bluuebunny/crossref_metadata_2025 huggingface dataset:
Moving forward on gait measurement: Toward a more refined approach
Authors: Lord Sue , Galna Brook , Rochester Lynn
Published: October 2013

Gait is emerging as a powerful measurement tool in neurodegenerative disorders to identify markers of incipient pathology, inform diagnostic algorithms and disease progression, and measure the efficacy of interventions. However, it is unclear which of the many gait outcomes is most appropriate for each of these purposes. In this review, we summarise key topics relating to gait measurement. We draw on literature from Parkinson's disease, ageing, and neurodegenerative disease to address the issue of variable selection with the goal of moving toward a structured approach to measurement. Findings from this review identify a wide range of spatiotemporal and dynamic characteristics; however, their suitability differs according to the aim of measurement. Gait speed is useful as a global characteristic of performance but may not capture the nature of underlying pathology. Inconsistent application, reporting, and interpretation of gait outcomes currently preclude a prescriptive approach. Conceptual models of gait may facilitate a reasoned approach to outcome selection. We also recommend harmonisation of protocols, longitudinal cohort studies, and use of novel technologies and methods of analysis to provide a complete picture of gait. Gait characteristics are “fit for purpose” when selected according to a clear rationale and in accordance with their clinimetric properties. Evidence supports the use of gait as a biomarker of disease and to complement diagnosis and inform disease management. A structured approach to measurement is urgently required to fully realise the contribution gait can make to our understanding of neurodegenerative disease. © 2013 International Parkinson and Movement Disorder Society
Dynamic control of posture across locomotor tasks
Authors: Earhart Gammon M.
Published: October 2013

Successful locomotion depends on postural control to establish and maintain appropriate postural orientation of body segments relative to one another and to the environment and to ensure dynamic stability of the moving body. This article provides a framework for considering dynamic postural control, highlighting the importance of coordination, consistency, and challenges to postural control posed by various locomotor tasks, such as turning and backward walking. The impacts of aging and various movement disorders on postural control are discussed broadly in an effort to provide a general overview of the field and recommendations for assessment of dynamic postural control across different populations in both clinical and research settings. Suggestions for future research on dynamic postural control during locomotion also are provided and include discussion of opportunities afforded by new and developing technologies, the need for long‐term monitoring of locomotor performance in everyday activities, gaps in our knowledge of how targeted intervention approaches modify dynamic postural control, and the relative paucity of literature regarding dynamic postural control in movement disorder populations other than Parkinson's disease. © 2013 International Parkinson and Movement Disorder Society
Effects of exercise on mobility in people with Parkinson's disease
Authors: van der Kolk Nicolien M. , King Laurie A.
Published: October 2013

Parkinson's disease is a prevalent neurodegenerative disorder for which only symptomatic treatment exists. Gait and balance disturbance is common in Parkinson's disease and is a major contributor to increased disability and decreased health‐related quality of life and survival. Balance and gait deficits in Parkinson's disease are notoriously difficult to treat and are not significantly helped by pharmacological or surgical treatment. The last two decades have seen a dramatic increase in the research and clinical interest in using exercise as a treatment for mobility problems in people with Parkinson's disease. With exciting advances in basic science research suggesting neurochemical and neuroplastic changes after exercise, an increasing number of high‐quality studies are documenting particular aspects of mobility improving after exercise. Exercise has the potential to help both motor (gait, balance, strength) and nonmotor (depression, apathy, fatigue, constipation) aspects of Parkinson's disease as well as secondary complications of immobility (cardiovascular, osteoporosis). This perspective article focuses primarily on recent evidence on the effects of exercise in improving mobility while highlighting the importance of targeted exercise intervention for maximizing the benefits of exercise. Suggestions for exercise guidelines, adherence issues, and directions for future research are provided. © 2013 International Parkinson and Movement Disorder Society
Higher‐level gait disorders: An open frontier
Authors: Nutt John G.
Published: October 2013

The term higher‐level gait disorders (HLGD) defines a category of balance and gait disorders that are not explained by deficits in strength, tone, sensation, or coordination. HLGD are characterized by various combinations of disequilibrium and impaired locomotion. A plethora of new imaging techniques are beginning to determine the neural circuits that are the basis of these disorders. Although a variety of neurodegenerative and other pathologies can produce HLGD, the most common cause appears to be microvascular disease that causes white‐matter lesions and thereby disrupts balance/locomotor circuits. © 2013 International Parkinson and Movement Disorder Society
Clinical syndromes: Parkinsonian gait
Authors: Ebersbach Georg , Moreau Caroline , Gandor Florin , Defebvre Luc , Devos David
Published: October 2013

Disturbances of gait manifest in almost all cases of Parkinson's disease (PD), often leading to loss of mobility and increased mortality. In this review a clinically oriented approach to gait disorders in different stages of PD is presented. In addition, interactions between motor behavior and mental processing will be discussed. Analyzing the clinical features of gait can be helpful to differentiate PD from atypical forms of parkinsonism. Bedside tests to distinguish parkinsonian gait disorders are reviewed. There is still an unmet need to effectively treat complex gait disturbances, which are frequently not responsive to dopamine replacement medication. We thus present current approaches for the management of dopa‐refractory gait disorders. © 2013 International Parkinson and Movement Disorder Society
Deep brain stimulation for gait and postural symptoms in Parkinson's disease
Authors: Pötter‐Nerger Monika , Volkmann Jens
Published: October 2013

In patients with Parkinson's disease, gait and balance difficulties have emerged as some of the main therapeutic concerns. During earlier stages of the disease, the dopamine‐responsive aspects of gait disorder can be treated initially with dopaminergic drugs or deep brain stimulation. However, certain temporal aspects of parkinsonian gait disorder remain therapeutically resistant in both the short term and the long term. In this review, we summarize the effects of deep brain stimulation on gait and postural symptoms in the five currently available targets (subthalamic nucleus, globus pallidus, ventralis intermedius thalamic nucleus, pedunculopontine nucleus, and substantia nigra) and describe programming strategies for patients who are mainly disabled by gait problems. © 2013 International Parkinson and Movement Disorder Society
Emerging therapies for gait disability and balance impairment: Promises and pitfalls
Authors: Maetzler Walter , Nieuwhof Freek , Hasmann Sandra E. , Bloem Bastiaan R.
Published: October 2013

Therapeutic management of gait and balance impairment during aging and neurodegeneration has long been a neglected topic. This has changed considerably during recent years, for several reasons: (1) an increasing recognition that gait and balance deficits are among the most relevant determinants of an impaired quality of life and increased mortality for affected individuals; (2) the arrival of new technology, which has allowed for new insights into the anatomy and functional (dis)integrity of gait and balance circuits; and (3) based in part on these improved insights, the development of new, more specific treatment strategies in the field of pharmacotherapy, deep brain surgery, and physiotherapy. The initial experience with these emerging treatments is encouraging, although much work remains to be done. The objective of this narrative review is to discuss several promising developments in the field of gait and balance treatment. We also address several pitfalls that can potentially hinder a fast and efficient continuation of this vital progress. Important issues that should be considered in future research include a clear differentiation between gait and balance as two distinctive targets for treatment and recognition of compensatory mechanisms as a separate target for therapeutic intervention. © 2013 International Parkinson and Movement Disorder Society
Characterizing freezing of gait in Parkinson's disease: Models of an episodic phenomenon
Authors: Nieuwboer Alice , Giladi Nir
Published: October 2013

Freezing of gait (FOG) is a very disabling and common gait disorder in Parkinson's disease (PD). The first aim of this article was to provide a methodological and critical review of the most common research approach to understand FOG, ie, comparing the behavior of freezers with that of non‐freezers. The review demonstrates that studies often fall short in clearly defining the freezer\non‐freezer groups and in controlling for disease severity and other confounders. These problems complicate data interpretation on FOG. The second aim of this article was to summarize the literature on the potential mechanisms behind the episodic nature of FOG in the following four models: (1) The threshold model assumes that FOG occurs when the accumulation of various motor deficits reinforce each other to a point of motor breakdown; (2) the interference model proposes that FOG represents an inability to deal with concurrent cognitive, limbic, and motor input, causing an interruption of locomotion; (3) the cognitive model views FOG as induced by a failure to process response conflict, leading to behavioral indecision; and (4) the decoupling model sees FOG as a disconnection between preparatory programming and the intended motor response as a result of which automatic movement generation gets stuck. These four theoretical premises are still incomplete and do not fully explain FOG. The depletion of motor and cognitive reserves and an increasingly complex response to levodopa with disease progression will also have an impact on the emergence of FOG episodes. © 2013 International Parkinson and Movement Disorder Society
Performance of a motor task learned on levodopa deteriorates when subsequently practiced off
Authors: Anderson Elise D. , Horak Fay B. , Lasarev Michael R. , Nutt John G.
Published: October 2013

Studies in animals and in people with Parkinson's disease (PD) demonstrate complex effects of dopamine on learning motor tasks; its effect on retention of motor learning has received little attention. Recent animal studies demonstrate that practicing a task in the off state, when initially learned in the on state, leads to progressive deterioration in performance. We measured the acquisition and retention of 3 different motor tasks in the presence and absence of levodopa. Twenty individuals with Hoehn and Yahr Stage 1.5 to 3 PD practiced the tasks daily for two 4‐day weeks, one half practicing on l‐dopa the first week and off the second week. The other half practiced off l‐dopa both weeks. The tasks were (1) alternate tapping of 2 keys, (2) moving the body toward 2 targets on a posturography device, and (3) mirror drawing of a star. For the tapping and body movement tests, those who practiced on the first week had a progressive decline in performance with practice during week 2, while subjects off during week 1 maintained or improved. In contrast, for the mirror task, subjects on l‐dopa initially had much more difficulty completing the task compared to subjects who practiced off. Both groups improved with practice the first week and had flat performance the second week. These data suggest that performance of speed‐accuracy tasks learned in the on state may progressively worsen if subsequently practiced in the off state. In addition, performance, but not learning, of some tasks may be impeded by l‐dopa. © 2013 International Parkinson and Movement Disorder Society.
Exploring the links between adult education and human resource development: Learning, risk‐taking, and democratic discourse
Authors: Reio Thomas G.
Published: October 2013

Learning is indeed an integral component of adapting successfully to an ever‐changing world, one full of intriguing possibilities and insidious barriers. Democratic societies establish educative systems where learning and development is promoted to advance a citizenry of skillful problem solvers, knowledgeable decision makers, incisive risk takers, and proactive participants in the democratic process. Learning and its unequivocal support are thus vital for an evolving democratic society where its citizens are mindful of and committed to the social good. The fields of adult education (AE) and human resource development (HRD) play particularly significant roles in providing quality learning and development opportunities for adults, yet both are underrated in terms of their contributions to society as a whole. In this paper, I exploreAEandHRDas closely related, but underestimated parts of a greater educative system. Both fields’ perceived marginal role as educative system participants may be a function of unnecessarily fractious debates among scholars and practitioners in their respective fields. Unfortunately, differences and not similarities are promoted too often at the expense of useful cooperation and one unified voice.
Adult continuing education and human resource development: Present competitors, potential partners
Authors: Smith Douglas H.
Published: October 2013

Author's Note : In May 1989, this article was published inLivelong Learning, the monthly practitioner journal of the American Association for Adult and Continuing Education (Vol. 12, No. 7, pp. 13–17). Now viewed as a period reference article, it presents the relationship of adult and continuing education (ACE) and human resource development (HRD) in the late 1980s, providing both a description of the differences betweenACEandHRDand the conceptual and programmatic reasons for these differences. When asked if it could be published again, I first thought of updating some of the data, particularly theACEandHRDproductivity. I didn't for two reasons. First, it would no longer be a period piece, where you could compare theACEandHRDproductivity with 25 year old data. Second, and more important, the purpose of the article was to emphasize how and whyACEandHRDwould benefit from working together. Now, some 25 year later it is my observation that little has changed. The relationship betweenACEandHRDis still about the same ‐ they remain competitors that still don't talk and work with each other.
Mutational analysis of BRAF and KRAS in ovarian serous borderline (atypical proliferative) tumours and associated peritoneal implants
Authors: Ardighieri Laura , Zeppernick Felix , Hannibal Charlotte G , Vang Russell , Cope Leslie , Junge Jette , Kjaer Susanne K , Kurman Robert J , Shih Ie‐Ming
Published: October 2013

There is debate as to whether peritoneal implants associated with serous borderline tumours/atypical proliferative serous tumours (SBT/APSTs) of the ovary are derived from the primary ovarian tumour or arise independently in the peritoneum. We analysed 57 SBT/APSTs from 45 patients with advanced‐stage disease identified from a nation‐wide tumour registry in Denmark. Mutational analysis for hotspots in KRAS and BRAF was successful in 55 APSTs and demonstrated KRAS mutations in 34 (61.8%) and BRAF mutations in eight (14.5%). Mutational analysis was successful in 56 peritoneal implants and revealed KRAS mutations in 34 (60.7%) and BRAF mutations in seven (12.5%). Mutational analysis could not be performed in two primary tumours and in nine implants, either because DNA amplification failed or because there was insufficient tissue for mutational analysis. For these specimens we performed VE1 immunohistochemistry, which was shown to be a specific and sensitive surrogate marker for a V600E BRAF mutation. VE1 staining was positive in one of two APSTs and seven of nine implants. Thus, among 63 implants for which mutation status was known (either by direct mutational analysis or by VE1 immunohistochemistry), 34 (53.9%) had KRAS mutations and 14 (22%) had BRAF mutations, of which identical KRAS mutations were found in 34 (91%) of 37 SBT/APST–implant pairs and identical BRAF mutations in 14 (100%) of 14 SBT/APST–implant pairs. Wild‐type KRAS and BRAF (at the loci investigated) were found in 11 (100%) of 11 SBT/APST–implant pairs. Overall concordance of KRAS and BRAF mutations was 95% in 59 of 62 SBT/APST–implant (non‐invasive and invasive) pairs (p < 0.00001). This study provides cogent evidence that the vast majority of peritoneal implants, non‐invasive and invasive, harbour the identical KRAS or BRAF mutations that are present in the associated SBT/APST, supporting the view that peritoneal implants are derived from the primary ovarian tumour. Copyright © 2013 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Simultaneous Determination of Sulphoraphane and Sulphoraphane Nitrile inBrassicaVegetables using Ultra‐Performance Liquid Chromatography with Tandem Mass Spectrometry
Authors: Alvarez‐Jubete Laura , Smyth Thomas J. , Valverde Juan , Rai Dilip K. , Barry‐Ryan Catherine
Published: October 2013

Introduction

Several analytical methods exist for the determination of sulphoraphane or sulphoraphane nitrile from biological matrices and plant extracts. However, no UPLC–MS/MS method exists for the simultaneous detection of both.

Objective

To develop and validate an UPLC–MS/MS method for the simultaneous analysis of sulphoraphane and sulphoraphane nitrile fromBrassica oleraceaL. ssp.italica

Methods

This method was developed utilising an Acquity BEH C8 column with gradient elution combined with tandem mass spectrometry, using positive electrospray ionisation in multiple reaction monitoring mode.

Results

The retention times for sulphoraphane and sulphoraphane nitrile were 0.4 and 0.6 min respectively, and total run time was 3 min. The method was validated for linearity, sensitivity, precision, accuracy, matrix effects and recovery. The method was employed to determine glucoraphanin hydrolysis products in broccoli and the predominant product was found to vary depending on the variety tested. It was also applied to the accurate determination of sulphoraphane and sulphoraphane nitrile in broccoli samples hydrolysed under different conditions. It was observed that the formation of sulphoraphane and sulphoraphane nitrile was influenced by the temperature of the reaction.

Conclusion

The validated UPLC–MS/MS method for simultaneous detection of sulphoraphane and sulphoraphane nitrile was shown to be applicable to broccoli plants and is expected to be applicable to other cruciferous sources. Copyright © 2013 John Wiley & Sons, Ltd.
Risk factors for venous thromboembolism during pregnancy
Authors: Jensen Thomas Bo , Gerds Thomas Alexander , Grøn Randi , Bretler Ditte‐Marie , Schmiegelow Michelle Dalgas , Andersson Charlotte , Azimi Aziza , Gislason Gunnar , Torp‐Pedersen Christian , Olesen Jonas Bjerring
Published: October 2013

Background

Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated.

Purpose

To examine pharmacological and non‐pharmacological VTE risk factors during pregnancy (antepartum).

Methods

The population comprised all pregnant women in Denmark aged 15–50 giving birth 2003–2010. Pregnancies were linked on an individual level with national registers for hospital admissions and drug dispenses from pharmacies. Risk of first occurring VTE antepartum was examined with Cox regression models.

Results

Out of 299 810 pregnancies, 337 experienced a VTE, incidence rate 1.1 (95% confidence interval [CI] 1.0–1.3) per 1000 pregnancies. Being underweight (body mass index [BMI] < 18.5 kg/m2) was associated with a decreased risk of VTE (hazard ratio [HR] 0.53 [CI 0.29–0.98]) compared to normal weight (18.5 ≤ BMI < 25 kg/m2). Overweight (25 ≤ BMI < 30 kg/m2) increased VTE risk (HR 1.30 [CI 1.01–1.67]) but obesity (BMI ≥ 30 kg/m2) was insignificant (HR 1.14 [CI 0.82–1.58]). A history of VTE was highly significant (HR 72.65 [CI 51.17–103.15]). The youngest (<20 years) and oldest (≥35 years) had insignificantly increased risks (HR 1.45 [CI 0.80–2.62] and HR 1.31 [CI 0.98–1.75], respectively) compared to those aged 20–30 years. Sixteen groups of medications, including anti‐infectious medications, hormones, aminosalicylic acid, insulin, and benzodiazepine derivatives, were associated with VTE.

Conclusion

The risk of antepartum VTE was increased in women with prior VTE. Compared to normal weight women, being underweight decreased the risk of VTE whereas being overweight increased the risk. Also, the use of several medications was associated with increased risk of VTE. Copyright © 2013 John Wiley & Sons, Ltd.
High‐Z Nanostructured Ceramics in Radiotherapy: First Evidence of Ta2O5‐Induced Dose Enhancement on Radioresistant Cancer Cells in an MV Photon Field
Authors: Brown Ryan , Tehei Moeava , Oktaria Sianne , Briggs Adam , Stewart Callum , Konstantinov Konstantin , Rosenfeld Anatoly , Corde Stephanie , Lerch Michael
Published: October 2013

This article pioneers a study into the use of the tantalum pentoxide nanoceramics as novel candidates for dose enhancement radiotherapy. It is revealed that a significant induced dose enhancement on radioresistant cancer cells expose to tantalum pentoxide nanoparticles and irradiated with 10 MV. In this study, in vitro experiments are performed. The radiobiological endpoint is clonogenic survival. We exposed 9L gliosarcoma cells to the nanoparticles at 50–500 μg mL−1 range and observed concentration‐dependent toxicity. Irradiation of the exposed and unexposed cells with 10 MV X‐ray photons reveals a sensitization enhancement ratio of 1.33. The associated cell survival curves demonstrate a significant change in shape, indicative of increased lethality of the local radiation environment. We postulate that this enhancement is primarily due to secondary electrons produced from photoelectric interaction and pair production, with backscattering on nanoparticle aggregates leading to increased radiobiological effectiveness.
Distribution of metastatic sites in patients with prostate cancer: A population‐based analysis
Authors: Gandaglia Giorgio , Abdollah Firas , Schiffmann Jonas , Trudeau Vincent , Shariat Shahrokh F. , Kim Simon P. , Perrotte Paul , Montorsi Francesco , Briganti Alberto , Trinh Quoc‐Dien , Karakiewicz Pierre I. , Sun Maxine
Published: October 2013

BACKGROUND

There is few data on what constitutes the distribution of metastatic sites in prostate cancer (PCa). The aim of our study was to systematically describe the most common sites of metastases in a contemporary cohort of PCa patients.

METHODS

Patients with metastatic PCa were abstracted from the Nationwide Inpatient Sample (1998–2010). Most common metastatic sites within the entire population were described. Stratification was performed according to the presence of single or multiple (≥2 sites) metastases. Additionally, we evaluated the distribution of metastatic sites amongst patients with and without bone metastases.

RESULTS

Overall, 74,826 patients with metastatic PCa were identified. The most common metastatic sites were bone (84%), distant lymph nodes (10.6%), liver (10.2%), and thorax (9.1%). Overall, 18.4% of patients had multiple metastatic sites involved. When stratifying patients according to the site of metastases, only 19.4% of men with bone metastases had multiple sites involved. Conversely, among patients with lymph nodes, liver, thorax, brain, digestive system, retroperitoneum, and kidney and adrenal gland metastases the proportion of men with multiple sites involved was 43.4%, 76.0%, 76.7%, 73.0%, 52.2%, 60.9%, and 76.4%, respectively. When focusing exclusively on patients with bone metastases, the most common sites of secondary metastases were liver (39.1%), thorax (35.2%), distant lymph nodes (24.6%), and brain (12.4%).

CONCLUSIONS

Although the majority of patients with metastatic PCa experience bone location, the proportion of patients with atypical metastases is not negligible. These findings might be helpful when planning diagnostic imaging procedures in patients with advanced PCa. Prostate 74:210–216, 2014. © 2013 Wiley Periodicals, Inc.
Experiments on Surface Reconstruction for Partially Submerged Marine Structures
Authors: Papadopoulos Georgios , Kurniawati Hanna , Shariff Ahmed Shafeeq Bin Mohd , Wong Liang Jie , Patrikalakis Nicholas M.
Published: October 2013

Over the past 10 years, significant scientific effort has been dedicated to the problem of three‐dimensional (3‐D) surface reconstruction for structural systems. However, the critical area of marine structures remains insufficiently studied. The research presented here focuses on the problem of 3‐D surface reconstruction in the marine environment. This paper summarizes our hardware, software, and experimental contributions on surface reconstruction over the past few years (2008–2011). We propose the use of off‐the‐shelf sensors and a robotic platform to scan marine structures both above and below the waterline, and we develop a method and software system that uses the Ball Pivoting Algorithm (BPA) and the Poisson reconstruction algorithm to reconstruct 3‐D surface models of marine structures from the scanned data. We have tested our hardware and software systems extensively in Singapore waters, including operating in rough waters, where water currents are around 1–2 m/s. We present results on construction of various 3‐D models of marine structures, including slowly moving structures such as floating platforms, moving boats, and stationary jetties. Furthermore, the proposed surface reconstruction algorithm makes no use of any navigation sensor such as GPS, a Doppler velocity log, or an inertial navigation system.
Coping Behaviours and Post‐traumatic Stress in War‐affected Eastern Congolese Adolescents
Authors: Mels Cindy , Derluyn Ilse , Broekaert Eric , García‐Pérez Coral
Published: October 2013

This study explores coping strategies used by war‐affected eastern Congolese adolescents across age and sex, and the association between post‐traumatic stress symptoms and engagement and disengagement coping.

Cross‐sectional data were collected in 11 secondary schools across four areas in the Ituri province, Democratic Republic of Congo. A total of 952 pupils (45.3% girls, 54.7% boys) aged 13–21 years (M = 15.83, standard deviation = 1.81) participated in self‐report assessment, using instruments that were either specifically developed (Adolescent Complex Emergency Exposure Scale, assessing traumatic exposure), validated (Impact of Event Scale Revised, assessing post‐traumatic stress symptoms) or reviewed (Kidcope, assessing coping strategies) for the study population.

Reported coping strategies varied with age, and boys more frequently reported problem solving and resignation as compared with girls. Disengagement coping was associated with lower symptom scores in younger adolescent girls, as was the interaction effect between engagement and disengagement coping.

We conclude that disengagement coping is not necessarily a maladaptive reaction to stressful events in war‐affected situations and that future research should aim to better understand the heterogeneous patterns of stress and coping responses, including the role of factors such as the nature and appraisal of stressors, available resources for coping and cultural preferences. Copyright © 2013 John Wiley & Sons, Ltd.
Uterine artery Doppler and sFlt‐1/PlGF ratio: prognostic value in early‐onset pre‐eclampsia
Authors: Gómez‐Arriaga P. I. , Herraiz I. , López‐Jiménez E. A. , Escribano D. , Denk B. , Galindo A.
Published: October 2013

Objective

To evaluate the performance of the mean uterine artery pulsatility index (UtA‐PI) and the automated measurement of the soluble fms‐like tyrosine kinase‐1 (sFlt‐1)/placental growth factor (PlGF) ratio for the prognostic assessment of both maternal and perinatal outcomes, and the time‐to‐delivery interval in early‐onset (≤ 34 + 0 weeks) pre‐eclampsia (PE) cases with attempted expectant management.

Methods

Fifty‐one singleton pregnancies with early‐onset PE were enrolled in the study. Mean UtA‐PI and sFlt/PlGF ratio were measured at diagnosis. The association of each marker and their combinations with adverse maternal and perinatal outcomes was assessed by univariable comparisons and multivariable logistic regression analysis and time‐to‐delivery interval by survival analysis.

Results

Twenty‐six (51%) had adverse maternal outcome and 14 (27%) had adverse perinatal outcome. At the time of onset of PE, only gestational age was significantly related to maternal complications. Gestational age at onset, mean UtA‐PI and sFlt‐1/PlGF ratio were significantly associated with perinatal complications, their combination reaching a sensitivity of 64% with 95% specificity, and an area under the receiver–operating characteristics curve of 0.89 (95% CI, 0.79–0.99). Regarding the time until delivery, 92% (12/13) of cases with sFlt‐1/PlGF ratio > 655 and 39% (15/38) of cases with a ratio ≤ 655 delivered within the first 48 h, 8% (1/13) and 19% (7/38), respectively, delivered between 48 h and 7 days and 0% (0/13) and 42% (16/38), respectively, delivered after 7 days.

Conclusion

Mean UtA‐PI and sFlt‐1/PlGF ratio in combination with gestational age are useful for the prognostic assessment of perinatal complications at the time of diagnosis of early‐onset PE, but this combination has limited value for the prediction of maternal complications. Moreover, sFlt‐1/PlGF ratio > 655 is closely related to the need to deliver within 48 h. [[ArtCopyrightmsg]]
The Drosophila auditory system
Authors: Boekhoff‐Falk Grace , Eberl Daniel F.
Published: October 2013

Development of a functional auditory system in Drosophila requires specification and differentiation of the chordotonal sensilla of Johnston's organ (JO) in the antenna, correct axonal targeting to the antennal mechanosensory and motor center in the brain, and synaptic connections to neurons in the downstream circuit. Chordotonal development in JO is functionally complicated by structural, molecular, and functional diversity that is not yet fully understood, and construction of the auditory neural circuitry is only beginning to unfold. Here, we describe our current understanding of developmental and molecular mechanisms that generate the exquisite functions of the Drosophila auditory system, emphasizing recent progress and highlighting important new questions arising from research on this remarkable sensory system. WIREs Dev Biol 2014, 3:179–191. doi: 10.1002/wdev.128

This article is categorized under:

Gene Expression and Transcriptional Hierarchies > Cellular Differentiation

Nervous System Development > Flies
Inhomogeneous holographic thermalization
Authors: Balasubramanian V. , Bernamonti A. , de Boer J. , Craps B. , Franti L. , Galli F. , Keski-Vakkuri E. , Müller B. , Schäfer A.
Published: October 2013

Abstract

The sudden injection of energy in a strongly coupled conformal field theory and its subsequent thermalization can be holographically modeled by a shell falling into anti-de Sitter space and forming a black brane. For a homogeneous shell, Bhattacharyya and Minwalla were able to study this process analytically using a weak field approximation. Motivated by event-by-event fluctuations in heavy ion collisions, we include inhomogeneities in this model, obtaining analytic results in a long wavelength expansion. In the early-time window in which our approximations can be trusted, the resulting evolution matches well with that of a simple free streaming model. Near the end of this time window, we find that the stress tensor approaches that of second-order viscous hydrodynamics. We comment on possible lessons for heavy ion phenomenology.
Intrathoracic Anastomotic Leakage after Gastroesophageal Cancer Resection Is Associated with Reduced Long‐term Survival
Authors: Kofoed Steen Christian , Calatayud Dan , Jensen Lone Susanne , Jensen Marianne Vinbaek , Svendsen Lars Bo
Published: October 2013

Background

Most likely because of low statistical power, no previous studies have shown any significant association between long‐term survival and anastomotic leakage in patients who have undergone gastroesophageal cancer resection.

Material and methods

The present study included, prospectively and consecutively, nationwide collected patients who underwent gastroesophageal cancer resection between 2003 and 2011 in Denmark. The operation was carried out as an Ivor Lewis procedure. Only patients with intrathoracic anastomosis were included in the analysis.

Results

From 2003 to 2011, 1,296 patients underwent gastroesophageal resection, and 128 (9.9 %) of these experienced anastomotic leakage. The overall 5‐year survival rates in patients with and without anastomotic leakage were 20 and 35 % (P < 0.0001), respectively. After exclusion of 4 weeks mortality, the 5‐year survival rate in patients with leakage was 22 % compared to 36 % in patients without anastomotic leakage (P < 0.001). After exclusion of 8 weeks mortality, the 5‐year survival rate was 23 % in patients with leakage and 36 % in those without (P = 0.009). The corresponding median time of survival was 74 versus 128, 87 versus 138, and 95 versus 138 weeks, respectively. The overall hazard ratios of death after anastomotic leakage, unadjusted, and after adjusting for potentially confounding factors, were 1.59 (1.27–1.99) and 1.45 (1.14–1.84). The unadjusted and adjusted odds ratios after exclusion of 4 weeks mortality were 1.51 (1.19–1.90) and 1.41 (1.10–1.81). After exclusion of 8 weeks mortality the odds ratios were 1.38 (1.08–1.77) and 1.32 (1.02–1.71).

Conclusions

This nationwide study confirms that patients experiencing anastomotic leakage after gastroesophageal cancer resection have a significantly lower long‐term survival, even following full recovery after the leakage.
The Impact of Posthepatectomy Liver Failure on the Recurrence of Hepatocellular Carcinoma
Authors: Iguchi Kohta , Hatano Etsuro , Yamanaka Kenya , Tanaka Shiro , Taura Kojiro , Uemoto Shinji
Published: October 2013

Background

Patients with hepatocellular carcinoma (HCC) who underwent hepatectomy often developed an intrahepatic recurrence, even though it was a curative one. The relationship between surgery‐induced liver damage and the recurrence of HCC has not been described. This study evaluated whether posthepatectomy liver failure, as defined by the International Study Group of Liver Surgery, affected the recurrence of HCC.

Methods

We performed a retrospective cohort study of 488 patients with HCC who underwent hepatectomy between 2004 and 2012 at Kyoto University Hospital. Early posthepatectomy liver failure (EPLF) was defined as liver failure occurring between postoperative days 5 and 10. The patients were divided into an EPLF group and a non‐EPLF group. Disease‐free survival (DFS) was compared between these groups. The influences of host‐related, surgery‐related, and tumor‐related factors on patient outcomes were evaluated using multivariate analyses.

Results

The EPLF group and the non‐EPLF group contained 153 and 335 patients, respectively. The probability of DFS was significantly increased in the non‐EPLF group (median: 574 days) compared to the EPLF group (median: 348 days) (hazard ratio, HR [95 % confidence interval, CI] 1.61 [1.29–2.00]). The multivariate analysis revealed that EPLF was an independent factor for DFS (HR [95 % CI] 1.43 [1.13–1.81]), besides the factors previously described, including fibrosis (1.32 [1.05–1.67]), stage (1.85 [1.34–2.51]), tumor differentiation (1.46 [1.11–1.89]), and des‐γ‐carboxyprothrombin (1.39 [1.10–1.74]).

Conclusions

EPLF was associated with postoperative HCC recurrence. The prevention of EPLF might improve the prognosis of patients with HCC.
State of the Art in Robotic Hepatobiliary Surgery
Authors: Milone Luca , Daskalaki Despoina , Fernandes Eduardo , Damoli Isacco , Giulianotti Pier Cristoforo
Published: October 2013

Hepatobiliary (HB) surgery is a challenging surgical subspecialty that requires highly specialized training and an adequate level of experience in order to be performed safely. As a result, minimally invasive HB surgery has been met with slower acceptance as compared to other subspecialties, with many surgeons in the field still reluctant to adopt the approach. Recently development of the robotic platform has provided a tool that can overcome many of the limitations of conventional laparoscopic HB surgery. Augmented dexterity enabled by the endowristed movements, software filtration of the surgeon’s movements, and high‐definition three‐dimensional vision provided by the stereoscopic camera combine to allow steady and careful dissection of the liver hilum structures, as well as prompt and precise endosuturing in cases of intraoperative bleeding. These advantages have fostered many centers to widen the indications for minimally invasive HB and gastric surgery, with encouraging initial results. As one of the surgical groups that has performed the largest number of robot‐assisted procedures worldwide, we provide a review of the state of the art in minimally invasive robot‐assisted HB surgery.
Value of Plasma Brain Natriuretic Peptide Levels for Predicting Postoperative Atrial Fibrillation: A Systemic Review and Meta‐analysis
Authors: Cai Guo‐Long , Chen Jin , Hu Cai‐Bao , Yan Mo‐Lei , Xu Qiang‐Hong , Yan Jing
Published: October 2013

Background

Blood natriuretic peptide (NP) levels have been reported to be useful for predicting postoperative atrial fibrillation (AF). We aimed to quantitatively synthesize the current evidence of the accuracy of using NP levels in predicting postoperative AF.

Methods and Results

Medline, Embase, and reference lists were searched. Studies were included if either brain natriuretic peptide (BNP) or N‐terminal pro‐b type natriuretic peptide (NT‐proBNP) had been evaluated perioperatively to predict postoperative AF. Data were analyzed to obtain summary accuracy estimates. Data from 1,844 patients in 10 studies were analyzed. Summary estimates for the sensitivity and specificity of using NP levels for predicting postoperative AF were 75 % [95 % confidence interval (CI) 67–79 %] and 80 % (95 % CI 62–91 %), respectively. The overall diagnostic odds ratio was 3.28 (95 % CI 2.23–4.84). Subgroup analysis showed that elevated NP levels in the perioperative period were a strong independent predictor of postoperative AF. NT‐proBNP appeared to have better predictive value than BNP, as did postoperative assessment over preoperative assessment. BNP had a better correlation with postoperative AF in patients undergoing thoracic surgery than in patients undergoing cardiac surgery.

Conclusions

Perioperative assessment of the natriuretic peptide level in patients undergoing major cardiothoracic surgery could be a valuable diagnostic aid for identifying patients at high risk of developing postoperative AF, and for providing critical clinical information to guide prophylactic antiarrhythmic therapy in the perioperative period.
Surgical Outcomes in Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombosis
Authors: Chok Kenneth S. H. , Cheung Tan To , Chan See Ching , Poon Ronnie T. P. , Fan Sheung Tat , Lo Chung Mau
Published: October 2013

Background

Different approaches to surgical treatment of portal vein tumor thrombosis (PVTT) have been advocated. This study investigated the outcomes of different surgical approaches in hepatocellular carcinoma (HCC) patients with PVTT.

Methods

We reviewed prospectively collected data for all patients who underwent hepatectomy for HCC at our hospital between December 1989 and December 2010. Patients were excluded from analysis if they had extrahepatic disease, PVTT reaching the level of the superior mesenteric vein, or hepatectomy with a positive resection margin. The remaining patients were divided into three groups for comparison: group 1, with ipsilateral PVTT resected in a hepatectomy; group 2, with PVTT extending to or beyond the portal vein bifurcation, treated by en bloc resection followed by portal vein reconstruction; group 3, with PVTT extending to or beyond the portal vein bifurcation, treated by thrombectomy.

Results

A total of 88 patients, with a median age of 54 years, were included in the analysis. Group 2 patients were younger, with a median age of 43.5 years versus 57 in group 1 and 49 in group 3 (p = 0.017). Group 1 patients had higher preoperative serum alpha‐fetoprotein levels, with a median of 8,493 ng/mL versus 63.25 in group 2 and 355 in group 3 (p = 0.004), and shorter operation time, with a median of 467.5 min versus 663.5 in group 2 and 753 in group 3 (p = 0.018). No patient had thrombus in the main portal vein. Two (2.8 %) hospital deaths occurred in group 1 and one (10 %) in group 2, but none in group 3 (p = 0.440). The rates of complication in groups 1, 2, and 3 were 31.9, 50.0, and 71.4 %, respectively (p = 0.079). The median overall survival durations were 10.91, 9.4, and 8.58 months, respectively (p = 0.962), and the median disease‐free survival durations were 4.21, 3.78, and 1.51 months, respectively (p = 0.363). The groups also had similar patterns of disease recurrence (intrahepatic: 33.8 vs. 28.6 vs. 40.0 %; extrahepatic: 16.9 vs. 14.3 vs. 0 %; both: 28.2 vs. 42.9 vs. 40.0 %; no recurrence: 21.1 vs. 14.3 vs. 20.0 %; p = 0.836).

Conclusions

The three approaches have similar outcomes in terms of survival, complication, and recurrence. Effective adjuvant treatments need to be developed to counteract the high incidence of recurrence.
With Allee effects, life for the social carnivore is complicated
Authors: Sanderson Claire Elizabeth , Jobbins Sarah Elizabeth , Alexander Kathleen Ann
Published: October 2013

Anthropogenic modification of the landscape, resultant habitat loss, and decades of persecution have resulted in severe decline and fragmentation of large carnivore populations worldwide. Infectious disease is also identified as a primary threat to many carnivores. In wildlife species, population demography and group persistence are strongly influenced by group or population size. This is referred to as the Allee effect, in which a population or group is at an increased risk of extinction when the number or density of individuals falls below some threshold due to ecological and/or genetic factors. However, in social mammalian species, the relationship between the number of individuals and the risk of extinction is complicated because aggregation may enhance pathogen exposure and transmission. Although theoretical studies of the interaction between infectious disease transmission and Allee effects reveal important implications for carnivore management and population extinction risk, information about the interaction has yet to be synthesized. In this paper, we assess life history strategies of medium to large carnivore species (≥2.4 kg) and their influence on population dynamics, with a special focus on infectious disease. While declining population trends are observed in 73 % of all carnivores (both social and solitary species), infectious disease is identified as a significant cause of population decline in 45 % of social carnivores and 3 % of solitary carnivores. Furthermore, where carnivores suffer a combination of rapid population decline and infectious disease, Allee effects may be more likely to impact social as compared to solitary carnivore populations. These potentially additive interactions may strongly influence disease transmission dynamics and population persistence potential. Understanding the mechanisms that can result in Allee effects in endangered carnivore populations and the manner in which infectious disease interfaces at this nexus may define the outcome of developed conservation strategies.
An Analysis of Natural Mentoring Relationship Profiles and Associations with Mentees’ Mental Health: Considering Links via Support from Important Others
Authors: Hurd Noelle M. , Zimmerman Marc A.
Published: October 2013

We explored associations between natural mentoring relationship profiles and young adults’ life satisfaction and symptoms of depression via participants’ perceived support from important others accounting for participants’ perceived support and mental health prior to the onset of their natural mentoring relationships. Participants included 396 young adults (57 % female; mean age = 30.97, SD = .6), the majority of whom identified as Black or African American (79 % Black, 18 % White, 3 % Biracial). Most participants had completed high school but few participants (13 %) had completed degrees from 4 year institutions. We used a latent profile approach to identify natural mentoring relationship profiles and employed structural equation modeling to test our study hypotheses. Slightly over half of study participants (53 %) reported the presence of a natural mentor in their lives since the age of 14. Results suggest that natural mentoring relationships characterized by high levels of relational closeness and either extended relationship duration or frequent contact may promote improvements in psychological well‐being among mentees over time via greater experiences of social support from important others.
Targeting Segments in the Australian Community to Increase Support for Climate Change Policy
Authors: Morrison Mark , Duncan Roderick , Parton Kevin A.
Published: October 2013

Public support for policies that address climate change, in Australia and elsewhere, has become polarised, and has declined in Australia. The polarisation and decline has occurred despite considerable efforts by government, non-government and scientific bodies to raise levels of support. In this research, therefore, we aim to better understand the preferences of politically salient household segments with the objective of more effectively communicating to those segments the desirability of addressing climate change. Replicating an American market segmentation study, we find that 26% of participants fell into the most politically salient household segment, labelled Cautious. This segment is relatively open to changing its views about climate change, and is supportive of both government and opposition policies. These findings suggest that segment members will potentially be influenced by targeted media campaigns by either side of politics. Additional findings relate to effective communication channels, and trusted sources including the use of celebrities.