bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of interferon‐gamma release assay (T‐SPOT.TB™) for diagnosis of tuberculosis infection in rheumatic disease patients
Authors: Jiang Bin , Ding Huihua , Zhou Li , Chen Xiaoxiang , Chen Sheng , Bao Chunde
Published: October 2015

Aim

Patients with rheumatic diseases are at higher risk of developing tuberculosis (TB). The objective of this prospective study was to evaluate the T‐SPOT.TB assay (T cell enzyme‐linked immuno‐spot assay), for the diagnosis of tuberculosis infection in rheumatic disease patients in China.

Methods

Prospectively enrolled patients came from the Department of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine between July 2008 and Aug 2012 for TB screening. Subjects' histories of TB infection, previous TB contact or bacille Calmette‐Guérin vaccination and concurrent immunosuppressive therapy, were reviewed carefully and recorded in detail. TST (tuberculin skin test) and TSPOT.TB assay were performed on the subjects. A prospective evaluation by Chi‐square test was used for sensitivity and specificity of both TST and T‐SPOT assay.

Results

A total of 311 subjects included 114 (36.66%) male and 197 (63.34%) female subjects, with a median age of 37.7 ± 12.6 years (range 17–72). Thirty‐two patients (10.29%) had a history of TB infection or previous TB contact; 256 patients (82.32%) were using glucocorticoids or immunosuppressants; 28 patients (9.0%) were clinically diagnosed as having TB infection. The sensitivity and specificity of TST for TB screening in rheumatic disease patients was 81.82% (9/11) and 67% (67/100), respectively. However, the sensitivity and specificity of T‐SPOT assay was statistically higher at 92.86% (26/28) and 93.64% (265/283), respectively (P < 0.05).

Conclusion

As a new immunoassay for TB diagnosis, the sensitivity and specificity of T‐SPOT is higher than TST. It is of great importance in the diagnosis of active or latent TB infection in rheumatic disease patients.
Methylation and gene expression of histone deacetylases 6 in systemic lupus erythematosus
Authors: Fang Tzu‐Jung , Lin Yuan‐Zhao , Liu Ching‐Ching , Lin Chia‐Hui , Li Ruei‐Nian , Wu Cheng‐Chin , Ou Tsan‐Teng , Tsai Wen‐Chan , Yen Jeng‐Hsien
Published: October 2015

Aim

The purpose of this study is to investigate the role of methylation in the histone deacetylases 6 (HDAC6) promoter and HDAC6 messenger RNA (mRNA) expression in the pathogenesis of systemic lupus erythematosus (SLE).

Method

Direct bisulfite‐polymerase chain reaction (PCR) sequencing was performed to detect the HDAC6 promoter methylation in 33 patients with SLE and 35 healthy controls. The HDAC6 mRNA expression was measured in 93 SLE patients and 84 healthy controls by using the method of quantitative real‐time PCR.

Results

This study demonstrated that the methylation rates at HDAC6‐680, ‐660 and ‐658 were significantly increased in the SLE patients compared with healthy controls (P = 0.041, 0.034 and 0.029, respectively). The SLE patients also had lower HDAC6 mRNA expression than the controls (P = 0.031). However, there was no significant difference in HDAC6 mRNA expression between patients with active and inactive SLE.

Conclusion

The SLE patients had higher methylation in the HDAC6 promoter and lower HDAC6 mRNA expression than the controls. These changes may be related to the susceptibility of SLE. However, they are not associated with the disease activity of SLE.
On the Measurement of Social Progress and Wellbeing: Some Further Thoughts
Authors: Fitoussi Jean‐Paul , Stiglitz Joseph E.
Published: October 2015

Since 2008, the world has experienced several dramatic events: the financial crisis of 2007–08, the earthquake in Japan, the sovereign debt crisis and the revolutions in the Arab world. All of these developments have called into question not just our current policies, but also the measurement systems on which we base their configuration. What we measure affects what we do. Increasingly, there is a demand to go beyond measures of market activity (GDP) and towards measures of wellbeing. Reductions in wellbeing (following deteriorations in people's physical and psychological health, community life or employment status, or in the provision of environmental goods) that are accepted in the name of maximization of material wealth results in totally misguided policies. This article surveys some recent and clear instances in which our measurements have gone wrong, and suggests revisions that may translate into better informed and more sustainable policies.
Multipurpose habitat networks for short‐range and long‐range connectivity: a new method combining graph and circuit connectivity
Authors: Rayfield Bronwyn , Pelletier David , Dumitru Maria , Cardille Jeffrey A. , Gonzalez Andrew
Published: October 2015

Biodiversity conservation in landscapes undergoing climate and land‐use changes requires designing multipurpose habitat networks that connect the movements of organisms at multiple spatial scales. Short‐range connectivity within habitat networks provides organisms access to spatially distributed resources, reduces local extinctions and increases recolonization of habitat fragments. Long‐range connectivity across habitat networks facilitates annual migrations and climate‐driven range shifts.

We present a method for identifying a multipurpose network of forest patches that promotes both short‐ and long‐range connectivity. Our method uses both graph‐theoretic analyses that quantify network connectedness and circuit‐based analyses that quantify network traversability as the basis for identifying spatial conservation priorities on the landscape.

We illustrate our approach in the agroecosystem, bordered by the Laurentian and Appalachian mountain ranges, that surrounds the metropolis of Montreal, Canada. We established forest conservation priorities for the ovenbird, a Neotropical migrant, sensitive to habitat fragmentation that breeds in our study area. All connectivity analyses were based on the same empirically informed resistance surface for ovenbird, but habitat pixels that facilitated short‐ and long‐range connectivity requirements had low spatial correlation. The trade‐off between connectivity requirements in the final ranking of conservation priorities showed a pattern of diminishing returns such that beyond a threshold, additional conservation of long‐range connectivity had decreased effectiveness on the conservation of short‐range connectivity. Highest conservation priority was assigned to a series of stepping stone forest patches across the study area that promote traversability between the bordering mountain ranges and to a collection of small forest fragments scattered throughout the study area that provide connectivity within the agroecosystem.

Landscape connectivity is important for the ecology and genetics of populations threatened by climate change and habitat fragmentation. Our method has been illustrated as a means to conserve two critical dimensions of connectivity for a single species, but it is designed to incorporate a variety of connectivity requirements for many species. Our approach can be tailored to local, regional and continental conservation initiatives to protect essential species movements that will allow biodiversity to persist in a changing climate.
Phosphate solubilisation and plant growth promoting potential by stress tolerant Bacillus sp. isolated from rhizosphere of apple orchards in trans Himalayan region of Himachal Pradesh
Authors: Mehta P. , Walia A. , Chauhan A. , Kulshrestha S. , Shirkot C. K.
Published: October 2015

Phosphate‐solubilising ability and co‐production of plant growth promoting traits of stress tolerant Bacillus subtilis CB8A isolated from apple rhizosphere was tested under in vitro conditions against a wide range of temperature (30–45°C), pH (7–9) and salt (0–5%) stresses. Under the extremes of temperature (45°C), pH‐9 and salt concentration (5%), production of soluble phosphate, indole acetic acid, siderophore and antifungal activity against Dematophora necatrix were reduced by 71.09%, 75.29%, 90.3% and 88.47%, respectively. Per cent decrease in P‐solubilisation at extreme temperature (45°C) and normal pH (7) without salt concentration was 36.23%; at extreme pH (9) and normal temperature (37°C) without salt concentration was 23.45% and at extreme salt concentration (5%), optimum temperature (37°C) and pH (7) was 36.7%. P‐solubilisation by CB8A was inversely correlated with pH (r = −0.78) and positively correlated with siderophore production (r = 0.81), indole acetic acid (r = 0.58) and antifungal activity (r = 0.63). Gluconic acid (1.43%) and citric acid (0.67%) were detected as major organic acids. P‐solubilisation and nitrogen fixing abilities of B. subtilis CB8A were confirmed by amplification of gdh and nifH genes. The ability of CB8A showing plant growth promoting rhizobacteria (PGPR) traits at a wide range of temperature, pH and varying salt concentration can be exploited for developing multifunctional biofertiliser in apple orchards.
Glove imprint templating: A versatile tool in skin graft surgery and more
Authors: Pagliaro Thomas , Coates Dougal
Published: October 2015

Measurement of the shape and size of skin lesions is an important component of skin excision and repair, especially in full‐thickness skin grafting. Current templating methods can be time‐consuming and may lead to inaccurate sizing of both full‐thickness and split‐thickness skin grafts. A novel, accurate, and time‐efficient method has been employed for 10 years in a dermatology clinic, in addition demonstrating utility in additional applications. A surgical glove is used to gain an imprint of a marked surgical incision site, to transcribe to the donor site for graft harvest. Further, the size of lesions in difficult‐to‐see areas of the body can be shown to patients. This method has been found to be clinically useful in reducing procedure times and providing accurate graft templates, as well as improving patients' satisfaction by helping them to understand the procedure. This method is also advantageous in obtaining informed consent by helping to clearly demonstrate the size of simple elliptical excisions.
Characterization of IL‐22 and IL‐17 Expressing Leukocytes in the Cervix
Authors: Makinde Hadijat M. , Lurain Nell , Bitterman Pincas , Martinson Jeff , Plants Jill , Landay Alan L. , Spear Greg T.
Published: October 2015

Problem

Identification of the types of cells that produce IL‐17 and IL‐22 in the genital tract can clarify the roles that these cytokines play in responses to pathogens.

Method of study

We isolated and stimulated cells from cervical tissue to identify and characterize cytokine‐producing cells.

Results

Upon stimulation of CD3+ CD4+ endocervical cells, 1.6, 3.4, and 1.5% were induced to produce IL‐22, IL‐17, and both cytokines, respectively. Stimulation of CD3+ CD4+ ectocervical cells resulted in 3.3% IL‐22+, 5.5% IL‐17+ and 2.6% IL‐22+ IL17+ cells. CD45+ CD3− cells had relatively high endogenous levels of cytokine expression that did not increase upon stimulation. Innate lymphoid cells (ILCs) made up 5.7–8% of CD45+ cervical cells and stimulation caused increases in IL‐17 and IL‐22.

Conclusion

These studies show that the majority of the CD45+ leukocytes that can be induced to produce IL‐22 and IL‐17 in cervix are CD3+ CD4+, but ILCs are also present and can make both cytokines.
Diabetic major amputation in Far North Queensland 1998–2008: What is the Gap for Indigenous patients?
Authors: O'Rourke Sharon , Steffen Christina , Raulli Alexandra , Tulip Fiona
Published: October 2015

Objective

To examine demographic and clinical characteristics of diabetic patients undergoing diabetes‐related major amputation in Far North Queensland to identify those at risk.

Design

A cohort was examined for differences between Indigenous and non‐Indigenous groups in age, co‐morbidities, indication for amputation and mortality. Attendance at the High Risk Foot Service was also reported.

Setting

Far North Queensland.

Participants

individuals with major amputations between 1998 and 2008.

Main outcome measures

Diabetes‐related major amputations and mortality.

Results

Of the 143 individuals who underwent major amputation during the study period, 52% were Indigenous. On average, Indigenous amputees were 14 years younger than non‐Indigenous amputees. There were more female Indigenous amputees compared with Indigenous male amputees. Indigenous amputees were more likely to suffer from chronic kidney disease (P < 0.000) and reside in a remote community (P < 0.000). Sepsis as an indication for amputation was more frequent in Indigenous subjects (P = 0.019). There was no statistically significant difference in mortality related to the procedure between Indigenous and non‐indigenous amputees.

Conclusion

Indigenous patients with renal disease living in remote communities are at higher risk of developing limb‐threatening diabetic foot complications. Further improvements in self‐care, diabetes management and foot‐care are required to reduce major amputation rates, particularly for those residing in remote areas.
Very low birthweight infants face an increased risk of bloodstream infections following the removal of umbilical catheters
Authors: Lindquist Simon , Hentz Elisabet , Tessin Ingemar , Elfvin Anders
Published: October 2015

Aim

This study examined whether there was a temporal association between removing umbilical catheters and bloodstream infections (BSI) in a neonatal intensive care unit, as this is an area of research that has not received sufficient attention.

Methods

We carried out a retrospective study of all neonates receiving umbilical catheters during 2011 and 2012 in the neonatal intensive care unit at Sahlgrenska University Hospital, Gothenburg, Sweden. The time from umbilical catheter removals to the first subsequent BSI was recorded.

Results

A total of 372 infants had umbilical catheters inserted and 146 of these had a birthweight of <1500 g. Antibiotics were discontinued when umbilical catheters were removed in 67 of these low birthweight infants and 20 of them needed to be retreated for BSI within 72 hours. We found that very low birthweight infants had a significantly increased risk of developing BSI if antibiotics were discontinued at the same time as umbilical catheters were removed, rather than being continued after removal (p < 0.001).

Conclusion

This NICU study demonstrated a temporal association between removing umbilical catheters and BSI in very low birthweight infants weighting <1500 g.
Perceived Characteristics of Innovative Nonprofit and Government Organizations in South Korea, China, and Argentina
Authors: Jaskyte Kristina , Yoo Sun‐Young , de Riobó María Susana R.M.
Published: October 2015

This article describes the characteristics of innovative organizations as perceived by employees of nonprofit and government organizations in three quite different countries, South Korea, China, and Argentina. A total of 44 employees participated in the studies (13 from South Korea; 16 from China; and 13 from Argentina). At the first stage of the study they were asked to free list characteristics of innovative organizations. At the second stage of the study, country‐specific measures containing characteristics of innovative organizations were created, and participants were asked to rate each characteristic on a Likert scale (1 = not characteristic at all of an innovative organization; 5 = extremely characteristic of an innovative organization). This task produced ratings of perceived characteristics of innovative organizations for each country. Cultural consensus analysis widely used in the field of cognitive anthropology was employed next to assess the degree of agreement among the participants on what consistutes an innovative organization. Among the common perceived characteristics of innovative organizations were participation in decision making, teamwork, responsiveness to emerging client and societal needs, adaptability, employee support and value, and accepting failure. While the characteristics produced through the free listing technique showed a lot of similarities, the importance of those characteristics was rated quite differently across the three samples.
Fly the coop! Vertical structures influence the distribution and behaviour of laying hens in an outdoor range
Authors: Rault J‐L , van de Wouw A , Hemsworth P
Published: October 2015

Background

The number of free‐range farms has greatly increased in the Australian egg industry, up by 64% over the past 5 years and representing 34% of the retail egg sales last year. Nonetheless, free‐range systems offer particular challenges to farmers. The use of the outdoor range is variable among hens; their distribution is usually not uniform across the range and they tend to stay close to features such as walls or fences, resulting in high stocking density in particular areas, with associated welfare and environmental concerns.

Methods

Using video recordings, we investigated the effect of erecting a series of vertical structures in the range on the hens' numbers, distribution and behaviour.

Results

Hens were very attracted to the structures, which altered their distribution and behaviour. Up to 160 hens were seen around each structure, giving a density of 6.4 hens/m2. The hens spent 40% of their time pecking at the structures and standing in these areas and less time walking, preening or ground pecking.

Conclusion

Elucidating which physical features fulfil hens' biological needs could improve their use of outdoor ranges.
Persisting Rise in Referrals During Labor in Primary Midwife‐led Care in The Netherlands
Authors: Offerhaus Pien M. , Hukkelhoven Chantal W.P.M. , de Jonge Ank , van der Pal‐de Bruin Karin M. , Scheepers Peer L.H. , Lagro‐Janssen Antoine L.M.
Published: October 2015

Background

There are concerns about the Dutch maternity care system, characterized by a strict role division between primary and secondary care. The objective of this study was to describe trends in referrals and in perinatal outcomes among labors that started in primary midwife‐led care.

Methods

We performed a descriptive study of all 789,795 labors that started in primary midwife‐led care during 2000 to 2008 in The Netherlands. Referrals to obstetrician‐led care or pediatrician were classified as urgent or nonurgent. Perinatal safety was described by perinatal mortality (intrapartum or neonatal 0–7 days), admission to neonatal intensive care unit 0–7 days, and Apgar score < 7 at 5 minutes.

Results

The proportion of referrals during labor or after birth declined from 52.6 to 42.6 percent for nulliparous women and from 83.2 to 76.7 percent for multiparous women. Especially nonurgent referrals during the first stage increased, for nulliparous women from 28.7 to 40.7 percent and for multiparous women from 10.5 to 16.5 percent. Referrals were less frequent in planned home births. Perinatal mortality was 0.9 per thousand births for nulliparous women, and 0.6 per thousand for multiparous women. A low Apgar score was registered in 8.6 per thousand births for nulliparous women, and 4.1 per thousand for multiparous women.

Conclusions

There was a considerable rise in nonurgent referrals to obstetrician‐led care in primary midwife‐led care during labor. Perinatal safety did not improve significantly over time. The persisting rise in referrals challenges the sustainability of the current strict role division between primary and secondary maternity care in The Netherlands.
Diagnosis and classification of mastocytosis in non‐specialized versus reference centres: a Spanish Network on Mastocytosis (REMA) study on 122 patients
Authors: Sánchez‐Muñoz Laura , Morgado Jose M. , Álvarez‐Twose Ivan , Matito Almudena , Garcia‐Montero Andrés C. , Teodosio Cristina , Jara‐Acevedo Maria , Mayado Andrea , Mollejo Manuela , Caldas Carolina , González de Olano David , Escribano Luis , Orfao Alberto
Published: October 2015

The diagnosis of ‘rare diseases’, such as mastocytosis, remains a challenge. Despite this, the precise benefits of referral of mastocytosis patients to highly specialized reference centres are poorly defined and whether patients should be managed at non‐specialized versus reference centres remains a matter of debate. To evaluate the quality and efficiency of diagnostic procedures performed at the reference centres for mastocytosis in Spain (REMA) versus other non‐reference centres, we retrospectively analysed a series of 122 patients, for the overall degree of agreement obtained for the World Health Organization (WHO) diagnostic and classification criteria betwen the referring and REMA centres. Our results showed that not all WHO diagnostic criteria were frequently investigated at the referring centres. Among the five WHO diagnostic criteria, the highest degree of agreement was obtained for serum tryptase levels [median 90% (95% confidence interval 84–96%)]; in turn, the overall agreement was significantly lower for the major histopathological criterion [80% (72–89%)], and the other three minor criteria: cytomorphology [68% (56–80%)] immunophenotyping of BM mast cells [75% (62–87%)] and detection of the KIT mutation [34% (8–60%)]. Referral of patients with diagnostic suspicion of mastocytosis to a multidisciplinary reference centre improves diagnostic efficiency and quality.
Working to Understand Our Role in the Patient's Mind: Countertransference and the Problems of Immersion
Authors: Waska Robert
Published: October 2015

To be fully helpful, in a way that respects both the internal and external needs and conflicts of our patients in analytic treatment, we must become immersed in their emotional perspective and have a feel for how they view and value themselves and their objects. Allowing ourselves to be carried into their inner phantasies and to be in touch with their strivings towards and away from love, hate, and knowledge is important in the analytic process. Countertransference is unavoidable but, if properly monitored and contained, it can provide a beneficial therapeutic device.

However, when treating disturbed patients who draw us into more paranoid transference states or primitive depressive position conflicts, we are often involved in various degrees of enactment. Even then, the countertransference, if carefully studied, can help us rebalance ourselves therapeutically and start to better understand how the patient is using us in their internal world and why they need to or desire to organize their object relational world in such terms. We cannot help but be immersed within the patient's unconscious belief system but, by being aware of our thoughts and feelings and reactions, we can keep our head above the choppy countertransference waters enough to act out less and offer constant interpretations that are more informed and focused on the patient's unique and personal object relational conflicts and internal belief system.

From an object relational, post‐Kleinian tradition, the author examines one case in depth. The patient consulted the analyst with concerns about her grown children and her perception of how damaged they were emotionally. The subsequent meetings involved intense transference and countertransference experiences that are explored. The author's approach builds on prior clinical understanding based on the Kleinian method (Waska, 2002, 2004, 2012, 2013).
Treatment efficacy and outcomes using a third generation shockwave lithotripter
Authors: Neisius Andreas , Wöllner Jens , Thomas Christian , Roos Frederik C. , Brenner Walburgis , Hampel Christian , Preminger Glenn M. , Thüroff Joachim W. , Gillitzer Rolf
Published: October 2015

Objectives

To evaluate the clinical efficiency of a third generation electromagnetic shock wave lithotripter, the Lithoskop® (Siemens, Erlangen, Germany), regarding outcomes, stone disintegration, retreatment and complication rates.

To compare the results of the Lithoskop with other currently available systems and the reference standard lithotripter, the HM‐3 (Dornier MedTech Europe GmbH, Wessling, Germany).

Patients and Methods

We analysed the data from 183 patients, including 13 children, undergoing extracorporeal shock wave lithotripsy (ESWL) for renal and ureteric calculi collected from a prospectively populated database.

Outcomes were assessed by plain abdominal film of kidney, ureter and bladder and renal ultrasonography for radiopaque and computerized tomography for radiolucent stones 1 day after treatment and after 3 months.

We analysed stone size and location before and after treatment, stone disintegration rate, retreatment rate, stone‐free and residual fragment rates after 3 months, along with auxiliary procedures and complications.

Results

The mean (range) patient age was 48.6 (1.3–81.4) years, including 13 children with a mean (range) age of 8.4 (1.3–16.7) years, and 77% of the patients were male.

In all, 46% of the calculi were localized in the kidney and 54% in the ureter. Renal stones were localized in the upper, middle and lower calyx and in the renal pelvis in 9, 29, 30 and 32% of patients, respectively. Ureteric stones were localized in the upper, mid‐ and distal ureter in 29, 19 and 52% of patients, respectively. The median (range) stone size before ESWL was 10 (4–25) mm in the kidney and 8 (4–28) mm in the ureteric calculi.

The overall stone‐free rate after 3 months was 91% (88% for renal and 93% for ureteric calculi); the mean number of sessions to achieve these rates was 1.3.

Stone‐free rates and the required number of sessions were determined only by stone size. In 7.1% of the patients (n = 13) post‐interventional auxiliary procedures were necessary.

We observed one perirenal haematoma as a major complication (0.5%), but this did not require any further therapy.

Conclusions

Clinical stone‐free rates with the Lithoskop are high and similar to those of other available systems, including the reference standard HM‐3 lithotripter.

Retreatment and complication rates are low, supporting the use of ESWL as first‐line therapy for urinary calculi <10 mm, independent of stone location.
Political transitions: Opportunities to renegotiate the public service bargain
Authors: Althaus Catherine , Vakil Thea
Published: October 2015

Adopting a public service perspective of transitions in Westminster systems and connecting literature on transitions with public service bargains (PSBs), this research note proposes that transitions not only increase existing tensions between politicians and the public service, but also provide opportunities to forge newPSBsto defuse these tensions. It argues that public service institutions should move beyond individually negotiated transition responses towards corporately drivenPSBnegotiations across the political–public service interface on a rolling basis in order to promote the cause of democratic governance. It also invites others to take up this perspective and develop research to probe these ideas further.
Developmental Differences in Relations Between Episodic Memory and Hippocampal Subregion Volume During Early Childhood
Authors: Riggins Tracy , Blankenship Sarah L. , Mulligan Elizabeth , Rice Katherine , Redcay Elizabeth
Published: October 2015

Episodic memory shows striking improvement during early childhood. However, neural contributions to these behavioral changes are not well understood. This study examined associations between episodic memory and volume of subregions (head, body, and tail) of the hippocampus—a structure known to support episodic memory in school‐aged children and adults—during early childhood (n = 45). Results revealed significant positive relations between episodic memory and volume of the hippocampal head in both the left and right hemispheres for 6‐ but not 4‐year‐old children, suggesting brain–behavior relations vary across development. These findings add new information regarding neural mechanisms of change in memory development during early childhood and suggest that developmental differences in hippocampal subregions may contribute to age‐related differences in episodic memory ability.
Historical Semantic Chaining and Efficient Communication: The Case of Container Names
Authors: Xu Yang , Regier Terry , Malt Barbara C.
Published: October 2015

Semantic categories in the world's languages often reflect a historical process of chaining: A name for one referent is extended to a conceptually related referent, and from there on to other referents, producing a chain of exemplars that all bear the same name. The beginning and end points of such a chain might in principle be rather dissimilar. There is also evidence supporting a contrasting picture: Languages tend to support efficient, informative communication, often through semantic categories in which all exemplars are similar. Here, we explore this tension through computational analyses of existing cross‐language naming and sorting data from the domain of household containers. We find (a) formal evidence for historical semantic chaining, and (b) evidence that systems of categories in this domain nonetheless support near‐optimally efficient communication. Our results demonstrate that semantic chaining is compatible with efficient communication, and they suggest that chaining may be constrained by the functional need for efficient communication.
Contemporary use of elastography in liver fibrosis and portal hypertension
Authors: Thiele Maja , Kjærgaard Maria , Thielsen Peter , Krag Aleksander
Published: October 2015

The risk and speed of progression from fibrosis to compensated and decompensated cirrhosis define the prognosis in liver diseases. Therefore, early detection and preventive strategies affect outcomes. Patients with liver disease have traditionally been diagnosed at an advanced stage of disease, in part due to lack of non‐invasive markers. Ultrasound elastography to measure liver stiffness can potentially change this paradigm. The purpose of this review was therefore to summarize advances in the field of ultrasound elastography with focus on diagnosis of liver fibrosis, cirrhosis and clinically significant portal hypertension, techniques and limitations. Four types of ultrasound elastography exist, but there is scarce evidence comparing the different techniques. The majority of experience concern transient elastography for diagnosing fibrosis and cirrhosis in patients with chronic viral hepatitis C. That said, the role of elastography in other aetiologies such as alcoholic‐ and non‐alcoholic liver fibrosis still needs clarification. Although elastography can be used to diagnose liver fibrosis and cirrhosis, its true potential lies in the possibility of multiple, repeated measurements that allow for treatment surveillance, continuous risk stratification and monitoring of complications. As such, elastography may be a powerful tool for personalized medicine. While elastography is an exciting technique, the nature of ultrasound imaging limits its applicability, due to the risk of failures and unreliable results. Key factors that limit the applicability of liver stiffness measurements are as follows: liver vein congestion, cholestasis, a recent meal, inflammation, obesity, observer experience and ascites. The coming years will show whether elastography will be widely adapted in general care.
Influence of CYP3A5 genetic variation on everolimus maintenance dosing after cardiac transplantation
Authors: Lesche Dorothea , Sigurdardottir Vilborg , Setoud Raschid , Englberger Lars , Fiedler Georg M. , Largiadèr Carlo R. , Mohacsi Paul , Sistonen Johanna
Published: October 2015

Background

Everolimus (ERL) has become an alternative to calcineurin inhibitors (CNIs) due to its renal‐sparing properties, especially in heart transplant (HTx) recipients with kidney dysfunction. However, ERL dosing is challenging due to its narrow therapeutic window combined with high interindividual pharmacokinetic variability. Our aim was to evaluate the effect of clinical and genetic factors on ERL dosing in a pilot cohort of 37 HTx recipients.

Methods

Variants in CYP3A5, CYP3A4, CYP2C8, POR, NR1I2, and ABCB1 were genotyped, and clinical data were retrieved from patient charts.

Results

While ERL trough concentration (C0) was within the targeted range for most patients, over 30‐fold variability in the dose‐adjusted ERL C0 was observed. Regression analysis revealed a significant effect of the non‐functional CYP3A5*3 variant on the dose‐adjusted ERL C0 (p = 0.031). ERL dose requirement was 0.02 mg/kg/d higher in patients with CYP3A5*1/*3 genotype compared to patients with CYP3A5*3/*3 to reach the targeted C0 (p = 0.041). ERL therapy substantially improved estimated glomerular filtration rate (28.6 ± 6.6 mL/min/1.73 m2) in patients with baseline kidney dysfunction.

Conclusion

Everolimus pharmacokinetics in HTx recipients is highly variable. Our preliminary data on patients on a CNI‐free therapy regimen suggest that CYP3A5 genetic variation may contribute to this variability.
Prophylactic CMV therapy does not improve three‐yr patient and graft survival compared to preemptive therapy
Authors: Werzowa Johannes , Schwaiger Benedikt , Hecking Manfred , Strassl Robert , Schmaldienst Sabine , Böhmig Georg A. , Genser Bernd , Säemann Marcus D.
Published: October 2015

Despite increasing evidence in favor of prophylactic valganciclovir treatment in kidney transplant recipients for the prevention of cytomegalovirus (CMV) infection, the impact of preemptive vs. prophylactic treatment on long‐term clinical outcomes is unclear. In this retrospective study, 187 kidney transplant recipients with serologic intermediate‐risk constellation (recipient CMV IgG positive) received either preemptive or prophylactic treatment with valganciclovir. Patient survival (primary endpoint), graft survival, viremia rates, and other CMV‐related outcomes were analyzed. Prophylactic therapy reduced the rates for CMV viremia during the first year (hazard ratio: 0.48, 95% confidence interval [CI] 0.30–0.75; p < 0.001). There was a trend for higher three‐yr patient mortality in the prophylactic group (hazard ratio: 5.08, 95% CI 0.62–41.3; p = 0.091), and the rate of graft loss was not reduced (hazard ratio: 0.93, 95% CI 0.32–2.68; p = 0.894). Estimated glomerular filtration rate over three yr was on average 6.8 mL/min/1.73 m2 lower in the prophylactic group (95% CI −11.68 to −1.81; p = 0.007) using a multivariate random effects model but showed more improvement over time. Prophylactic valganciclovir treatment reduced the rate of CMV infections during the first year post‐transplant but no effects of prophylactic treatment on patient and graft survival or kidney function over three yr were observed.
The use of special stains at two dermatopathology laboratories in East Africa
Authors: Kiprono S. , Muchunu J. , Beltraminelli H.
Published: October 2015

Background

Histopathology is often essential to establish an accurate diagnosis. Pathology laboratories are scarce in most Sub‐Saharan Africa where dermatopathology is a developing field. In resource‐poor countries, most specimens are analyzed only after hematoxylin and eosin staining. The availability of special stains is very limited and restricted to only few centers. The aim of this study is to analyze the extent of dermatopathological cases which can be adequately diagnosed after hematoxylin and eosin alone. Secondly, to investigate which cases required further special stains.

Methods

All skin specimens submitted to two University Hospitals (Tanzania and Kenya) were included in this study. All specimens were first analyzed with hematoxylin and eosin and a diagnosis established when possible. All cases in which an accurate diagnosis after hematoxylin and eosin only was not possible, were registered and evaluated after further special stains.

Results

A total of 386 specimens were examined. A proper histopathologic diagnosis with hematoxylin and eosin alone was possible in 344 (89.1%) samples. In 45 (11.6%) cases, mostly skin infections, further special stains were necessary.

Conclusion

A proper histopathologic diagnosis was possible after hematoxylin and eosin alone in almost 90% of the specimens submitted to the two laboratories in Sub‐Saharan Africa.
Engaging the Experts in Museum Computing: Seven Years of Queries on MCN‐L
Authors: Marty Paul F. , Alemanne Nicole D.
Published: October 2015

MCN‐L, an email listserv administered by the Museum Computer Network, is open to anyone interested in discussing information technology in museums and other cultural heritage organizations. To determine how MCN‐L meets the needs of museum information professionals, this study presents an analysis of more than 6,000 emails sent to the listserv over a seven‐year period (2004–2011). The results of this analysis indicate that MCN‐L adds value to the online community of museum information professionals by providing an online communication channel focused on professional outreach and expert support, backed up by specific examples drawn from personal experiences. MCN‐L's emphasis on personal expertise is a key characteristic that speaks to the listserv's lasting value to the museum community and has implications for researchers and practitioners as they consider the future of computer‐mediated communication for all museum professionals.
749. TROPAEOLUM ARGENTINUM
Authors: Rix Martyn
Published: October 2015

Tropaeolum argentinum Buch., a climber from the mountains of Argentina and Bolivia, is illustrated. Its history, relationships and cultivation are discussed.
752. SACOILA CERRADICOLA
Authors: Meneguzzo Thiago E. C.
Published: October 2015

This work describes and illustrates a new species of orchid, Sacoila cerradicola. Its differences from other Sacoila species from Brazil are demonstrated, and notes about its habitat, ecology, conservation status and suggestions for its cultivation are provided.
Extending Budgetary Participation beyond Budget Pitsos in Botswana
Authors: Botlhale Emmanuel
Published: October 2015

Waves of budget reforms are sweeping unremittingly across Africa with an overarching objective of democratising the budgetary process, mainly by increased popular participation. In this connection, Botswana introduced reforms in 2010 in the form of pitsos (opinion‐gathering meetings) to enable citizens to participate more in the budget. This article attempts to answer the question, ‘Are pitsos enough to enhance budgetary participation?’. Relying on both primary and secondary sources, the answer is in the negative. Even though the pitsos can enhance participation, there is a need for thoroughgoing reforms, for example a Budget Act and a strong Parliament, to complement them.
Social Protection and Climate Change: Emerging Issues for Research, Policy and Practice
Authors: Johnson Craig , Bansha Dulal Hari , Prowse Martin , Krishnamurthy Krishna , Mitchell Tom
Published: October 2015

This article lays the foundation for this special issue on social protection and climate change, introducing and evaluating the ways in which the individual articles contribute to our understanding of the subject.
No Empathy – No Service
Authors: Tripp Cindy
Published: October 2015

Empathy is the launching pad for new ideas about how you might be of greater service.

Empathy arrives when a company is able to put aside its own “lens” and see through the customer's eyes.
The DMI Design Value Scorecard: A New Design Measurement and Management Model
Authors: Westcott Michael , Sato Steve , Mrazek Deb , Wallace Rob , Vanka Surya , Bilson Carole , Hardin Dianne
Published: October 2015

Our team of academics and design practitioners joined forces with Microsoft to come up with a useful scorecard that DMI members could use to assess design's impact and importance in their own organizations.

Here's a way to assess the impact and value of design in your own organization, with a little help from DMI.
Appreciating the Complexity of Project Management Execution: Using Simulation in the Classroom
Authors: Hartman Nathan S. , Watts Charles A. , Treleven Mark D.
Published: October 2015

As the popularity and importance of project management increase, so does the need for well‐prepared project managers. This article discusses our experiences using a project management simulation in undergraduate and MBA classes to help students better grasp the complexity of project management. This approach gives students hands‐on experience with many facets in the project management life cycle and provides them with feedback on their performance as project managers. This article provides an overview of the simulation exercises, guidance for classroom integration, and evidence of effectiveness.
HOUSEHOLD FINANCES, INCOME SHOCKS, AND FAMILY SEPARATION IN BRITAIN
Authors: Bridges Sarah , Disney Richard
Published: October 2015

We examine the effect of household financial indebtedness on the incidence of partnership dissolution using a large survey of families with children in Britain. We use detailed data on household finances to provide a robust statistical analysis of the relationship between indebtedness and partnership dissolution and to avoid the potential simultaneity of financial and psychological health responses that arise when using self‐reported data on the extent of household “financial problems.” We examine whether the data provide any support for the “economic” models of divorce and separation developed by Gary Becker and his colleagues. (JEL J12, D12)
Response to erythropoietic‐stimulating agents in patients with chronic myelomonocytic leukemia
Authors: Xicoy Blanca , Germing Ulrich , Jimenez María‐José , Garcia Olga , Garcia Regina , Schemenau Jeniffer , Pedro Carme , Luño Elisa , Bernal Teresa , González Bernardo , Strupp Corinna , Ardanaz Maite , Kuendgen Andrea , Cedena María‐Teresa , Neukirchen Judith , Calabuig Marisa , Brunet Salut , Medina Angeles , Amigo María‐Luz , Ramos Fernando , Callejas Marta , Díez‐Campelo María , Bailén Alicia , Collado Rosa , Vicente Ana , Arnan Montserrat , Valcarcel David , Arilla María Jesús , Zamora Lurdes , Benlloch Luis , Sanz Guillermo
Published: October 2015

Background

The efficacy of erythropoietic‐stimulating agents (ESA) in chronic myelomonocytic leukemia (CMML) is unknown. Our objective was to analyze erythroid response (ER) and overall survival (OS) in a series of 94 patients with CMML treated with ESA.

Methods

We analyzed a series of 94 patients with CMML treated with ESA included in the Spanish and Düsseldorf‐MDS registries.

Findings

ER was observed in 64% of patients and red blood cell (RBC) transfusion independence in 31%. The median duration of ER was 7 months (range, 0–88). CPSS and EPO level were significantly associated with ER in multivariate analysis (P = 0.003). Considering only patients with CPSS low‐ or intermediate‐1‐risk group, the absence of RBC transfusion dependence and erythropoietin (EPO) level predicted ER (P = 0.003 and P = 0.008, respectively). In multivariate analysis, only the EPO level retained its prognostic value (P = 0.029). Achievement of ER correlated with a better survival since ER evaluation (P = 0.016).

Interpretation

The CPSS and EPO levels are adequate tools to select CMML patients with symptomatic anemia who may benefit from treatment with ESA. A significant ER to ESA is expected in anemic patients with low/intermediate‐1 CMML risk by the CPSS and a low endogenous serum EPO level.
Bede, iconoclasm and the Temple of Solomon
Authors: Darby Peter
Published: October 2015

In Bede's lifetime (c.673–735) the churches at Wearmouth‐Jarrow were richly decorated with panel paintings from Rome. This essay examines the significance that those paintings held for Bede and his community, and it reveals the strategies that Bede employed to defend them in his commentary on the Temple of Solomon (De templo), which was written after images had become a contentious issue in Byzantium during the reign of Emperor Leo III (714–41). This has important implications for our understanding of Bede's place in the intellectual landscape of early eighth‐century Europe, and it shows the ambitious nature and topical relevance of his mature exegetical programme.
The Impact of Process Instructions on Judges’ Use of Examinee Performance Data in Angoff Standard Setting Exercises
Authors: Mee Janet , Clauser Brian E. , Margolis Melissa J.
Published: October 2015

Despite being widely used and frequently studied, the Angoff standard setting procedure has received little attention with respect to an integral part of the process: how judges incorporate examinee performance data in the decision‐making process. Without performance data, subject matter experts have considerable difficulty accurately making the required judgments. Providing data introduces the very real possibility that judges will turn their content‐based judgments into norm‐referenced judgments. This article reports on three Angoff standard setting panels for which some items were randomly assigned to have incorrect performance data. Judges were informed that some of the items were accompanied by inaccurate data, but were not told which items they were. The purpose of the manipulation was to assess the extent to which changing the instructions given to the judges would impact the extent to which they relied on the performance data. The modified instructions resulted in the judges making less use of the performance data than judges participating in recent parallel studies. The relative extent of the change judges made did not appear to be substantially influenced by the accuracy of the data.
Using State Assessments for Predicting Student Success in Dual‐Enrollment College Classes
Authors: Kingston Neal M. , Anderson Gretchen
Published: October 2015

Scores on state standards‐based assessments are readily available and may be an appropriate alternative to traditional placement tests for assigning or accepting students into particular courses. Many community colleges do not require test scores for admissions purposes but do require some kind of placement scores for first‐year English and math courses. In this study, we examine the efficacy of using the reading and math portions of the Kansas State Assessment (KSA) for predicting the success of high school students taking College Algebra and College English I at a Kansas community college. Results showed that in this sample KSA scores predicted as well or better than more traditional placement tests and with no extra cost to the institution.
The conservation genetics juggling act: integrating genetics and ecology, science and policy
Authors: Haig Susan M. , Miller Mark. P. , Bellinger Renee , Draheim Hope M. , Mercer Dacey M. , Mullins Thomas D.
Published: October 2015

The field of conservation genetics, when properly implemented, is a constant juggling act integrating molecular genetics, ecology, and demography with applied aspects concerning managing declining species or implementing conservation laws and policies. This young field has grown substantially since the 1980s following the development of polymerase chain reaction and now into the genomics era. Our laboratory has ‘grown up’ with the field, having worked on these issues for over three decades. Our multidisciplinary approach entails understanding the behavior and ecology of species as well as the underlying processes that contribute to genetic viability. Taking this holistic approach provides a comprehensive understanding of factors that influence species persistence and evolutionary potential while considering annual challenges that occur throughout their life cycle. As a federal laboratory, we are often addressing the needs of the U.S. Fish and Wildlife Service in their efforts to list, de‐list, or recover species. Nevertheless, there remains an overall communication gap between research geneticists and biologists who are charged with implementing their results. Therefore, we outline the need for a National Center for Small Population Biology to ameliorate this problem and provide organizations charged with making status decisions firmer ground from which to make their critical decisions.