bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence of cancer‐promoting roles for AMPK and related kinases
Authors: Monteverde Tiziana , Muthalagu Nathiya , Port Jennifer , Murphy Daniel J.
Published: October 2015

The discovery that the 5′AMP‐activated protein kinase (AMPK) serves to link the tumour suppressors LKB1 and the tuberous sclerosis complex and functions to slow macromolecular synthesis through attenuation of the mechanistic target of rapamycin complex 1 revealed a role for AMPK in tumour suppression. On the other hand, the well‐recognized role of AMPK in maintaining ATP homeostasis, through suppression of anabolism and promotion of catabolism, as well as the role of AMPK in neutralizing reactive oxygen species, via maintenance of NADPH‐dependent reductive capacity, point to tumour‐protective roles in the context of metabolic stress, which is a key feature of many solid tumours. A growing number of studies thus suggest a duality of functions for AMPK that are either pro‐ or anti‐cancer, depending upon context. Importantly, AMPK is composed of three subunits, and multiple isoforms exist for all three, allowing for different permutations to assemble and the potential for specific AMPK complexes to regulate distinct cellular processes. Moreover, certain subunits of the AMPK complex are frequently overexpressed in a spectrum of human cancer types, suggesting an outright oncogenic function for specific AMPK complexes. Adding complexity to this picture, the catalytic AMPK alpha subunits belong to a family of 14 kinases that can all be activated by LKB1 and studies are beginning to reveal a similar duality of roles in cancer for other members of the AMPK‐related kinase family.
Short‐term carbon cycling responses of a mature eucalypt woodland to gradual stepwise enrichment of atmospheric CO2 concentration
Authors: Drake John E. , Macdonald Catriona A. , Tjoelker Mark G. , Crous Kristine Y. , Gimeno Teresa E. , Singh Brajesh K. , Reich Peter B. , Anderson Ian C. , Ellsworth David S.
Published: October 2015

Projections of future climate are highly sensitive to uncertainties regarding carbon (C) uptake and storage by terrestrial ecosystems. The Eucalyptus Free‐Air CO2 Enrichment (EucFACE) experiment was established to study the effects of elevated atmospheric CO2 concentrations (eCO2) on a native mature eucalypt woodland with low fertility soils in southeast Australia. In contrast to other FACE experiments, the concentration of CO2 at EucFACE was increased gradually in steps above ambient (+0, 30, 60, 90, 120, and 150 ppm CO2 above ambient of ~400 ppm), with each step lasting approximately 5 weeks. This provided a unique opportunity to study the short‐term (weeks to months) response of C cycle flux components to eCO2 across a range of CO2 concentrations in an intact ecosystem. Soil CO2 efflux (i.e., soil respiration or Rsoil) increased in response to initial enrichment (e.g., +30 and +60 ppm CO2) but did not continue to increase as the CO2 enrichment was stepped up to higher concentrations. Light‐saturated photosynthesis of canopy leaves (Asat) also showed similar stimulation by elevated CO2 at +60 ppm as at +150 ppm CO2. The lack of significant effects of eCO2 on soil moisture, microbial biomass, or activity suggests that the increase in Rsoil likely reflected increased root and rhizosphere respiration rather than increased microbial decomposition of soil organic matter. This rapid increase in Rsoil suggests that under eCO2, additional photosynthate was produced, transported belowground, and respired. The consequences of this increased belowground activity and whether it is sustained through time in mature ecosystems under eCO2 are a priority for future research.
Plant responses to climatic extremes: within‐species variation equals among‐species variation
Authors: Malyshev Andrey V. , Arfin Khan Mohammed A. S. , Beierkuhnlein Carl , Steinbauer Manuel J. , Henry Hugh A. L. , Jentsch Anke , Dengler Jürgen , Willner Evelin , Kreyling Juergen
Published: October 2015

Within‐species and among‐species differences in growth responses to a changing climate have been well documented, yet the relative magnitude of within‐species vs. among‐species variation has remained largely unexplored. This missing comparison impedes our ability to make general predictions of biodiversity change and to project future species distributions using models. We present a direct comparison of among‐ versus within‐species variation in response to three of the main stresses anticipated with climate change: drought, warming, and frost. Two earlier experiments had experimentally induced (i) summer drought and (ii) spring frost for four common European grass species and their ecotypes from across Europe. To supplement existing data, a third experiment was carried out, to compare variation among species from different functional groups to within‐species variation. Here, we simulated (iii) winter warming plus frost for four grasses, two nonleguminous, and two leguminous forbs, in addition to eleven European ecotypes of the widespread grass Arrhenatherum elatius. For each experiment, we measured: (i) C/N ratio and biomass, (ii) chlorophyll content and biomass, and (iii) plant greenness, root 15N uptake, and live and dead tissue mass. Using coefficients of variation (CVs) for each experiment and response parameter, a total of 156 within‐ vs. among‐species comparisons were conducted, comparing within‐species variation in each of four species with among‐species variation for each seed origin (five countries). Of the six significant differences, within‐species CVs were higher than among‐species CVs in four cases. Partitioning of variance within each treatment in two of the three experiments showed that within‐species variability (ecotypes) could explain an additional 9% of response variation after accounting for the among‐species variation. Our observation that within‐species variation was generally as high as among‐species variation emphasizes the importance of including both within‐ and among‐species variability in ecological theory (e.g., the insurance hypothesis) and for practical applications (e.g., biodiversity conservation).
Low‐temperature dunite hydration: evaluating CH4 and H2 production from H2O and CO2
Authors: Neubeck A. , Nguyen D. T. , Etiope G.
Published: October 2015

Abiotic methane (CH4) and hydrogen (H2) produced after hydration of mafic/ultramafic rocks represent energy sources for microbes that may thrive in the deep subsurface regions of Earth and possibly on other planets. While H2 is a direct product of serpentinization, CH4 can form via Fischer–Tropsch Type (FTT) reactions (carbon reduction) that, due to potential H2 migration, can be spatially and temporally detached from serpentinization. We tested an alternative process hypothesized by some scholars, in which CO2 can be reduced through dunite hydration without initially added H2, implying that CH4 can form in the same serpentinized fluid–rock system. The experiment used natural dunite sand (Forsterite 92), CO2 with δ13C ~ −25‰ (VPDB), and a 1 mm dissolved SiO2 solution mixed in 30 glass bottles (118 mL) stored for up to 8 months at low temperature (50°C) to simulate land‐based serpentinization systems. In addition, 30 control bottles without olivine were used as blanks. Trivial amounts of CH4 (orders of 0.2–0.9 ppmv) were detected in both samples and blanks, likely representing analytical noise; essentially, no significant amount of CH4 formed under the experimental conditions used in this work. Low amounts of H2 (~2.55 ± 1.39 ppmv) were generated, with production yields that were one order of magnitude lower than in previously published experiments. Moderate concentrations of SiO2 appeared to hinder low‐temperature H2 production. Our experiment confirms that the low‐temperature reduction of CO2 into CH4 through direct olivine hydration, without initial H2, is sluggish and not straightforward, which is consistent with previous studies. The presence of substantial amounts of H2, as well as suitable metal catalysts, appears to be essential in the low‐temperature production of abiotic CH4, as observed in published FTT experiments.
Who Will Be the “Principled‐Principals”? Perceptions of Corruption and Willingness to Engage in Anticorruption Activism
Authors: Peiffer Caryn , Alvarez Linda
Published: October 2015

Many anticorruption campaigns aim to encourage citizens to demand better control over corruption. Recent literature suggests that perceived high levels of corruption and government effectiveness in controlling corruption will limit citizens' willingness to actively oppose corruption. UsingTransparencyInternational's 2013GlobalCorruptionBarometer, we test these ideas across a 71‐country sample. We find that perceived government effectiveness tends to encourage anticorruption civic action, while perceptions of corruption being widespread tend to have the opposite impact in non‐OECDcountries. Our analyses also suggest that the interaction between these perceptions is important; we find that, especially among those who perceive that the level of corruption is high, when confidence in the government's efforts grows, so does their willingness fight corruption.
Interferon‐γ constrains cytokine production of group 2 innate lymphoid cells
Authors: Kudo Fujimi , Ikutani Masashi , Seki Yoichi , Otsubo Takeshi , Kawamura Yuki I. , Dohi Taeko , Oshima Kenshiro , Hattori Masahira , Nakae Susumu , Takatsu Kiyoshi , Takaki Satoshi
Published: October 2015

Group 2 innate lymphoid cells (ILC2s) produce a significant amount of interleukin‐5 (IL‐5), which supports eosinophil responses in various tissues; they also produce IL‐13, which induces mucus production and contributes to tissue repair or fibrosis. The ILC2s are activated by alarmins, such as IL‐33 released from epithelia, macrophages and natural killer T (NKT) cells in response to infection and allergen exposure, leading to epithelial injury. We examined gene expression in lung ILC2s and found that ILC2s expressed Ifngr1, the receptor for interferon‐γ (IFN‐γ). Interferon‐γ severely inhibited IL‐5 and IL‐13 production by lung and kidney ILC2s. To evaluate the effects in vivo, we used α‐galactosylceramide (α‐GalCer) to induce NKT cells to produce IL‐33 and IFN‐γ. Intraperitoneal injection of α‐GalCer in mice induced NKT cell activation resulting in IL‐5 and IL‐13 production by ILC2s. Administration of anti‐IFN‐γ together with α‐GalCer significantly enhanced the production of IL‐5 and IL‐13 by ILC2s in lung and kidney. Conversely, cytokine production from ILC2s was markedly suppressed after injection of exogenous IL‐33 in Il33−/− mice pre‐treated with α‐GalCer. Hence, IFN‐γ induced or already present in tissues can impact downstream pleiotropic functions mediated by ILC2s, such as inflammation and tissue repair.
Improving wound healing and preventing surgical site complications of closed surgical incisions: a possible role of Incisional Negative Pressure Wound Therapy. A systematic review of the literature
Authors: Scalise Alessandro , Calamita Roberto , Tartaglione Caterina , Pierangeli Marina , Bolletta Elisa , Gioacchini Matteo , Gesuita Rosaria , Di Benedetto Giovanni
Published: October 2015

Advances in preoperative care, surgical techniques and technologies have enabled surgeons to achieve primary closure in a high percentage of surgical procedures. However, often, underlying patient comorbidities in addition to surgical‐related factors make the management of surgical wounds primary closure challenging because of the higher risk of developing complications. To date, extensive evidence exists, which demonstrate the benefits of negative pressure dressing in the treatment of open wounds; recently, Incisional Negative Pressure Wound Therapy (INPWT) technology as delivered by Prevena™ (KCI USA, Inc., San Antonio, TX) and Pico (Smith & Nephew Inc, Andover, MA) systems has been the focus of a new investigation on possible prophylactic measures to prevent complications via application immediately after surgery in high‐risk, clean, closed surgical incisions. A systematic review was performed to evaluate INPWT's effect on surgical sites healing by primary intention. The primary outcomes of interest are an understanding of INPWT functioning and mechanisms of action, extrapolated from animal and biomedical engineering studies and incidence of complications (infection, dehiscence, seroma, hematoma, skin and fat necrosis, skin and fascial dehiscence or blistering) and other variables influenced by applying INPWT (re‐operation and re‐hospitalization rates, time to dry wound, cost saving) extrapolated from human studies. A search was conducted for published articles in various databases including PubMed, Google Scholar and Scopus Database from 2006 to March 2014. Supplemental searches were performed using reference lists and conference proceedings. Studies selection was based on predetermined inclusion and exclusion criteria and data extraction regarding study quality, model investigated, epidemiological and clinical characteristics and type of surgery, and the outcomes were applied to all the articles included. 1 biomedical engineering study, 2 animal studies, 15 human studies for a total of 6 randomized controlled trials, 5 prospective cohort studies, 7 retrospective analyses, were included. Human studies investigated the outcomes of 1042 incisions on 1003 patients. The literature shows a decrease in the incidence of infection, sero‐haematoma formation and on the re‐operation rates when using INPWT. Lower level of evidence was found on dehiscence, decreased in some studies, and was inconsistent to make a conclusion. Because of limited studies, it is difficult to make any assertions on the other variables, suggesting a requirement for further studies for proper recommendations on INPWT.
New Thorium Isotope Ratio Measurements in Silicate Reference Materials: A‐THO, AGV‐2, BCR‐2, BE‐N, BHVO‐2 and BIR‐1
Authors: Carpentier Marion , Gannoun Abdelmouhcine , Pin Christian , Sigmarsson Olgeir
Published: October 2015

A two‐step Th isolation protocol, involving micro‐columns of TRU‐Spec extraction chromatography material and AG1 resin, was evaluated. The MC‐ICP‐MS procedure included 232Th tailing characterisation and correction, and calibrator bracketing using an in‐house standard solution (ThS1) to correct for instrumental mass bias and Faraday cup to secondary electron multiplier relative gain. Repeated analyses of reference solutions (UCSC Th ‘A’, WUN, OU Th ‘U’, IRMM‐36) were consistent with published data. Six reference materials (A‐THO, BCR‐2, AGV‐2, BHVO‐2, BE‐N and BIR‐1) were processed. The average 230Th/232Th values obtained for these samples are in excellent agreement with published data. In addition, we report the first 230Th/232Th values for BE‐N and BIR‐1. The intermediate precisions for rock samples ranged from ± 0.24 to ± 0.49% (2 RSD) and were similar to those achieved for synthetic solutions, thereby supporting the overall validity of the chemical separation, data acquisition and reduction procedures. Counting statistics on the 230Th isotope was the most significant source of uncertainty. The intermediate precision of the mean 230Th/232Th for the Th‐depleted BIR‐1 (5.64 × 10−6 ± 0.27%, 2 RSD) is in the range of the analyses of other reference materials analysed in this study.
Geographical variation in the importance of water and energy for oak diversity
Authors: Xu Xiaoting , Wang Zhiheng , Rahbek Carsten , Sanders Nathan J. , Fang Jingyun
Published: October 2015

Aim

The water–energy dynamics hypothesis posits that species diversity is correlated with water availability and temperatures; diversity is lowest when water availability is reduced at low temperatures because few species can persist under such conditions. However, the relationship between water and energy availability and diversity likely varies geographically along environmental gradients. Here, we examined the drivers of such variability, using a global‐scale data set on oaks.

Location

Global.

Method

To quantify spatial variation in both species diversity–water relationships and species diversity–energy relationships, we performed geographically weighted regressions (GWR) of (1) species diversity against energy availability, measured as potential evapotranspiration and temperature, and (2) species diversity against water availability, measured by precipitation and an aridity index. We then regressed the local slopes of these GWR models against water and energy separately, and water × energy combined to assess whether the regional‐scale relationships among oak diversity, water and energy depended on climatic conditions at larger spatial extents.

Results

We found that the effects of low water availability and cold temperatures on oak diversity varied geographically. In particular, the effects of water and energy availability on oak diversity increased as water and energy availability decreased. Furthermore, the interaction between water and energy availability influenced regional‐scale oak diversity–energy relationships but not oak diversity–water relationships.

Main conclusion

Our results suggest that the relationship between climate (and potentially climatic change) and oak diversity varies geographically, and that the effects of limiting water and temperature are likely to be most severe in arid environments.
Chloroplast phylogeography of Dirca palustris L. indicates populations near the glacial boundary at the Last Glacial Maximum in eastern North America
Authors: Peterson Bryan J. , Graves William R.
Published: October 2015

Aim

Little is known about the distribution of temperate forest shrubs in eastern North America during the Last Glacial Maximum (LGM), and how far they subsequently migrated to occupy previously glaciated landscapes. We assessed whether populations of Dirca palustris L. persisted near the glacial margin during the LGM. Such populations might explain how the species colonized northern latitudes, despite scant evidence for contemporary long‐distance seed dispersal.

Location

Eastern North America, Mexico and California.

Methods

We conducted ecological niche modelling (ENM) and sequenced five non‐coding regions of the chloroplast genome from 390 plants among 104 populations representing the four species of Dirca. We used a Bayesian approach to identify relationships among individuals and to estimate timing of lineage splits. The spatial genetic structure of D. palustris was evaluated qualitatively and by statistical methods, including Monmonier's algorithm and analysis of molecular variance (AMOVA).

Results

Ecological niche modelling indicated suitable climate at the LGM in the Gulf Coastal Plain, but also north to the Ozark Plateaus Province (northern Arkansas), Interior Low Plateaus and Appalachian Plateaus Provinces (portions of Tennessee and Kentucky), and the Piedmont and Coastal Plain Provinces of the Carolinas and Virginia. Sequence variation was extensive and indicated deep lineage splits within D. palustris. Numerous haplotypes, many private, were identified at middle latitudes (c. 35–40° N), Monmonier's algorithm identified multiple genetic discontinuities within this region, and northern and southern regions differed by AMOVA.

Main conclusions

Ecological niche modelling and genetic analyses indicate that populations likely existed within several hundred km of the Laurentide ice sheet at the LGM. Deep Pleistocene diversification, along with weak geographical fidelity of haplotypes, probably resulted from repeated isolation, differentiation, and secondary contact during Quaternary glacial cycles. The absence of many northern haplotypes south of 35° N supports the hypothesis that temperate understorey shrubs accompanied temperate trees of eastern North America in populations near the glacial margin at the LGM.
Molecular and fossil evidence disentangle the biogeographical history ofPodocarpus, a key genus in plant geography
Authors: Quiroga María Paula , Mathiasen Paula , Iglesias Ari , Mill Robert R. , Premoli Andrea C.
Published: October 2015

Aim

The genusPodocarpus(Podocarpaceae) provides an opportunity to contrast biogeographical hypotheses within and among continents, and to analyse divergence between disjunct tropical and temperate forests of South America. We developed a calibrated phylogeny ofPodocarpusto reconstruct the ancestral areas and potential expansion routes within Podocarpaceae.

Location

Podocarpusconsists of two extant subgenera:Foliolatusfrom Asia and Oceania, andPodocarpuslocated in Gondwanan continents and north to the Caribbean. The paper focuses mainly on the area occupied by the latter subgenus.

Methods

We combined previously published and novelDNAsequences with fossil records. New species sequenced are members ofPodocarpussubgenusPodocarpusfrom South and Central America. We assembledDNAsequences of the chloroplast (matK andrbcL) and nuclear (ITS1 andITS2) to analyse phylogenetic relationships withinPodocarpussubgenusPodocarpusby Bayesian methods, which were calibrated using macrofossils that could be confidently identified as modern genera. Ancestral areas were inferred using the dispersal–extinction–cladogenesis model.

Results

The phylogenetic reconstruction inferred a minimum age for the origin ofPodocarpuss.l. in the late Cretaceous–early Palaeogene (63 Ma) and strongly supported monophyly of the genusPodocarpusand of subgeneraPodocarpusandFoliolatus. SubgenusPodocarpusconsists of two monophyletic, latitudinally structured clades. One clade consists of temperate American species while the other includes species from tropical‐subtropical Africa and South America.

Main conclusions

The history of the subgenera withinPodocarpusis older than previously reported: they can be traced back to late Cretaceous–early Palaeocene biogeographical connections between Australasia and South America through Antarctica. Latitudinally disjunct lineages within South America most probably diverged from widespread ancestors as a result of a persistent arid barrier that was established prior to the late Palaeogene. The calibrated age for the Tropical–Subtropical clade suggests an Atlantic–subtropical biogeographical corridor between South America and Africa long after the breakup of Gondwana and the stabilization of the circum‐Antarctic current.
Randomized controlled multicenter study comparing short dental implants (6 mm) versus longer dental implants (11–15 mm) in combination with sinus floor elevation procedures. Part 2: clinical and radiographic outcomes at 1 year of loading
Authors: Schincaglia Gian Pietro , Thoma Daniel S. , Haas Robert , Tutak Marcin , Garcia Abel , Taylor Thomas D. , Hämmerle Christoph H. F.
Published: October 2015

Aim

To compare, clinically and radiographically, short dental implants (6 mm) to long implants (11–15 mm) placed with sinus grafting.

Methods

Participants with 5–7 mm of bone height in the posterior maxilla were randomly allocated to receive short implants (GS) or long implants with sinus grafting (GG). Implants were loaded with single crowns 6 months after placement (PR). Patients were re‐evaluated 12 months after loading (FU‐1). Outcome variables included: Implant survival rate (CSR), marginal bone level alteration (MBL), periodontal probing depth (PPD), bleeding on probing (BoP), plaque control record (PCR) and crown‐to‐implant ratios (C/I). Statistical analysis was performed using parametric tests.

Results

In 97 subjects, 132 implants were re‐evaluated at FU‐1. The CSR was 100%. The MBL from implant placement (IP) to (PR) was −0.22 ± 0.4 mm for GG and −0.3 ± 0.45 mm for GS (p < 0.001). MBL from IP to FU‐1 was −0.37 ± 0.59 mm for GG and −0.22 ± 0.3 mm for GS (p < 0.001). Intergroup comparisons showed non‐significant differences for MBL (p > 0.05), PPD (p = 1) and PCR (p = 0.09). BoP was higher in the GS (p = 0.04). The C/I was 0.99 ± 0.17 for GG and 1.86 ± 0.23 for GS (p < 0.001). No correlation was observed between C/I and MBL, (GG: p = 0.13; GS: p = 0.38).

Conclusions

Both treatment modalities provided similar outcomes.
Rapid changes in genetic architecture of behavioural syndromes following colonization of a novel environment
Authors: Karlsson Green K. , Eroukhmanoff F. , Harris S. , Pettersson L. B. , Svensson E. I.
Published: October 2015

Behavioural syndromes, that is correlated behaviours, may be a result from adaptive correlational selection, but in a new environmental setting, the trait correlation might act as an evolutionary constraint. However, knowledge about the quantitative genetic basis of behavioural syndromes, and the stability and evolvability of genetic correlations under different ecological conditions, is limited. We investigated the quantitative genetic basis of correlated behaviours in the freshwater isopod Asellus aquaticus. In some Swedish lakes, A. aquaticus has recently colonized a novel habitat and diverged into two ecotypes, presumably due to habitat‐specific selection from predation. Using a common garden approach and animal model analyses, we estimated quantitative genetic parameters for behavioural traits and compared the genetic architecture between the ecotypes. We report that the genetic covariance structure of the behavioural traits has been altered in the novel ecotype, demonstrating divergence in behavioural correlations. Thus, our study confirms that genetic correlations behind behaviours can change rapidly in response to novel selective environments.
Description and Phylogeny of Urostyla grandis wiackowskii subsp. nov. (Ciliophora, Hypotricha) from an Estuarine Mangrove in Brazil
Authors: Paiva Thiago da Silva , Shao Chen , Fernandes Noemi Mendes , Borges Bárbara do Nascimento , da Silva‐Neto Inácio Domingos
Published: October 2015

Interphase specimens, aspects of physiological reorganization and divisional morphogenesis were investigated in a strain of a hypotrichous ciliate highly similar to Urostyla grandis Ehrenberg, (type species of Urostyla), collected from a mangrove area in the estuary of the Paraíba do Sul river (Rio de Janeiro, Brazil). The results revealed that albeit interphase specimens match with the known morphologic variability in U. grandis, morphogenetic processes have conspicuous differences. Parental adoral zone is entirely renewed during morphogenesis, and marginal cirri exhibit a unique combination of developmental modes, in which left marginal rows originate from multiple anlagen arising from innermost left marginal cirral row, whereas right marginal ciliature originates from individual within‐row anlagen. Based on such characteristics, a new subspecies, namely U. grandis wiackowskii subsp. nov. is proposed, and consequently, U. grandis grandis Ehrenberg, stat. nov. is established. Bayesian and maximum‐likelihood analyses of the 18S rDNA unambiguously placed U. grandis wiackowskii as adelphotaxon of a cluster formed by other U. grandis sequences. The implications of such findings to the systematics of Urostyla are discussed.
Ultrathin unsedated transnasal gastroscopy in monitoring eosinophilic esophagitis
Authors: Philpott Hamish , Nandurkar Sanjay , Royce Simon G , Gibson Peter R
Published: October 2015

Background

Ultrathin unsedated transnasal gastroscopy (UTEG) has a number of advantages applicable to eosinophilic esophagitis (EoE) and has not been evaluated for this condition.

Aim

The aim of the study is to determine the feasibility of UTEG in patients with EoE and the acceptability of histological specimens obtained at biopsy.

Method

All patients with a diagnosis of EoE presenting to the outpatients department of two hospitals (Box Hill Hospital and The Alfred Hospital, Melbourne Australia) were asked to participate in the study. UTEG was performed on consenting individuals. Feasibility was determined by the success of nasal intubaton, patient perception according to post procedural survey, and adequacy of esophageal biopsies was assessed.

Results

Ninety‐six consecutive patients with EoE were offered UTEG, and 24 agreed to participate in the study. Seventy‐four UTEGs were performed over a period of 26 months (September 2012 to December 2014). Nineteen patients had repeat procedures. Successful nasal intubation occurred in 97% (72 of 74 procedures), and 21 of 24 (86%) described high satisfaction with the procedure and minimal discomfort, and would choose UTEG for future procedures. Mean duration was 5 min. Adverse events of epistaxis (three cases) and vomiting of liquid contents during the procedure (two cases) were recorded, cardiorespiratory parameters remaining normal in all patients. All completed procedures produced adequate histological samples.

Conclusion

In those who decide to undergo UTEG, it is a safe and well‐tolerated procedure
Trends in the incidence of Oral and Pharyngeal Cancer (ICD00‐14) in Guilan, North of Iran
Authors: Rabiei Maryam , Basirat Maryam , Rezvani Seyed Mahmood
Published: October 2015

Aim

This study sought to assess the incidence of oral and pharyngeal cancer based on ICD‐10 in Guilan, Iran, from 2004 to 2009.

Method

This retrospective study assessed data collected from the Iranian cancer registries and publications. The rate, age‐standardized incidence, type, and location of lesions according to ICD‐10 were evaluated. Annual percent changes (APC) were estimated.

Results

A total of 1533 head and neck cancers were recorded. Of them, 290 cases (185 males and 105 females) were identified with oral and pharyngeal carcinoma (ICD00‐14) with a mean age of 58.92 ± 17.94 years. The most common type of cancer was oral squamous cell carcinoma (n = 156). Cancer of the oropharynx (ICD 06) and lips (ICD00) had high incidence. APC was 1.36%. ASR was 3.5 and 2.04 per 100 000 among males and females, respectively. The mean crude rate was 3.69 per 1 000 000.

Conclusion

In contrast to the global cancer statistics (ICD 00‐14), Guilan showed lower incidence of oral and pharyngeal cancer during the understudy years. Oral squamous cell carcinoma was the most common type of cancer in this region.
Evaluation of paper gradient concentration strips for antifungal combination testing of Candida spp.
Authors: Siopi Maria , Siafakas Nikolaos , Zerva Loukia , Meletiadis Joseph
Published: October 2015

In vitro combination testing with broth microdilution chequerboard (CHEQ) method is widely used although it is time‐consuming, cumbersome and difficult to apply in routine setting of clinical microbiology laboratory. A new gradient concentration paper strip method, the Liofilchem® MIC test strips (MTS), provides an alternative easy and fast method enabling the simultaneous diffusion of both drugs in combination. We therefore tested a polyene+azole and an azole+echinocandin combination against 18 Candida isolates with the CHEQ method based on EUCAST guidelines and the MTS method in research and routine settings. Fractional inhibitory concentration (FIC) indices were calculated after 24 and 48 h of incubation based on complete and prominent (FIC‐2) growth inhibition endpoints. Reproducibility and agreement within 1 twofold dilution was assessed. The FICs of the two methods were correlated quantitatively with t‐test and Pearson analysis and qualitatively with Chi‐squared test. The reproducibility of the CHEQ and MTS method was 88–100% and their agreement was 80% with 62–77% of MTS FICs being higher than the corresponding CHEQ FICs. A statistically significant Pearson correlation (r = 0.86, P = 0.0003) and association (χ2 = 17.05, df = 4, P = 0.002) was found between MTS FIC and CHEQ FIC‐2 after 24 h. Categorical agreement was 63% with no very major or major errors. All MTS synergistic interactions were also synergistic with the CHEQ method.
Pediatric deceased donor renal transplantation: An approach to decision making I. Pediatric kidney allocation in the USA: The old and the new
Authors: Chaudhuri Abanti , Gallo Amy , Grimm Paul
Published: October 2015

Renal transplantation is the treatment of choice for children with end‐stage renal disease. More than 50% of children receive a deceased donor renal transplant. Marked disparity between the number of children on the renal transplant wait list and the supply has prompted numerous advances to increase supply as well as maximize the utility of donor organs. Allocation of deceased donor kidneys is based on several criteria. The organ allocation system policy is continually evaluated and changed incrementally to optimize allocation. We, in the United Sates, are in the process of transitioning into a new kidney allocation system to enhance post‐transplant survival benefit, increase utilization of donated kidneys, and increase transplant access for biologically disadvantaged candidates. This review will provide a brief overview of the organ sharing system in the United States, compare the “old” and the “new” allocation system, and discuss the considerations for the pediatric nephrologist while accepting a deceased donor kidney for a particular pediatric patient.
Does Elicitation Method Matter? Behavioral and Neuroimaging Evidence from Capacity Allocation Game
Authors: Zhao Yukun , Zhao Xiaobo , Wang Lihong , Chen Yefen , Zhang Xinmeng
Published: October 2015

To date, it has not been elucidated whether the strategy method and the direct‐response method lead to different behaviors in experiments of economic games. In this study, we investigate this issue under a multi‐round setting of the capacity allocation game with both of the elicitation methods. In the first experiment (regular behavioral experiment), subjects are paired to make decisions in a laboratory through a computer network platform. In the second experiment (neuroimaging experiment), the functional magnetic resonance imaging (fMRI) technique is applied to observe similarities and differences in brain activities between the two elicitation methods. The results show that no significant difference is observed in the ordering behaviors between the two methods. Meanwhile, the neuroimaging data reveal that the strategy method induces comparable activations in similar brain regions, as does the direct‐response method. Additionally, it is more likely that subjects adjust their decisions during the feedback phase, rather than during the decision phase. Our results indicate that, in multi‐round game experiments without features such as emotion, the effect of the elicitation method is not likely to be exhibited.
Vitamin D and Clinical Outcomes in Dialysis
Authors: Parikh Coral , Gutgarts Victoria , Eisenberg Elliot , Melamed Michal L.
Published: October 2015

Most dialysis patients are vitamin D deficient, including deficiencies in both activated vitamin D (1, 25‐dihydroxyvitamin D) and the less active 25‐hydroxyvitamin D. These and other abnormalities associated with chronic kidney disease (CKD), if they remain untreated, lead to secondary hyperparathyroidism and bone changes, such as osteitis fibrosa cystica. Activated vitamin D has been proven to decrease parathyroid hormone (PTH) levels in dialysis patients and is currently used for this indication. There are multiple other potential “pleotrophic” effects associated with vitamin D therapy. These include associations with lower all‐cause and cardiovascular mortality, lower rates of infections and improved glycemic indexes. Meta‐analyses of multiple observational studies have shown activated vitamin D therapy to be associated with improved survival. Observational data also suggest fewer infections and better glucose control. There have been no randomized clinical trials powered to evaluate mortality or other clinical outcomes. Small trials of nutritional vitamin D (ergocalciferol and cholecalciferol) showed increases in 25‐hydroxyvitamin D levels without hypercalcemia or hyperphosphatemia, even when given in addition to activated vitamin D therapy. While activated vitamin D therapy is associated with improved outcomes, it also leads to higher fibroblast growth factor 23 (FGF‐23) levels, which may be detrimental in dialysis patients. Further research is needed to evaluate whether activated or nutritional vitamin D therapy are beneficial in dialysis patients for outcomes other than secondary hyperparathyroidism.
Grain‐size distributions and coastal morphodynamics along the southern Maryland and Virginia barrier islands
Authors: Fenster Michael S. , Dolan Robert , Smith Jodi Jones
Published: October 2015

This study examined grain‐size distributions to address questions regarding geological and oceanographic controls on island morphodynamics along one of the longest undeveloped, mixed‐energy barrier island systems in the world. In particular, statistical analyses (i.e. analysis of variance, Tukey honest significant difference multiple comparison tests, nonparametric statistics and linear regression analysis) of 230 barrier island samples from Ocean City Inlet, Maryland, to the mouth of the Chesapeake Bay and 134 nearshore samples (d ≤ 10 m) identified grain‐size trends related to the morphodynamic characteristics of these systems. In general, the Virginia barrier islands north of Wachapreague Inlet and Assateague Island form a statistically different subset of grain sizes (medium‐grained to coarse‐grained sand) from the islands south of Wachapreague Inlet (fine‐grained sand). These textural trends corroborate the Pleistocene headlands of the Delmarva coastal compartment as the sediment source and indicate that some of the coarse‐grained to medium‐grained sediment bypasses the large sinks in the net southward longshore sediment transport system (i.e. Fishing Point and Chincoteague Inlet). This research also demonstrates that the preferential accumulation of coarse‐grained to medium‐grained sand on the ebb‐tidal delta at Wachapreague Inlet probably controls the erosional morphodynamics of the islands located downdrift (south) of the inlet. These results suggest that an increase in tidal prism, set up by sea‐level rise and/or a shift in wave climate/refraction patterns, may lead to barrier island fragmentation and a runaway transgression of this predominantly natural barrier island system. Consequently, a grain analysis of major coastal compartments, across multiple driving forces, can be used to assess coastal morphodynamics and the potential impact of climate change on coastal systems.
Perinatal outcomes after hypertensive disorders in pregnancy in a low resource setting
Authors: Browne J. L. , Vissers K. M. , Antwi E. , Srofenyoh E. K. , Van der Linden E. L. , Agyepong I. A. , Grobbee D. E. , Klipstein‐Grobusch K.
Published: October 2015

Objective

The objective of this study was to evaluate perinatal outcomes of pregnancies complicated by hypertensive disorders in pregnancy in an urban sub‐Saharan African setting.

Methods

A prospective cohort study of 1010 women of less than 17 weeks of gestation was conducted at two antenatal clinics in Accra, Ghana, between July 2012 and March 2014. Information about hypertensive disorders was available for analysis on 789 pregnancies. The main outcomes were pre‐term birth, birthweight, Apgar scores, small for gestational age and mortality. Relative risk (RR, 95% confidence interval (CI)) for the association between hypertensive disorders of pregnancy and perinatal outcomes was assessed using logistic regression adjusting for potential confounders.

Results

A total of 88.7% of women remained normotensive, 7.5% developed pregnancy‐induced hypertension, 2.0% had chronic hypertension, and 1.7% developed (pre‐)eclampsia. No adverse effects were observed in women with pregnancy‐induced hypertension. Women with chronic hypertension were more likely to have a lower gestational age at delivery (38.0 ± 2.3 weeks vs. 39.0 ± 1.9 weeks, P = 0.04) and higher risk of pre‐term delivery (aRR 4.63, 95% CI 1.35–15.91). Women with pre‐eclampsia had emergency Caesarean section significantly more often (88.9% vs. 50%, P = 0.04), with a higher risk for low birthweight infants (aRR 7.95, 95% CI 1.41–44.80) and a higher risk of neonatal death (aRR 18.41, 95% CI 1.20–283.22).

Conclusion

Comparable to high‐income countries, in Accra hypertensive disorders during pregnancy were associated with increased risk of adverse perinatal outcomes necessitating maternal and newborn care.
Risk of gentamicin toxicity in neonates treated for possible severe bacterial infection in low‐ and middle‐income countries: Systematic Review
Authors: Musiime Grace M. , Seale Anna C. , Moxon Sarah G. , Lawn Joy E.
Published: October 2015

Objectives

To assess the risk of gentamicin toxicity and potential number of neonates exposed annually to this risk, through treatment with WHO‐recommended first‐line antibiotics (gentamicin with penicillin) for the 6.9 million neonates with possible serious bacterial infection (PSBI).

Methods

Systematic literature review and assessment of the evidence using Cochrane and GRADE criteria. Meta‐analysis was undertaken for pooled estimates where appropriate.

Results

Eleven studies (946 neonates) were included (nine randomised controlled trials and two prospective cohort studies). Six trials reported consistently measured ototoxicity outcomes in neonates treated with gentamicin, and the pooled estimate for hearing loss was 3% (95% CI 0–7%). Nephrotoxicity could not be assessed due to variation in case definitions used. Estimates of the number of neonates potentially affected by gentamicin toxicity were not undertaken due to insufficient data.

Conclusion

Given wider scale‐up of outpatient‐based and lower‐level treatment of PSBI, improved data are essential to better assess the risks from neonatal gentamicin treatment without assessment of blood levels, to maximise benefit and reduce harm.
Protecting patients with cardiovascular diseases from catastrophic health expenditure and impoverishment by health finance reform
Authors: Sun Jing , Liabsuetrakul Tippawan , Fan Yancun , McNeil Edward
Published: October 2015

Objectives

To compare the incidences of catastrophic health expenditure (CHE) and impoverishment, the risk protection offered by two health financial reforms and to explore factors associated with CHE and impoverishment among patients with cardiovascular diseases (CVDs) in rural Inner Mongolia, China.

Methods

Cross‐sectional study conducted in 2014 in rural Inner Mongolia, China. Patients with CVDs aged over 18 years residing in the sample areas for at least one year were eligible. The definitions of CHE and impoverishment recommended by WHO were adopted. The protection of CHE and impoverishment was compared between the New Cooperative Medical Scheme (NCMS) alone and NCMS plus National Essential Medicines Scheme (NEMS) using the percentage change of incidences for CHE and impoverishment. Logistic regression was used to explore factors associated with CHE and impoverishment.

Results

The incidences of CHE and impoverishment under NCMS plus NEMS were 11.26% and 3.30%, respectively, which were lower than those under NCMS alone. The rates of protection were higher among households with patients with CVDs covered by NCMS plus NEMS (25.68% and 34.65%, respectively). NCMS plus NEMS could protect the poor households more from CHE but not impoverishment. NCMS plus NEMS protected more than one‐fourth of households from CHE and more than one‐third from impoverishment.

Conclusion

NCMS plus NEMS was more effective at protecting households with patients with CVDs from CHE and impoverishment than NCMS alone. An integration of NCMS with NEMS should be expanded. However, further strategies to minimise catastrophic health expenditure after this health finance reform are still needed.
Dengue in the State of Rio Grande do Norte, Brazil, 2010–2012
Authors: Branco Mário S. D. , Sousa Denise M. C. , Sousa Daíse M. C. , Monteiro Joelma D. , Costa Diego M. P. , Almeida Junior Renato F. , Lima Tábata L. C. , Farias Kleber J. S. , Medeiros Ralfo C. , Queiroz Maria Goretti L. , Gil Laura H. V. G. , Fernandes José V. , Nogueira Rita M. R. , Araújo Josélio M. G.
Published: October 2015

Objective

To present results of virological surveillance and epidemiological aspects of dengue in the State of Rio Grande do Norte, Brazil.

Methods

A total of 1581 cases, reported from 2010 to 2012 at various health centres in the state, were analysed by viral isolation and/or RT‐PCR for viral detection and typing. To identify whether different genotypes were circulating in the state during this period, sequencing of the complete E gene for DENV (1485 bp in length) was performed directly from patient serum samples.

Results

All four serotypes of dengue virus circulated in Rio Grande do Norte, with the introduction of DENV‐4 in the state in 2011. In 2012, DENV‐4 represented 100% of positive confirmed cases. 53.97% of cases occurred in Natal. Case numbers peaked in April (21%) and May (23%). Genetic characterisation of circulating strains confirmed the circulation of genotypes V, south‐east Asian/American and II, respectively, for DENV‐1, DENV‐2 and DENV‐4.

Conclusions

This work furthers a better understanding of dengue viruses in the State of Rio Grande do Norte. Strengthening control efforts in the region is important considering the impact of dengue.
Tuberculin reaction and BCG scar: association with infant mortality
Authors: Timmermann Clara Amalie Gade , Biering‐Sørensen Sofie , Aaby Peter , Fisker Ane Bærent , Monteiro Ivan , Rodrigues Amabelia , Benn Christine Stabell , Ravn Henrik
Published: October 2015

Objective

To test the hypothesis that having a scar and a positive tuberculin skin test (TST) response after vaccination with Bacille Calmette–Guérin (BCG) is associated with reduced infant mortality.

Methods

We studied cohorts of 2709 normal‐birthweight (NBW) and 1102 low‐birthweight (LBW) infants in Guinea‐Bissau. Children were enrolled in randomised trials between year 2002 and 2008 and received BCG vaccination at birth. BCG scars and TST responses were assessed at 2 and 6 months of age. The infants were followed for mortality to 12 months of age, and survival was analysed using Cox regression.

Results

At age 2 months, 88% of NBW children and 91% of LBW children had a BCG scar, and 36% and 17% had a TST response, respectively. The LBW infants had nearly twofold higher mortality (4.5%) than the NBW infants (2.8%) between 2 and 12 months of age. In the LBW cohort, the adjusted mortality rate ratio (MRR) comparing children with a BCG scar with those without was 0.42 (95% CI = 0.19; 0.93). There was a similar tendency for TST positivity: MRR = 0.47 (95% CI = 0.14; 1.54). For LBW children who had both a positive TST reaction and a scar, the MRR was 0.22 (95% CI = 0.05; 0.87). For NBW children, a scar and a positive TST were associated with 20% reductions in mortality, which did not reach statistical significance.

Conclusion

We confirmed previous observations that having a scar and a TST response after BCG vaccination is associated with lower mortality risk. The possibility of revaccinating scar‐negative children should be considered.