bluuebunny/crossref_metadata_2025 huggingface dataset:
Emergence of HPV16-Positive Oropharyngeal Cancer in Black Patients Over Time: University of Maryland 1992–2007
Authors: Zandberg Dan P. , Liu Sandy , Goloubeva Olga G. , Schumaker Lisa M. , Cullen Kevin J.
Published: June 2014

While we previously reported a striking racial difference in the prevalence of human papilloma virus (HPV)–positive squamous cell carcinoma of the oropharynx (OPSCC), less is known about differences in outcomes and trends over time in OPSCC by HPV status and race. We conducted a retrospective analysis of 467 patients with OPSCC treated at the University of Maryland Greenebaum Cancer Center (Baltimore, MD) between 1992 and 2007, of which 200 had tissue available for HPV16 testing. HPV16-positive patients were significantly more likely to be white, with 45.5% of whites and 15.5% of blacks testing positive for HPV16. There was a significant increase in HPV16-positive OPSCC for all patients over time from 15.6% in 1992 to 1995 to 43.3% in 2004 to 2007 (P = 0.01). From 1992 to 1995, 33% of white patients were HPV16-positive, with no black patients positive. From 2004 to 2007, 17.7% of black patients and 54% of white patients were HPV16-positive. White and black patients with HPV16-positive tumors had an identical and favorable overall survival (OS; median, 8.1 and 8.1 years, respectively). However, among HPV16-negative patients, whites had an improved OS compared with blacks (median, 2.3 vs. 0.9 years, respectively; P = 0.02), including when analyzed in a multivariable Cox regression model. From 1992 to 2007, the percentage of HPV16-positive OPSCC increased for white patients and was seen for the first time in black patients. While survival for HPV-positive black and white patients was similar and favorable, outcomes for HPV-negative patients were poor, with blacks having worse survival even after controlling for baseline characteristics.Cancer Prev Res; 8(1); 12–19. ©2014 AACR.

See related article by E. Cohen and C. Fakhry, p. 9
The BEHAVE-AD Assessment System: A Perspective, A Commentary on New Findings, and A Historical Review
Authors: Reisberg Barry , Monteiro Isabel , Torossian Carol , Auer Stefanie , Shulman Melanie B. , Ghimire Santosh , Boksay Istvan , Guillo BenArous Francoise , Osorio Ricardo , Vengassery Aninditha , Imran Sheema , Shaker Hussam , Noor Sadaf , Naqvi Shazia , Kenowsky Sunnie , Xu Jinfeng
Published: June 2014

Background: Behavioral and psychological symptoms of dementia (BPSD) and associated disturbances in Alzheimer's disease (AD) are a source of distress and burden for spouses, professional caregivers, and others with responsibilities for the care of individuals with AD. BPSD with behavioral disturbances are also associated with more rapid institutionalization and increased morbidity and mortality for persons with AD. Objectives: In this review and commentary, we discuss the history of the development of BPSD and behavioral disturbance assessments, which are distinct from those evaluating cognitive and functional symptoms of AD. In particular, we review the informant-based Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), the related, potentially more sensitive, BEHAVE-AD Frequency-Weighted Severity Scale (BEHAVE-AD-FW), and the direct subject evaluation-based Empirical BEHAVE-AD Rating Scale (E-BEHAVE-AD). The kinds of medications that alleviate behavioral symptoms on these measures as well as the problems and possibilities for further advances with these medications are discussed. Finally, the importance of distinguishing BPSD and behavioral disturbance remediation in AD from the treatment of cognitive decline and other aspects of AD is emphasized in the context of appropriate assessment methodology. The objective of this paper is to provide a framework for further advances in the treatment of BPSD and associated behavioral disturbances in AD and, consequently, a framework for continuing improvements in the lives of individuals with AD and those who share the burden of the disease with the AD person.
Tau-Based Therapeutic Approaches for Alzheimer's Disease - A Mini-Review
Authors: Boutajangout Allal , Wisniewski Thomas
Published: June 2014

The accumulation of aggregated, hyperphosphorylated tau as neurofibrillary tangles and neuropil threads are cardinal features of Alzheimer's disease (AD). The other lesions found in AD include amyloid plaques and congophilic amyloid angiopathy, both associated with the extracellular accumulation of the amyloid-beta (Aβ) peptide. AD is the most common cause of dementia globally. Currently, there are no effective means to treat AD or even to slow it down. The dominant theory for the causation of AD is the amyloid cascade hypothesis, which suggests that the aggregation of Aβ as oligomers and amyloid plaques is central to the pathogenesis of AD. Numerous therapies have been developed directed to Aβ-related pathology, in particular various immunotherapeutic approaches. So far all of these have failed in clinical trials. Recently, there has been more focus on therapy directed to tau-related pathology, which correlates better with the cognitive status of patients, compared to the amyloid burden. Immunotherapeutic targeting of tau pathology has shown great potential in treating tau pathologies in mouse models of AD. A number of studies have shown the efficacy of both passive and active immunization. This review summarizes recent advances in therapy targeting pathological tau protein, in particular focusing on immunotherapeutic approaches which are showing great promise.
Accuracy of the Spot Sign on Computed Tomography Angiography as a Predictor of Haematoma Enlargement after Acute Spontaneous Intracerebral Haemorrhage: A Systematic Review
Authors: Del Giudice Angela , D'Amico Delia , Sobesky Jan , Wellwood Ian
Published: June 2014

Background: A common early complication of intracerebral haemorrhage (ICH) is haematoma enlargement (HE), a strong independent predictor of a poor outcome. Therapeutic options to limit haematoma progression are currently scarce. Haemostatic therapy may be effective in patients with ICH, but it carries the risk of thromboembolic events in unselected patients. Accurate patient selection would, therefore, be of key importance for delivering potentially successful therapeutic strategies. Currently, there is no gold standard to accurately predict HE. The presence of contrast extravasation within the haematoma on computed tomography angiography (CTA), the ‘spot sign', has been reported in several studies and seems a particularly promising marker but lacks a standardised evaluation so far. Summary: We conducted a systematic review of published data to address the research question: In adults with acute spontaneous ICH, how accurately does the spot sign predict HE on follow-up imaging and thus poor functional outcome or mortality? We searched PubMed and Embase databases (from 1980 to May 2012), using a highly sensitive search strategy and including all studies involving adult patients with spontaneous ICH evaluated with CTA and follow-up CT scans, reporting any measure of clinical outcome, and reporting or allowing calculation of accuracy measures of the spot sign in predicting HE and clinical outcome. Baseline characteristics, accuracy measures and effect measures, as well as bias assessment, were reported according to PRISMA recommendations. The quality of the studies was appraised using an adapted version of the REMARK reporting recommendations. From 259 potentially relevant studies, we finally selected 6 studies (1 of them was a multicentre cohort study) covering a total of 709 patients. Studies varied substantially in terms of size, methodological quality, definitions of terms, outcomes selected and results. In particular, definition of the spot sign was not consistent in all studies. Furthermore, the only outcome measure consistently available was HE, while definitions and analyses of clinical outcomes seemed not adequate. Lastly, the choice of candidate variables for univariate and multivariate analyses did not include all determinants of HE and poor functional outcome. High heterogeneity was demonstrated (I2: 94% for HE) with substantial potential of bias. Key Messages: Studies of the spot sign are diverse and therefore complex to interpret. Our research question could not be answered due to heterogeneity and potential of bias in the selected studies. Further appropriately powered studies using standardised definitions and taking all predictors of HE and poor clinical outcome into account are required for a proper clinical implementation.
Advantages and Challenges of Small Animal Magnetic Resonance Imaging as a Translational Tool
Authors: Hoyer Carolin , Gass Natalia , Weber-Fahr Wolfgang , Sartorius Alexander
Published: June 2014

The utilization of magnetic resonance imaging (MRI) methods in rodent models of psychiatric disorders provides considerable benefits for the identification of disease-associated brain circuits and metabolic changes. In this review, we discuss advantages and challenges of animal MRI and provide an overview of the major structural (voxel-based morphometry and diffusion tensor imaging) and functional approaches [resting-state functional MRI (rs-fMRI), MR spectroscopy (MRS), regional cerebral blood volume measurement and arterial spin labelling] that are applied in animal MRI research. The review mainly focuses on rs-fMRI and MRS. Finally, we take a look at some recent developments and refinements in the field.
Arterial Stiffness: A Nexus between Cardiac and Renal Disease
Authors: Jia Guanghong , Aroor Annayya R. , Sowers James R.
Published: June 2014

Vascular disease is the leading cause of morbidity and mortality in the Western world, and vascular function is determined by structural and functional properties of the arterial vascular wall. Cardiorenal metabolic syndrome such as obesity, diabetes, hypertension, kidney disease, and aging are conditions that predispose to arterial stiffening, which is a pathological alteration of the vascular wall and ultimately results in target organ damage in heart and kidney. In this review, we provide new insights on the interactions between arterial stiffness, vascular resistance and pulse wave velocity as well as final end-organ damage in heart and kidney. Better understanding of the mechanisms of arterial functional and hemodynamic alteration may help in developing more refined therapeutic strategies aimed to reduce cardiovascular and chronic kidney diseases.
Hematological Toxicity of Combined 177Lu-Octreotate Radiopeptide Chemotherapy of Gastroenteropancreatic Neuroendocrine Tumors in Long-Term Follow-Up
Authors: Kesavan Murali , Claringbold Phillip G. , Turner J. Harvey
Published: June 2014

Background: The combination of radiopeptide therapy [peptide receptor radionuclide therapy (PRRT)] with radiosensitizing chemotherapy of gastroenteropancreatic neuroendocrine tumors (GEP NETs) may improve efficacy, but has the potential to increase myelotoxicity. In a prospective clinical study of GEP NET patients treated with 177Lu-octreotate PRRT in combination with capecitabine and temozolomide, as a prelude to a planned Australasian Gastro-Intestinal Trials Group (AGITG) international randomized controlled trial, we characterized the incidence and degree of hematological toxicity. Materials and Methods: Well-differentiated progressive metastatic GEP NETs in 65 patients were treated with 4 cycles of 7.8 GBq 177Lu-octreotate, 1,650 mg/m2 capecitabine (n = 28) and 1,500 mg/m2 capecitabine with 200 mg/m2 temozolomide (n = 37), and monitored for hematological toxicity over a 5-year period. Results: Short-term, self-limited hematological toxicity grade 3/4 comprised anemia in 1 patient (3.5%) in the 28 patient-cohort of patients treated with 177Lu-octreotate and capecitabine. One of these patients (3.5%) later developed significant anemia and one developed thrombocytopenia (3.5%) over a median follow-up of 60 months (SD 20). The incidence of short-term grade 3/4 reversible myelosuppression in 37 patients after 177Lu-octreotate/capecitabine/temozolomide was zero. Long- term follow-up for a median of 36 months (SD 11) showed significant thrombocytopenia in 2.7% and neutropenia in 2.7% of the patients and anemia in 10.8% of the patients (n = 4). The 3-year median hemoglobin and platelet and neutrophil counts trended downwards, but remained within normal ranges. Two patients in this cohort developed myelodysplastic syndrome. Conclusion: The modest reversible hematological toxicity of PRRT of GEP NETs is not significantly increased by the addition of radiosensitizing chemotherapy with capecitabine and temozolomide in combination with 177Lu-octreotate, which has the potential to enhance the efficacy of radiopeptide therapy.
Consensus on the Prevention, Screening, Early Diagnosis and Treatment of Colorectal Tumors in China: Chinese Society of Gastroenterology, October 14-15, 2011, Shanghai, China
Authors: Fang Jing-Yuan , Zheng Shu , Jiang Bo , Lai Mao-De , Fang Dian-Chun , Han Ying , Sheng Qian-Jiu , Li Jing-Nan , Chen Ying-Xuan , Gao Qin-Yan
Published: June 2014

Background: Colorectal cancer (CRC) is steadily increasing in China. Colorectal adenoma (CRA) is the most important precancerous disease of CRC. Screening for colorectal tumors can aid early diagnosis. Advances in endoscopic mucosal resection and endoscopic submucosal dissection can aid the early treatment of colorectal tumors. Furthermore, because of high risk of recurrence after removal of adenomas under endoscopy, factors contributing to recurrence, the follow-up mode and the interval established, and the feasibility of application and the time of various chemical preventions should be concerned. However, a relevant consensus on the screening, early diagnosis and treatment, and prevention of colorectal tumors in China is lacking. Summary: The consensus recommendations include epidemiology, pathology, screening, early diagnosis, endoscopic treatment, monitoring and follow-up, and chemoprevention of colorectal tumors in China. Key Message: This is the first consensus on the prevention, screening, early diagnosis and treatment of CRA and CRC in China based on evidence in the literature and on local data. Practical Implications: Through reviewing the literature, regional data and passing the consensus by an anonymous vote, gastroenterology experts from all over China launch the consensus recommendations in Shanghai. The incidence and mortality of CRC in China has increased, and the incidence or detection rate of CRA has increased rapidly. Screening for colorectal tumors should be performed at age 50-74 years. Preliminary screening should be undertaken to find persons at high risk, followed by colonoscopy. A screening cycle of 3 years is recommended for persistent interventions. Opportunistic screening is a mode suitable for the current healthcare system and national situation. Colonoscopy combined with pathological examination is the standard method for the diagnosis of colorectal tumors. CRA removal under endoscopy can prevent CRC to some extent, but CRA has an obvious recurrence trend. The follow-up interval after the removal or surgery of colorectal tumors should be different with lesions. Primary prevention of CRA includes improved diet with more fiber, supplements containing calcium and vitamin D, supplements containing folic acid for those with low hemoglobin levels, and cessation of tobacco smoking. Non-steroidal anti-inflammatory drugs and selective cyclooxygenase-2 inhibitors have been recognized to prevent recurrence after adenoma removal.
46,XY Disorder of Sex Development in a Sudanese Patient Caused by a Novel Mutation in the HSD17B3 Gene
Authors: Ellaithi Mona , Werner Ralf , Riepe Felix G. , Krone Nils , Kulle Alexandra E. , Diab Tayseer , Kamel Alaa K. , Arlt Wiebke , Holterhus Paul-Martin , Sabir Omyma , Hiort Olaf
Published: June 2014

In this study, we present a Sudanese 46,XY patient raised as a female and diagnosed at the age of 20 years with having 17β-hydroxysteroid dehydrogenase type 3 (17β-HSD3) deficiency. She presented with primary amenorrhea, undeveloped breasts and a male pattern of secondary sexual characteristics. Examination of her external genitalia showed type IV genital circumcision. Steroid measurements both in urine and serum pointed to 17β-HSD3 deficiency. A novel homozygous splice-site mutation [c.524 + 2T>A] was detected in intron 7 of the HSD17B3 gene. In this patient, steroid concentration clearly supported both the clinical diagnosis of 17β-HSD3 deficiency and the functional relevance of the mutation. Interestingly, despite of the type IV genital circumcision, the patient expressed her interest in reassigning her sex from female to male.
Intrauterine Exposure to Cigarette Smoke Is Associated with Increased Ghrelin Concentrations in Adulthood
Authors: Paslakis Georgios , Buchmann Arlette F. , Westphal Sabine , Banaschewski Tobias , Hohm Erika , Zimmermann Ulrich S. , Laucht Manfred , Deuschle Michael
Published: June 2014

Background: The appetite-stimulating hormone ghrelin is a fundamental regulator of human energy metabolism. A series of studies support the notion that long-term appetite and weight regulation may be already programmed in early life and it could be demonstrated that the intrauterine environment affects the ghrelin system of the offspring. Animal studies have also shown that intrauterine programming of orexigenic systems persists even until adolescence/adulthood. Methods: We hypothesized that plasma ghrelin concentrations in adulthood may be associated with the intrauterine exposure to cigarette smoke. We examined this hypothesis in a sample of 19-year-olds followed up since birth in the framework of the Mannheim Study of Children at Risk, an ongoing epidemiological cohort study of the long-term outcome of early risk factors. Results: As a main finding, we found that ghrelin plasma concentrations in young adults who had been exposed to cigarette smoke in utero were significantly higher than in those without prenatal smoke exposure. Moreover, individuals with intrauterine nicotine exposure showed a significantly higher prevalence of own smoking habits and lower educational status compared to those in the group without exposure. Conclusion: Smoking during pregnancy may be considered as an adverse intrauterine influence that may alter the endocrine-metabolic status of the offspring even until early adulthood.
Similar Psychopathological Profiles in Female and Male Cushing's Disease Patients after Treatment but Differences in the Pathogenesis of Symptoms
Authors: Milian Monika , Honegger Juergen , Gerlach Christine , Hemeling Xenia , Psaras Tsambika
Published: June 2014

Background: Female Cushing's disease (CD) patients with active disease present more frequently with depression compared to their male co-sufferers. This study investigated whether the gender difference prevails after remission and whether gender-specific factors contributing to mental health exist. Methods: 72 biochemically cured CD patients (11 male, mean age 45.9 ± 13.7 years) who underwent transsphenoidal tumour removal filled out the Symptom Checklist-90-Revised inventory on average 42.1 ± 32.9 months after surgery. Multiple regression analyses included the following independent factors: (i) age, (ii) presence of comorbidities, (iii) presence of hypocortisolism, (iv) presence of hypopituitarism, (v) disease duration until diagnosis, (vi) time elapsed since surgery, and (vii) postoperative radiotherapy to predict postoperative psychopathology. Results: Regarding the Global Severity Index, 23.0% of the female and 27.3% of the male CD patients presented with abnormal scores. In all nine dimensions, psychopathological abnormalities were present in both female and male patients with the same frequency and intensity (each p > 0.05). Prolonged time to diagnosis was a strong predictive factor for worse psychopathological status only in male patients. Among female patients, only the presence of comorbidities and to some extent pituitary deficiencies were related to psychopathological status. Conclusions: During the remission phase of CD, female and male patients present with similar psychopathological profiles. In males, long-term biochemical effects of previous hypercortisolism seem to be salient for psychopathology. In contrast, in females, the presence of comorbidities/stressors they have to cope with is the predictive factor for psychopathology. The results underline gender differences in CD and the need to separate them on various issues.
Acute Effects of 3,4-Methylenedioxymethamphetamine and Methylphenidate on Circulating Steroid Levels in Healthy Subjects
Authors: Seibert Julia , Hysek Cédric M. , Penno Carlos A. , Schmid Yasmin , Kratschmar Denise V. , Liechti Matthias E. , Odermatt Alex
Published: June 2014

3,4-Methylenedioxymethamphetamine (MDMA, ‘ecstasy') and methylphenidate are widely used psychoactive substances. MDMA primarily enhances serotonergic neurotransmission, and methylphenidate increases dopamine but has no serotonergic effects. Both drugs also increase norepinephrine, resulting in sympathomimetic properties. Here we studied the effects of MDMA and methylphenidate on 24-hour plasma steroid profiles. 16 healthy subjects (8 men, 8 women) were treated with single doses of MDMA (125 mg), methylphenidate (60 mg), MDMA + methylphenidate, and placebo on 4 separate days using a cross-over study design. Cortisol, cortisone, corticosterone, 11-dehydrocorticosterone, aldosterone, 11-deoxycorticosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androstenedione, and testosterone were repeatedly measured up to 24 h using liquid chromatography-tandem mass spectroscopy. MDMA significantly increased the plasma concentrations of cortisol, corticosterone, 11-dehydrocorticosterone, and 11-deoxycorticosterone and also tended to moderately increase aldosterone levels compared with placebo. MDMA also increased the sum of cortisol + cortisone and the cortisol/cortisone ratio, consistent with an increase in glucocorticoid production. MDMA did not alter the levels of cortisone, DHEA, DHEAS, androstenedione, or testosterone. Methylphenidate did not affect any of the steroid concentrations, and it did not change the effects of MDMA on circulating steroids. In summary, the serotonin releaser MDMA has acute effects on circulating steroids. These effects are not observed after stimulation of the dopamine and norepinephrine systems with methylphenidate. The present findings support the view that serotonin rather than dopamine and norepinephrine mediates the acute pharmacologically induced stimulation of the hypothalamic-pituitary-adrenal axis in the absence of other stressors.
A morte do autor: um retorno à cena do crime
Authors: Bellei Sérgio Luiz Prado
Published: June 2014

O questionamento radical do sujeito cartesiano promovido pela crítica pós-estruturalista a partir da década de sessenta do século passado abriu caminho para a reformulação do conceito de “autor”.  Entendido anteriormente como marcado pela imaginação criadora capaz de dar origem a grandes obras literárias, percebidas como expressões universais e supremas do espírito humano, começa o autor a perder a sua força cultural à medida que as novas teorias declaram a sua morte ou restringem a sua atividade anteriormente sacralizada a uma “função autoral” que tem por objetivo a prática repressora da disseminação incontrolável de sentido. O presente ensaio pretende revisitar o momento iconoclasta da morte do autor, com o objetivo de avaliar  possíveis contribuições para o pensamento de uma ética da leitura no momento contemporâneo.
Da morte ou o entrar na escritura: enunciação em Barthes e Benveniste
Authors: Bellocchio Carolina Molinar
Published: June 2014

Este artigo objetiva tecer uma relação entre o questionamento da autoria barthesiano e a manipulação da noção de enunciação de Émile Benveniste. Considera-se que exista um eco entre ambas as noções e que Barthes se valeu da destruição linguística do sujeito para repensar a figura do autor na escritura.
Everolimus-Eluting Stents Improve Vascular Response in a Diabetic Animal Model
Authors: Habib Anwer , Karmali Vinit , John Michael C. , Polavarapu Rohini , Nakazawa Gaku , Pachura Kim , Davis Talina , Kolodgie Frank D. , Virmani Renu , Finn Aloke V.
Published: June 2014

Background—

Preclinical evaluation of the vascular response of drug-eluting stents is limited especially in the setting of diabetes mellitus preventing the evaluation of changes in drug-eluting stent design and eluted drugs after clinical use.

Methods and Results—

Cultured human aortic endothelial cells were used to assess the differences between sirolimus and its analog, everolimus, in the setting of hyperglycemia on various cellular functions necessary for endothelial recovery. A diabetic rabbit model of iliac artery stenting was used to compare histological and morphometric characteristics of the vascular response to everolimus-eluting, sirolimus-eluting, and bare metal stent placement. Under hyperglycemic conditions, sirolimus impaired human aortic endothelial cell barrier function, migration, and proliferation to a greater degree compared with everolimus. In our in vivo model of diabetes mellitus, endothelialization at 28 days was significantly lower and endothelial integrity was impaired in sirolimus-eluting stent compared with both everolimus-eluting and bare metal stents. Neointimal area, uncovered struts, and fibrin deposition were significantly higher in sirolimus-eluting compared with everolimus-eluting and bare metal stents.

Conclusions—

Use of everolimus-eluting stent results in improved vascular response in our preclinical models of diabetes mellitus.
Permanent Alteration of PCSK9 With In Vivo CRISPR-Cas9 Genome Editing
Authors: Ding Qiurong , Strong Alanna , Patel Kevin M. , Ng Sze-Ling , Gosis Bridget S. , Regan Stephanie N. , Cowan Chad A. , Rader Daniel J. , Musunuru Kiran
Published: June 2014

Rationale
:

Individuals with naturally occurring loss-of-function proprotein convertase subtilisin/kexin type 9 (
PCSK9
) mutations experience reduced low-density lipoprotein cholesterol levels and protection against cardiovascular disease.

Objective
:

The goal of this study was to assess whether genome editing using a clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated system can efficiently introduce loss-of-function mutations into the endogenous
PCSK9
gene in vivo.

Methods and Results
:

We used adenovirus to express CRISPR-associated 9 and a CRISPR guide RNA targeting
Pcsk9
in mouse liver, where the gene is specifically expressed. We found that <3 to 4 days of administration of the virus, the mutagenesis rate of
Pcsk9
in the liver was as high as >50%. This resulted in decreased plasma PCSK9 levels, increased hepatic low-density lipoprotein receptor levels, and decreased plasma cholesterol levels (by 35–40%). No off-target mutagenesis was detected in 10 selected sites.

Conclusions
:

Genome editing with the CRISPR–CRISPR-associated 9 system disrupts the
Pcsk9
gene in vivo with high efficiency and reduces blood cholesterol levels in mice. This approach may have therapeutic potential for the prevention of cardiovascular disease in humans.
Emergence of the Primary Pediatric Stroke Center
Authors: Bernard Timothy J. , Rivkin Michael J. , Scholz Kelley , deVeber Gabrielle , Kirton Adam , Gill Joan Cox , Chan Anthony K. , Hovinga Collin A. , Ichord Rebecca N. , Grotta James C. , Jordan Lori C. , Benedict Susan , Friedman Neil R. , Dowling Michael M. , Elbers Jorina , Torres Marcela , Sultan Sally , Cummings Dana D. , Grabowski Eric F. , McMillan Hugh J. , Beslow Lauren A. , Amlie-Lefond Catherine
Published: June 2014

Background and Purpose—

In adult stroke, the advent of thrombolytic therapy led to the development of primary stroke centers capable to diagnose and treat patients with acute stroke rapidly. We describe the development of primary pediatric stroke centers through preparation of participating centers in the Thrombolysis in Pediatric Stroke (TIPS) trial.

Methods—

We collected data from the 17 enrolling TIPS centers regarding the process of becoming an acute pediatric stroke center with capability to diagnose, evaluate, and treat pediatric stroke rapidly, including use of thrombolytic therapy.

Results—

Before 2004, <25% of TIPS sites had continuous 24-hour availability of acute stroke teams, MRI capability, or stroke order sets, despite significant pediatric stroke expertise. After TIPS preparation, >80% of sites now have these systems in place, and all sites reported increased readiness to treat a child with acute stroke. Use of a 1- to 10-Likert scale on which 10 represented complete readiness, median center readiness increased from 6.2 before site preparation to 8.7 at the time of site activation (
P
≤0.001).

Conclusions—

Before preparing for TIPS, centers interested in pediatric stroke had not developed systematic strategies to diagnose and treat acute pediatric stroke. TIPS trial preparation has resulted in establishment of pediatric acute stroke centers with clinical and system preparedness for evaluation and care of children with acute stroke, including use of a standardized protocol for evaluation and treatment of acute arterial stroke in children that includes use of intravenous tissue-type plasminogen activator.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01591096.
Length of Occlusion Predicts Recanalization and Outcome After Intravenous Thrombolysis in Middle Cerebral Artery Stroke
Authors: Rohan Vladimir , Baxa Jan , Tupy Radek , Cerna Lenka , Sevcik Petr , Friesl Michal , Polivka Jiri , Polivka Jiri , Ferda Jiri
Published: June 2014

Background and Purpose—

The length of large vessel occlusion is considered a major factor for therapy in patients with ischemic stroke. We used 4D-CT angiography evaluation of middle cerebral artery occlusion in prediction of recanalization and favorable clinical outcome and after intravenous thrombolysis (IV-tPA).

Methods—

In 80 patients treated with IV-tPA for acute complete middle cerebral artery/M1 occlusion determined using CT angiography and temporal maximum intensity projection, calculated from 4D-CT angiography, the length of middle cerebral artery proximal stump, occlusion in M1 or M1 and M2 segment were measured. Univariate and multivariate analyses were performed to define independent predictors of successful recanalization after 24 hours and favorable outcome after 3 months.

Results—

The length of occlusion was measureable in all patients using temporal maximum intensity projection. Recanalization thrombolysis in myocardial infarction 2 to 3 was achieved in 37 individuals (46%). The extension to M2 segment as a category (odds ratio, 4.58; 95% confidence interval, 1.39–15.05;
P
=0.012) and the length of M1 segment occlusion (odds ratio, 0.82; 95% confidence interval, 0.73–0.92;
P
=0.0007) with an optimal cutoff value of 12 mm (sensitivity 0.67; specificity 0.71) were significant independent predictors of recanalization. Favorable outcome (modified Rankin scale 0–2) was achieved in 25 patients (31%), baseline National Institutes of Health Stroke Scale (odds ratio, 0.82; 95% confidence interval, 0.72–0.93;
P
=0.003) and the length of occlusion M1 in segment (odds ratio, 0.79; 95% confidence interval, 0.69–0.91;
P
=0.0008) with an optimal cutoff value of 11 mm (sensitivity 0.74; specificity 0.76) were significant independent predictors of favorable outcome.

Conclusions—

The length of middle cerebral artery occlusion is an independent predictor of successful IV-tPA treatment.
Advancing Tacit Knowledge: Malaysian Family SMEs in Manufacturing
Authors: Yew John Lee Kean , Gomez Edmund Terence
Published: June 2014

The family business literature in developing countries suggests that their organizational features inhibit innovations that create niche products. In industrializing Malaysia, where family small- and medium-scale enterprises (SMEs) are undergoing a generational shift, there is little research on their capacity to develop the tacit knowledge of the founding generation. This assessment of 29 thriving family SMEs in plastics and food manufacturing evaluates how a new generation has nurtured innovative management, manufacturing, and marketing techniques. By adopting a business history approach that appraises the development of tacit knowledge, this study validates the need for family SMEs to institute organizational reforms to codify knowledge and therefore ensure long-term sustainability.
Adoption, Adaptive Innovation, and Creative Innovation Among SMEs in Malaysian Manufacturing
Authors: Hosseini Seyed Mehrshad Parvin , Narayanan Suresh
Published: June 2014

We categorized innovating firms in an ascending order as adopters, adapters, and creators to examine factors motivating these activities. For small firms, creation and adaption were significantly correlated with export orientation, engaging in collaborative research and development (R&D), receiving technical support from outside agencies, gaining technology from parent establishments, and supplying parts to multinationals. For medium-sized firms, R&D incentives, collaborative research, and accessing technology from parent plants were significant. Adoption in small firms was associated with export exposure and operating for 11 years or more. R&D incentives, collaborative research, and technology transfer from parent plants were negatively related to adoption in medium-sized firms.
Silene triflora (Bornm.) Bornm. (Caryophyllaceae), a neglected species from the Central Balkans
Authors: ĐUROVIĆ SANJA ZORAN , TOMOVIĆ GORDANA , STEVANOVIĆ VLADIMIR , MATEVSKI VLADO , NIKETIĆ MARJAN
Published: June 2014

Status of numerous taxa from Silene sect. Saxifragoideae is still taxonomically unresolved, especially in the Balkans. In 1925 Bornmüller described a taxon from northern part of the Republic of Macedonia, first as S. saxifraga var. triflora and twelve years later as a separate species S. triflora. This taxon is listed in the Flora of the Republic of Macedonia as a variety of S. saxifraga. In other regional Floras regarding the Republic of Macedonia and the Balkans it is not included at any subgeneric level, or as a synonym. Delimitation between S. triflora and S. saxifraga is discussed on the basis of multivariate analysis of morphometric and meristic characters. The most significant characters for distinguishing these two taxa are stem length, inflorescence length, longest internode length, middle leaf length and the number of flowers. Considering that it was perceived that these two taxa differ significantly only in the number of flowers, addition to the original description of S. triflora is given. A specimen designated here as lectotype is deposited in JE. Considering geographic range and the number of locations, as well as the number of mature individuals in the largest population IUCN threatened status vulnerable (VU) is proposed.
A new giant Vellozia (Velloziaceae) from Minas Gerais, Brazil with comments on the V. compacta complex and conservation
Authors: Alves Ruy José Válka , Guimarães Alessandra Ribeiro , Rezende Claudia De Moraes , Braga Laura Di Spirito , Silva Nílber Gonçalves da
Published: June 2014

A new giant Vellozia species from the Ouro Branco range, Minas Gerais, is described and compared morphologically to the other dracenoid species. Leaf-anatomical characters and a unique suite of chemical constituents which help to separate the new species from V. compacta, sympatric in the range, are provided. Furthermore we discuss the circumscription of V. compacta and argue that this binomial is applied to a species complex in need of further taxonomic study.
The Epimedium wushanense (Berberidaceae) species complex, with one new species from Sichuan, China
Authors: Zhang Yanjun , Dang Haishan , Li Jianqiang , Wang Ying
Published: June 2014

Epimedium wushanense (Berberidaceae) as treated in the Flora of China includes four species similar in leaflet shape: E. wushanense, E. ilicifolium, E. jinchengshanense (sp. nov.), and E. pseudowushanense. Its seven type specimens represent three of the four species. In the present paper, E. wushanense is identified according to morphological characters of its holotype. Except for four of the seven type specimens belonging to E. wushanense and E. ilicifolium, the remaining three specimens represent a new species, E. jinchengshanense. Furthermore, E. wushanense from Guangxi and Guizhou as treated in the Flora of China is recognized as E. pseudowushanense. Epimedium wushanense, E. ilicifolium, E. jinchengshanense, and E. pseudowushanense differ by their distributions and flowers. Based on the floral characters, E. jinchengshanense is grouped into ser. Dolichocerae, E. wushanense is adjusted from ser. Dolichocerae to ser. Davidianae, and E. ilicifolium is moved from ser. Davidianae to ser. Dolichocerae.
Two new desma-less species of Theonella Gray, 1868 (Demospongiae: Astrophorida: Theonellidae), from the Great Barrier Reef, Australia,and a re-evaluation of one species assigned previously to Dercitus Gray, 1867
Authors: HALL KATHRYN A. , EKINS MERRICK G. , HOOPER JOHN N.A.
Published: June 2014

Extensive surveys of the biodiversity on the seafloor of the inter-reef regions of the Great Barrier Reef, Australia, have resulted in the collection of large numbers of sponges, many of which are likely new to science. Identification of these sponges, however, was made difficult by the absence in some specimens of key diagnostic characters, such as megascleres. We used an integrated approach to the taxonomy of these sponges, incorporating morphological examination by SEM, analysis of DNA sequence data (using the COI barcoding fragment of mtDNA) and preliminary studies of the chemistry of the sponges, to describe the new species, which were found to contain no native spicules other than acanthose microrhabds. Here, we propose two new species of Theonella Gray, 1868: Theonella deliqua n. sp. (found in association with a single unidentified species of siliquariid mollusc) and Theonella maricae n. sp. from the Great Barrier Reef. Further, we propose the new combination of Theonella xantha (Sutcliffe, Hooper and Pitcher 2010) n. comb. for another microrhabd-only-bearing species. On the basis of our gene trees, we recognise Theonella (and Theonellidae Lendenfeld, 1903) within Astrophorida Sollas, 1887. We discuss the potential for chemotaxonomic and DNA-based insights into the origins and radiation of species of Theonella and explore the evolutionary significance of the reduced morphology of the three additional species recognised here.
Contributions to the taxonomy and faunistics of some arctic species of Spilogona Schnabl (Diptera: Muscidae)
Authors: SOROKINA VERA S. , MICHELSEN VERNER
Published: June 2014

New synonymies in the genus Spilogona Schnabl, 1911 are proposed: S. novaesibiriae (Frey, 1915) = S. obsoleta (Malloch, 1920), syn. nov.; S. trianguligera (Zetterstedt, 1838) = S. setinervis (Huckett, 1932), syn. nov. Spilogona trianguligera and S. tendipes (Malloch, 1920) are newly recorded from Greenland, and S. trianguligera also from W Siberia. The female of S. vikhrevi Sorokina, 2010 is described and the species in newly recorded from Wrangel Island (Far East Russia).
Taxonomy of the genus Erymus Bordoni (Coleoptera: Staphylinidae, Staphylininae, Xantholinini) in China with descriptions of two new species
Authors: ZHOU YU-LINGZI , ZHOU HONG-ZHANG
Published: June 2014

This paper studies the taxonomy of the genus Erymus Bordoni, 2002 (Coleoptera: Staphylinidae, Staphylininae, Xantholinini) from China. Two new species are described: Erymus wufengensis sp. n. from Hubei, and E. gilvus sp. n. from Hainan, Guangxi, and Guangdong provinces of China. The previously known four species of this genus are redescribed, and the identification key to all six Chinese species of the genus is provided. The type specimens of the new species are deposited in the Institute of Zoology, Chinese Academy of Sciences (IZ-CAS).
Characterizing Observed Midtopped Cloud Regimes Associated with Southern Ocean Shortwave Radiation Biases
Authors: Mason Shannon , Jakob Christian , Protat Alain , Delanoë Julien
Published: June 2014

Clouds strongly affect the absorption and reflection of shortwave and longwave radiation in the atmosphere. A key bias in climate models is related to excess absorbed shortwave radiation in the high-latitude Southern Ocean. Model evaluation studies attribute these biases in part to midtopped clouds, and observations confirm significant midtopped clouds in the zone of interest. However, it is not yet clear what cloud properties can be attributed to the deficit in modeled clouds. Present approaches using observed cloud regimes do not sufficiently differentiate between potentially distinct types of midtopped clouds and their meteorological contexts.

This study presents a refined set of midtopped cloud subregimes for the high-latitude Southern Ocean, which are distinct in their dynamical and thermodynamic background states. Active satellite observations from CloudSat and Cloud–Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) are used to study the macrophysical structure and microphysical properties of the new cloud regimes. The subgrid-scale variability of cloud structure and microphysics is quantified within the cloud regimes by identifying representative physical cloud profiles at high resolution from the radar–lidar (DARDAR) cloud classification mask.

The midtopped cloud subregimes distinguish between stratiform clouds under a high inversion and moderate subsidence; an optically thin cold-air advection cloud regime occurring under weak subsidence and including altostratus over low clouds; optically thick clouds with frequent deep structures under weak ascent and warm midlevel anomalies; and a midlevel convective cloud regime associated with strong ascent and warm advection. The new midtopped cloud regimes for the high-latitude Southern Ocean will provide a refined tool for model evaluation and the attribution of shortwave radiation biases to distinct cloud processes and properties.
The Diagnostic Accuracy of Clinical Dehydration Scale in Identifying Dehydration in Children With Acute Gastroenteritis
Authors: Falszewska Anna , Dziechciarz Piotr , Szajewska Hania
Published: June 2014

Aim. To systematically update diagnostic accuracy of the Clinical Dehydration Scale (CDS) in clinical recognition of dehydration in children with acute gastroenteritis. Methods. Six databases were searched for diagnostic accuracy studies in which population were children aged 1 to 36 months with acute gastroenteritis; index test was the CDS; and reference test was post-illness weight gain. Results. Three studies involving 360 children were included. Limited evidence showed that in high-income countries the CDS provides strong diagnostic accuracy for ruling in moderate and severe (>6%) dehydration (positive likelihood ratio 5.2-6.6), but has limited value for ruling it out (negative likelihood ratio 0.4-0.55). In low-income countries, the CDS has limited value either for ruling moderate or severe dehydration in or out. In both settings, the CDS had limited value for ruling in or out dehydration <3% or dehydration 3% to 6%. Conclusion. The CDS can help assess moderate to severe dehydration in high-income settings. Given the limited data, the evidence should be viewed with caution.
Structural and behavioural independence: mapping the meaning of agency independence at the field level
Authors: Jackson Carolyn
Published: June 2014

For regulators, independence is associated with good governance, reform and best practice. It has become one of the most claimed characteristics of the regulatory state. But what does it really mean to be an independent agency? This article explores this question with stakeholders of five privacy (and information) commissions to map the understanding of those actually involved in the everyday processes of regulation. It is argued that the beliefs and expectations of stakeholders shape not only relationships but ultimately the legitimacy of regulatory practices. Six separate themes of understanding are identified. The themes represent areas of particular concern for each stakeholder group. Together they suggest a shared understanding of independence that encompasses both behavioural qualities as well as structural arrangements. A framework is proposed that provides a means for incorporating the different accounts of independence and recognizing the active role of agencies in determining independence.

Points for practitioners

Agency independence relates to behavioural qualities as well as structural arrangements. Behavioural qualities of independence encompass championing public interest, engendering trust and demonstrating impartiality. Procedures and routines based on clear principles of procedural fairness and transparency are likely to enhance agency independence.
Sufism and Politics in Contemporary Egypt: A Study of Sufi Political Engagement in the Pre and Post-revolutionary Reality of January 2011
Authors: Ladjal Tarek , Bensaid Benaouda
Published: June 2014

Experts on Sufi movements relegate a rather significant and critical role for Sufism in the formation of redefined political forces on the new post-Arab Spring political map. This is particularly true for one of the most vibrant Sufi capitals of the Muslim world, Egypt, holding a record sum of more than 10 million Sufi members. In spite of this, however, one year after the Revolution in Egypt, political developments exhibited a pattern of failure of Sufis gaining political ground in the post-Mubarak political arena. This paper discusses contentions and problematic issues Sufis faced with respect to politics in Egypt, with particular focus given to their political experience in Egypt. This study seeks to explore the Sufi experience throughout the process of political struggle, while examining their contributions to the November 2011 elections in an attempt to unveil the factors culminating in their political setback in spite of their massive membership base, and the official favored support of the state, both on the local and international fronts. The study concludes that the nature of the Sufi practice itself contributed to a restraining of their political presence, in addition to their lack of political awareness, poor organization and populism, all of which acted critically toward creating a failed political journey for the Sufi orders in modern Egypt.
Spatial Integration in Residential Suburbs of East London, South Africa (1993–2008)
Authors: Bwalya John , Seethal Cecil
Published: June 2014

This paper analyses residential property transfer data (1993–2008) to examine integration in selected suburbs in East London, South Africa. The results show that a greater proportion (74%) of Black residential property transfers took place in relatively cheaper residential suburbs while 65.2% of white buyers bought in more expensive suburbs. Using the chi-square test of association, the paper tests the hypothesis that race was related to the pattern of residential property transfers. The paper concludes that the nature of residential property purchases underscores the link between class and spatial integration in former white residential suburbs.
Latest progresses in the preparation of tannin-based cellular solids
Authors: Celzard Alain , Szczurek Andrzej , Jana Prasanta , Fierro Vanessa , Basso Maria-Cecilia , Bourbigot Serge , Stauber Martin , Pizzi Antonio
Published: June 2014

Tannins are non toxic, cheap and abundant polyphenolic oligomers extracted from tree barks. They can be easily used for preparing thermoset resins that are natural at the 70–95% level, depending on the cases. From these resins, highly porous monoliths can be obtained by different techniques such as classical physical or chemical foaming, mixed physical/chemical foaming, by less-conventional methods such as emulsion-templating and stabilisation and hardening of either aerated emulsions or liquid foams. The resultant materials are not only interesting per se, but are also key precursors of novel cellular carbons having a broad range of applications. The present paper briefly reviews the latest advances for producing tannin-based cellular materials and their related characteristics and properties.