bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of heparin in sepsis: much more than just an anticoagulant
Authors: Li Xu , Ma Xiaochun
Published: August 2017

Despite progress in antibiotic treatment, mechanical ventilation, fluid resuscitation and blood glucose maintenance, sepsis remains a cause of high mortality in the intensive care unit to date, there are no proven treatment strategies for the routine management of septic patients. The extensive interaction between inflammation and coagulation contributes to the basic pathophysiology of sepsis. Thus, the agents that attenuate the activation of both inflammation and coagulation may improve the outcome in sepsis. Apart from the well‐known anticoagulant effects of heparin, it also possesses various immunomodulatory properties and protects glycocalyx from shedding. Hence, heparin seems to be such an agent. Immunothrombosis plays an important role in early host defence against bacterial dissemination, thus the proper timing for anticoagulant therapy should be determined. We review the available experimental and clinical data supporting the use of heparin in sepsis. At this time the use of heparin in the treatment of sepsis is conflicting. Future trials of heparin therapy for sepsis should concentrate on the very severely ill patients, in whom benefit is most likely to be demonstrated.
Diagnosis of CLL revisited: increased specificity by a modified five‐marker scoring system including CD200
Authors: Köhnke Thomas , Wittmann Veronika K. , Bücklein Veit L. , Lichtenegger Felix , Pasalic Zlatana , Hiddemann Wolfgang , Spiekermann Karsten , Subklewe Marion
Published: August 2017

The modified Matutes score has been the basis for the diagnosis of chronic lymphocytic leukaemia (CLL) by flow cytometry for the past 15 years. To increase the specificity of the current score we systematically evaluated the diagnostic value of established as well as novel markers, such as CD200, in a large cohort of patients with untreated B‐cell malignancies (n = 370). Double positivity for CD5 and CD23 was of very high value to differentiate between CLL and non‐CLL cases. In addition, lack of FMC7 expression as well as CD79b expression intensity showed high sensitivity (90·4% and 92·3%) with acceptable specificity (74·4% and 76·9%). For surface IgM, low or absent expression displayed poor specificity in distinguishing CLL from non‐CLL cases (51,3%; sensitivity 83,7%). Finally, CD200 positivity showed high sensitivity and specificity. Therefore, CD5/CD23, FMC7, CD79b and CD200 were included in our new CLLflow score, which retained high sensitivity (97·1% vs. 98·6% for the Matutes score, P = 0·38), but showed markedly increased specificity (87·2% vs. 53·8%, P < 0·001). These results were confirmed in our validation cohort (sensitivity 97·0% vs. 100%, P = not applicable; specificity 86·4% vs. 59·1%, P = 0·03). Our data support the use of our new CLLflow score for the diagnosis of CLL with significantly higher specificity.
What contributes to action plan enactment? Examining characteristics of physical activity plans
Authors: Fleig Lena , Gardner Benjamin , Keller Jan , Lippke Sonia , Pomp Sarah , Wiedemann Amelie U.
Published: August 2017

Objectives

Individuals with chronic conditions can benefit from formulating action plans to engage in regular physical activity. However, the content and the successful translation of plans into action, so‐called plan enactment, are rarely adequately evaluated. The aim of this study was to describe the content of user‐specified plans and to examine whether participants were more likely to enact their plans if these plans were highly specific, viable, and instrumental.

Design and methods

The study presents secondary analyses from a larger behavioural intervention in cardiac and orthopaedic rehabilitation. The content of 619 action plans from 229 participants was evaluated by two independent raters (i.e., qualitative analyses and ratings of specificity) and by participants themselves (i.e., instrumentality and viability). Plan enactment was also measured via self‐reports. Multilevel analyses examined the relationship between these plan characteristics and subsequent plan enactment, and between plan enactment and aggregated physical activity.

Results

Participants preferred to plan leisure‐time physical activities anchored around time‐based cues. Specificity of occasion cues (i.e., when to act) and highly instrumental plans were positively associated with plan enactment. Interestingly, individuals who planned less specific behavioural responses (i.e., what to do) were more likely to enact their plans. Plan enactment was positively associated with aggregated behaviour.

Conclusions

Interventions should not only emphasize the importance of planning, but also the benefits of formulating specific contextual cues. Planning of the behavioural response seems to require less precision. Allowing for some flexibility in executing the anticipated target behaviour seems to aid successful plan enactment.

Statement of Contribution

What is already known on this subject?

Action planning interventions are efficacious in promoting health behaviour.

Characteristics of plan content (i.e., specificity) matter for unconditional behaviour change.

Plan enactment (i.e., degree to which plan is followed through) is positively linked to behaviour change.

What does this study add?

Specificity of occasion cues (i.e., when to act) and highly instrumental plans were positively associated with plan enactment.

Individuals who planned less specific behavioural responses (i.e., what to do) were more likely to enact their plans.

Planning interventions should focus on specificity of context cues but flexibility of behavioural action.
Feasibility and safety of focal irreversible electroporation as salvage treatment for localized radio‐recurrent prostate cancer
Authors: Scheltema Matthijs J. , van den Bos Willemien , Siriwardana Amila R. , Kalsbeek Anton M.F. , Thompson James E. , Ting Francis , Böhm Maret , Haynes Anne‐Maree , Shnier Ron , Delprado Warick , Stricker Phillip D.
Published: August 2017

Objectives

To evaluate the feasibility, safety, early quality‐of‐life (QoL) and oncological outcomes of salvage focal irreversible electroporation (IRE) for radio‐recurrent prostate cancer (PCa).

Patients and Methods

Patients with localized, radio‐recurrent PCa without evidence of metastatic or nodal disease were offered focal IRE according to the consensus guidelines. Patients with a minimum follow‐up of 6 months were eligible for analysis. Adverse events were monitored using the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE version 4.0). Patient‐reported QoL data were collected at baseline, 6 weeks, 3, 6 and 12 months using the Expanded Prostate Cancer Index Composite (EPIC), the American Urological Association (AUA) symptom score and the 12‐item short‐from health survey (SF‐12) physical and mental component summary questionnaires. Oncological control was evaluated according to serial prostate‐specific antigen (PSA), 6‐month multiparametric magnetic resonance imaging (mpMRI) and 12‐month prostate biopsy. Wilcoxon's signed rank test was used to assess QoL differences over time in paired continuous variables.

Results

A total of 18 patients were included in the analysis. The median follow‐up was 21 months. No high‐grade adverse events (CTCAE >2) or recto‐urethral fistulae occurred. No statistically significant declines were observed in QoL outcomes (n = 11) on the EPIC bowel domain (P = 0.29), AUA symptom score (P = 0.77), or the SF‐12 physical (P = 0.17) or SF‐12 mental component summary (P = 0.77) questionnaires. At 6 months, patients who had undergone salvage therapy experienced a decline in EPIC sexual domain score (median of 38–24; P = 0.028) and urinary domain (median of 96–92; P = 0.074). Pad‐free continence and erections sufficient for intercourse were preserved in 8/11 patients and 2/6 patients at 6 months, respectively. The mpMRI was clear in 11/13 patients, with two single out‐field lesions (true‐positive and false‐positive, respectively). The median (interquartile range) nadir PSA was 0.39 (0.04–0.43) μg/L. Three and four patients experienced biochemical failure using the Phoenix and Stuttgart definitions of biochemical failure, respectively. Eight out of 10 of the patients were clear of any PCa on follow‐up biopsy, whereas two patients had significant PCa on follow‐up biopsy (International Society of Urological Pathology grade 5).

Conclusion

Our short‐term safety, QoL and oncological control data show that focal IRE is a feasible salvage option for localized radio‐recurrent PCa. A prospective multicentre study (FIRE trial) has been initiated that will provide further insight into the ability of focal IRE to obtain oncological control of radio‐recurrent PCa with acceptable patient morbidity.
Iron metabolism in patients with Graves’ hyperthyroidism
Authors: Fischli Stefan , von Wyl Viktor , Trummler Michael , Konrad Daniel , Wueest Stephan , Ruefer Axel , Heering Kerstin , Streuli Regina , Steuer Christian , Bernasconi Luca , Recher Mike , Henzen Christoph
Published: August 2017

Objectives

Graves’ hyperthyroidism (GH) interferes with iron metabolism and elevates ferritin. The precise mechanisms remain unclear. The influence of thyroid hormones on the synthesis/regulation of hepcidin, an important regulator of iron metabolism, remains uncharacterized.

Design

Prospective observational study.

Patients

We included patients (n = 31) with new‐onset and untreated GH.

Measurements

Laboratory parameters indicative of iron metabolism (ferritin, transferrin, hepcidin), inflammatory markers/cytokines and smoking status were assessed at the diagnosis of GH (T0) and at euthyroidism (T1) in the same patients using multivariable analyses. Hepcidin was measured by mass spectrometry (hepcidinMS) and ELISA (hepcidinEL). The impact of T3 on hepatic hepcidin expression was studied in a cell culture model using HepG2 cells.

Results

Median ferritin levels were significantly lower and transferrin significantly higher at T1 than at T0. HepcidinMS levels were lower in males and females at T1 (statistically significant in males only). No statistically significant difference in hepcidinEL was detected between T0 and T1. Plasma levels of inflammatory markers (high‐sensitive CRP, procalcitonin) and cytokines (interleukin 6, interleukin 1ß, tumour necrosis factor α) were not different between T0 and T1. Smokers tended to have lower fT3 and fT4 at T0 than nonsmoking GH patients. T3 significantly induced hepcidin mRNA expression in HepG2 cells.

Conclusions

Iron metabolism in patients with GH undergoes dynamic changes in patients with GH that resemble an acute‐phase reaction. Inflammatory parameters and cytokines were unaffected by thyroid status. Gender and smoking status had an impact on ferritin, hepcidin and thyroid hormones.
An Economic Analysis of Western Canadian Grain Export Capacity
Authors: Torshizi Mohammad , Gray Richard
Published: August 2017

Record grain supplies combined with insufficient grain export capacity in the 2013–14 and 2014–15 crop years resulted in depressed Western Canadian grain prices costing producers several billion dollars. The exceptional size of the crop and the harsh winter weather contributing to this costly event raise an important question as to whether additional investment in export capacity is warranted. This study systematically assesses the need for additional grain export capacity in Western Canada. Somewhat conservative grain production forecasts and rational expectations storage are used within a spatial mathematical programming model to simulate a competitive market, moving grain to export positions. We find in the absence of additional export capacity there will be increasingly frequent periods of costly congestion. A 10 million tonnes (Mt) (5 Mt) improvement in both rail and West Coast capacity implies $9.2 billion ($6.0 billion) of cost‐saving benefits for the producers over the 2016–25 period. While these estimates are sensitive to future realized production levels, their magnitude suggests that innovation to increase export capacity is economically important for grain producers in Western Canada.

Des approvisionnements records de grains combinés à une capacité exportatrice insuffisante de ces derniers en 2013–14 et en 2014–15 ont engendré le bas prix du grain de l'Ouest canadien représentant une perte de milliards de dollars pour les producteurs. La production exceptionnelle et l'hiver particulièrement rude ont contribué à cet événement coûteux et soulèvent une question importante concernant le besoin pour des investissements additionnels en capacité exportatrice. Cette étude évalue systématiquement le besoin pour une capacité exportatrice accrue des céréales provenant de l'Ouest canadien. Les prévisions relativement prudentes de production de grains et l'anticipation rationnelle de stockage servent dans le cadre d'un modèle de programmation mathématique spatiale pour simuler un marché compétitif, transportant le grain vers les points d'exportation. Les trouvailles indiquent qu'en l'absence de capacité supplémentaire exportatrice, surviendront des périodes de plus en plus fréquentes de congestion coûteuse. Une amélioration de 10 Mt (5 Mt) à la capacité ferroviaire et de la Côte Ouest suppose des réductions de coûts à la hauteur de 9,2 milliards de dollars (6 milliards de dollars) pour les producteurs pour la période entre 2016 et 2025. Ces estimations étant liées à l'atteinte de futurs niveaux de production, leur importance suggère que l'innovation en vue d'accroître la capacité exportatrice s'avère économiquement essentielle pour les producteurs céréaliers de l'ouest du Canada.
The prevalence and fate of the defunctioning stoma in patients with anal cancer: a regional experience following the ACT II trial
Authors: Poynter L. R. , Raman R. , Wegstapel H. , Summers J. , Lawes D. A.
Published: August 2017

Aim

UK guidance advises the creation of a defunctioning stoma for anal tumours infiltrating the vagina, impending obstruction or significant faecal incontinence. Other patients may be offered a defunctioning stoma at the discretion of the clinician. The purpose of this study was to establish the prevalence and fate of defunctioning stomas in a regional anal cancer service, with reference to the results from the recent ACT II trial.

Method

Oncological treatment was standardized as described in the ACT II trial. All patients from 2010 to 2013 inclusive were included. Collected data were correlated with both the IMRT guidelines and the outcomes of the ACT II trial. Kaplan–Meier survival analysis was applied to stoma‐free survival to the end of the study period.

Results

Seventy‐six patients were identified during the study period, of whom 51% had a defunctioning stoma. Twenty were performed for anterior tumours without infiltration into the vagina (Group A), whilst 19 had a stoma for indications as set out by the guidelines (Group B). Stoma reversal was performed in 41% of patients, 13/20 in Group A and 3/19 in Group B. The median time to reversal was 11 months. Eleven deaths were recorded and six patients still had their stomas at time of death. Stoma‐free survival was 74%. No new ano‐vaginal fistulation occurred as a consequence of treatment.

Conclusion

The tumour features that are indications for defunctioning as advised by the UK IMRT guidelines are associated with a poorer overall outcome, and these stomas are less likely to be reversed. The majority of stomas, however, were formed for anterior tumours without infiltration into the vagina and were more likely to be successfully reversed.
A Gender Perspective on Entrepreneurial Leadership: Female Leaders in Kazakhstan
Authors: Kakabadse Nada K. , Tatli Ahu , Nicolopoulou Katerina , Tankibayeva Aliya , Mouraviev Nikolai
Published: August 2017

The paper proposes a conceptual model to understand female entrepreneurial leadership through an exploration of the perceptions and experiences of women entrepreneurs within their leadership roles. The paper addresses an existing knowledge gap on entrepreneurial leadership by bringing together three key constructs of gender, leadership and entrepreneurship. We apply Stewart's model of role demands‐constraints‐choices (DCC) to women entrepreneurs in Kazakhstan in order to understand their perceptions of the demands, constraints and choices they experience within their leadership roles. The results of in‐depth interviews with women entrepreneurs present deeper conceptualization of their leadership enactment as a co‐developing, co‐constructed relational activity between leaders and others in their wider business environments and context.
GBA mutations in Parkinson disease: earlier death but similar neuropathological features
Authors: Adler C. H. , Beach T. G. , Shill H. A. , Caviness J. N. , Driver‐Dunckley E. , Sabbagh M. N. , Patel A. , Sue L. I. , Serrano G. , Jacobson S. A. , Davis K. , Belden C. M. , Dugger B. N. , Paciga S. A. , Winslow A. R. , Hirst W. D. , Hentz J. G.
Published: August 2017

Background and purpose

Mutations in the glucocerebrosidase (GBA) gene are known to be a risk factor for Parkinson's disease (PD). Data on clinicopathological correlation are limited. The purpose of this study was to determine the clinicopathological findings that might distinguish PD cases with and without mutations in the GBA gene.

Methods

Data from the Arizona Study of Aging and Neurodegenerative Disorders were used to identify autopsied PD cases that did or did not have a GBA gene mutation. Clinical and neuropathological data were compared.

Results

Twelve PD cases had a GBA mutation and 102 did not. The GBA mutation cases died younger (76 vs. 81 years of age) but there was no difference in disease duration or clinical examination findings. No neuropathological differences were found in total or regional semi‐quantitative scores for Lewy‐type synucleinopathy, senile plaques, neurofibrillary tangles, white matter rarefaction or cerebral amyloid angiopathy scores.

Conclusions

In longitudinally assessed, autopsied PD cases, those with GBA mutations had a younger age at death but there was no evidence for clinical or neuropathological differences compared to cases without GBA mutations. Due to the small GBA group size, small differences cannot be excluded.
Magnetic resonance imaging findings of the proximal metacarpus in Quarter Horses used for cutting: Retrospective analysis of 32 horses 2009–2012
Authors: Barrett M. F. , Manchon P. T. , Hersman J. , Kawcak C. E.
Published: August 2017

Background

Injury to the proximal suspensory ligament is a common cause of lameness in cutting horses. Radiographic and ultrasonographic imaging of lesions responsible for lameness can provide ambiguous results. MRI provides the most comprehensive diagnostic imaging evaluation of lesions specifically affecting cutting horses.

Objectives

To describe the distribution and severity of bone and soft tissue lesions present in the proximal metacarpus of Quarter Horse cutting horses and to assess the impact of these lesions on return to competition.

Study design

Retrospective case series.

Methods

Retrospective analysis of 32 cutting horses referred for MRI of the proximal metacarpus between 2009 and 2012 with a 2‐year follow‐up period. MRI studies were evaluated by a board‐certified veterinary radiologist; the severity of lesions was graded from 0 (absent) to 3 (severe).

Results

A total of 20 right and 24 left forelimbs (12 bilateral studies) of 32 horses were evaluated. The most common findings were: third metacarpal (McIII) sclerosis at the proximal suspensory ligament (PSL) origin (42/44), McIII resorption at the PSL origin (32/44), PSL dorsal margin fibre irregularity (30/44) and McIII bone contusion (22/39). Of the 30 horses, 22 horses successfully returned to competition, irrespective of severity of injury. Strong correlation exists between the degree of resorption in the palmar cortex of proximal McIII, degree of McIII sclerosis and severity of dorsal margin fibre irregularity.

Main limitations

Statistical significance was limited by small study population. Further analysis of prognosis was limited by availability of comprehensive medical records.

Conclusions

Cutting horses with proximal metacarpal pain have significant pathological change within the proximal suspensory ligament and its enthesis on the palmar cortex of McIII. Severity of lesions and degree of lameness at the time of diagnosis does not influence return to performance. Accurate diagnosis of proximal metacarpal lesions based on MRI offers clinicians the capacity to select treatment protocols targeted to each disease process.
Crossover Cases of High‐Conflict Families Involving Child Protection Services: Ontario Research Findings and Suggestions for Good Practices
Authors: Houston Claire , Bala Nicholas , Saini Michael
Published: August 2017

Child protection services (CPS) are increasingly becoming involved in high‐conflict separations and the related custody and access proceedings. CPS involvement is often necessary to respond to abuse or neglect allegations or protect children from emotional harm. However, these crossover cases are very challenging for family justice professionals. This article reports on research on crossover cases in Ontario, including an analysis of reported court decisions, a survey of CPS staff, and interviews with family justice professionals. We suggest clearer CPS policies; improved understanding of respective professional roles; CPS summary reports for family courts; increased interagency coordination, communication, and training; and use of judicial case management.
Shuttle and Online Mediation: A Review of Available Research and Implications for Separating Couples Reporting Intimate Partner Violence or Abuse
Authors: Rossi Fernanda S. , Holtzworth‐Munroe Amy , Applegate Amy G. , Beck Connie J. , Adams Jeannie M. , Hale Darrell F.
Published: August 2017

Whether family law cases with a history of severe intimate partner violence and/or abuse (IPV/A cases) should have the option of settling family‐related issues using mediation is the subject of significant debate. Recommendations for potentially safer ways to mediate IPV/A cases have been developed, including shuttle and online mediation. Given the current lack of research on these forms of mediation with IPV/A cases, we review the research on shuttle and online mediation in other contexts and theorize how the findings might apply to IPV/A cases. We argue that, although online and shuttle mediation may benefit IPV/A cases, aspects of these procedures require special considerations.
Comparative effects of food processing liquid slurry and inorganic fertilizers on tanner grass (Brachiaria arrecta) pasture: grass yield, crude protein and P levels and residual soil N and P
Authors: St. Luce M. , Gouveia G. G. , Eudoxie G. D.
Published: August 2017

This small‐plot field study evaluated food processing liquid slurry (FPLS) as a potential fertilizer for tanner grass (Brachiaria arrecta) production on an acidic loam soil. The treatments, arranged in a randomized complete block design with three replicates, consisted of an unfertilized control, inorganic fertilizer applied at 50 and 200 kg nitrogen (N) ha−1 with and without phosphorus (P) at 50 kg P ha−1, and FPLS applied at 50 and 200 kg N ha−1. Compared to the unfertilized control, the FPLS applied at 200 kg N ha−1 significantly increased grass dry‐matter yield (DMY), herbage crude protein (CP) and P content, and N and P uptake in the second of two trials and P uptake in both trials. However, DMY and contents, of CP and P were generally lower for the FPLS treatments compared to the inorganic fertilizers. Apparent N recovery was higher for the inorganic fertilizer treatments than FPLS treatments in trial 1, while apparent P recovery was similar among all treatments in both trials. The FPLS treatments did not significantly increase soil NO3‐N and P concentrations, but increased NH4‐N in the 0–15 cm layer. The results suggest that application of FPLS to tanner grass pastures is an alternative to its disposal in landfill.
Clear cell sarcomas of the kidney are characterised by BCOR gene abnormalities, including exon 15 internal tandem duplications and BCOR–CCNB3 gene fusion
Authors: Wong Meng K , Ng Cedric C Y , Kuick Chik H , Aw Sze J , Rajasegaran Vikneswari , Lim Jing Q , Sudhanshi Jain , Loh Eva , Yin Minzhi , Ma Jing , Zhang Zhongde , Iyer Prasad , Loh Amos H P , Lian Derrick W Q , Wang Shi , Goh Shaun G H , Lim Tse H , Lim Alvin S T , Ng Tony , Goytain Angela , Loh Alwin H L , Tan Puay H , Teh Bin T , Chang Kenneth T E
Published: August 2017

Aims

Clear cell sarcoma of the kidney (CCSK) is a rare paediatric renal malignant tumour. The majority of CCSKs have internal tandem duplications (ITDs) of the BCOR gene, whereas a minority have the YWHAE–NUTM2 gene fusion. A third ‘double‐negative’ (DN) category comprises CCSKs with neither BCOR ITDs nor YWHAE–NUTM2 fusion. The aim of this study was to characterise 11 histologically diagnosed CCSKs immunohistochemically (with CCND1, BCOR and CCNB3 stains) and genetically.

Methods and results

By next‐generation sequencing, 10 cases (90.9%) had BCOR exon 15 ITDs, with positive BCOR immunoreactivity being found in four (36%) or eight (72%) cases, depending on the antibody clone. By reverse transcription polymerase chain reaction, none had the YWHAE–NUTM2 fusion. The DN case had a BCOR–CCNB3 fusion and strong nuclear CCNB3 and BCOR immunoreactivity. Quantitative polymerase chain reaction showed markedly elevated BCOR expression in this case, whereas BCOR ITD cases had lower levels of elevated BCOR expression.

Conclusions

The majority of the CCSKs in our cohort had BCOR ITDs, and none had the YWHAE–NUTM2 fusion. We verified the strong, diffuse cyclin D1 (CCND1) immunoreactivity in CCSKs described in recent reports. BCOR immunoreactivity was not consistently positive in all CCSKs with BCOR ITDs, and therefore cannot be used as a diagnostic immunohistochemical stain to identify BCOR ITD cases. The DN case was a BCOR–CCNB3 fusion sarcoma. BCOR–CCNB3 sarcoma is typically a primary bone sarcoma affecting male adolescents, and this is the first report of it presenting in a kidney of a young child as a CCSK. The full spectrum of DN CCSKs awaits more comprehensive characterisation.
Nationwide skin cancer screening in Germany: Evaluation of the training program
Authors: Anders Markus P. , Fengler Susanne , Volkmer Beate , Greinert Rüdiger , Breitbart Eckhard W.
Published: August 2017

Background

In July 2008, the German statutory health insurance introduced a nationwide skin cancer screening program. Before the introduction, eligible physicians had to qualify to perform the screening test and counsel their patients on skin cancer screening. To educate physicians, a curriculum and training materials were developed. Since 2015 a revised curriculum and training materials have been used. The purpose of this paper is to provide information about the curriculum and to evaluate the revised training program.

Methods

A total of 573 completed pre‐ and posttests were analyzed with regard to changes in the identification of skin cancer, diagnostic accuracy, knowledge, and physicians’ self‐assessed‐confidence. For statistical analysis, Mann‐Whitney U test, Cohen'sd, and chi‐square test were used.

Results

General practitioners (GPs) diagnosed 7.45 of 12 skin lesions correctly before and 9.26 after the training course (P< 0.001). Compared toGPs, dermatologists’ accuracy was higher at pre‐ and posttest (pre: 10.03, post: 10.21,P= 0.160).

The mean of correctly answered questions increased significantly in knowledge on screening and early detection (4.46–5.14,P< 0.001) as well as skin cancer and skin cancer screening (5.51–6.39,P< 0.001).

Conclusion

Participating physicians got a comprehensive understanding of skin cancer screening and counseling through the training and increased their diagnostic skills. In particular,GPs identified and diagnosed significantly more skin lesions correctly after the training compared to before the training, while dermatologists’ diagnostic skills were high at both times, before and after.
Healing of chronic venous ulcer with topical sevoflurane
Authors: Imbernon‐Moya Adrian , Ortiz‐de Frutos Francisco Javier , Sanjuan‐Alvarez Mónica , Portero‐Sanchez Isabel , Merinero‐Palomares Raúl , Alcazar Victoria
Published: August 2017

The present study assesses the efficacy and safety of topical sevoflurane in chronic venous ulcers and its impact on analgesia and healing.

This retrospective study included 30 patients older than 65 years with painful refractory chronic venous ulcers. Patients were treated with topical sevoflurane prior to the usual ulcer cleaning every 2 days for a period of 1 month. Treatment was initiated with a saline solution, followed by direct irrigation of 1 ml of liquid sevoflurane over the wound size, which was measured as cm2.

Sevoflurane had a fast, intense and long‐lasting analgesic effect. Latency time ranged from 2 to 7 minutes (3·9 ± 1·5 minutes), and duration varied from 8 to 18 hours (12 ± 2·9). The mean ulcer size was 8·4 ± 9·7 cm2. There was a progressive decrease in size in all patients, with a mean size of 4·2 ± 5·4 cm2 at the end of the study. There were no adverse systemic effects. Local adverse effects were mild and transient, including pruritus, erythema and heat.

Topical sevoflurane is a new, efficient and safe therapeutic alternative in painful chronic venous ulcers, refractory to usual analgesic treatment. It can improve the ulcer‐healing process that shortens the cicatrisation period.
Simultaneous control of the chemical state and local environment of Cr dopant in glass for extended emission
Authors: Chen Jiejie , Yu Yongze , Luo Hao , Lin Liting , Zhou Shifeng
Published: August 2017

Control of the chemical state and local environment of Cr dopant in glass through self‐limited nanocrystallization is presented. Interesting wavelength‐tunable and ultra‐broadband near‐infrared luminescence with the full width at half maximum of about 380 nm from obtained Cr‐activated glass‐ceramics are demonstrated. The results indicate that the presented method may be an effective means of fabricating multifunctional optical gain materials and wideband fiber light sources.
Thermal regimes of Li‐ion conductivity in β‐eucryptite
Authors: Chen Yachao , Manna Sukriti , Ciobanu Cristian V. , Reimanis Ivar E.
Published: August 2017

While it is well‐established that ionic conduction in lithium aluminosilicates proceeds via hopping of Li ions, the nature of the various hoping‐based mechanisms in different temperature regimes has not been fully elucidated. The difficulties associated with investigating the conduction have to do with the presence of grains and grain boundaries of different orientations in these usually polycrystalline materials. Herein, we use electrochemical impedance spectroscopy (EIS) to investigate the ion conduction mechanisms in β‐eucryptite, which is a prototypical lithium aluminosilicate. In the absence of significant structural transitions in grain boundaries, we find that there are three conduction regimes for the one‐dimensional ionic motion along the c axis channels in the grains, and determine the activation energies for each of these temperature regimes. Activation energies computed from molecular statics calculations of the potential energy landscape encountered by Li ions suggest that at temperatures below 440°C conduction proceeds via cooperative or correlated motion, in agreement with established literature. Between 440°C and 500°C, the activation barriers extracted from EIS measurements are large and consistent with those from atomistic calculations for uncorrelated Li ion hopping. Above 500°C the activation barriers decrease significantly, which indicates that after the transition to the Li‐disordered phase of β‐eucryptite, the Li ion motion largely regains the correlated character.
Board governance and corporate performance
Authors: Shaukat Amama , Trojanowski Grzegorz
Published: August 2017

We examine the link between the monitoring capacity of the board and corporate performance of UK listed firms. We also investigate how firms use the flexibility offered by the voluntary governance regime to make governance choices. We find a strong positive association between the board governance index we construct and firm operating performance. Our results imply that adherence to the board‐related recommendations of the UK Corporate Governance Code strengthens the board's monitoring capacity, potentially helping mitigate agency problems, but that investors do not value it correspondingly. Moreover, in contrast to prior UK findings suggesting efficient adoption of Code recommendations, we find that firms at times use the Code flexibility opportunistically, aiming to decrease the monitoring capacity of the board, which is followed by subsequent underperformance. This finding questions the effectiveness of the voluntary approach to governance regulation followed in the UK and in many countries around the world.
Genomic estimation of additive and dominance effects and impact of accounting for dominance on accuracy of genomic evaluation in sheep populations
Authors: Moghaddar N. , van der Werf J. H. J.
Published: August 2017

The objectives of this study were to estimate the additive and dominance variance component of several weight and ultrasound scanned body composition traits in purebred and combined cross‐bred sheep populations based on single nucleotide polymorphism (SNP) marker genotypes and then to investigate the effect of fitting additive and dominance effects on accuracy of genomic evaluation. Additive and dominance variance components were estimated in a mixed model equation based on “average information restricted maximum likelihood” using additive and dominance (co)variances between animals calculated from 48,599 SNP marker genotypes. Genomic prediction was based on genomic best linear unbiased prediction (GBLUP), and the accuracy of prediction was assessed based on a random 10‐fold cross‐validation. Across different weight and scanned body composition traits, dominance variance ranged from 0.0% to 7.3% of the phenotypic variance in the purebred population and from 7.1% to 19.2% in the combined cross‐bred population. In the combined cross‐bred population, the range of dominance variance decreased to 3.1% and 9.9% after accounting for heterosis effects. Accounting for dominance effects significantly improved the likelihood of the fitting model in the combined cross‐bred population. This study showed a substantial dominance genetic variance for weight and ultrasound scanned body composition traits particularly in cross‐bred population; however, improvement in the accuracy of genomic breeding values was small and statistically not significant. Dominance variance estimates in combined cross‐bred population could be overestimated if heterosis is not fitted in the model.
Ganglionated plexi as neuromodulation targets for atrial fibrillation
Authors: Choi Eue‐Keun , Zhao Ye , Everett Thomas H. , Chen Peng‐Sheng
Published: August 2017

The autonomic nervous system plays an important role in the genesis of atrial fibrillation and is one of the candidate targets for atrial fibrillation therapy. This review focuses on the role of the autonomic nervous system in atrial fibrillation development and discusses the results of the ganglionated plexi catheter and surgical ablation in preclinical and clinical studies. The heart is innervated by the extrinsic and intrinsic autonomic nervous systems. The intrinsic autonomic nervous system consists of multiple ganglionated plexi and axons, which innervate the neighboring atrial myocardium and control their electrophysiological properties. Abnormal autonomic innervation has been observed in an animal model of atrial fibrillation and in humans. Direct recordings of autonomic nerve activity in canine models showed that atrial tachyarrhythmia episodes were invariably preceded by intrinsic cardiac autonomic nerve activity, thus supporting the importance of intrinsic cardiac autonomic nerve activity as the triggers for atrial tachyarrhythmia. Targeting ganglionated plexi with catheter ablation improves the outcomes of paroxysmal atrial fibrillation ablation in addition to pulmonary vein antrum isolation. Ablation of ganglionated plexi alone without pulmonary vein isolation is also useful in controlling paroxysmal atrial fibrillation in some patients. However, surgical ganglionated plexi ablation in patients with a large left atrium, persistent atrial fibrillation, and/or a history of prior catheter ablation does not result in additional benefits. These different outcomes suggest that ganglionated plexi ablation is effective in managing patients with paroxysmal atrial fibrillation, but its effects in patients with persistent atrial fibrillation and advanced atrial diseases might be limited.
The relationship between a blunted morning surge and a reversed nocturnal blood pressure dipping or “riser” pattern
Authors: Fujiwara Takeshi , Tomitani Naoko , Sato Keiko , Okura Ayako , Suzuki Noriyuki , Kario Kazuomi
Published: August 2017

The authors sought to determine the association between the blunted morning blood pressure (BP) surge and nocturnal BP dipping of the “riser” pattern in 501 patients with hypertension enrolled in the ACHIEVE‐ONE (Ambulatory Blood Pressure Control and Home Blood Pressure [Morning and Evening] Lowering by the N‐Channel Blocker Cilnidipine) trial. The patients' sleep‐trough morning BP surge and prewaking surge were calculated and then classified according to their nocturnal systolic BP reduction pattern as extreme dippers, dippers, nondippers, and risers. The prevalence of the riser pattern was significantly higher in both the lowest sleep‐trough morning BP surge decile and the prewaking surge decile (blunted surge group) compared with the remaining deciles (56.0% vs 10.4% [P<.0001] and 59.2% vs 10.2% [P<.0001], respectively). The riser pattern was a significant determinant of both blunted sleep‐trough morning BP surge (odds ratio, 73.3; P<.0001) and blunted prewaking surge (odds ratio, 14.8; P<.0001). The high prevalence of the riser pattern in patients with blunted morning BP surges may account for the cardiovascular risk previously reported in such patients.
Racial differences in nocturnal dipping status in diabetic kidney disease: Results from the STOP‐DKD (Simultaneous Risk Factor Control Using Telehealth to Slow Progression of Diabetic Kidney Disease) study
Authors: Zullig Leah L. , Diamantidis Clarissa J. , Bosworth Hayden B. , Bhapkar Manjushri V. , Barnhart Huiman , Oakes Megan M. , Pendergast Jane F. , Miller Julie J. , Patel Uptal D.
Published: August 2017

While racial variation in ambulatory blood pressure (BP) is known, patterns of diurnal dipping in the context of diabetic kidney disease have not been well defined. The authors sought to determine the association of race with nocturnal dipping status among participants with diabetic kidney disease enrolled in the STOP‐DKD (Simultaneous Risk Factor Control Using Telehealth to Slow Progression of Diabetic Kidney Disease) trial. The primary outcome was nocturnal dipping—percent decrease in average systolic BP from wake to sleep—with categories defined as reverse dippers (decrease <0%), nondippers (0%–<10%), and dippers (≥10%). Twenty‐four‐hour ambulatory BP monitoring was completed by 108 participants (54% were nondippers, 24% were dippers, and 22% were reverse dippers). In adjusted models, the common odds of reverse dippers vs nondippers/dippers and reverse dippers/nondippers vs dippers was 2.6 (95% confidence interval, 1.2–5.8) times higher in blacks than in whites. Without ambulatory BP monitoring data, interventions that target BP in black patients may be unable to improve outcomes in this high‐risk group.
Hypoxia‐induced activin A diminishes endothelial cell vasculogenic activity
Authors: Merfeld‐Clauss Stephanie , Lu Hongyan , Wu Xue , March Keith L. , Traktuev Dmitry O.
Published: August 2017

Acute ischaemia causes a significant loss of blood vessels leading to deterioration of organ function. Multiple ischaemic conditions are associated with up‐regulation of activin A, but its effect on endothelial cells (EC) in the context of hypoxia is understudied. This study evaluated the role of activin A in vasculogenesis in hypoxia. An in vitro vasculogenesis model, in which EC were cocultured with adipose stromal cells (ASC), was used. Incubation of cocultures at 0.5% oxygen led to decrease in EC survival and vessel density. Hypoxia up‐regulated inhibin BA (monomer of activin A) mRNA by 4.5‐fold and activin A accumulation in EC‐conditioned media by 10‐fold, but down‐regulated activin A inhibitor follistatin by twofold. Inhibin BA expression was also increased in human EC injected into ischaemic mouse muscles. Activin A secretion was positively modulated by hypoxia mimetics dimethyloxalylglycine and desferrioxamine. Silencing HIF1α or HIF2α expression decreased activin A secretion in EC exposed to hypoxia. Introduction of activin A to cocultures decreased EC number and vascular density by 40%; conversely, blockade of activin A expression in EC or its activity improved vasculogenesis in hypoxia. Activin A affected EC survival directly and by modulating ASC paracrine activity leading to diminished ability of the ASC secretome to support EC survival and vasculogenesis. In conclusion, hypoxia up‐regulates EC secretion of activin A, which, by affecting both EC and adjacent mesenchymal cells, creates a micro‐environment unfavourable for vasculogenesis. This finding suggests that blockade of activin A signalling in ischaemic tissue may improve preservation of the affected tissue.
Establishment of a cell line with high transfection efficiency from zebrafish Danio rerio embryos and its susceptibility to fish viruses
Authors: Jin Y. L. , Chen L. M. , Le Y. , Li Y. L. , Hong Y. H. , Jia K. T. , Yi M. S.
Published: August 2017

A cell line ZBE3 isolated from a continuous cell culture derived from zebrafish Danio rerio blastomeres by clonal growth was characterized. ZBE3 cells had been subcultured for >120 passages since the initial primary culture of the blastomeres. The ZBE3 cells grow stably at temperature from 20 to 32° C with an optimum temperature of 28° C in ESM2 or ESM4 medium with 15% foetal bovine serum (FBS). The optimum FBS concentration for ZBE3 cell growth ranged from 15 to 20%. Cytogenetical analysis indicated that the modal chromosome number of ZBE3 cells was 50, the same as the diploid chromosome number of D. rerio. Significant cytopathic effect was observed in ZBE3 cells after infection with redspotted grouper nervous necrosis virus, Singapore grouper iridovirus and grass carp reovirus, and the viral replication in the cells was confirmed by real‐time quantitative PCR and transmission electron microscopy, indicating the susceptibility of ZBE3 cells to the three fish viruses. After transfected with pEGFP‐N3 plasmid, ZBE3 cells showed a transfection efficiency of about 40% which was indicated by the percentage of cells expressing green fluorescence protein. The stable growth, susceptibility to fish viruses as well as high transfection efficiency make ZBE3 cells be a useful tool in transgenic manipulation, fish virus‐host cell interaction and immune response in fish.
Systematic Review of Sex‐Specific Reporting of Data: Cholinesterase Inhibitor Example
Authors: Mehta Nishila , Rodrigues Craig , Lamba Manpreet , Wu Wei , Bronskill Susan E. , Herrmann Nathan , Gill Sudeep S. , Chan An‐Wen , Mason Robin , Day Suzanne , Gurwitz Jerry H. , Rochon Paula A.
Published: August 2017

Objectives

To improve the value of research for older adults, we examine sex‐specific reporting of data from drug trials for the management of dementia. These data are important because they may influence considerations ranging from the health of populations to shared decision‐making by individual patient and caregiver about the risk and benefit of a drug therapy.

Methods

Randomized controlled trials of cholinesterase inhibitors (i.e., donepezil, rivastigmine, or galantamine) with clinical outcomes were identified from searches of MEDLINE, EMBASE, and the Cochrane Library. Sex‐specific data were extracted from nine sections (title, abstract, introduction, methods, outcomes, results, discussion, limitations, and conclusion). Among the donepezil trials only, more detailed harms data were obtained.

Findings

Thirty‐three randomized controlled trials were identified evaluating 15,971 participants (9,103 (57%) female). Trials were highly cited (median citations 158, interquartile range 62–441) and published in high impact journals (median impact factor 7.4, interquartile range 3.4–8.2). Sex was not mentioned in the title, introduction, limitations, or conclusion section of any trial. Only three trials (9%) mentioned sex in the abstract (all as a demographic characteristic), and 8 (24%) in the methods. Almost all (32 (97%)) trials mentioned sex in the results as a demographic variable. One trial reported a sex difference for a secondary outcome. Among the 16 trials studying donepezil, adverse events were frequently reported and often dose‐related. No trial provided sex‐specific reporting of adverse events.

Conclusions

There is an almost complete lack of sex‐specific reporting of data in clinical trials for dementia drug therapies, and no sex‐specific reporting of adverse events. Sex‐specific reporting of data should be required in drug trials to increase research value and ultimately inform more tailored prescribing for older adults.
Effect of New Oral Anticoagulants on Prescribing Practices for Atrial Fibrillation in Older Adults
Authors: Fohtung Raymond B. , Novak Eric , Rich Michael W.
Published: August 2017

Objectives

To determine the effect of new oral anticoagulants (NOACs) on prescribing practices in older adults with atrial fibrillation (AF).

Design

Retrospective observational cohort study.

Setting

Academic medical center in St. Louis, Missouri.

Participants

Individuals aged 75 and older with AF admitted to the hospital from October 2010 through September 2015 (N = 6,568, 50% female, 15% non‐white).

Measurements

Information on NOACs and warfarin prescribed at discharge was obtained from hospital discharge summaries, and linear regression was used to examine quarterly trends in their use. Multivariable logistic regression was used to assess independent predictors of anticoagulant use.

Results

NOAC use increased over time (correlation coefficient (r) = 0.87, P < .001), warfarin use did not change (r = −0.16, P = .50), and overall anticoagulant use (NOACs and warfarin) increased (r = 0.68, P = .001). NOAC use increased over time in all age groups (75–79, 80–84, 85–89) except aged 90 and older, but increasing age attenuated the rate of NOAC uptake. There was no consistent relationship between age and warfarin or overall anticoagulant use, except that individuals aged 90 and older had consistently lower use. Overall, fewer than 45% of participants were prescribed an anticoagulant. In multivariable analysis, younger age, white race, female sex, higher hemoglobin, higher creatinine clearance, being on a medical service, hypertension, stroke or transient ischemic attack, no history of intracranial hemorrhage, and a modified HAS‐BLED score of less than 3 increased the likelihood of receiving NOACs.

Conclusion

Prescription of anticoagulants for AF increased in older adults primarily because of an increase in the use of NOACs. Nonetheless, fewer than 45% of participants were prescribed an anticoagulant. Additional research is needed to optimize prescribing practices for older adults with AF.