bluuebunny/crossref_metadata_2025 huggingface dataset:
[Re]considering Respect for Persons in a Globalizing World
Authors: Padela Aasim I. , Malik Aisha Y. , Curlin Farr , De Vries Raymond
Published: April 2014

Contemporary clinical ethics was founded on principlism, and the four principles: respect for autonomy, nonmaleficence, beneficence and justice, remain dominant in medical ethics discourse and practice. These principles are held to be expansive enough to provide the basis for the ethical practice of medicine across cultures. Although principlism remains subject to critique and revision, the four‐principle model continues to be taught and applied across the world. As the practice of medicine globalizes, it remains critical to examine the extent to which both the four‐principle framework, and individual principles among the four, suffice patients and practitioners in different social and cultural contexts. Using the four‐principle model we analyze two accounts of surrogate decision making – one from the developed and one from the developing world – in which the clinician undertakes medical decision‐making with apparently little input from the patient and/or family. The purpose of this analysis is to highlight challenges in assessing ethical behaviour according to the principlist model. We next describe cultural expectations and mores that inform both patient and clinician behaviors in these scenarios in order to argue that the principle of respect for persons informed by culture‐specific ideas of personhood may offer an improved ethical construct for analyzing and guiding medical practice in a globalized and plural world.
Reuse Of Pacemakers In Ghana And Nigeria: Medical, Legal, Cultural And Ethical Perspectives
Authors: Ochasi Aloysius , Clark Peter
Published: April 2014

According to the World Health Organization (WHO) cardiovascular disease (CVD) is the leading cause of death globally. Over 80% of CVD deaths take place in low‐ and middle‐income countries (LMICs). It is estimated that 1 million to 2 million people worldwide die each year due to lack of access to an implantable cardiac defibrillator (ICD) or a pacemaker. Despite the medical, legal, cultural and ethical controversies surrounding the pacemaker reutilization, studies done so far on the reuse of postmortem pacemakers show it to be safe and effective with an infection rate of 1.97% and device malfunction rate of 0.68%. Pacemaker reutilization can be effectively and safely done and does not pose significant additional risk to the recipient. Heart patients with reused pacemakers have an improved quality of life compared to those without pacemakers. The thesis of this paper is that pacemaker reutilization is a life‐saving initiative in LMICs of Nigeria and Ghana. It is cost effective; consistent with the principles of beneficence, nonmaleficence, and justice with a commitment to stewardship of resources and the Common Good. Used pacemakers with adequate battery life can be properly sterilized for use by patients in LMICs who cannot afford the cost of a new pacemaker.
A Brief History of Biomedical Research Ethics in Iran: Conflict of Paradigms
Authors: Aramesh Kiarash
Published: April 2014

During the past two decades, Iran has experienced a noteworthy growth in its biomedical research sector. At the same time, ethical concerns and debates resulting from this burgeoning enterprise has led to increasing attention paid to biomedical ethics. In Iran, Biomedical research ethics and research oversight passed through major periods during the past decades, separated by a paradigm shift. Period 1, starting from the early 1970s, is characterized by research paternalism and complete reliance on researchers as virtuous and caring physicians. This approach was in concordance with the paternalistic clinical practice of physicians outside of research settings during the same period. Period 2, starting from the late 1990s, was partly due to revealing of ethical flaws that occurred in biomedical research in Iran. The regulatory and funding bodies concluded that it was not sufficient to rely solely on the personal and professional virtues of researchers to safeguard human subjects' rights and welfare. The necessity for independent oversight, emphasized by international declarations, became obvious and undeniable. This paradigm shift led to the establishment of research ethics committees throughout the country, the establishment of academic research centers focusing on medical ethics (MEHR) and the compilation of the first set of national ethical guidelines on biomedical research–one of the first and most important projects conducted by and in the MEHR. Although not yet arrived, ‘period 3’ is on its way. It is predictable from the obvious trends toward performance of high‐quality clinical research and the appearance of a highly educated new generation, especially among women.
The lens equator: A platform for molecular machinery that regulates the switch from cell proliferation to differentiation in the vertebrate lens
Authors: Mochizuki Toshiaki , Masai Ichiro
Published: April 2014

The vertebrate lens is a transparent, spheroidal tissue, located in the anterior region of the eye that focuses visual images on the retina. During development, surface ectoderm associated with the neural retina invaginates to form the lens vesicle. Cells in the posterior half of the lens vesicle differentiate into primary lens fiber cells, which form the lens fiber core, while cells in the anterior half maintain a proliferative state as a monolayer lens epithelium. After formation of the primary fiber core, lens epithelial cells start to differentiate into lens fiber cells at the interface between the lens epithelium and the primary lens fiber core, which is called the equator. Differentiating lens fiber cells elongate and cover the old lens fiber core, resulting in growth of the lens during development. Thus, lens fiber differentiation is spatially regulated and the equator functions as a platform that regulates the switch from cell proliferation to cell differentiation. Since the 1970s, the mechanism underlying lens fiber cell differentiation has been intensively studied, and several regulatory factors that regulate lens fiber cell differentiation have been identified. In this review, we focus on the lens equator, where these regulatory factors crosstalk and cooperate to regulate lens fiber differentiation. Normally, lens epithelial cells must pass through the equator to start lens fiber differentiation. However, there are reports that when the lens epithelium structure is collapsed, lens fiber cell differentiation occurs without passing the equator. We also discuss a possible mechanism that represses lens fiber cell differentiation in lens epithelium.
Time‐lapse imaging system with shell‐less culture chamber
Authors: Funahashi Jun‐ichi , Nakamura Harukazu
Published: April 2014

We have developed a system for imaging whole chick embryos from embryonic day 1.5 (E1.5) to E4.5. Our system consists of a custom‐made culture chamber, the top and bottom of which were heated and the inside was humidified. The system also has a fixed stage uplight fluorescent microscope, and long‐working distance objective lenses were adopted. The albumen removed‐yolk with the embryo in the dish was put in the chamber. It is of importance that we adopted long working distance lenses because the working distance of conventional objective lenses is too short for observation of the embryo in a humidified chamber. The objective lens we adopted has sufficient resolution to detect fluorescent protein expression at the single‐cell level. Transparent glass heater set on the top of the chamber helps to reduce dew condensation; the bottom heater keeps the temperature inside the chamber, and the water bath surrounding the egg maintains humidity. This system was used to detect fluorescent protein expressing cells in embryos. We could successfully trace those cells for 17 h in vivo. In conclusion, this system is useful for time‐lapse analysis of fluorescent protein expression and distribution for a longer period of time.
Transcription factor Tbx6 plays a central role in fate determination between mesenchyme and muscle in embryos of the ascidian, Halocynthia roretzi
Authors: Kumano Gaku , Negoro Nobue , Nishida Hiroki
Published: April 2014

Developmental fates are determined in relation to other fates in surrounding cells within the embryo, creating diversified tissue or cell types in the course of development. In ascidian embryos, maternally localized factors and inductive signals play essential and cooperative roles in fate determination at appropriate spatial and temporal positions during embryogenesis. Here, to clarify fate determination mechanisms of mesenchyme and muscle during mesenchyme induction by the fibroblast growth factor (FGF) signal in Halocynthia roretzi, we examined the function of transcription factor Tbx6, which acts as a pivotal mediator of the maternally localized muscle differentiation determinant Macho‐1. Our results suggest that the level of Tbx6 expression increases in muscle lineage cells through positive feedback regulation that promotes muscle differentiation as well as mesenchymal fate suppression. In addition, the FGF signal inactivated Tbx6 transcriptional activity and positive feedback, leading to induction of the mesenchymal lineage. Taken together, our finding suggests that Tbx6 is an important factor for determining mesenchyme and muscle fates.
Looking for predictors of functional outcomes in children with cerebellar abnormalities
Authors: Jissendi‐Tchofo Patrice
Published: April 2014

This commentary is on the original article by Al‐Maawali et al. on pages 460–467 of this issue.
Evaluation of patient satisfaction after non‐vital bleaching in traumatized discolored intact anterior teeth
Authors: Gupta Saurabh K. , Saxena Payal
Published: April 2014

Aim

This study evaluated patient satisfaction and clinical effectiveness of intracoronal bleach in traumatized anterior discolored intact teeth. Assessment of awareness and knowledge of the patient regarding treatment modalities for such cases was also performed.

Material and method

Forty‐one patients were included in the study. Walking bleach was performed using sodium perborate (tetrahydrate) after root canal treatment and proper cervical seal. Patient was recalled after 1 week for evaluation. The bleaching procedure was repeated again till the patient agreed for it. On each recall visit, shade evaluation was performed using the Vita Classic shade guide. On completion of treatment, the patients were questioned as to their satisfaction level. Statistical analysis was carried out using anova.

Results

87.8% of the subjects were highly satisfied with the results obtained; 7.32% were satisfied, while 4.9% were not satisfied. Average number of appointments needed for highly satisfied group was 2.75, and average shade change obtained was 11.97. Significantly more number of appointments were needed for the older patients (P < 0.01) or patients with older trauma (P < 0.05)/discoloration (P < 0.05). Severity of discoloration did not affect the number of appointments (P > 0.05). Most of the participants (97.6%) were not aware of bleaching procedure. The aspect of this treatment, which satisfied them the most, was improvement of the tooth coloration followed by conservation of tooth structure while the most perplexing thing was the unpredictability of final shade achieved and lack of color stability.

Conclusions

High level of patient satisfaction after non‐vital tooth bleach treatment strongly supports this treatment modality to be a conservative treatment alternative for traumatized discolored anterior tooth.
Evaluating an early intervention in psychosis service for ‘high‐risk’ adolescents: symptomatic and social recovery outcomes
Authors: Lower Rebecca , Wilson Jonathan , Medin Evelina , Corlett Emma , Turner Ruth , Wheeler Karen , Fowler David
Published: April 2014

Aim

This study presents client characteristics and treatment outcomes for a group of young people seen by Central Norfolk Early Intervention Team (CNEIT). The team offers an intensive outreach model of treatment to young people with complex co‐morbid emotional, behavioural and social problems, as well as the presence of psychotic symptoms.

Methods

Outcomes include both client self‐report and clinician‐rated measures. Data are routinely collected at acceptance into service, after 12 months of service and at point of discharge.

Results

Data show that clients seen by the CNEIT youth team are a group of young people at high risk of developing long‐term mental illness and social disability. Outcomes show significant reductions in not only psychotic symptomatology, but also co‐morbid anxiety and depression, as well as improvements in social recovery. At the end of their time with the service, the majority of clients are discharged back to the care of their general practitioner, which indicates that the team successfully managed to reduce the complexity of needs and difficulties associated with this client group.

Conclusions

Outcomes support the use of an intensive outreach approach for young people at high risk of developing psychotic disorders. It has been suggested that this model may be successfully broadened to young people with other emerging, potentially severe or complex mental disorders. Norfolk and Suffolk NHS Foundation Trust has built on the success of its youth early intervention team and innovatively redesigned its services in line with this model by developing a specific youth mental health service.
Premorbid self‐disorders and lifetime diagnosis in the schizophrenia spectrum: a prospective high‐risk study
Authors: Parnas Josef , Carter John , Nordgaard Julie
Published: April 2014

Aim

The notion of a disordered self as a core disturbance of schizophrenia was proposed in many foundational texts. Recent studies, spurred by the development of the Examination of Anomalous Self‐Experience (EASE), seem to indicate that self‐disorders are a specific manifestation of schizophrenia vulnerability. Follow‐up studies of help‐seeking, prodromal and first‐admission patients have demonstrated the utility of self‐disorders for predicting later schizophrenia‐spectrum disturbance. We wished to extend these findings by gauging the predictive value of self‐disorders in a premorbid, non‐clinical population at high risk for schizophrenia.

Methods

Children from the Copenhagen High‐Risk Project with high‐genetic risk for schizophrenia (N = 212) were assessed premorbidly (average age = 15), and diagnostically re‐evaluated after 10 and 25 years. Since the EASE was not available at the time of premorbid assessment, we hypothesized that a proxy scale drawn from the Minnesota Multiphasic Personality Inventory (MMPI) could distinguish those who later developed a schizophrenia‐spectrum disorder (N = 68) from those who remained healthy (N = 64). The Self‐Disorder Scale comprised 32 items whose content suggested an aspect of self‐disorder as measured by the EASE.

Results

Premorbid Self‐Disorder Scale scores significantly predicted lifetime schizophrenia‐spectrum diagnosis in the high‐risk cohort. Although there was considerable item overlap between the new scale and an existing MMPI scale (psychoticism), the overlap did not account for the Self‐Disorder Scale's predictive efficacy.

Conclusion

The results support the notion of self‐disorders as a core vulnerability feature in schizophrenia, detectable premorbidly in those developing later schizophrenia‐spectrum disorders.
Early lymphocyte recovery at 28 d post‐transplant is predictive of reduced risk of relapse in patients with acute myeloid leukemia transplanted with peripheral blood stem cell grafts
Authors: Michelis Fotios V. , Messner Hans A. , Loach David , Uhm Jieun , Gupta Vikas , Lipton Jeffrey H. , Seftel Matthew D. , Kuruvilla John , Kim Dennis D.
Published: April 2014

Allogeneic hematopoietic cell transplantation (HCT) is potentially curative for acute myeloid leukemia (AML). Impact of lymphocyte recovery on post‐transplant outcomes has been suggested but reports are conflicting. We evaluated the impact of lymphocyte recovery at 28 d post‐HCT in 191 AML patients using peripheral blood stem cells as graft. Patients were divided into those with absolute lymphocyte count (ALC) ≥0.5 × 109/L (n = 111, 58%; high ALC group) and those with ALC <0.5 × 109/L (n = 80, 42%; low ALC group), at day 28 post‐transplant. With a median follow‐up of 49 months, overall survival (OS) was significantly improved in the high ALC group (59% at 3 yr) vs. patients with low ALC (40% at 3 yr, P = 0.03). Cumulative incidence of relapse (CIR) was significantly lower in the high ALC group (16% at 3 yr) vs. low ALC group (36% at 3 yr, P = 0.001). Multivariable analysis for CIR demonstrated high ALC group as an independent factor decreasing relapse risk (P = 0.03, HR = 0.49, 95% CI = 0.26–0.92). Multivariable analysis for OS and non‐relapse mortality did not demonstrate ALC ≥0.5 × 109/L at 28 d post‐transplant to be predictive. We conclude that lymphocyte recovery with ALC ≥0.5 × 109/L at day 28 post‐transplant is associated with less relapse in AML patients undergoing allogeneic peripheral blood HCT, but without survival benefit.
Reading difficulty is associated with failure to lateralize temporooccipital function
Authors: Tailby Chris , Weintrob David L. , Saling Michael M. , Fitzgerald Carly , Jackson Graeme D.
Published: April 2014

Objective

Studies of focal epilepsy have revealed abnormalities of language organization; however, little attention has been paid to disorders of reading in this group. We hypothesized that language functional magnetic resonance imaging (fMRI) would reveal differences in language organization between focal epilepsy patients with and without reading difficulties.

Methods

We conducted language fMRI studies of 10 focal epilepsy patients with reading difficulties, 34 focal epilepsy patients without reading difficulties, and 42 healthy controls.

Results

We defined regions of interests on the basis of activation patterns on an orthographic lexical retrieval task. Comparison of activations within these ROIs on a second Noun‐Verb task revealed epilepsy‐related effects (relative to healthy controls: reduced activation in left inferior frontal cortex), as well as greater activation in the right temporooccipital cortex specific to the reading difficulty group.

Significance

These findings identify a focal epilepsy effect in the left frontal region (present in patients with and without reading difficulties), and a functional abnormality specific to the reading difficulty group localized to right temporooccipital cortex—a region implicated in lexicosemantic processing. Our observations suggest a failure of left hemisphere specialization among focal epilepsy patients with reading difficulties.

A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.
The influence of sampling design on tree‐ring‐based quantification of forest growth
Authors: Nehrbass‐Ahles Christoph , Babst Flurin , Klesse Stefan , Nötzli Magdalena , Bouriaud Olivier , Neukom Raphael , Dobbertin Matthias , Frank David
Published: April 2014

Tree‐rings offer one of the few possibilities to empirically quantify and reconstruct forest growth dynamics over years to millennia. Contemporaneously with the growing scientific community employing tree‐ring parameters, recent research has suggested that commonly applied sampling designs (i.e. how and which trees are selected for dendrochronological sampling) may introduce considerable biases in quantifications of forest responses to environmental change. To date, a systematic assessment of the consequences of sampling design on dendroecological and‐climatological conclusions has not yet been performed. Here, we investigate potential biases by sampling a large population of trees and replicating diverse sampling designs. This is achieved by retroactively subsetting the population and specifically testing for biases emerging for climate reconstruction, growth response to climate variability, long‐term growth trends, and quantification of forest productivity. We find that commonly applied sampling designs can impart systematic biases of varying magnitude to any type of tree‐ring‐based investigations, independent of the total number of samples considered. Quantifications of forest growth and productivity are particularly susceptible to biases, whereas growth responses to short‐term climate variability are less affected by the choice of sampling design. The world's most frequently applied sampling design, focusing on dominant trees only, can bias absolute growth rates by up to 459% and trends in excess of 200%. Our findings challenge paradigms, where a subset of samples is typically considered to be representative for the entire population. The only two sampling strategies meeting the requirements for all types of investigations are the (i) sampling of all individuals within a fixed area; and (ii) fully randomized selection of trees. This result advertises the consistent implementation of a widely applicable sampling design to simultaneously reduce uncertainties in tree‐ring‐based quantifications of forest growth and increase the comparability of datasets beyond individual studies, investigators, laboratories, and geographical boundaries.
Comparison of experimental fine‐mapping to in silico prediction results of HIV‐1 epitopes reveals ongoing need for mapping experiments
Authors: Roider Julia , Meissner Tim , Kraut Franziska , Vollbrecht Thomas , Stirner Renate , Bogner Johannes R. , Draenert Rika
Published: April 2014

Methods for identifying physiologically relevant CD8 T‐cell epitopes are critically important not only for the development of T‐cell‐based vaccines but also for understanding host–pathogen interactions. As experimentally mapping an optimal CD8 T‐cell epitope is a tedious procedure, many bioinformatic tools have been developed that predict which peptides bind to a given MHC molecule. We assessed the ability of the CD8 T‐cell epitope prediction tools syfpeithi, ctlpred and iedb to foretell nine experimentally mapped optimal HIV‐specific epitopes. Randomly – for any of the subjects' HLA type and with any matching score – the optimal epitope was predicted in seven of nine epitopes using syfpeithi, in three of nine epitopes using ctlpred and in all nine of nine epitopes using iedb. The optimal epitope within the three highest ranks was given in four of nine epitopes applying syfpeithi, in two of nine epitopes applying ctlpred and in seven of nine epitopes applying iedb when screening for all of the subjects' HLA types. Knowing the HLA restriction of the peptide of interest improved the ranking of the optimal epitope within the predicted results. Epitopes restricted by common HLA alleles were more likely to be predicted than those restricted by uncommon HLA alleles. Epitopes with aberrant lengths compared with the usual HLA‐class I nonamers were most likely not predicted. Application of epitope prediction tools together with literature searches for already described optimal epitopes narrows down the possibilities of optimal epitopes within a screening peptide of interest. However, in our opinion, the actual fine‐mapping of a CD8 T‐cell epitope cannot yet be replaced.
A Cognitive Interpretation of Data Analysis
Authors: Grolemund Garrett , Wickham Hadley
Published: April 2014

This paper proposes a scientific model to explain the analysis process. We argue that data analysis is primarily a procedure to build understanding, and as such, it dovetails with the cognitive processes of the human mind. Data analysis tasks closely resemble the cognitive process known as sensemaking. We demonstrate how data analysis is a sensemaking task adapted to use quantitative data. This identification highlights a universal structure within data analysis activities and provides a foundation for a theory of data analysis. The competing tensions of cognitive compatibility and scientific rigour create a series of problems that characterise the data analysis process. These problems form a useful organising model for the data analysis task while allowing methods to remain flexible and situation dependent. The insights of this model are especially helpful for consultants, applied statisticians and teachers of data analysis.
Does stimulant use impair housing outcomes in low‐demand supportive housing for chronically homeless adults?
Authors: Edens Ellen L. , Tsai Jack , Rosenheck Robert A.
Published: April 2014

Background

Recent research suggests low‐demand housing (ie, not contingent upon abstinence) is effective in helping people exit homelessness, even among recent active substance users. Whether active users of illicit drugs and stimulants have worse housing outcomes than primary alcohol users, however, is unknown.

Methods

A total of 149 participants in a multisite supportive housing program who reported high levels of active substance use at program entry were classified as either (1) predominantly “Alcohol Use” (>10 of 30 days alcohol, but not >10 days of drug use) or (2) “Illicit Drug Use” (>10 of 30 days any single illicit drug use with or without alcohol use). Sub‐analysis of the “Illicit Drug Use” group compared participants reporting high levels of “Stimulant Use” (>10 days cocaine, crack, or methamphetamine use) to those with high levels of “Non‐stimulant Use” (>10 days marijuana or other non‐stimulant drug use). Group differences in housing outcomes were examined with mixed model multivariate regression.

Results

During 24‐month follow‐up, days housed increased dramatically for both the “Alcohol Use” and the “Illicit Drug Use” groups without significant differences. Sub‐analysis of illicit drug users showed stimulant use was associated with fewer days housed (p = .01) and more days homeless (p = .02) over time.

Conclusions

Among illicit drug users, stimulant users have somewhat less successful housing outcomes than other active drug and alcohol users, though both groups maintained substantial housing improvements in low‐demand housing. (Am J Addict 2014;23:243–248)
Sex differences in smoking cue reactivity: Craving, negative affect, and preference for immediate smoking
Authors: Doran Neal
Published: April 2014

Background and Objectives

Female smokers have greater difficulty quitting, possibly due to increased reactivity to smoking‐related cues. This study assessed sex differences in craving, affect, and preference for immediate smoking after cue exposure.

Methods

Regular smokers (n = 60; 50% female) were exposed to smoking and neutral cues in separate, counterbalanced sessions. Outcomes included changes in craving and affect and preference for immediate smoking following cue exposure.

Results

Findings indicated that women exhibited greater preference for immediate smoking (p = .004), and reported greater cue‐induced increases in cigarette craving (p = .046) and negative affect (p = .025).

Discussion and Conclusions

These data suggest that women may have greater difficulty inhibiting smoking after cue exposure, possibly as a consequence of greater increases in craving and negative affect.

Scientific Significance and Future Directions

Findings suggest a mechanism that may contribute to greater cessation failure among female smokers. (Am J Addict 2014;23:211–217)
Indirect effects of 12‐session seeking safety on substance use outcomes: Overall and attendance class‐specific effects
Authors: Morgan‐Lopez Antonio A. , Saavedra Lissette M. , Hien Denise A. , Campbell Aimee N. , Wu Elwin , Ruglass Lesia , Patock‐Peckham Julie A. , Bainter Sierra C.
Published: April 2014

Objectives

This study examined in‐ and post‐treatment mediation effects of a 12‐session dose of Seeking Safety (SS)—an integrative cognitive behavioral treatment for comorbid PTSD and SUDs—on alcohol and cocaine outcomes in comparison to Women's Health Education (WHE) in a seven‐site randomized controlled effectiveness trial.

Methods

Women (n = 353) enrolled in outpatient substance abuse treatment, who had experienced multiple traumas in childhood and/or adulthood and who had comorbid PTSD, were randomly assigned to receive SS or WHE delivered in open enrollment groups for 12 sessions in 6 weeks (unlike the full 25‐topic SS protocol). Data were analyzed under two forms of longitudinal mediation analysis, each accounting for changes over time in group membership and group context, respectively.

Results

Women in SS, compared to WHE, showed significantly steeper decreases in PTSD frequency and severity, which in turn, showed significant impact in reducing both cocaine and alcohol use. This pattern was strongest for those who completed most of the treatment sessions, which was the majority of patients in the trial; these patterns only emerged during the in‐treatment phase.

Conclusions

Use of an integrated approach to PTSD/SUD such as SS can be helpful to more rapidly reduce PTSD, which consequently reduce SUD symptoms, particularly for those who attend most of the available treatment sessions.

Scientific Significance

This is one of the first studies to illustrate such effects in treating comorbid PTSD and SUD in the context of a highly impaired population delivered by community‐based providers. (Am J Addict 2014;23:218–225)
Alcoholics anonymous and twelve‐step recovery: A model based on social and cognitive neuroscience
Authors: Galanter Marc
Published: April 2014

Background

In the course of achieving abstinence from alcohol, longstanding members of Alcoholics Anonymous (AA) typically experience a change in their addiction‐related attitudes and behaviors. These changes are reflective of physiologically grounded mechanisms which can be investigated within the disciplines of social and cognitive neuroscience.

Objective

This article is designed to examine recent findings associated with these disciplines that may shed light on the mechanisms underlying this change.

Method

Literature review and hypothesis development.

Results

Pertinent aspects of the neural impact of drugs of abuse are summarized. After this, research regarding specific brain sites, elucidated primarily by imaging techniques, is reviewed relative to the following: Mirroring and mentalizing are described in relation to experimentally modeled studies on empathy and mutuality, which may parallel the experiences of social interaction and influence on AA members. Integration and retrieval of memories acquired in a setting like AA are described, and are related to studies on storytelling, models of self‐schema development, and value formation. A model for ascription to a Higher Power is presented.

Conclusion

The phenomena associated with AA reflect greater complexity than the empirical studies on which this article is based, and certainly require further elucidation. Despite this substantial limitation in currently available findings, there is heuristic value in considering the relationship between the brain‐based and clinical phenomena described here.

Scientific Significance

There are opportunities for the study of neuroscientific correlates of Twelve‐Step‐based recovery, and these can potentially enhance our understanding of related clinical phenomena. (Am J Addict 2014;23:300–307)
Epidemiological trends and the advances of treatments of amphetamine‐type stimulants (ATS) in China
Authors: Sun Hong‐Qiang , Chen Hong‐Mei , Yang Fu‐De , Lu Lin , Kosten Thomas R.
Published: April 2014

Background and Objectives

Amphetamine‐type stimulants (ATS) have quickly spread and been widely abused in many parts of the world, particularly in China. This review focuses on and describes the epidemiological trends and the advances of treatments of ATS in China.

Methods

A descriptive study based on literature identified from searches of the China National Knowledge Infrastructure (1979–2013), PubMed databases, hand‐picked references, and online references with emphasis on epidemiology, treatment and traditional Chinese medicine. This review covers some traditional Chinese treatments and their complementary Western approaches.

Results and Conclusions

The epidemiological trends of ATS in China have led to its being 2.2 times the rate of morphine abuse and second only to marijuana abuse. The treatment programs in China have used traditional herbal approaches as well as acupuncture, often in combination with Western medications such as fluoxetine for depression associated with ATS abuse. Other herbal treatments have reversed the cardiac arrhythmias associated with ATS intoxication, and acupuncture has been used successfully for the protracted depressive and somatic symptoms of ATS withdrawal over a period of 3 months.

Scientific Significance

These traditional Chinese treatments may be increasingly available to the world, but will remain a consistent complementary therapy for ATS in China and the Far East, where ATS has become such a prevalent problem. (Am J Addict 2014;23:313–317)
Injured workers in China: Injustice, conflict and social unrest
Authors: ZHU Ying , CHEN Peter Y. , ZHAO Wei
Published: April 2014

Compared to other, developed countries, there has been a disproportionately high level of work‐related accidents and ill health in China over the past decade, resulting in increased conflict and unrest, thereby undermining social stability and social harmony. To investigate how key stakeholders address occupational safety and health (OSH) challenges, the authors interview 25 injured workers from five Chinese provinces about: safety practices at work; potential causes of injury; how the workers were treated – or mistreated – when they were injured; and the compensation process, and present recommendations for addressing OSH problems in China, in order to ensure social justice and social harmony.
Ethnic wage gaps in Peru: What drives the particular disadvantage of indigenous women?
Authors: KOLEV Alexandre , SUÁREZ ROBLES Pablo
Published: April 2014

Ethnic inequality in labour market outcomes has long been on the policy agenda across Latin America. Using National Household Survey data, the authors analyse Peru's ethnic wage gap by sex over the period 2005–11. Although the gender wage gap is smaller than the ethnic gap, indigenous women compound both disadvantages. Interpreting the unexplained component of the gap as an upperlimit measure of ethnic discrimination, the authors then decompose the explained component into the discrete effects of individual, job and locational characteristics. Since more of the ethnic wage gap can be explained on these grounds among women, they conclude with targeted policy proposals.
Pulse Wave Velocity in Four Extremities for Assessing Cardiovascular Risk Using a New Device
Authors: Muñoz‐Tsorrero Juan Francisco Sanchez , Tardio‐Fernandez Marcos , Valverde‐Valverde Jose M. , Duque‐Carrillo Francisco , Vega‐Fernandez Jose M. , Joya‐Vazquez Pedro , Vega‐Fernandez Jorge
Published: April 2014

Pulse wave velocity (PWV) is used for evaluating atherosclerosis; however, it is far from routine use. The authors validate a new device measuring PWV independently in each limb and explore its usefulness. Validity was studied in 40 patients. PWV was compared with endovascular measurements and comparisons were made between PWV in the extremities in 220 patients. The correlation between brachial PWV and endovascular catheter was (r=0.83, P<.001). The correlation coefficients for interobserver and intraobserver were r=0.87 and r=0.91, respectively. The sum of PWV in limbs allowed better stratification of patients according to cardiovascular risk. The validity and reproducibility of PWV measured with this device was good. The sum of PWV in extremities was a good index for stratifying patients according to vascular risk. These results suggest that the device is useful in the evaluation of arteriosclerosis and could possibly replace measurement devices available today.
Why acquiesce? Worker reproductive parasitism in the Eastern honeybee (Apis cerana)
Authors: Holmes M. J. , Tan K. , Wang Z. , Oldroyd B. P. , Beekman M.
Published: April 2014

Most societies are vulnerable to rogue individuals that pursue their own interests at the expense of the collective entity. Societies often protect themselves from selfish behaviour by ‘policing’, thereby enforcing the interests of the collective over those of individuals. In insect societies, for example, selfish workers can activate their ovaries and lay eggs, exploiting the collective brood rearing system for individual benefit. Policing, usually in the form of oophagy of worker‐laid eggs, controls selfish behaviour. Importantly, once an effective system of policing has evolved, the incentive for personal reproduction is lost, and ‘reproductive acquiescence’ in which ovary activation is rare or absent is predicted to evolve. Studies of social Hymenoptera have largely supported the prediction of worker ‘acquiescence’; workers of most species where policing is well developed have inactive ovaries. However, the eastern honeybee Apis cerana appears to be an exception. A. cerana colonies are characterized by highly efficient policing, yet about 5% of workers have active ovaries, even when a queen is present. This suggests that the evolution of acquiescence is incomplete in A. cerana. We regularly sampled male eggs and pupae from four A. cerana colonies. Workers had high levels of ovary activation overall (11.7%), and 3.8% of assignable male eggs and 1.1% of assignable male pupae were worker‐laid. We conclude that workers with active ovaries lay their eggs, but these rarely survive to pupation because of intense policing. We then used our findings as well as previously published data on A. cerana and A. mellifera to redo the meta‐analysis on which reproductive acquiescence theory is based. Including data on both species did not affect the relationship between effectiveness of policing and levels of worker reproduction. Their inclusion did, however, seriously weaken the relationship between relatedness among workers and levels of worker reproduction. Our work thus suggests that relatedness among workers does not affect the probability that workers will attempt to reproduce, but that it is coercion by peers that limits worker reproduction.
Shifting the Fat‐Tailed Distribution of Blockbuster Punitive Damages Awards
Authors: Viscusi W. Kip , McMichael Benjamin J.
Published: April 2014

The distribution of blockbuster punitive damages awards has fat tails similar to the distributions of losses from natural disasters. Extremely large awards occur more often and are more difficult to predict than if blockbuster awards were distributed normally. The size and predictability of awards are important factors in theU.S.SupremeCourt's decisions on punitive damages. This article examines the effect of theCourt's decision inStateFarm v.Campbellon blockbuster punitive damages awards.StateFarmshifts the fat tail of the distribution of blockbuster awards down (or “thins” the tail), which is consistent with a restraining effect on award size.StateFarmreduces the size of blockbuster awards in general, but this reduction is most salient in the upper half of the distribution of awards.StateFarmalso has a negative influence on the probability of exceeding a single‐digit ratio between punitive and compensatory damages. This article also examines the largest awards and considers why defendants may not pay large punitive damages awards.
Salvelinus namaycushspawning substratum attracts egg predators and opportunists through chemosensory cues
Authors: Wasylenko B. A. , Callaghan D. T. , Blanchfield P. J. , Pyle G. G.
Published: April 2014

Two separate field experiments were conducted in a series of small boreal lakes to test for the attraction of egg predators to lake troutSalvelinus namaycushspawning shoals and subsequently to determine whether chemosensory cues attract egg predators to these sites. In the first experiment, minnow traps set on spawning sites captured significantly more egg predators than those set on structurally similar non‐spawning sites. Captures of slimy sculpinCottus cognatus, common shinerLuxilus cornutus, blacknose shinerNotropis heterolepisand virile crayfishOrconectes viriliswere more than double on spawning sites relative to non‐spawning sites for the two study lakes. To test whether chemosensory cues could attract egg predators toS. namaycushspawning sites, paired minnow traps were placed on eight to 10 sites in each of the three study lakes; one trap contained visually concealedS. namaycushspawning substratum and the other with visually concealed non‐spawning substratum. Traps containing spawning substratum consistently captured more fish and had higher mean daily catches than those that contained non‐spawning substratum. The combined results demonstrate a greater prevalence of egg predators onS. namaycushspawning shoals that appears to be the result of chemosensory attraction to spawning substratum.
Colonic diverticular hemorrhage associated with the use of nonsteroidal anti‐inflammatory drugs, low‐dose aspirin, antiplatelet drugs, and dual therapy
Authors: Nagata Naoyoshi , Niikura Ryota , Aoki Tomonori , Shimbo Takuro , Kishida Yoshihiro , Sekine Katsunori , Tanaka Shohei , Watanabe Kazuhiro , Sakurai Toshiyuki , Yokoi Chizu , Akiyama Junichi , Yanase Mikio , Mizokami Masashi , Uemura Naomi
Published: April 2014

Background and Aim

The effects of various medications on lower gastrointestinal tract remains unknown. Here, we investigated the effects of nonsteroidal anti‐inflammatory drugs (NSAIDs), low‐dose aspirin, and antiplatelet drugs associated with diverticular bleeding.

Methods

This prospective study involved patients with diverticulosis who underwent colonoscopy. Alcohol and smoking, medications, and Charlson comorbidity index and Gastrointestinal Symptom Rating Scale scores were assessed. The medications evaluated were nine kinds of NSAIDs, two kinds of low‐dose aspirin, 10 kinds of nonaspirin antiplatelet drugs, three kinds of anticoagulants, acetaminophen, and corticosteroids. Adjusted odds ratios (aOR) were estimated by a logistic regression model.

Results

A total of 911 patients with non‐bleeding diverticula (n = 758) and bleeding diverticula (n = 153) were enrolled. Independent risk factors were alcohol consumption (light drinker, aOR 3.4; ≥ moderate drinker, aOR 3.3), smoking index (≥ 400, aOR 2.0), NSAIDs (aOR 4.6), low‐dose aspirin (aOR 1.9), and nonaspirin antiplatelet drugs (aOR 2.2). The drugs significantly associated with bleeding were loxoprofen (aOR 5.0), diclofenac (aOR 3.1), diclofenac suppository (aOR 8.0), etodolac (aOR 4.9), enteric‐coated aspirin (aOR 3.9), buffered aspirin (aOR 9.9), clopidogrel (aOR 2.5), and cilostazol (aOR 7.3). Dual therapy carried a higher risk than monotherapy (single NSAID, aOR 3.6, P < 0.01; dual, aOR 23, P < 0.01; single antiplatelet drug, aOR 2.0, P < 0.01; dual, aOR 4.1, P < 0.01).

Conclusions

Besides alcohol and smoking, NSAIDs, low‐dose aspirin, and antiplatelet drugs are risk factors for diverticular bleeding. The magnitude of risk may differ between different kinds of NSAIDs and antiplatelet drugs, and dual therapy with NSAIDs or antiplatelet drugs increases the risk of bleeding.
Associations of FUT2 and FUT3 gene polymorphisms with Crohn's disease in Chinese patients
Authors: Hu Ding‐yuan , Shao Xiao‐xiao , Xu Chang‐long , Xia Sheng‐long , Yu Li‐qin , Jiang Li‐jia , Jin Jie , Lin Xiu‐qing , Jiang Yi
Published: April 2014

Background and Aim

FUT2 and FUT3 genes are responsible for the formation of histo‐blood group antigens, which act as binding sites for some intestinal microbes. Several studies suggested that FUT2 gene might affect the intestinal microbiota composition and modulate innate immune responses. However, the effect of FUT2 polymorphisms on Crohn's disease (CD) is uncertain. Our study aimed to analyze associations of CD with FUT2 and FUT3 polymorphisms in Chinese population.

Methods

A total of 273 CD patients and 479 controls were recruited. The genotypes of FUT2 (rs281377, rs1047781, and rs601338) and FUT3 (rs28362459, rs3745635, and rs3894326) were detected by SNaPshot analysis.

Results

Compared with controls, homozygote TT of FUT2 (rs1047781) was significantly increased in CD patients (TT vs others; P = 0.002, odds ratio [OR] = 1.767, 95% confidence interval [CI] = 1.235–2.528). The haplotype TT formed with FUT2 (rs281377) and (rs1047781) was more prevalent in CD patients than in controls (48.9% vs 43.5%, P = 0.046). Mutant T allele and homozygote TT of FUT2 (rs1047781) were increased in colonic CD patients compared with controls (P < 0.001, OR = 1.843, 95% CI = 1.353–2.512; P < 0.001, OR = 2.607, 95% CI = 1.622–4.191, respectively). Although allele and genotypic distributions of FUT3 were not statistically different between CD patients and controls, mutant allele and genotype of FUT3 (rs28362459) and (rs3745635) were significantly discrepant in three subgroups of CD patients according to lesion locations (all P < 0.05).

Conclusions

Our study strongly implicates the polymorphic locus of FUT2 (rs1047781) in CD susceptibility in Chinese population. Mutations of FUT3 (rs28362459) and (rs3745635) might influence the lesion locations in CD patients.
Murine genetic deficiency of neuronal nitric oxide synthase (nNOS‐/‐) and interstitial cells of Cajal (W/Wv): Implications for achalasia?
Authors: Müller Michaela , Colcuc Sebastian , Drescher Daniel G. , Eckardt Alexander J. , von Pein Harald , Taube Christian , Schumacher Johannes , Gockel Henning R. , Schimanski Carl C. , Lang Hauke , Gockel Ines
Published: April 2014

Background and Aim

Nitric oxide (NO) is an important inhibitory mediator of esophageal function, and its lack leads to typical features of achalasia. In contrast, the role of intramuscular interstitial cells of Cajal (ICC‐IM) and vasoactive intestinal peptide (VIP) in lower esophageal sphincter (LES) function is still controversial. Therefore, we examined the function and morphology of the LES in vivo in NO‐deficient (nNOS‐/‐), ICC‐IM‐deficient (W/Wv)‐, and wild‐type (WT) mice.

Methods

Esophageal manometry was performed with a micro‐sized transducer catheter to quantify LES pressure, swallow evoked LES relaxation, and esophageal body motility. The LES morphology was examined by semiquantitative analysis of the immunoreactivity (reduction grade I–IV) of neuronal NOS (nNOS), ICC‐IM, and VIP and their correlation with esophageal function.

Results

nNOS‐/‐ in comparison to WT mice showed a significantly higher LES mean resting pressure with an impaired swallow induced relaxation, whereas W/Wv mice had a hypotensive LES with decreased relaxation. W/Wv and nNOS‐/‐ mice demonstrated differing degrees of tubular esophageal dysfunction.

The reduced immunoreactivity of nNOS correlated with an increased LES pressure and decreased LES relaxation, respectively. Cajal‐cell reduction correlated with impaired LES relaxation, whereas VIP reduction revealed no correlation with esophageal function.

Conclusions

The reduction of ICC‐IM and nNOS can cause dysfunction of the LES and esophageal peristalsis, whereas VIP reduction seems to have no effect. ICC‐IM and nNOS deficiency might be independent relevant causes of esophageal dysfunction similar to that seen in human achalasia.