bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic role of 25‐hydroxyvitamin D in patients with liver metastases from colorectal cancer treated with radiofrequency ablation
Authors: Facciorusso Antonio , Del Prete Valentina , Muscatiello Nicola , Crucinio Nicola , Barone Michele
Published: February 2016

Background and Aim

Vitamin D is implicated in the etiology of several neoplastic diseases, but its relationship with colorectal cancer survival is still unclear. Aim of this study was to determine whether vitamin D levels influence survival outcomes in colorectal cancer liver metastases patients treated with percutaneous radiofrequency ablation.

Methods

We measured 25‐hydroxyvitamin D levels in 143 patients with 215 colorectal liver metastases who underwent radiofrequency ablation between 1999 and 2011 at our institution. The influence of 25‐hydroxyvitamin D levels on overall survival and time to recurrence was evaluated in univariate and multivariate Cox analyses.

Results

Median age was 68 years (range 41–85), and median number of nodules was 2 (1–3) with a median maximum diameter of 26 mm (10–48). Median survival was 44 months (36–62), and survival rate was 91.4%, 46.5%, and 42.2% at 1, 4, and 5 years in the whole cohort. Median survival was 65 months (52–74) if 25‐hydroxyvitamin D >20 ng/mL and 34 months (24–41) if ≤20 ng/mL (P < 0.001). In the whole cohort, median time to recurrence was 34 months (26–47), 50 months (36–62) in the case of 25‐hydroxyvitamin D >20 ng/mL and 24 months (20–32) if ≤20 ng/mL (P < 0.001). Nodule size and 25‐hydroxyvitamin D resulted as significant predictors of both overall survival and time to recurrence in multivariate analysis.

Conclusions

Our study provides support for the use of 25‐hydroxyvitamin D as a new predictor of outcome for colorectal liver metastases patients.
Association Between Anthropometric Measures and Long‐Term Survival in Frail Older Women: Observations from the Women's Health Initiative Study
Authors: Zaslavsky Oleg , Rillamas‐Sun Eileen , LaCroix Andrea Z. , Woods Nancy F. , Tinker Lesley F. , Zisberg Anna , Shadmi Efrat , Cochrane Barbara , Edward Beatrice J. , Kritchevsky Stephen , Stefanick Marcia L. , Vitolins Mara Z. , Wactawski‐Wende Jean , Zelber‐Sagi Shira
Published: February 2016

Objectives

To evaluate the association between currently recommended guidelines and commonly used clinical criteria for body mass index (BMI), waist circumference (WC), and waist‐to‐hip ratio (WHR) and all‐cause mortality in frail older women.

Design

Longitudinal prospective cohort study.

Setting

Women's Health Initiative (WHI)—Observational Study.

Participants

A sample of women aged 65–84 with complete data to characterize frailty in the third year of WHI follow‐up (N = 11,070).

Measurements

Frailty phenotype was determined using the modified Fried criteria. Information on anthropometric measures (BMI, WC, WHR) was collected in clinical examinations. Cox proportional hazards models were used to estimate the effect of BMI, WC, and WHR on mortality adjusted for demographic characteristics and health behaviors.

Results

Over a mean follow‐up of 11.5 years, there were 2,911 (26%) deaths in the sample. Women with a BMI from 25.0 to 29.9 kg/m2 (hazard rate ratio (HR) = 0.80, 95% confidence interval (CI) = 0.73–0.88) and those with a BMI from 30.0 to 34.9 kg/m2 (HR = 0.79, 95% CI = 0.71–0.88) had lower mortality than those with a BMI from 18.5 to 24.9 kg/m2. Women with a WHR greater than 0.8 had higher mortality (HR = 1.16, 95% CI = 1.07–1.26) than those with a WHR of 0.8 or less. No difference in mortality was observed according to WC. Stratifying according to chronic morbidity or smoking status or excluding women with early death and unintentional weight loss did not substantially change these findings.

Conclusion

In frail, older women, having a BMI between 25.0 and 34.9 kg/m2 or a WHR of 0.8 or less was associated with lower mortality. Currently recommended healthy BMI guidelines should be reevaluated for frail older women.
Elder‐Clowning in Long‐Term Dementia Care: Results of a Pilot Study
Authors: Kontos Pia , Miller Karen‐Lee , Colobong Romeo , Palma Lazgare Luis I. , Binns Malcolm , Low Lee‐Fay , Surr Claire , Naglie Gary
Published: February 2016

Objectives

To assess the effects of elder‐clowning on moderate to severe behavioral and psychological symptoms of dementia (BPSD) in nursing home residents with dementia, primarily of the Alzheimer's type.

Design

Before‐and‐after study.

Setting

Nursing home.

Participants

Nursing home residents with moderate to severe BPSD, as defined according to a Neuropsychiatric Inventory—Nursing Home version (NPI‐NH) score of 10 or greater (N = 23), and their care aides.

Intervention

A pair of elder‐clowns visited all residents twice weekly (~10 minutes per visit) for 12 weeks. They used improvisation, humor, empathy, and expressive modalities such as song, musical instruments, and dance to individualize resident engagement.

Measurements

Primary outcomes were BPSD measured using the the NPI‐NH, quality of life measured using Dementia Care Mapping (DCM), and nursing burden of care measured using the Modified Nursing Care Assessment Scale (M‐NCAS). Secondary outcomes were occupational disruptiveness measured using the NPI‐NH, agitation measured using the Cohen Mansfield Agitation Inventory (CMAI), and psychiatric medication use.

Results

Over 12 weeks, NPI‐NH scores declined significantly (t22 = −2.68, P = .01), and DCM quality‐of‐life scores improved significantly (F1,50 = 23.09, P < .001). CMAI agitation scores decreased nominally, but the difference was not statistically significant (t22 = −1.86, P = .07). Occupational disruptiveness score significantly improved (t22 = −2.58, P = .02), but there was no appreciable change in M‐NCAS scores of staff burden of care.

Conclusion

Results suggest that elder‐clowning reduced moderate to severe BPSD of nursing home residents with dementia, primarily of the Alzheimer's type. Elder‐clowning is a promising intervention that may improve Alzheimer's disease care for nursing home residents.
Fluid‐fluxed melting and melt loss in a syntectonic contact metamorphic aureole from the Variscan eastern Pyrenees
Authors: Aguilar C. , Liesa M. , Reche J. , Powell R.
Published: February 2016

Open‐system behaviour through fluid influx and melt loss can produce a variety of migmatite morphologies and mineral assemblages from the same protolith composition. This is shown by different types of granulite facies migmatite from the contact aureole of the Ceret gabbro–diorite stock in the Roc de Frausa Massif (eastern Pyrenees). Patch, stromatic and schollen migmatites are identified in the inner contact aureole, whereas schollen migmatites and residual melanosomes are found as xenoliths inside the gabbro–diorite. Patch and schollen migmatites record D1 and D2 structures in folded melanosome and mostly preserve the high‐T D2 in granular or weakly foliated leucosome. Stromatic migmatites and residual melanosomes only preserve D2. The assemblage quartz–garnet–biotite–sillimanite–cordierite±K‐feldspar–plagioclase is present in patch and schollen migmatites, whereas stromatic migmatites and residual melanosomes contain a sub‐assemblage with no sillimanite and/or K‐feldspar. A decrease in
X

Fe (molar Fe/(Fe + Mg)) in garnet, biotite and cordierite is observed from patch migmatites through schollen and stromatic migmatites to residual melanosomes. Whole‐rock compositions of patch, schollen and stromatic migmatites are similar to those of non‐migmatitic rocks from the surrounding area. These metasedimentary rocks are interpreted as the protoliths of the migmatites. A decrease in the silica content of migmatites from 63 to 40 wt% SiO2 is accompanied by an increase in Al2O3 and MgO+FeO and by a depletion in alkalis. Thermodynamic modelling in the NCKFMASHTO system for the different types of migmatite provides peak metamorphic conditions ~7–8 kbar and 840 °C. A nearly isothermal decompression history down to 5.5 kbar was followed by isobaric cooling from 840 °C through 690 °C to lower temperatures. The preservation of granulite facies assemblages and the variation in mineral assemblages and chemical composition can be modelled by ongoing H2O‐fluxed melting accompanied by melt loss. The fluids were probably released by the crystallizing gabbro–diorite, infiltrating the metasedimentary rocks and fluxing melting. Release of fluids and melt loss were probably favoured by coeval deformation (D2). The amount of melt remaining in the system varied considerably among the different types of migmatite. The whole‐rock compositions of the samples, the modelled compositions of melts at the solidus at 5.5 kbar and the residues show a good correlation.
High glucose‐induced oxidative stress represses sirtuin deacetylase expression and increases histone acetylation leading to neural tube defects
Authors: Yu Jingwen , Wu Yanqing , Yang Peixin
Published: February 2016

Aberrant epigenetic modifications are implicated in maternal diabetes‐induced neural tube defects (NTDs). Because cellular stress plays a causal role in diabetic embryopathy, we investigated the possible role of the stress‐resistant sirtuin (SIRT) family histone deacetylases. Among the seven sirtuins (SIRT1‐7), pre‐gestational maternal diabetes in vivo or high glucose in vitro significantly reduced the expression of SIRT 2 and SIRT6 in the embryo or neural stem cells, respectively. The down‐regulation of SIRT2 and SIRT6 was reversed by superoxide dismutase 1 (SOD1) over‐expression in the in vivo mouse model of diabetic embryopathy and the SOD mimetic, tempol and cell permeable SOD, PEGSOD in neural stem cell cultures. 2,3‐dimethoxy‐1,4‐naphthoquinone (DMNQ), a superoxide generating agent, mimicked high glucose‐suppressed SIRT2 and SIRT6 expression. The acetylation of histone 3 at lysine residues 56 (H3K56), H3K14, H3K9, and H3K27, putative substrates of SIRT2 and SIRT6, was increased by maternal diabetes in vivo or high glucose in vitro, and these increases were blocked by SOD1 over‐expression or tempol treatment. SIRT2 or SIRT6 over‐expression abrogated high glucose‐suppressed SIRT2 or SIRT6 expression, and prevented the increase in acetylation of their histone substrates. The potent sirtuin activator (SRT1720) blocked high glucose‐increased histone acetylation and NTD formation, whereas the combination of a pharmacological SIRT2 inhibitor and a pan SIRT inhibitor mimicked the effect of high glucose on increased histone acetylation and NTD induction. Thus, diabetes in vivo or high glucose in vitro suppresses SIRT2 and SIRT6 expression through oxidative stress, and sirtuin down‐regulation‐induced histone acetylation may be involved in diabetes‐induced NTDs.

image

The mechanism underlying pre‐gestational diabetes‐induced neural tube defects (NTDs) is still elusive. Our study unravels a new epigenetic mechanism in which maternal diabetes‐induced oxidative stress represses sirtuin deacetylase 2 (SIRT2) and 6 (SIRT6) expression leading to histone acetylation and gene expression. SIRT down‐regulation mediates the teratogenicity of diabetes leading to (NTD) formation. The study provides a mechanistic basis for the development of natural antioxidants and SIRT activators as therapeutics for diabetic embryopathy.
THE LOCATIONAL DYNAMICS OF MANUFACTURING IN CHINA'S COUNTIES: INFLUENCE OF EXPRESSWAY INVESTMENT
Authors: Xu Hangtian , Zhou Hao , Liang Liang
Published: February 2016

This study investigates the impact of expressway investment in China's counties. By identifying expressway accessibility through toll station locations, we estimate the manufacturing distribution along expressways for 2001–2005. We find that expressway accessibility promotes manufacturing employment for inland counties by around 41 percent; however, for coastal counties that already have high road density and dense manufacturing layouts, the returns from new expressways are small. Furthermore, counties close to large cities benefit more from expressway accessibility than do counties that are far from them. The gap first increases in the period of expressway construction and then decreases as expressway effects are smoothed.
Extra‐hepatic replication and infection of hepatitis E virus in neuronal‐derived cells
Authors: Drave S. A. , Debing Y. , Walter S. , Todt D. , Engelmann M. , Friesland M. , Wedemeyer H. , Neyts J. , Behrendt P. , Steinmann E.
Published: February 2016

Hepatitis E virus (HEV) is the causative agent of hepatitis E in humans and a member of the genus Orthohepevirus in the family Hepeviridae. Infection usually leads to acute hepatitis that can become fulminant, particularly among pregnant women and in patients with preexisting liver disease, or may evolve to a chronic state, especially in immunosuppressed individuals. HEV has been shown to produce a range of extra‐hepatic manifestations including aplastic anaemia, acute thyroiditis, glomerulonephritis as well as neurological disorders such as Guillain‐Barré syndrome, neuralgic amyotrophy and encephalitis. The pathogenesis of these neurological injuries remains largely unknown, and it is also uncertain whether or not HEV can directly infect neuronal cells. In this study, we investigated whether HEV is capable of completing the viral life cycle in human neuronal‐derived cell lines such as neuroepithelioma (SK‐N‐MC), desmoplastic cerebellar medulloblastoma (DAOY), glioblastoma multiforme (DBTRG), glioblastoma astrocytoma (U‐373 MG) and oligodendrocytic (M03.13) cells. Following transfection of these cells with HEV Gaussia luciferase reporter virus, all tested cell lines supported HEV RNA replication. Furthermore, extra‐ and intracellular viral capsid was detected by an HEV antigen ELISA as a marker for virus assembly and release. Permissiveness for HEV cell entry could be demonstrated for the oligodendrocytic cell line M03.13. In conclusion, these results indicate that HEV tropism is not restricted to the liver and HEV can potentially complete the full viral life cycle in neuronal‐derived tissues explaining neurologic disorders during HEV infection.
Capturing Direct and Cross Price Effects in a Differentiated Products Duopoly Model
Authors: Kopel Michael , Ressi Anna , Lambertini Luca
Published: February 2016

We show that a frequently used direct demand system with product differentiation in a duopoly market generates unexpected effects of increasing the substitutability of firms’ products on prices, outputs, profits and welfare. Using the original demand system introduced by Bowley (The Mathematical Groundwork of Economics, Oxford, Oxford University Press, 1924) as a reference, we argue that this alternative model does not capture a consumer's taste for variety. Moreover, we demonstrate that positive values for the parameter which represents cross‐price effects in the alternative demand system corresponds to the regime of complementary products in the original Bowley model. As a consequence, for increasing values of this parameter—meant to capture increasing competition in the usual sense—prices do not converge towards marginal costs and profits do not vanish. Finally, we study a duopoly with international transfer pricing and demonstrate that conflicting policy conclusions are derived depending on which of the models is used to capture demand.
Root‐knot nematodes induce pattern‐triggered immunity in Arabidopsis thaliana roots
Authors: Teixeira Marcella A. , Wei Lihui , Kaloshian Isgouhi
Published: February 2016

Root‐knot nematodes (RKNs; Meloidogyne spp.) are plant parasites with a broad host range causing great losses worldwide. To parasitize their hosts, RKNs establish feeding sites in roots known as giant cells. The majority of work studying plant–RKN interactions in susceptible hosts addresses establishment of the giant cells and there is limited information on the early defense responses.

Here we characterized early defense or pattern‐triggered immunity (PTI) against RKNs in Arabidopsis thaliana. To address PTI, we evaluated known canonical PTI signaling mutants with RKNs and investigated the expression of PTI marker genes after RKN infection using both quantitative PCR and β‐glucuronidase reporter transgenic lines.

We showed that PTI‐compromised plants have enhanced susceptibility to RKNs, including the bak1‐5 mutant. BAK1 is a common partner of distinct receptors of microbe‐ and damage‐associated molecular patterns. Furthermore, our data indicated that nematode recognition leading to PTI responses involves camalexin and glucosinolate biosynthesis. While the RKN‐induced glucosinolate biosynthetic pathway was BAK1‐dependent, the camalexin biosynthetic pathway was only partially dependent on BAK1.

Combined, our results indicate the presence of BAK1‐dependent and ‐independent PTI against RKNs in A. thaliana, suggesting the existence of diverse nematode recognition mechanisms.
Effects of multipurpose solutions on the adhesion of Acanthamoeba to rigid gas permeable contact lenses
Authors: Lee Ga‐Hyun , Yu Hak‐Sun , Lee Ji‐Eun
Published: February 2016

Purpose

To evaluate the effect of multipurpose contact lens care solutions (MPSs) on the adhesion of Acanthamoeba to rigid gas permeable (RGP) contact lenses.

Methods

Acanthamoeba castellanii (AC) trophozoites were inoculated onto untreated RGP contact lenses (FP, Extra, or Menicon Z), and numbers of trophozoites adhering to lenses were counted under a phase contrast microscope at 18 h post‐inoculation (controls). Similarly, adhering trophozoites were counted at 6 h post‐inoculation on each of the three RGP lens types with one of three MPSs (Boston Simplus, Menicare Plus, and O2 Care). Scanning electron microscopic examinations were performed to compare lens surfaces.

Results

Adhesion of AC trophozoites to untreated FP was greater than to untreated Extra or Menicon Z. Surfaces of Extra and Menicon Z lenses were waxier, smoother, and more homogeneous than those of FP lenses. After treatment with Boston Simplus, adhesion of AC trophozoites was significantly reduced for all lens types as compared with controls (p < 0.0001). Treatments with Menicare Plus or O2 Care reduced the number of adherent AC trophozoites significantly on FP lenses only as compared with controls (p < 0.0001).

Conclusions

The adhesion rates of AC trophozoites to RGP lenses depended on lens surfaces. Boston Simplus reduced the adhesion rate of AC trophozoites more than Menicare Plus or O2 Care. Appropriate RGP lens and MPS selection could decrease the prevalence of Acanthamoeba keratitis.
Profile of refractive errors in European Caucasian children with Autistic Spectrum Disorder; increased prevalence and magnitude of astigmatism
Authors: Anketell Pamela M. , Saunders Kathryn J. , Gallagher Stephen , Bailey Clare , Little Julie‐Anne
Published: February 2016

Purpose

Autistic Spectrum Disorder (ASD) is a common neurodevelopmental disorder characterised by impairment of communication, social interaction and repetitive behaviours. Only a small number of studies have investigated fundamental clinical measures of vision including refractive error. The aim of this study was to describe the refractive profile of a population of children with ASD compared to typically developing (TD) children.

Methods

Refractive error was assessed using the Shin‐Nippon NVision‐K 5001 open‐field autorefractor following the instillation of cyclopentolate hydrochloride 1% eye drops.

Results

A total of 128 participants with ASD (mean age 10.9 ± 3.3 years) and 206 typically developing participants (11.5 ± 3.1 years) were recruited. There was no significant difference in median refractive error, either by spherical equivalent or most ametropic meridian between the ASD and TD groups (Spherical equivalent, Mann–Whitney U307 = 1.15, p = 0.25; Most Ametropic Meridian, U305 = 0.52, p = 0.60). Median refractive astigmatism was −0.50DC (range 0.00 to −3.50DC) for the ASD group and −0.50DC (Range 0.00 to −2.25DC) for the TD group. Magnitude and prevalence of refractive astigmatism (defined as astigmatism ≥1.00DC) was significantly greater in the ASD group compared to the typically developing group (ASD 26%, TD 8%, magnitude U305 = 3.86, p = 0.0001; prevalence ( , p < 0.0001).

Conclusions

This is the first study to describe the refractive profile of a population of European Caucasian children with ASD compared to a TD population of children. Unlike other neurodevelopmental conditions, there was no increased prevalence of spherical refractive errors in ASD but astigmatic errors were significantly greater in magnitude and prevalence. This highlights the need to examine refractive errors in this population.
Myopia among school students in rural China (Yunnan)
Authors: Qian Deng‐Juan , Zhong Hua , Li Jun , Niu Zhiqiang , Yuan Yuansheng , Pan Chen‐Wei
Published: February 2016

Purpose

We described the prevalence and associated factors of myopia and high myopia in school children of different ethnicities in a rural community in Yunnan province, China.

Methods

A total of 7681 (93.4%) primary and secondary school students aged 5–16 years in Mangshi participated in this study. Cycloplegic refraction was performed using an auto‐refractor. Information regarding demographic factors, socioeconomic status and lifestyle‐related exposures were collected using a questionnaire. Multivariate logistic regression models were fitted to estimate the risk factors for myopia and high myopia.

Results

The overall prevalence of myopia and high myopia was 39.1% (95% confidence interval [CI]: 38.0, 40.2) and 0.6% (95% CI: 0.4, 0.8) in this study. Myopia prevalence increased significantly with increasing age (p for trend <0.001). Girls were more likely to have myopia compared with boys (p < 0.001). In multivariate analysis, the presence of myopia was associated with increasing height (odds ratio [OR] = 1.02; 95% CI: 1.01, 1.03), computer use (OR = 1.17; 95% CI: 1.03, 1.32), having myopic father (OR = 1.56; 95% CI: 1.24, 1.94), having myopic mother (OR = 1.33; 95% CI: 1.08, 1.63), and increasing time on reading (OR = 1.18; 95% CI: 1.09, 1.28) after adjusting for age, sex and ethnicity.

Conclusions

Nowadays myopia but not high myopia is prevalent among school children in rural China. Significant ethnic differences in myopia prevalence were not observed. A significant ‘cohort effect’ of myopia previously observed in urban cities had occurred in rural communities in China.
Validation of a New Arabic Version of the Neuropathic Pain Diagnostic Questionnaire (DN4)
Authors: Chatila Nadwa , Pereira Bruno , Maarrawi Joseph , Dallel Radhouane
Published: February 2016

The “Douleur Neuropathique 4 (DN4) questionnaire” was developed for screening neuropathic pain. The purpose of this work was to validate the DN4 questionnaire in the standard Arabic language. First, the questionnaire was translated and semantically adapted to Arabic according to the international guidelines for cross‐cultural adaptation. Second, a prospective observational study was performed to validate this questionnaire.

A total of 195 patients with chronic pain (n = 99 with neuropathic pain and n = 96 without neuropathic pain) were enrolled in the study. The internal consistency Kuder–Richardson's Formula 20 for the whole DN4 questionnaire was 0.86 (P < 0.001) and the intraclass correlation coefficient 0.99 (95% CI: 0.99 to 1.00). The test–retest reliability kappa coefficient for each item ranged from 0.92 to 1.00. Using a receiver‐operating characteristic (ROC) curve analysis, the areas under the curve were 0.94 and 0.97 for the 7‐item DN4 and 10‐item DN4, respectively. A cut‐off score of 3 resulted in a sensitivity of 97.0% and a specificity of 82.3% for the 7‐item DN4, while a cut‐off score of 5 for the 10‐item DN4 resulted in a sensitivity of 93.0% and a specificity of 95.8%. Tingling, numbness, and hypoesthesia to touch and to pricking were the most discriminating pain items. The sensitivity and specificity of the 7‐item DN4 and 10‐item DN4 were not influenced by either pain severity or educational level.

In conclusion, this new Arabic version DN4 questionnaire is a simple, reliable, and valid tool for discriminating between neuropathic and non‐neuropathic pain. It represents a useful tool in clinical setting and population‐based studies.
Systemic lupus erythematosus presenting with mixed‐type fulminant autoimmune hemolytic anemia
Authors: Hirano Yoko , Itonaga Takaaki , Yasudo Hiroki , Isojima Tsuyoshi , Miura Kenichiro , Harita Yutaka , Sekiguchi Masahiro , Kato Motohiro , Takita Junko , Oka Akira
Published: February 2016

We report the case of a 9‐year‐old girl who presented with mixed‐type fulminant autoimmune hemolytic anemia (AIHA) at the onset of systemic lupus erythematosus (SLE). On admission, laboratory investigations indicated very severe anemia (Hb, 2.7 g/dL) with reticulocytosis and positive direct/indirect Coombs tests. In addition, agglutinative reaction was clinically observed. Based on further examinations, the patient was diagnosed with AIHA complicated with SLE, and mixed‐type AIHA was clinically identified. With oral prednisolone and methylprednisolone pulse therapy, the patient entered remission.
Traumatic herniation of the buccal fat pad
Authors: Iehara Tomoko , Tomoyasu Chihiro , Nakajima Hisakazu , Osamura Toshio , Hosoi Hajime
Published: February 2016

Traumatic herniation of the buccal fat pad is a rare traumatic disease. Treatment consists of either excision or replacement. We herein report the first case in which a traumatic herniation of the buccal fat pad healed naturally. It was necessary to differentiate the disease from lipoblastoma. A 17‐month‐old boy was admitted to a clinic with an intraoral tumor that had suddenly increased in size. The tumor was diagnosed as herniation of the buccal fat pad on pathology of a biopsy specimen. In the present case, the escaped buccal fat body returned naturally and engrafted without dysfunction or facial defects. Given that young children may easily fall down with various objects in their mouth, care is required to prevent traumatic accidents. Traumatic herniation of the buccal fat pad should be considered in the differentiation of tumors of the oral cavity in young children.
Decompressive craniectomy 116 h after malignant middle cerebral artery infarction
Authors: Yamaguchi Hiroshi , Yamamoto Kazuki , Akutsu Nobuyuki , Kusumoto Mayumi , Kajihara Shinsuke , Yamaguchi Yoshimichi , Takeda Hiroki , Kawamura Atsushi , Uetani Yoshiyuki
Published: February 2016

The optimal timing of decompressive craniectomy in pediatric patients after presentation with malignant middle cerebral artery infarction is unknown. We report herein the case of a previously healthy 6‐year‐old Japanese girl who had good outcome after emergency decompressive craniectomy 116 h after malignant middle cerebral artery infarction. This case suggests that the timing of decompressive craniectomy can be delayed until deterioration of neurological findings and, compared with adults, a more prolonged time course for surgical intervention might be acceptable.
Outcome of renal proximal tubular dysfunction with Fanconi syndrome caused by sodium valproate
Authors: Yamazaki Sawako , Watanabe Toru , Sato Seiichi , Yoshikawa Hideto
Published: February 2016

Background

Although Fanconi syndrome is rare in patients with epilepsy treated with sodium valproate (VPA), the prevalence might be higher in children with severe motor and intellectual disabilities (SMID). VPA‐induced Fanconi syndrome usually has a favorable outcome, but the long‐term outcome of renal tubular dysfunction in SMID patients remains unknown. The aim of this study was therefore to investigate the long‐term outcome of renal proximal dysfunction in SMID children with Fanconi syndrome caused by VPA.

Methods

The records of six children with SMID and Fanconi syndrome caused by VPA were retrospectively reviewed to assess long‐term proximal renal tubular function after discontinuation of VPA. All six patients had intractable epilepsy and required tube feeding.

Results

Proximal tubular dysfunction improved in almost all patients after VPA discontinuation, although abnormal uric acid reabsorption persisted in three patients. Five patients had hypocarnitinemia. After carnitine supplementation, one of these three patients with decreased ability to reabsorb uric acid had a normal serum level and improved fractional excretion of uric acid.

Conclusions

Secondary carnitine deficiency may cause prolonged tubular dysfunction in some SMID patients with VPA‐induced Fanconi syndrome. Fanconi syndrome caused by VPA is a usually reversible dysfunction of the proximal tubules, but can be permanent. Although not effective for all patients, carnitine is recommended for patients with VPA‐induced Fanconi syndrome, especially children with SMID.
Neural and non‐neural contributions to sexual dimorphism of mid‐day sleep in Drosophila melanogaster: a pilot study
Authors: Khericha Mobina , Kolenchery Jaison B. , Tauber Eran
Published: February 2016

Many of the characteristics associated with mammalian sleep are also observed in Drosophila melanogaster Meigen, making the fruit fly a powerful model organism for studying the genetics of this important process. Included among the similarities is the presence of sexual dimorphic sleep patterns, which, in flies, are manifested as increased mid‐day sleep (‘siesta’) in males compared with females. In the present study, targeted mis‐expression of the genes transformer (tra) and tra2 is used to either feminize or masculinize specific neural and non‐neural tissues in the fly. Feminization of male D. melanogaster using three different GAL4 drivers that are expressed in the mushroom bodies induces a female‐like reduced siesta, whereas the masculinization of females using these drivers triggers the male‐like increased siesta. A similar reversal of sex‐specific sleep is also observed by mis‐expressing tra in the fat body, which is a key tissue in energy metabolism and hormone secretion. In addition, the daily expression levels of takeout, an important circadian clock output gene, are sexually dimorphic. Taken together, these experiments suggest that sleep sexual dimorphism in D. melanogaster is driven by multiple neural and non‐neural circuits, within and outside the brain.
Collective invasion of cancer: Perspectives from pathology and development
Authors: Wang Xiaoze , Enomoto Atsushi , Asai Naoya , Kato Takuya , Takahashi Masahide
Published: February 2016

Clinical pathologists have long been aware that in many types of human malignant tumors, the cells are often connected and form groups of various sizes or “nests”. In this way, they achieve “collective invasion” into the surrounding stroma, rather than spreading out individually. Such collective behavior is also a common feature of migration during embryonic and postnatal developmental stages, suggesting there are advantages gained by collective cell migration in the organisms. Recent studies have revealed the mechanisms underlying the collective invasion of cancer cells. These mechanisms differ from those observed in the migration of single cells in culture, including reliance on the epithelial–mesenchymal transition program. Whereas intercellular adhesion appears to be coordinated, cancer cell groups can be heterogenous, including cells that are leaders and those that are followers. There is also interaction with the tumor microenvironment that is a prerequisite for collective invasion of cancer. In this review, we describe recently emerging mechanisms underlying the collective migration of cells, with a particular focus in our studies on the actin‐binding protein Girdin/GIV and the transcriptional regulator tripartite motif containing 27. These studies provide new perspectives on the mechanistic analogy between cancer and development.
Histological methods to detect the clubroot pathogen Plasmodiophora brassicae during its complex life cycle
Authors: Schuller A. , Ludwig‐Müller J.
Published: February 2016

The clubroot pathogen Plasmodiophora brassicae is an obligate biotrophic protist that lives in close relationship with its host cell. The roots of the host plants are colonized and the plant growth is altered upon infection. While shoots can be stunted and show wilt symptoms after longer infection periods, the root system is converted to a tumorous root tissue, called ‘clubroot’, by alterations of the plant growth promoting hormones auxin, cytokinin and brassinosteroid. Because the life cycle occurs largely within the host cells, this leads to dramatic changes in host root morphology and anatomy. Thus, the identification of the respective protist structures in the host tissue by microscopy is challenging. Different staining methods as well as fluorescence and electron microscopy of thin sections can reveal specific life stages of P. brassicae and can yield additional information on the changes in the host tissues concerning, for example, cell wall properties. In addition, promoter–reporter fusions, immunostaining methods and in situ hybridization techniques can be used to gain additional information on the changes in the host roots.
The Limits to Power without Persuasion
Authors: Dickinson Matthew J. , Gubb Jesse
Published: February 2016

Research on executive action often assumes that presidents face an either/or decision between issuing an administrative order and seeking legislation. This premise, however, ignores differing structural characteristics of administrative and legislative policy vehicles. This article will argue that, rather than see administrative actions as equivalent to legislation, presidents understand the distinct advantages and disadvantages each policy instrument brings and act accordingly. Using data linking executive orders (EOs) and presidential legislative proposals, as well as a case study of the creation of the Department of Homeland Security, we show that when presidents issue more EOs, they do not issue fewer legislative proposals. In fact, presidents sometimes follow up on significant EOs with proposals to enshrine them in statute. Our research supports viewing EOs as a tool in the legislative toolbox rather than a challenge to the legislative process.
The Contemporary Presidency: Magna Carta and the Contemporary Presidency
Authors: Pfiffner James P.
Published: February 2016

Despite arguments by some scholars that Magna Carta has been inaccurately mythologized, this article argues that it continues to be relevant to contemporary governance. After an overview of the historical circumstances of the Great Charter, and a discussion of its major clauses, this article examines expansions of individual rights and limits on government in Anglo‐American jurisprudence that trace their origins to Magna Carta. It argues that the timeless principles embedded in Magna Carta continue to be relevant to contemporary governments, particularly the U.S. presidency. It concludes that Magna Carta continues to be important as a classic statement of rule of law, limited government, and individual rights and a potent symbol and argument for restraining government in general and executives in particular.
The Historical Presidency: “The Fibre of which Presidents Ought to Be Made”: Union Busting from Rutherford Hayes to Scott Walker
Authors: Walker Alexis N.
Published: February 2016

Scott Walker's meteoric rise from a Milwaukee county executive in 2010 to a leading contender for the 2016 Republican presidential nomination surprised many observers. But Walker's trajectory is part of a robust tradition dating back to the 1870s of conservative presidential hopefuls and presidents advancing and defining their careers through union busting. Like Governor Walker, Governor Hayes, McKinley, and Coolidge used confrontations with organized labor to thrust themselves into the national spotlight and position themselves for a presidential run. Challenging labor has also boosted the reputations of incumbent presidents for tough and decisive leadership, most recently, as Walker knew well, in the case of Ronald Reagan's response to the air traffic controllers’ strike. Presidents and presidential hopefuls have battled organized labor to demonstrate that they are presidential material, and Walker learned the lesson well: union busting pays.
Radiological Risk Assessment by Convergence Methodology Model in RDD Scenarios
Authors: Rother Fagner C. , Rebello Wilson F. , Healy Matthew J. F. , Silva Mauricio M. , Cabral Paulo A. M. , Vital Hélio C. , Andrade Edson R.
Published: February 2016

A radiological dispersal device (RDD) is a simple weapon capable of causing human harm, environmental contamination, disruption, area denial, and economic cost. It can affect small, large, or long areas depending on atmospheric stability. The risk of developing a radio‐induced cancer depends on exposure, and an effective response depends upon available timely guidance. This article proposes and demonstrates a convergence of three different capabilities to assess risk and support rapid safe resource efficient response. The three capabilities that are integrated are Hotspot for dispersion, RERF for epidemiological risk, and RESRAD‐RDD for response guidance. The combined methodology supports decisions on risk reduction and resource allocation through work schedules, the designation and composition of response teams, and siting for operations. In the illustrative RDD scenario, the contamination area for sheltering, evacuation, and long‐term public concern was greatest for calm atmospheric conditions, whilst close‐quarter responders faced highest dose rates for neutral atmospheric conditions. Generally, the risks to women responders were found to be significantly greater than for men, and the risks to 20‐year‐old responders were three times that of their 60‐year‐old counterparts for similar exposure.
The ambulatory hypotensive effect of aerobic training: a reappraisal through a meta‐analysis of selected moderators
Authors: Sosner P. , Guiraud T. , Gremeaux V. , Arvisais D. , Herpin D. , Bosquet L.
Published: February 2016

The effectiveness of regular exercise in decreasing both systolic and diastolic blood pressure (BP) is well‐established. Our purpose was to assess the impact of both subject and physical activity program characteristics on ambulatory BP through a meta‐analysis of the existing literature. Three databases (PubMed, Embase, Web of Science) were searched using relevant terms and strategies. From 637 identified records, 37 studies met inclusion criteria: details about training intervention and participant characteristics, pre‐ and post‐training ambulatory BP measurements, at home (HBPM) or during 24‐h (ABPM). The weighted mean difference was for 24‐h systolic/diastolic ABPM (n = 847 participants): −4.06/−2.77 mmHg (95%CI: −5.19 to −2.93/−3.58 to −1.97; P < 0.001), for daytime (ABPM or HBPM, n = 983): −3.78/−2.73 mmHg (95%CI: −5.09 to −2.47/−3.57 to −1.89; P < 0.001) and nighttime ABPM periods (n = 796): −2.35/−1.70 mmHg (95%CI: −3.26 to −1.44/−2.45 to −0.95; P < 0.001). Characteristics significantly influencing BP improvement were: an initial office BP ≥130/85 mmHg and diet‐induced weight‐loss. We found no differences according to sex, age, or training characteristics (intensity, number of sessions, training duration). Antihypertensive effects of aerobic training assessed by ambulatory BP measurements appear significant and clinically relevant for both daytime and nighttime periods, in particular for participants with an office BP ≥130/85 mmHg.
Jumping for recognition: Women's ski jumping viewed as a struggle for rights
Authors: Andersen W. , Loland S.
Published: February 2016

With the campaign for women's participation in international and Olympic ski jumping as a practical case, sport's potential for recognition of individual rights is explored. In line with Honneth's influential ethical theory, recognition of rights refers to a mutual recognition between persons of each other as rational and responsible agents with an equal right to take part in the public formation and development of their community or practice. The argument is that women ski jumpers were entitled to compete as they had actual and/or potential capabilities and skills to contribute in the public formation and development of their sport. Their exclusion was a violation of individual rights. At a more general level, sport is discussed as a sphere for recognition of rights. It is argued that the basic principles of equal opportunity to take part and to perform make sport a particularly clear and potent sphere for such recognition, and also for the identification of rights violations. In sport, rights, or the violation of rights, are demonstrated in concrete and embodied ways. It is concluded that struggles for recognition and individual rights are a continuous process in sport as in most other human institutions and practices.
Back pain prevalence in adolescent athletes
Authors: Müller J. , Müller S. , Stoll J. , Fröhlich K. , Otto C. , Mayer F.
Published: February 2016

The research aimed to investigate back pain (BP) prevalence in a large cohort of young athletes with respect to age, gender, and sport discipline. BP (within the last 7 days) was assessed with a face scale (face 1–2 = no pain; face 3–5 = pain) in 2116 athletes (m/f 61%/39%; 13.3 ± 1.7 years; 163.0 ± 11.8 cm; 52.6 ± 13.9 kg; 4.9 ± 2.7 training years; 8.4 ± 5.7 training h/week). Four different sports categories were devised (a: combat sports, b: game sports; c: explosive strength sport; d: endurance sport). Analysis was described descriptively, regarding age, gender, and sport. In addition, 95% confidence intervals (CI) were calculated. About 168 (8%) athletes were allocated into the BP group. About 9% of females and 7% of males reported BP. Athletes, 11–13 years, showed a prevalence of 2–4%; while prevalence increased to 12–20% in 14‐ to 17‐year olds. Considering sport discipline, prevalence ranged from 3% (soccer) to 14% (canoeing). Prevalences in weight lifting, judo, wrestling, rowing, and shooting were ≥10%; in boxing, soccer, handball, cycling, and horse riding, ≤6%. 95% CI ranged between 0.08–0.11. BP exists in adolescent athletes, but is uncommon and shows no gender differences. A prevalence increase after age 14 is obvious. Differentiated prevention programs in daily training routines might address sport discipline‐specific BP prevalence.
Identification of a novel HLA‐B*40 allele, HLA‐B*40:324, by sequence‐based typing, in a Chinese individual
Authors: Zou J. , Qiang W. , Shen G. , Zhu Y. Y. , Li W. X. , Liu G. J.
Published: February 2016

The new allele, HLA‐B*40:324 differs from B*40:63 by two nucleotide changes in exon 3.
Visceral leishmaniasis after orthotopic liver transplantation: a rare cause of infection
Authors: Pereira C.M. , Oliveira H.M. , Lopes V. , Gandara J. , Ferreira S. , Daniel J. , Miranda H.P.
Published: February 2016

Visceral leishmaniasis (VL) was known as an opportunistic infection associated with immunosuppression, particularly related to human immunodeficiency virus infection and rarely to solid organ transplant recipients. We report a case of VL, 6 months after liver transplantation, in a patient who presented with febrile pancytopenia. The diagnosis was made by demonstration of amastigotes in smears from bone marrow. VL is a very rare infection in patients who undergo liver transplantation and, to our knowledge, this is the first case diagnosed in Portugal.
Economic burden of underweight and overweight among adults in the Asia‐Pacific region: a systematic review
Authors: Hoque Mohammad Enamul , Mannan Munim , Long Kurt Z. , Mamun Abdullah Al
Published: February 2016

Objective

To assess the economic burden of underweight and overweight among adults in the Asia–Pacific region.

Method

Systematic review of articles published until March 2015.

Results

Seventeen suitable articles were found, of which 13 assess the economic burden of overweight/obesity and estimate that it accounts for 1.5–9.9% of a country's total healthcare expenditure. Four articles on the economic burden of underweight estimate it at 2.5–3.8% of the country's total GDP. Using hospital data, and compared to normal weight individuals, four articles estimated extra healthcare costs for overweight individuals of 7–9.8% and more, and extra healthcare costs for obese individuals of 17–22.3% and higher.

Conclusion

Despite methodological diversity across the studies, there is a consensus that both underweight and overweight impose a substantial financial burden on healthcare systems in the Asia–Pacific region.
Family planning, antenatal and delivery care: cross‐sectional survey evidence on levels of coverage and inequalities by public and private sector in 57 low‐ and middle‐income countries
Authors: Campbell Oona M. R. , Benova Lenka , MacLeod David , Baggaley Rebecca F. , Rodrigues Laura C. , Hanson Kara , Powell‐Jackson Timothy , Penn‐Kekana Loveday , Polonsky Reen , Footman Katharine , Vahanian Alice , Pereira Shreya K. , Santos Andreia Costa , Filippi Veronique G. A. , Lynch Caroline A. , Goodman Catherine
Published: February 2016

Objective

The objective of this study was to assess the role of the private sector in low‐ and middle‐income countries (LMICs). We used Demographic and Health Surveys for 57 countries (2000–2013) to evaluate the private sector's share in providing three reproductive and maternal/newborn health services (family planning, antenatal and delivery care), in total and by socio‐economic position.

Methods

We used data from 865 547 women aged 15–49, representing a total of 3 billion people. We defined ‘met and unmet need for services’ and ‘use of appropriate service types’ clearly and developed explicit classifications of source and sector of provision.

Results

Across the four regions (sub‐Saharan Africa, Middle East/Europe, Asia and Latin America), unmet need ranged from 28% to 61% for family planning, 8% to 22% for ANC and 21% to 51% for delivery care. The private‐sector share among users of family planning services was 37–39% across regions (overall mean: 37%; median across countries: 41%). The private‐sector market share among users of ANC was 13–61% across regions (overall mean: 44%; median across countries: 15%). The private‐sector share among appropriate deliveries was 9–56% across regions (overall mean: 40%; median across countries: 14%). For all three healthcare services, women in the richest wealth quintile used private services more than the poorest. Wealth gaps in met need for services were smallest for family planning and largest for delivery care.

Conclusions

The private sector serves substantial numbers of women in LMICs, particularly the richest. To achieve universal health coverage, including adequate quality care, it is imperative to understand this sector, starting with improved data collection on healthcare provision.
What factors affect patient access and engagement with clubfoot treatment in low‐ and middle‐income countries? Meta‐synthesis of existing qualitative studies using a social ecological model
Authors: Drew Sarah , Lavy Christopher , Gooberman‐Hill Rachael
Published: February 2016

Objectives

To conduct a systematic synthesis of previous research to identify factors that affect treatment‐seeking for clubfoot and community‐level interventions to improve engagement in low‐ and middle‐income counties.

Methods

A search of five databases was conducted, and articles screened using six criteria. Quality was appraised using the Critical Appraisal Skills Programme checklist. Eleven studies were identified for inclusion. Analysis was informed by a social ecological model, which specifies five inter‐related factors that may affect treatment‐seeking: intrapersonal, interpersonal, institutional, community or socio‐cultural factors and public policy.

Results

Intrapersonal barriers experienced were a lack of income and additional responsibilities. At the interpersonal level, support from fathers, the extended family and wider community affected on treatment‐seeking. Institutional or organisational factors included long distances to treatment centres, insufficient information about treatments and challenges following treatment. Guardians’ beliefs about the causes of clubfoot shaped behaviour. At the level of public policy, two‐tiered healthcare systems made it difficult for some groups to access timely care. Interventions to address these challenges included counselling sessions, outreach clinics, brace recycling and a range of education programmes.

Conclusions

This study identifies factors that affect access and engagement with clubfoot treatment across diverse settings and strategies to address them.