Mountains Region, measured by net related index (NRI) and net nearest taxon index (NTI). We found both the indices of phylogenetic diversity indicated that alpine plants tended to show phylogenetic overdispersion at low elevational belts, implying that the distribution of alpine plants in these belts was mainly determined by interspecific competition. Alpine plants at higher elevational belts tended to phylogenetic clustering indicated by NRI, and NTI revealed phylogenetic clustering at the belts between 4300 m and 5500 m, which presumably suggested environment filtering and rapid speciation. Above 5500 m, NTI indicated that the phylogenetic structure became random again, perhaps due to the low intensity of filtering and the large distances between plants at the top of the scree slopes. We concluded that phylogenetic structure was, indeed, influenced by the environmental filter, interspecies interaction, rapid speciation during the uplift of the Qinghai–Tibet Plateau, and distance between plants.
Psychometric properties of the Adolescent Sleep Hygiene Scale
Authors: Storfer‐Isser Amy , Lebourgeois Monique K. , Harsh John , Tompsett Carolyn J. , Redline Susan
Published: May 2013

This study evaluated the psychometric properties of the Adolescent Sleep Hygiene Scale (ASHS), a self‐report measure assessing sleep practices theoretically important for optimal sleep. Data were collected on a community sample of 514 adolescents (16–19; 17.7 ± 0.4 years; 50% female) participating in the late adolescent examination of a longitudinal study on sleep and health. Sleep hygiene and daytime sleepiness were obtained from adolescent reports, behavior from caretaker reports, and sleep‐wake estimation on weekdays from wrist actigraphy. Confirmatory factor analysis indicated the empirical and conceptually based factor structure were similar for six of the eight proposed sleep hygiene domains. Internal consistency of the revised scale (ASHSr) was α = 0.84; subscale alphas were: physiological: α = 0.60; behavioural arousal: α = 0.62; cognitive/emotional: α = 0.81; sleep environment: α = 0.61; sleep stability: α = 0.68; daytime sleep: α = 0.78. Sleep hygiene scores were associated positively with sleep duration (r = 0.16) and sleep efficiency (r = 0.12) and negatively with daytime sleepiness (r = −0.26). Results of extreme‐groups analyses comparing ASHSr scores in the lowest and highest quintile provided further evidence for concurrent validity. Correlations between sleep hygiene scores and caretaker reports of school competence, internalizing and externalizing behaviours provided support for convergent validity. These findings indicate that the ASHSr has satisfactory psychometric properties for a research instrument and is a useful research tool for assessing sleep hygiene in adolescents.
Predictive value of ALT levels for non‐alcoholic steatohepatitis (NASH) and advanced fibrosis in non‐alcoholic fatty liver disease (NAFLD)
Authors: Verma Siddharth , Jensen Donald , Hart John , Mohanty Smruti R.
Published: May 2013

Background

Non‐alcoholic fatty liver disease (NAFLD) patients with elevated serum alanine aminotransferase (ALT) generally undergo a liver biopsy to evaluate for possible non‐alcoholic steatohepatitis (NASH) or advanced fibrosis. However, patients with normal ALT could also have advanced stages of NAFLD.

Aim

To determine ALT value that will accurately predict NASH and advanced fibrosis using area under the receiver operating characteristics curve (AUROC) analysis.

Methods

Demographic, clinical and laboratory data of an ethnically diverse cohort of biopsy proven NAFLD patients were retrospectively analysed under univariate and multivariate analyses. Liver biopsies were scored using NASH clinical research network (NASH CRN) system. AUROC were performed for NAFLD Activity Score ≥5 (NASH) and fibrosis score ≥2 (advanced fibrosis).

Results

Two hundred and twenty‐two patients were analysed. Fifty six (23%) had normal ALT. There was no difference in the rate of advanced fibrosis between normal and elevated ALT (26.8% vs. 18.1%, P = 0.19). However, significantly lower percentage of normal ALT group had NASH compared with elevated ALT group (10.7% vs. 28.9%, P < 0.01). Overall, 37.5% of normal ALT group had NASH or advanced fibrosis, whereas 53% of elevated ALT had no NASH or advanced fibrosis. Higher ALT values correlated with higher specificity, but lower sensitivity for both NASH and advanced fibrosis. AUROC for ALT level correlating NASH and advanced fibrosis were 0.62 and 0.46 respectively.

Conclusion

There is no optimal ALT level to predict NASH and advanced fibrosis. Metabolic risk factors should be evaluated to select patients for a liver biopsy to confirm NASH and advanced fibrosis.
Attenuated Systemic Microvascular Function in Men with Coronary Artery Disease is Associated with Angina but not Explained by Atherosclerosis
Authors: Strain W. David , Hughes Alun D. , Mayet Jamil , Wright Andrew R. , Kooner Jaspal , Chaturvedi Nish , Shore Angela C.
Published: May 2013

Introduction

Refractory angina is the occurrence of clinical symptoms despite maximal therapy. We investigated associations between microvascular function, atherosclerotic burden, and clinical symptoms in subjects with CAD.

Methods

Skin microvascular response to heating and ischemia was assessed in 167 male volunteers by laser Doppler fluximetry; 82 with CAD on maximal therapy and 85 with no known CAD (noCAD). CAC scores, carotid IMT, and femoral IMT were measured and symptoms were scored using the Rose angina questionnaire.

Results

Patients with CAD had poorer microvascular response to heating (114[95% CI 106–122]au CAD vs. 143[134–153]au no CAD; p < 0.0001) and ischemia (42[38–46]au CAD vs. 53[78–58]au. noCAD; p = 0.001). Thirty‐eight percent of the noCAD group had elevated CAC scores. There were no associations between markers of atherosclerosis and microvascular function. Forty‐two percent of the CAD group had refractory angina. This was associated with impaired microvascular function compared to those with elevated CAC scores but no symptoms (109 [95–124]au vs. 131[122–140]au; p = 0.008).

Conclusions

Men with symptomatic CAD have poorer microvascular function compared to individuals without CAD. Microvascular function does not correlate with atherosclerosis, but is impaired in individuals with refractory angina. Microvascular dysfunction may play a role in the symptomatology of angina.
Nail psoriasis masqueraded by secondary infection with Rhodotorula mucilaginosa
Authors: Martini K. , Müller H. , Huemer H. P. , Höpfl R.
Published: May 2013

A 38‐year‐old man presented with whitish nail changes on all fingers as the sole symptom. The condition had developed within a few days and led to dystrophy of the proximal part of the nail plates. As microscopic examination of nail scrapings demonstrated budding hyphae and the patient working as a teacher reported frequent use of a wet sponge, antifungal therapy was initiated. Subsequent cultures and molecular typing identified Rhodotorula mucilaginosa (formerly R. rubra). This environmental yeast was repeatedly isolated despite of therapy with itraconazole. As no improvement was achieved and testing of the biological activity of the fungus revealed only marginal keratolytic activity, it was considered as a coloniser of a destructed nail matrix. Finally, a biopsy of the nail bed confirmed the diagnosis of nail psoriasis, which rapidly responded to treatment with acitretin and topical calcipotriol/betamethasone cream. Fungal growth in destructed nails masqueraded the underlying disease and may have triggered the psoriatic nail reaction.
Transcriptome analysis of the sulfate deficiency response in the marine microalga Emiliania huxleyi
Authors: Bochenek Michal , Etherington Graham J. , Koprivova Anna , Mugford Sam T. , Bell Thomas G. , Malin Gill , Kopriva Stanislav
Published: May 2013

The response to sulfate deficiency of plants and freshwater green algae has been extensively analysed by system biology approaches. By contrast, seawater sulfate concentration is high and very little is known about the sulfur metabolism of marine organisms.

Here, we used a combination of metabolite analysis and transcriptomics to analyse the response of the marine microalga Emiliania huxleyi as it acclimated to sulfate limitation.

Lowering sulfate availability in artificial seawater from 25 to 5 mM resulted in significant reduction in growth and intracellular concentrations of dimethylsulfoniopropionate and glutathione. Sulfate‐limited E. huxleyi cells showed increased sulfate uptake but sulfate reduction to sulfite did not seem to be regulated. Sulfate limitation in E. huxleyi affected expression of 1718 genes. The vast majority of these genes were upregulated, including genes involved in carbohydrate and lipid metabolism, and genes involved in the general stress response.

The acclimation response of E. huxleyi to sulfate deficiency shows several similarities to the well‐described responses of Arabidopsis and Chlamydomonas, but also has many unique features. This dataset shows that even though E. huxleyi is adapted to constitutively high sulfate concentration, it retains the ability to re‐program its gene expression in response to reduced sulfate availability.
Vegetation limits the impact of a warm climate on boreal wildfires
Authors: Girardin Martin P. , Ali Adam A. , Carcaillet Christopher , Blarquez Olivier , Hély Christelle , Terrier Aurélie , Genries Aurélie , Bergeron Yves
Published: May 2013

Strategic introduction of less flammable broadleaf vegetation into landscapes was suggested as a management strategy for decreasing the risk of boreal wildfires projected under climatic change. However, the realization and strength of this offsetting effect in an actual environment remain to be demonstrated.

Here we combined paleoecological data, global climate models and wildfire modelling to assess regional fire frequency (RegFF, i.e. the number of fires through time) in boreal forests as it relates to tree species composition and climate over millennial time‐scales.

Lacustrine charcoals from northern landscapes of eastern boreal Canada indicate that RegFF during the mid‐Holocene (6000–3000 yr ago) was significantly higher than pre‐industrial RegFF (ad c. 1750). In southern landscapes, RegFF was not significantly higher than the pre‐industrial RegFF in spite of the declining drought severity. The modelling experiment indicates that the high fire risk brought about by a warmer and drier climate in the south during the mid‐Holocene was offset by a higher broadleaf component.

Our data highlight an important function for broadleaf vegetation in determining boreal RegFF in a warmer climate. We estimate that its feedback may be large enough to offset the projected climate change impacts on drought conditions.
Spatiotemporal changes in the role of cytokinin during root development
Authors: Del Bianco Marta , Giustini Leonardo , Sabatini Sabrina
Published: May 2013

The root is a dynamic system whose structure is regulated by a complex network of interactions between hormones. The primary root meristem is specified in the embryo. After germination, the primary root meristem grows and then reaches a final size that will be maintained during the life of the plant. Subsequently, secondary structures such as lateral roots and root nodules form via the re‐specification of differentiated cells. Cytokinin plays key roles in the regulation of root development. Down‐regulation of the cytokinin response is required for the specification of a new stem cell niche, during both embryo and lateral root development. In the root meristem, cytokinin signalling regulates the longitudinal zonation of the meristem by controlling cell differentiation. Moreover, cytokinin regulates radial patterning of root vasculature by promoting protophloem cell identity and by spatially inhibiting protoxylem formation. In this review, an effort is made to describe the known details of the role of cytokinin during root development, taking into account also the interactions between cytokinin and other hormones. Attention is given on the dynamicity of cytokinin signalling output during different developmental events. Indeed, there is much evidence that the effects of cytokinin change as organs grow, underlining the importance of the spatiotemporal specificity of cytokinin signalling.

Contents

Summary
324

I.
Introduction
324

II.
Cytokinin cellular pathway
325

III.
Cytokinin signalling in root development
327

IV.
Spatiotemporal variations of cytokinin signalling
332

V.
Concluding remarks
334

Acknowledgements
335

References
335
Human B‐1 cells take the stage
Authors: Rothstein Thomas L. , Griffin Daniel O. , Holodick Nichol E. , Quach Tam D. , Kaku Hiroaki
Published: May 2013

B‐1 cells play critical roles in defending against microbial invasion and in housekeeping removal of cellular debris. B‐1 cells secrete natural antibody and manifest functions that influence T cell expansion and differentiation and in these and other ways differ from conventional B‐2 cells. B‐1 cells were originally studied in mice where they are easily distinguished from B‐2 cells, but their identity in the human system remained poorly defined for many years. Recently, functional criteria for human B‐1 cells were established on the basis of murine findings, and reverse engineering resulted in identification of the phenotypic profile, CD20+CD27+CD43+CD70−, for B‐1 cells found in both umbilical cord blood and adult peripheral blood. Human B‐1 cells may contribute to multiple disease states through production of autoantibody and stimulation/modulation of T cell activity. Human B‐1 cells could be a rich source of antibodies useful in treating diseases present in elderly populations where natural antibody protection may have eroded. Manipulation of human B‐1 cell numbers and/or activity may be a new avenue for altering T cell function and treating immune dyscrasias.
Ultrasound‐guided parasacral approach to the sciatic nerve block in children
Authors: Dillow Jennifer M. , Rosett Randy L. , Petersen Timothy R. , Vagh Firoz S. , Hruschka James A. , Lam Nicholas C. K.
Published: May 2013

Background

The parasacral (PS) approach to sciatic nerve blockade has the potential for safe and effective use in children, but has never been studied in this population. Its potential advantages include increased posterior cutaneous nerve block reliability, potential for hip joint analgesia, and decreased nerve depth, making ultrasound guidance easier.

Objective

To assess the efficacy of an ultrasound‐guided PS sciatic nerve block in children.

Methods

Nineteen patients, 1–16 years old, scheduled for lower limb surgery with peripheral nerve blockade (PNB) were prospectively enrolled. A PS sciatic block was performed using both ultrasound guidance and nerve stimulation, and 0.5 ml·kg−1 ropivacaine 0.2% (maximum 20 ml) was administered. Patient demographics, the time to perform the block, the lowest intensity of nerve stimulation, evoked response, identification of gluteal arteries, and amount of narcotic given were recorded. Postoperatively, pain scores, block success or failure, block duration, and complications were recorded.

Results

The block was performed using the PS approach in 95% of the cases. The success rate was 100% in the PS sciatic blocks performed. The pain scores for all patients in the first postsurgical hour were zero, except one patient that had a pain score of 3 of 10 at 30 min; his pain improved to 0 of 10 after administration of one dose of fentanyl and distraction techniques. The blocks lasted 17.3 ± 5.4 h. No complications were identified.

Conclusion

The PS approach is an effective option for sciatic nerve blockade to provide postoperative pain relief in children having lower extremity surgery.
Positive blood culture is not associated with increased mortality in patients with sepsis‐induced acute respiratory distress syndrome
Authors: Yang Szu‐Chun , Liao Kuang‐Ming , Chen Chang‐Wen , Lin Wei‐Chieh
Published: May 2013

Background and objective

Previous studies have demonstrated that positive blood culture could contribute to poorer outcomes in patients with pneumonia. However, the impact of positive blood culture on the outcomes of patients with sepsis‐induced acute respiratory distress syndrome (ARDS) has not been evaluated.

Methods

An observational study that prospectively screened 4861 patients admitted to medical or surgical intensive care units (ICUs) of a tertiary referral centre was performed.

Results

Among 4861 admitted patients, 146 diagnosed with sepsis‐induced ARDS were enrolled (mean age: 66.1 years). Lower PaO2/FiO2, decreased respiratory system compliance, and higher lung injury scores (LIS) on the day of ARDS diagnosis were associated with positive blood cultures (n = 68) rather than negative blood cultures (n = 78). There was no relationship between positive blood culture and in‐hospital mortality. Kaplan–Meier estimates also revealed that positive blood culture was not associated with 60‐day mortality but with an increased length of stay in the hospital and in the ICU (P = 0.007 and P = 0.016, respectively). Using multivariate logistic regression, higher LIS was independently associated with positive blood culture. In addition, chronic pulmonary disease, lower platelet count, higher LIS, and the development of shock on the diagnosis of ARDS, were independent risk factors for in‐hospital mortality.

Conclusions

This study suggests that the presence of positive blood culture is not associated with increased mortality; however, the mean durations of hospital and ICU stays in patients with sepsis‐induced ARDS are increased.
Effects of whole body vibration training in patients with severe chronic obstructive pulmonary disease
Authors: Pleguezuelos Eulogio , Pérez Maria Engracia , Guirao Lluis , Samitier Beatriz , Costea Maria , Ortega Pilar , González Maria Victoria , Del Carmen Virgilio Amin. , Ovejero Laura , Moreno Eva , Miravitlles Marc
Published: May 2013

Background and objective

To determine if whole body vibration training (WBVT) improves muscular force and modifies functional capacity parameters in patients with severe chronic obstructive pulmonary disease (COPD).

Methods

We performed a randomized controlled trial in the outpatient Physical Medicine and Rehabilitation Department of a general hospital. Sixty stable male patients with COPD and mean forced expiratory volume in 1 s (FEV1) 34.3% (predicted) were enrolled with 51 patients completing the study. Participants were randomized into two groups: Whole Body Vibration Training Group (WBVTG), (n = 26) undergoing three sessions per week for a total of 6 weeks and a Control Group (CG) (n = 25) without intervention. The main outcome measures were isokinetic knee flexor and extensor testing in a concentric–concentric regime and exercise capacity measured by the 6‐min walking test (6MWT). Secondary outcomes were pulmonary muscular assessment with maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP).

Results

No significant differences were observed between groups in maximum moment of isokinetic knee flexor/extensor testing force in a concentric‐concentric regime. In contrast, WBVTG patients showed a significant increase in the 6MWT (81.2 ± 9.2) meters; mean ± SD; P < 0.001). There was also a significant decrease in maximum oxygen desaturation in the 6MWT after 6 weeks of training (3.1 ± 1.1; P = 0.01). There were significant differences between groups in MIP and MEP at the end of the study in favour of the WBVTG.

Conclusions

WBVT provided significant improvements in functional capacity in severe COPD patients without changes in muscular force.