bluuebunny/crossref_metadata_2025 huggingface dataset:
A role for neuropeptide Y in the gender‐specific gastrointestinal, corticosterone and feeding responses to stress
Authors: Forbes S , Herzog H , Cox HM
Published: March 2012

BACKGROUND AND PURPOSE Exposure to an acute stress inhibits gastric emptying and stimulates colonic transit via central neuropeptide Y (NPY) pathways; however, peripheral involvement is uncertain. The anxiogenic phenotype of NPY−/− mice is gender‐dependent, raising the possibility that stress‐induced gastrointestinal (GI) responses are female‐dominant through NPY. The aim of this study was to determine GI transit rates, corticosterone levels and food intake after acute restraint (AR) or novel environment (NE) stress in male and female NPY−/− and WT mice.

EXPERIMENTAL APPROACH Upper gastrointestinal transit (UGIT) (established 30 min after oral gavage) and corticosterone levels were determined under basal or restrained conditions (30 min) and after treatment i.p. with Y1 antagonist BIBO3304 or Y2 antagonist BIIE0246. Faecal pellet output (FPO) was established after AR and treatment i.p. with NPY in the NE, as were colonic bead expulsion rates.

KEY RESULTS UGIT and FPO were similar in unrestrained male and female mice. NPY−/− females displayed significantly slower UGIT than NPY−/− males after AR, but both genders displayed significantly higher FPO and reduced food intake relative to WT counterparts. Peripheral NPY treatment increased bead expulsion time in WT mice. AR male NPY−/− mice had higher levels of corticosterone than male WT mice; whilst in AR WT mice, after peripheral Y1 and Y2 receptor antagonism in males, and Y2 antagonism in females, corticosterone was significantly elevated.

CONCLUSIONS AND IMPLICATIONS NPY possesses a role in the gender‐dependent susceptibility to stress‐induced GI responses. Furthermore, NPY inhibits GI motility through Y2 receptors and corticosterone release via peripheral Y1 and Y2 receptors.
Accuracy of Diagnostic Tests for Helicobacter pylori in Patients with Peptic Ulcer Bleeding
Authors: Choi Yoon J. , Kim Nayoung , Lim Jihwan , Jo So Y. , Shin Cheol M. , Lee Hye S. , Lee Sang H. , Park Young S. , Hwang Jin‐Hyeok , Kim Jin‐Wook , Jeong Sook‐Hyang , Lee Dong H. , Jung Hyun C.
Published: March 2012

Background and Aims:  To assess the validity of biopsy‐based tests (histology, culture, and urease test) and serology in detecting current H. pylori infection for the peptic ulcer patients who had gastric bleeding.

Methods:  A total of 398 peptic ulcer patients were enrolled and divided into two groups, according to the presence or absence of bleeding. The diagnosis for current H. pylori infection was verified using the gold standard combining individual H. pylori tests. Sensitivity, specificity, and positive and negative predictive values of the culture, Campylobacter‐like organism (CLO) test (urease test), histology, and serology were compared.

Results:  Of the total study population (N = 398), 157 (39.4%) patients were categorized into the bleeding group. The sensitivities of the culture (40.0%) and CLO (85.0%) in the bleeding group were significantly lower than culture (58.1%) and CLO (96.4%) in the nonbleeding group (p = .012 and p < .001, respectively). In the bleeding group, the sensitivity of CLO (85.0%) was significantly lower than histology (92.5%) and serology (97.4%) (p = .013 and p = .002, respectively), which was not found in the nonbleeding group. The specificity of serology in the bleeding group (56.3%) was significantly lower than that of nonbleeding group (74.2%) (p = .038). Similarly, the specificity of serology was significantly lower than the other H. pylori tests in the bleeders.

Conclusions:  Bleeding decreased the sensitivity of H. pylori tests in patients with peptic ulcer, especially in urease test or culture. In contrast, histology was found to be a quite reliable test, regardless of the presence of bleeding.
Non‐invasive Genotyping of Helicobacter pylori cagA, vacA, and hopQ from Asymptomatic Children
Authors: Sicinschi Liviu A. , Correa Pelayo , Bravo Luis E. , Peek Richard M. , Wilson Keith T. , Loh John T. , Yepez Maria C. , Gold Benjamin D. , Thompson Dexter T. , Cover Timothy L. , Schneider Barbara G.
Published: March 2012

Background:  Helicobacter pylori infection is usually acquired in childhood, but little is known about its natural history in asymptomatic children, primarily due to the paucity of non‐invasive diagnostic methods. H. pylori strains harboring cagA and specific alleles of hopQ and vacA are associated with increased risk for gastric cancer. Many studies of H. pylori virulence markers in children have the bias that symptomatic subjects are selected for endoscopy, and these children may harbor the most virulent strains. Our aim is to genotype cagA, hopQ, and vacA alleles in stool DNA samples of healthy Colombian children residing in an area with high incidence of gastric cancer, to avoid selection bias resulting from endoscopy.

Methods:  H. pylori status of 86 asymptomatic children was assessed by 13C‐urea breath test (UBT) and PCR. H. pylori 16S rRNA, cagA, hopQ, and vacA genes were amplified from stool DNA samples and sequenced.

Results:  UBT was positive in 69 (80.2%) of 86 children; in stool DNA analysis, 78.3% were positive by 16S rRNA PCR. cagA, vacA, and hopQ were detected in 66.1%, 84.6%, and 72.3% of stool DNA samples from 16S rRNA‐positive children. Of the children’s DNA samples, which revealed vacA and hopQ alleles, 91.7% showed vacA s1 and 73.7% showed type I hopQ. Type I hopQ alleles were associated with cagA positivity and vacA s1 genotypes (p < 0.0001).

Conclusions:  Using stool DNA samples, virulence markers of H. pylori were successfully genotyped in a high percentage of the asymptomatic infected children, revealing a high prevalence of genotypes associated with virulence. Type I hopQ alleles were associated with the presence of cagA and the vacA s1 genotype.
Association of Inflammation and Cytotoxin‐Associated Gene A Positive Strains of Helicobacter Pylori in Cardiac Syndrome X
Authors: Rasmi Yousef , Raeisi Sina , Seyyed Mohammadzad Mir H.
Published: March 2012

Background:  Cardiac syndrome X (CSX) is a condition in which patients have the pain of angina despite normal coronary angiogram. Helicobacter pylori (H. pylori) infection causes chronic inflammation which may play a pathogenic role in CSX. We surveyed the association of inflammation with H. pylori and its virulent strain (cytotoxin‐associated gene A positive; CagA+) infections with CSX.

Material and Methods:  Sixty patients with CSX (38 women/22 men; mean age: 51.8 ± 12.3) and 60 age‐ and gender‐matched healthy controls (39 women/21 men; mean age: 48.9 ± 6.3) were enrolled.

Plasma samples were tested for the presence of IgG antibody to H. pylori using enzyme linked immunosorbent assay (ELISA) method. IgG‐ positive patients were determined by the presence of IgG antibody to CagA, also by ELISA method. Also, plasma levels of interleukin‐6 (IL‐6) and tumor necrosis factor‐alpha (TNF‐α) were measured by ELISA method.

Results:  Patients with CSX were detected to have significantly higher plasma IL‐6 and TNF‐α level in comparison with normal controls (33.6 ± 3.5 vs 3.2 ± 0.4 and 24.2 ± 2.3 vs 3.1 ± 0.4, respectively; p < 0.01). The plasma levels of these inflammatory factors in CgA+ were significantly higher than those in CagA− (CSX: IL‐6: 43.05 ± 5.04 vs 23.97 ± 4.58 and TNF‐α: 31.43 ± 3.13 vs 16.47 ± 2.93, Controls: IL‐6: 3.52 ± 1.39 vs 2.90 ± 0.67 and TNF‐α: 5.39 ± 1.17 vs 2.22 ± 0.43, respectively; p < 0.05).

Conclusion:  The CagA+ strain of H. pylori, can not only be a trigger, and may also have a role via chronic inflammation in the pathogenesis of CSX.
Comparison of Demographic Characteristics and Upper Gastrointestinal Endoscopy Findings in HIV‐Positive, Antiretroviral‐Treated Patients With and Without Helicobacter pylori Coinfection
Authors: Nkuize Marcel , De Wit Stephane , Muls Vinciane , Ntounda Ruffin , Gomez‐Galdon Maria , Buset Michel
Published: March 2012

Objectives:  We evaluated demographic characteristics in HIV‐positive patients receiving highly active antiretroviral therapy (HAART) who had upper gastrointestinal (UGI) symptoms requiring UGI endoscopy and compared the findings in patients with and without H. Pylori coinfection.

Methods:  We prospectively observed all HIV‐infected patients treated with antiretroviral therapy who underwent UGI endoscopy for the first time and were tested for H. pylori from January 2004 to December 2008. Data collected included the following: demographics (age, gender, ethnicity, body mass index [BMI], tobacco use, alcohol intake, and HIV risk behavior); comorbidity (viral hepatitis B or C, any organ dysfunction, or opportunistic disease); medication, including antibiotics, H2 blockers, proton pump inhibitors, and NSAIDs; CD4 cell counts, viral load; symptoms; and endoscopic and histologic diagnoses (H. pylori determined by Giemsa staining). Patients were compared according to H. pylori status (presence vs absence).

Results:  One hundred and forty‐five patients were evaluated. Compared to patients without H. pylori infection (n = 97), those with H. pylori infection (n = 48) had a significantly higher CD4 cell count (p = .008), were more likely to be heterosexual (p = .047), had a higher BMI (p = .027), had a greater incidence of duodenal ulcers (p = .005), had lower viral loads (p < .01), were less likely to have received macrolide antibiotics in the last 3 months (p = .00), and had less comorbidity (p = .03). They were also more frequently of Black African than Caucasians. In multivariate analysis, being heterosexual and having a low viral load were independently associated with an increased risk of having H. Pylori coinfection.

Conclusion:  In the antiretroviral therapy era, HIV–H. pylori coinfection is associated with a greater incidence of duodenal ulcers and higher CD4 counts, higher BMI, less comorbidity, and less frequent use of macrolides.
Migraine With Persistent Visual Aura
Authors: Evans Randolph W. , Aurora Sheena K.
Published: March 2012

(Headache 2012;52:494‐501)
Humor as an Optics: Bergson and the Ethics of Humor
Authors: Shuster Martin
Published: March 2012

Although the ethics of humor is a relatively new field, it already seems to have achieved a consensus about ethics in general. In this paper, I implicitly (1) question the view of ethics that stands behind many discussions in the ethics of humor; I do this by explicitly (2) focusing on what has been a chief preoccupation in the ethics of humor: the evaluation of humor. Does the immoral content of a joke make it more or less humorous? Specifically, I analyze whether a sexist joke is more humorous because of its sexism. Contra recent trends in the ethics of humor, I answer this question affirmatively. To this end, the paper presents a detailed and novel reading of Bergson's philosophy of humor, which I argue connects most easily and significantly to the alternate view of ethics I have in mind.
Particle Flow Analysis
Authors: Arvidsson Rickard , Molander Sverker , Sandén Björn A.
Published: March 2012

Several authors have highlighted the potential risks of nanoparticles (NPs). Still, little is known about the magnitude of emissions of NPs from society. Here, the method of explorative particle flow analysis (PFA), a modification of the more well‐known substance flow analysis (SFA), is suggested. In explorative PFA, particle number instead of mass is used as flow and stock metric and explorative scenarios are used to account for potential technology diffusion and, consequently, potentially higher emissions. The method has been applied in a case study of the use phase of titanium dioxide (TiO2) NPs in paint, sunscreen and self‐cleaning cement. The results indicate that the current largest emissions of TiO2 NPs originate from the use of sunscreen. One scenario implies that, in the future, the largest flows and stocks of TiO2 NPs could be related to self‐cleaning cement. Gaps in current knowledge are identified and suggestions for future research are given.
Current information on the immunologic status of occult hepatitis B infection
Authors: Arababadi Mohammad Kazemi , Nasiri Ahmadabadi Behzad , Kennedy Derek
Published: March 2012

Hepatitis B is one of the most frequently occurring posttransfusion infections. Occult hepatitis B (OB) is a form of hepatitis B in which, despite the presence of hepatitis B virus (HBV) DNA in the serum and hepatocytes of a carrier, hepatitis B surface antigen is absent. In addition to the risk of transfusion of infection, OB can lead to cirrhosis, hepatic cancer, and reactivation of the viral duplication process in the carrier. The mechanisms responsible for progression of OB are yet to be clarified; however, some investigators have suggested that genetic and immunologic variables may play a significant role in the resistance of some individuals and sensitivity of other patients. This review addresses the current information regarding immunologic status of OB‐infected patients.
Splenectomy and/or cyclophosphamide as salvage therapies in thrombotic thrombocytopenic purpura: the French TMA Reference Center experience
Authors: Beloncle François , Buffet Marc , Coindre Jean‐Philippe , Munoz‐Bongrand Nicolas , Malot Sandrine , Pène Frédéric , Mira Jean‐Paul , Galicier Lionel , Guidet Bertrand , Baudel Jean‐Luc , Subra Jean‐François , Tanguy‐Schmidt Aline , Pourrat Jacques , Azoulay Elie , Veyradier Agnès , Coppo Paul ,   for the Thrombotic Microangiopathies Reference Center
Published: March 2012

BACKGROUND: The objective was to assess the efficacy and safety of splenectomy and cyclophosphamide as salvage therapies in severe thrombotic thrombocytopenic purpura (TTP).

STUDY DESIGN AND METHODS: During a 10‐year period, patients who did not improve with plasma exchanges, steroids, vincristine, and/or rituximab were considered for splenectomy or cyclophosphamide. Patients with a documented severe (<10% of normal value) acquired ADAMTS13 deficiency are reported here.

RESULTS: Eighteen patients with a severe acquired ADAMTS13 deficiency required a salvage therapy. Thirteen patients had a splenectomy 19 (interquartile range [IQR], 10‐51) days after TTP diagnosis. One patient died the day after splenectomy. The remaining patients improved platelets (PLTs) until Day 6, along with a rapid and major lactate dehydrogenase improvement. Six patients, however, subsequently experienced a transient worsening. Durable PLT count recovery in survivors was observed within 13 (IQR, 11.5‐25.5) days. Postoperative complications included thromboembolic events (two cases) and infections (five cases). Five patients received pulses of cyclophosphamide 12 (IQR, 12‐15) days after TTP diagnosis. All patients recovered PLTs 10 (IQR, 9‐24) days after the first pulse and two experienced a transient worsening. Three patients experienced infections. Three relapses occurred 5 months, 2.5 years, and 4.5 years after splenectomy and one relapse occurred 3.5 years after cyclophosphamide. After a 2.5 (IQR, 0.75‐6.2)‐year follow‐up, the overall survival was 94%.

CONCLUSION: Cyclophosphamide and splenectomy provide comparable high remission rates in severe TTP with acceptable side effects and should be considered in the more severe patients who do not improve with other therapies.
Iron chelation therapy in the management of transfusion‐related cardiac iron overload
Authors: Fernandes Juliano Lara
Published: March 2012

Iron overload is one of the major causes of morbidity and death in patients undergoing chronic transfusion therapy. Furthermore, excessive iron accumulation in the heart may result in impaired left ventricular dysfunction. With accurate monitoring techniques and treatment regimens, progression of heart complications can be followed, and their natural history changed. Iron chelation therapy is the mainstay of prevention and reversal of myocardial iron overload. Despite recent appraisals of general chelating strategies, the management of iron chelation in chronically transfused patients with a focus on the heart has not been extensively assessed. New studies published in the past couple of years have provided important new data in this topic and therefore this review summarizes the major studies that examined the removal of iron from the heart with the iron chelators: deferoxamine, deferiprone, and deferasirox. Since chronically transfused patients and their cardiac clinical presentations vary widely, this review tries to identify—with each drug—the precise scenarios evaluated, linking patients' baseline characteristics, clinical setting, and drug intake and dosing. Ultimately, by stratifying patients according to their cardiac iron overload status and ventricular function, this review identifies possible approaches for the initial treatment and follow‐up of transfusion‐related cardiac iron overload.
Isolated Ventricular Noncompaction: Implications for Mechanisms of Sudden Cardiac Death
Authors: LEE WILLIAM , KUCHAR DENNIS L. , WALKER BRUCE D. , SUBBIAH RAJESH N.
Published: March 2012

We present a case of a young patient, whose first manifestation of isolated ventricular noncompaction (IVNC) was sudden cardiac arrest precipitated by ventricular fibrillation. Furthermore we had the rare opportunity to record the onset of subsequent episodes of ventricular fibrillation—with discussion on the mechanisms of ventricular arrhythmias in IVNC. (PACE 2013; 36:e153–e155)
“Living Cadavers” in Bangladesh: Bioviolence in the Human Organ Bazaar
Authors: Moniruzzaman Monir
Published: March 2012

The technology‐driven demand for the extraction of human organs—mainly kidneys, but also liver lobes and single corneas—has created an illegal market in body parts. Based on ethnographic fieldwork, in this article I examine the body bazaar in Bangladesh: in particular, the process of selling organs and the experiences of 33 kidney sellers who are victims of this trade. The sellers’ narratives reveal how wealthy buyers (both recipients and brokers) tricked Bangladeshi poor into selling their kidneys; in the end, these sellers were brutally deceived and their suffering was extreme. I therefore argue that the current practice of organ commodification is both exploitative and unethical, as organs are removed from the bodies of the poor by inflicting a novel form of bioviolence against them. This bioviolence is deliberately silenced by vested interest groups for their personal gain.[organ trade, kidney seller, bioviolence, suffering, social justice]
The Inextricable Link between Sovereign Debt and Pensions in Argentina, 1993–2010
Authors: Datz Giselle
Published: March 2012

Established with the reform of 1993, Argentina’s private pension funds became crucial sources of credit for the national government. They purchased large amounts of sovereign bonds defaulted on in 2001 and hence were key to the success of the debt restructuring of 2005. The private pillar was always vulnerable to political maneuvering; the nationalization of private pension funds in 2008 was only the last stage in an iterated process of state intervention, a function of public debt dynamics. This article argues that the financial pressures associated with Argentina’s sovereign debt burden systematically shortened the temporality of pension policy decisions, taking those away from long-term concerns about the stability of the social security system and toward the immediacy of debt-financing imperatives. Therefore, the politics of pension reform reversal in Argentina were determined by the increasingly strong and inextricable link between debt and pensions.
Maintenance of MHC Class IIB diversity in a recently established songbird population
Authors: Whittaker Danielle J. , Dapper Amy L. , Peterson Mark P. , Atwell Jonathan W. , Ketterson Ellen D.
Published: March 2012

We examined variation at MHC Class IIB genes in a recently established population of dark‐eyed juncos Junco hyemalis in a coastal urban environment in southern California, USA relative to an ancestral‐range population from a nearby species‐typical montane environment. The founding population is estimated to have been quite small, but we predicted that variation at the major histocompatibility complex (MHC) among the founders would nevertheless be preserved owing to the high functional significance of MHC. Previous studies of MHC in songbirds have had varying degrees of success in isolating loci, as passerines show extensive MHC gene duplication. In order to compare diversity in the two populations, we employed two published approaches to sequencing MHC Class II exon 2: direct sequencing with exon‐based primers, and traditional cloning and sequencing with intron‐based primers. Results from both methods show that the colonist population has maintained high levels of variation. Our results also indicate varying numbers of alleles across individuals, corroborating evidence for gene duplication in songbird MHC. While future studies in songbirds may need to take a genomic approach to fully understand the structure of MHC in this lineage, our results show that it is possible to use traditional methods to reveal functional variation across populations.
Range‐wide patterns of migratory connectivity in the western sandpiper Calidris mauri
Authors: Franks Samantha E. , Norris D. Ryan , Kyser T. Kurt , Fernández Guillermo , Schwarz Birgit , Carmona Roberto , Colwell Mark A. , Sandoval Jorge Correa , Dondua Alexey , Gates H. River , Haase Ben , Hodkinson David J. , Jiménez Ariam , Lanctot Richard B. , Ortego Brent , Sandercock Brett K. , Sanders Felicia , Takekawa John Y. , Warnock Nils , Ydenberg Ron C. , Lank David B.
Published: March 2012

Understanding the population dynamics of migratory animals and predicting the consequences of environmental change requires knowing how populations are spatially connected between different periods of the annual cycle. We used stable isotopes to examine patterns of migratory connectivity across the range of the western sandpiper Calidris mauri. First, we developed a winter isotope basemap from stable‐hydrogen (δD), ‐carbon (δ13C), and ‐nitrogen (δ15N) isotopes of feathers grown in wintering areas. δD and δ15N values from wintering individuals varied with the latitude and longitude of capture location, while δ13C varied with longitude only. We then tested the ability of the basemap to assign known‐origin individuals. Sixty percent of wintering individuals were correctly assigned to their region of origin out of seven possible regions. Finally, we estimated the winter origins of breeding and migrant individuals and compared the resulting empirical distribution against the distribution that would be expected based on patterns of winter relative abundance. For breeding birds, the distribution of winter origins differed from expected only among males in the Yukon‐Kuskokwim (Y‐K) Delta and Nome, Alaska. Males in the Y‐K Delta originated overwhelmingly from western Mexico, while in Nome, there were fewer males from western North America and more from the Baja Peninsula than expected. An unexpectedly high proportion of migrants captured at a stopover site in the interior United States originated from eastern and southern wintering areas, while none originated from western North America. In general, we document substantial mixing between the breeding and wintering populations of both sexes, which will buffer the global population of western sandpipers from the effects of local habitat loss on both breeding and wintering grounds.
The treatment of sinusitis following maxillary sinus grafting with the association of functional endoscopic sinus surgery (FESS) and an intra‐oral approach
Authors: Chiapasco M. , Felisati G. , Zaniboni M. , Pipolo C. , Borloni R. , Lozza P.
Published: March 2012

Aim of the study

To present the results of a prospective study on the management of infectious complications following maxillary sinus floor elevation procedures with a combined endoscopic (FESS) and intra‐oral approach.

Materials and methods

From 2005 to 2009, twenty consecutive patients were diagnosed for sinusal chronic infectious complications refractory to medical treatment following maxillary sinus floor elevation and grafting procedures. All patients were treated with a combination of functional endoscopic sinus surgery (FESS) through a transnasal approach and an intra‐oral approach, performed by an ear, nose, and throat team and an oral and maxillofacial team, respectively, in the same surgical session under general anesthesia.

Results

In 16 of 20 patients, the 4‐week endoscopic control demonstrated a complete clinical healing and recovery of the normal sinus ventilation and drainage. In two patients, the persisting sinusitis at the 4‐week control was successfully treated (8th week) with an antibiotic therapy based on the antibiogram carried out on the bacterial culture obtained by the aspiration of the sinusal content. In one patient, the persisting sinusitis (3 months after surgery) was successfully treated with the aspiration of the infectious material from the maxillary sinus. In one patient, finally, it was necessary to perform a second combined surgical treatment to treat the persisting sinusitis.

Discussion and conclusions

In this study, a relevant number of cases of chronic infectious complications following sinus floor elevation procedures are presented. To the authors' knowledge, it is the first time that well‐defined treatment protocols based on a combined endoscopic (FESS) and intra‐oral surgical approach are proposed. The positive, albeit preliminary, results obtained in this study seem to validate this treatment modality.
Thalidomide and dexamethasone vs. bortezomib and dexamethasone for melphalan refractory myeloma: a randomized study
Authors: Hjorth Martin , Hjertner Øyvind , Knudsen Lene Meldgaard , Gulbrandsen Nina , Holmberg Erik , Pedersen Per Trøllund , Andersen Niels Frost , Andréasson Björn , Billström Rolf , Carlson Kristina , Carlsson Margaretha S. , Flogegård Max , Forsberg Karin , Gimsing Peter , Karlsson Torbjörn , Linder Olle , Nahi Hareth , Othzén Annika , Swedin Agneta ,   for the Nordic Myeloma Study Group (NMSG)
Published: March 2012

Objectives:  Thalidomide and bortezomib have been frequently used for second‐line therapy in patients with myeloma relapsing after or refractory to initial melphalan‐based treatment, but no randomized trials have been published comparing these two treatment alternatives.

Methods:  Thalidomide‐ and bortezomib‐naïve patients with melphalan refractory myeloma were randomly assigned to low‐dose thalidomide + dexamethasone (Thal‐Dex) or bortezomib + dexamethasone (Bort‐Dex). At progression on either therapy, the patients were offered crossover to the alternative drug combination. An estimated 300 patients would be needed for the trial to detect a 50% difference in median PFS between the treatment arms.

Results:  After inclusion of 131 patients, the trial was prematurely closed because of low accrual. Sixty‐seven patients were randomized to Thal‐Dex and 64 to Bort‐Dex. Progression‐free survival was similar (median, 9.0 months for Thal‐Dex and 7.2 for Bort‐Dex). Response rate was similar (55% for Thal‐Dex and 63% for Bort‐Dex), but time to response was shorter (P < 0.05) and the VGPR rate higher (P < 0.01) for Bort‐Dex. Time‐to‐other treatment after crossover was similar (median, 13.2 months for Thal‐Dex and 11.2 months for Bort‐Dex), as was overall survival (22.8 months for Thal‐Dex and 19.0 for Bort‐Dex). Venous thromboembolism was seen in seven patients and cerebrovascular events in four patients in the Thal‐Dex group. Severe neuropathy, reactivation of herpes virus infections, and mental depression were more frequently observed in the Bort‐Dex group. In the quality‐of‐life analysis, no difference was noted for physical function, pain, and global quality of life. Fatigue and sleep disturbances were significantly more prevalent in the Bort‐Dex group.

Conclusions:  Thalidomide (50–100 mg daily) in combination with dexamethasone seems to have an efficacy comparable with that of bortezomib and dexamethasone in melphalan refractory myeloma. However, the statistical strength of the results in this study is limited by the low number of included patients.
T‐type calcium channel blockade improves survival and cardiovascular function in thalassemic mice
Authors: Kumfu Sirinart , Chattipakorn Siriporn , Chinda Kroekkiat , Fucharoen Suthat , Chattipakorn Nipon
Published: March 2012

Objectives:  Iron‐overload cardiomyopathy is a major cause of morbidity and mortality in patients with thalassemia. However, the precise mechanisms of iron entry and sequestration in the heart are still unclear. Our previous study showed that Fe2+ uptake in thalassemic cardiomyocytes are mainly mediated by T‐type calcium channels (TTCC). Nevertheless, the role of TTCC as well as other transporters such as divalent metal transporter1 (DMT1) and L‐type calcium channels (LTCC) as possible portals for iron entry into the heart in in vivo thalassemic mice under an iron‐overload condition has not been investigated.

Methods:  An iron‐overload condition was induced in genetically altered β‐thalassemic mice and adult wild‐type mice by feeding them with an iron diet (0.2% ferrocene w/w) for 3 months. Then, blockers for LTCC (verapamil and nifedipine), TTCC (efonidipine), and DMT1 (ebselen) as well as iron chelator desferoxamine (DFO) were given for 1 month with continuous iron feeding.

Results:  Treatment with LTCC, TTCC, DMT1 blockers, and DFO reduced cardiac iron deposit, cardiac malondialdehyde (MDA), plasma non‐transferrin‐bound iron, and improved heart rate variability and left ventricular (LV) function in thalassemic mice with iron overload. Only TTCC and DMT1 blockers and DFO reduced liver iron accumulation, liver MDA, plasma MDA, and decreased mortality rate in iron‐overloaded thalassemic mice.

Conclusions:  DMT1, LTCC, and TTCC played important roles for iron entry in the thalassemic heart under an iron‐overloaded condition. Unlike LTCC blocker, TTCC blocker provided all benefits including attenuating iron deposit in both the heart and liver, reduced oxidative stress, and decreased mortality in iron‐overloaded mice.
Tests of density dependence using indices of relative abundance in a deer population
Authors: Simard M. Anouk , Côté Steeve D. , Gingras André , Coulson Tim
Published: March 2012

A major question in animal ecology is explaining the causes of population fluctuations. Consensus about the most reliable method to detect density dependence (DD) or environmental effects from time‐series data, however, has not yet been achieved. Times series analyses have been used with indices of relative abundance in numerous studies, although these indices are rarely validated. Here, we used three different time series of relative abundance (number of deer seen per hunter per day, hunting success and proportion of males in the harvest) to explore direct and delayed DD in a white‐tailed deer Odocoileus virginianus population on Anticosti Island, Québec, Canada. Three mathematical approaches were tested: linear models, autoregressive (AR) models, and total DD in life history. Tests of DD using different indices of abundance on the same population should lead to similar results if all indices exhibit similar behaviour. Indices of relative abundance correlated with each other, although sometimes weakly, such that we obtained similar DD estimates with each index using detrended non‐stationary series. In most time series, linear regression of Nt−1 and Nt and AR models did not detect DD, while we obtained strong evidence for DD from the life‐history approach. This meant that contrasting conclusions about the role of density dependence within this population were reached depending on which method was used. We conclude that the method that incorporates most biological realism, the life‐history approach, provided a different result than classical interpretation of autoregressive coefficients. Only the life‐history interpretation supported our a priori belief that density dependence operating through competition for food regulates the Anticosti deer population. Phenomenological analysis aiming to investigate changes in abundance should be carefully conducted as the use of inappropriate indices or methods could lead to inappropriate conclusions or management strategies. Preferably, the method used should match the time scale of the population sampling regime and species life history.
Neutral communities in fragmented landscapes
Authors: Campos Paulo R. A. , Neto Elias D. C. , Oliveira Viviane M. de , Gomes M. A. F.
Published: March 2012

Habitat fragmentation displays a crucial role in conservation biology. Despite this, little is known about the detailed ecological consequences of habitat fragmentation due to the scarce number of controlled experimental surveys. The species–area relationship, a fundamental concept in ecology, requires the understanding of the fragmentation effects in a long term perspective, which turns this task even harder. Here we address the spatial patterns of species distribution in fragmented landscapes, assuming a neutral community model. We study the species area relationship and how its shape changes as the landscape becomes more fragmented. Recent investigations, based on extensive computer simulation, have contributed to establish some definite conclusions in the study of non‐fragmented landscapes: the existence of a three‐regime or two‐regime scenario for the species–area relationship, the emergence of a power‐law regime at intermediate scales and the augment of the species–area exponent z with the speciation rate. Despite the recent efforts, some other questions remain, such as the dependence of z in the whole range of the speciation rate. Questions like these are currently debated but generalizations cannot be drawn. This is the first paper, to our knowledge, that uses the coalescence method and neutral theory to examine biodiversity on more complex spatial structures. Our simulation results corroborate that the fragmentation plays a crucial role in shaping the species–area relationship, by determining the existence and extension of the power‐law regime associated with small and intermediate areas. On the other hand, when individuals are allowed to disperse over longer distances the species–area relationship now displays the classic triphasic pattern, and the intermediate regime, which is well described by a power‐law, is established even for highly fragmented landscapes.
Behavioral actions of alcohol: phenotypic relations from multivariate analysis of mutant mouse data
Authors: Blednov Y. A. , Mayfield R. D. , Belknap J. , Harris R. A.
Published: March 2012

Behavioral studies on genetically diverse mice have proven powerful for determining relationships between phenotypes and have been widely used in alcohol research. Most of these studies rely on naturally occurring genetic polymorphisms among inbred strains and selected lines. Another approach is to introduce variation by engineering single‐gene mutations in mice. We have tested 37 different mutant mice and their wild‐type controls for a variety (31) of behaviors and have mined this data set by K‐means clustering and analysis of correlations. We found a correlation between a stress‐related response (activity in a novel environment) and alcohol consumption and preference for saccharin. We confirmed several relationships detected in earlier genetic studies, including positive correlation of alcohol consumption with saccharin consumption and negative correlations with conditioned taste aversion and alcohol withdrawal severity. Introduction of single‐gene mutations either eliminated or greatly diminished these correlations. The three tests of alcohol consumption used (continuous two‐bottle choice and two limited access tests: drinking in the dark and sustained high alcohol consumption) share a relationship with saccharin consumption, but differ from each other in their correlation networks. We suggest that alcohol consumption is controlled by multiple physiological systems where single‐gene mutations can disrupt the networks of such systems.
An evidence‐based view on hyperbilirubinaemia
Authors: Dijk Peter H. , Hulzebos Christian V.
Published: March 2012

Introduction:  We conducted a review of the evidence which contributes to the current care of jaundiced newborn infants.

Methods:  Literature was searched for reviews and randomized controlled trials (RCTs).

Results:  Six Cochrane reviews and eight other reviews and eighteen recent RCTs are discussed.

Conclusions:  Many children still suffer life‐long consequences of severe hyperbilirubinaemia, which could almost always have been prevented relatively easily. Up to date, guidelines summarizing the available evidence into unambiguous recommendations are needed to guide healthcare professionals in the prevention, diagnosis and treatment for infants with hyperbilirubinaemia.
Hyperoxia in the term newborn: more evidence is still needed for optimal oxygen therapy
Authors: Saugstad Ola Didrik
Published: March 2012

It took more than 30 years from the first observations that oxygen may be toxic during resuscitation till international guidelines changed to recommend that term and near term newborn infants should be resuscitated with air instead of 100% oxygen. There are still a number of unanswered questions related to oxygen therapy of the newborn infant. The newborn brain, lungs and other organs are susceptible to oxygen injury, and newborns still develop injury caused by hyperoxia.
Evidence for oxygen use in preterm infants
Authors: Triven Bashambu Monuj , Bhola Monika , Walsh Michele
Published: March 2012

Aim:  To review the evidence for optimal oxygen use in preterm infants.

Results:  Clinicians have embraced lower saturation targets to minimize retinopathy of prematurity (ROP). Large randomized trials now have shown that while such targets reduce ROP, neonatal mortality is increased significantly.

Conclusions:  Preterm infants should be resuscitated with blended oxygen (30–90%) targeted to avoid hyperoxia. Later, saturation management remains uncertain. Until ongoing trials and follow‐up are complete, it is prudent to avoid saturation of 85–89%.
Interventions to improve the oral feeding performance of preterm infants
Authors: Lau C , Smith EO
Published: March 2012

Aim:  Preterm infants have difficulty oral feeding. We hypothesized that a specific sucking and swallowing exercises vs. no intervention accelerate the attainment of independent oral feeding through a faster maturation of infants’ oral feeding skills (OFS).

Methods:  Very low birthweight infants were randomized to a control, sucking and swallowing groups. Sucking consisted of active sucking on a pacifier, and swallowing of placing a milk bolus (0.05–0.2 mL) on the tongue where the bolus rests prior to entering the pharynx. Primary outcome was days from start to independent oral feeding (SOF‐IOF). Secondary outcomes included overall transfer (OT, % volume taken/volume prescribed), proficiency (PRO, % volume taken at 5 min/volume prescribed), rate of transfer (RT, mL/min) over the entire feeding and infants’ OFS levels. OFS levels were defined by PRO and RT.

Results:  Days from SOF to IOF vs controls (21 ± 2) were similar for the sucking group (19 ± 2) and shorter for the swallowing group (15 ± 2; p = 0.019). Only the latter infants demonstrated more mature OFS levels than controls.

Conclusion:  The swallowing exercise is an efficacious intervention in facilitating the attainment of independent oral feeding, but not the sucking exercise. We speculate that the swallowing benefit resulted from an accelerated maturation of infants’ OFS levels.
The Use of Withdrawal among Birth Limiters in Iran and Turkey
Authors: Erfani Amir , Yuksel‐Kaptanoglu Ilknur
Published: March 2012

Despite a decline in fertility, an increase in contraceptive prevalence, and a wide expansion of family planning programs in Iran and Turkey, a large proportion of “birth limiters” rely on withdrawal to avoid pregnancy. Adopting a comparative approach, this study draws on data from the 2000 Iran DHS and 2003 Turkey DHS to examine the determinants of the practice of withdrawal among birth limiters. Multivariate logistic regression analyses were employed to estimate the likelihood of withdrawal use among two representative samples of birth limiters. Higher education and wealth were associated with greater likelihood of withdrawal use among birth limiters in Iran, while an inverse association was found in Turkey. Older age was positively associated with withdrawal in both countries, whereas having more than four children was inversely related to use. Study results suggest that family planning and reproductive health programs in Iran and Turkey should be aware of the groups that have high rates of withdrawal use, should educate couples in the effective use of withdrawal, and should encourage the use of more effective modern methods and emergency contraceptives when appropriate.
Correlates of and Couples' Concordance in Reports of Recent Sexual Behavior and Contraceptive Use
Authors: Koffi Alain K. , Adjiwanou Visseho D. , Becker Stan , Olaolorun Funmilola , Tsui Amy O.
Published: March 2012

This study uses couple‐level data to measure couples' concordance of self‐reported time since last coitus and of condom and other contraceptive use at last sexual intercourse among monogamous couples in Liberia (N = 1,673), Madagascar (N = 4,138), and Namibia (N = 588). The study also examines the characteristics associated with sexual behavior and contraceptive use occurring in the 28 days prior to the interviews among couples whose reports are concordant. Overall, our study finds less than 75 percent concordance in reporting of time since last coitus. Use of condoms and other contraceptives yielded fair (0.27) to substantial (0.67) agreement on the kappa index. Factors predicting a shorter time since last coitus among concordant couples in at least two of the countries included wealth, spousal age difference, education, and both partners wanting another child. The discordant reports of recent sexual behavior and contraceptive use suggest that caution should be exercised when inferring couples' behavior from the report of one spouse, that concordant reports should be examined when possible, that methodological changes to improve the validity of spousal reports should be pursued, and that family planning and HIV‐prevention programs should target those groups found to be using condoms and other contraceptives less frequently, particularly poorer couples.
Kynurenines: from the perspective of major psychiatric disorders
Authors: Myint Aye M.
Published: March 2012

Psychiatric disorders are documented to be associated with a mild pro‐inflammatory state. Pro‐inflammatory mediators could activate the tryptophan breakdown and kynurenine pathway with a shift toward the neurotoxic arm where excitotoxic N‐methyl‐d‐aspartate receptor agonist quinolinic acid is formed. An unbalanced metabolism in terms of neuroprotective and neurotoxic effects, such as reduced kynurenic acid to kynurenine ratio, has been demonstrated in the major psychiatric disorders such as unipolar depression, bipolar manic‐depressive disorder and schizophrenia, and in drug‐induced neuropsychiatric side effects such as interferon‐α treated patients. The changes in serum or plasma are shown to be associated with central changes such as in the cerebrospinal fluid and certain brain areas. While currently available antidepressants and mood stabilizers could not efficiently improve these neurochemical changes within the same period that could induce clinical improvement, some antipsychotic treatments could reverse certain metabolic imbalances. Some of these changes were tested also in animal models. In this review the role of this unbalanced kynurenine metabolism through interactions with other neurochemicals is discussed as a major contributing pathophysiological mechanism in psychiatric disorders. Moreover, the biomarker role of kynurenine metabolites and future therapeutic opportunities are also discussed.
Efficacy and safety of a gauze pad containing hyaluronic acid in treatment of leg ulcers of venous or mixed origin: a double‐blind, randomised, controlled trial
Authors: Humbert Philippe , Mikosinki Jacek , Benchikhi Hakima , Allaert François‐André
Published: March 2012

Topical hyaluronic acid (HA) is routinely used in the local treatment of chronic wounds, but few data have been reported to date. A 60‐day double‐blind, randomised, controlled superiority trial was designed to investigate the efficacy and safety of a gauze pad containing HA in local treatment of venous leg ulcers, compared with its neutral vehicle. The primary endpoint was the percentage of wound size reduction after 45 days. Totally 89 patients were included. At day 45, the percentage of ulcer surface reduction was significantly greater in the HA group (73 ± 4·6%) versus neutral vehicle group (46 ± 9·6%) (P = 0·011). The number of healed ulcers was significantly higher in the HA group at day 45 (31·1% versus 9·3% respectively) and day 60 (37·8% versus 16·3% respectively; P < 0·05). At day 30, pain intensity based on visual analogue scale was significantly lower in the HA group (12·4 mm ± 2·6 versus 22·8 mm ± 3·8; P = 0·026). Tolerance of both treatments was comparable in the two groups. HA gauze pad, in local treatment of venous leg ulcers, was significantly more effective than the neutral vehicle on wound size reduction, healed ulcers rate and pain management with a good safety profile.
Achieving international consensus for the prevention of orthopaedic wound blistering: results of a Delphi survey
Authors: Ousey Karen , Gillibrand Warren , Stephenson John
Published: March 2012

This article presents the results of an international 2 stage Delphi survey carried out via e‐mail to achieve consensus as to the most effective postoperative wound management to prevent blistering and other complications. Seventeen prospective participants were invited to be members of the Delphi Panel of which 13 agreed to be involved. The panel suggested that an ideal wound dressing would conform easily to the wound, be easy to apply and remove, allow for swelling and minimise pain on removal. Participants were in agreement that the primary wound dressing should be left in situ for as long as possible, providing there was no excessive oozing or signs of infection. The authors recognise that the Delphi Panel was relatively compact; however, the study arguably provides some useful data that can be used to identify the consequences of wound blistering and important factors that need to be considered when choosing a wound dressing to prevent blistering.
NAFTA, LABOR, AND THE RECOVERY PROJECT
Authors: Rothlisberger Leisa
Published: March 2012

As I contend in this article, neoliberal, globalizing policies have significant cultural repercussions. In particular, the North American Free Trade Agreement (NAFTA) imbricates the “Recovering the U.S. Hispanic Literary Heritage” project, an academic publishing series initiated coincidentally with the NAFTA negotiations in the early 1990s. The project publishes so‐called Hispanic literature that spans the geographic and cultural boundaries of the current relationship between the U.S. and Mexico. As responses to the labor and immigrant conditions promulgated by precursors to NAFTA, the recovered texts offer a potent critique of the current situation that parallels the context of the historic texts. Specifically, María Ruiz de Burton'sThe Squatter and the Don's republication by the Recovery project overcomes the limitations of neoliberal multiculturalism through its depiction of immigrant labor and model of proper U.S. citizenship. By engaging these issues, the text indicts NAFTA's repercussion for individuals, especially laborers, in the U.S. and Mexico, illustrating the critical potential of the Recovery project.