bluuebunny/crossref_metadata_2025 huggingface dataset:
Review article: the pathophysiology and medical management of diverticulosis and diverticular disease of the colon
Authors: Tursi A. , Papa A. , Danese S.
Published: July 2015

Background

The incidence of diverticulosis and diverticular disease of the colon, including diverticulitis, is increasing worldwide, and becoming a significant burden on national health systems. Treatment of patients with diverticulosis and DD is generally based on high‐fibre diet and antibiotics, respectively. However, new pathophysiological knowledge suggests that further treatment may be useful.

Aim

To review the current treatment of diverticulosis and diverticular disease.

Methods

A search of PubMed and Medline databases was performed to identify articles relevant to the management of diverticulosis and diverticular disease. Major international conferences were also reviewed.

Results

Two randomised controlled trials (RCT) found the role of antibiotics in managing acute diverticulitis to be questionable, particularly in patients with no complicating comorbidities. One RCT found mesalazine to be effective in preventing acute diverticulitis in patients with symptomatic uncomplicated diverticular disease. The role of rifaximin or mesalazine in preventing diverticulitis recurrence, based on the results of 1 and 4 RCTs, respectively, remains unclear. RCTs found rifaximin and mesalazine to be effective in treating symptomatic uncomplicated diverticular disease. The use of probiotics in diverticular disease and in preventing acute diverticulitis occurrence/recurrence appears promising but unconclusive. Finally, the role of fibre in treating diverticulosis remains unclear.

Conclusions

Available evidence suggests that antibiotics have a role only in the treatment of complicated diverticulitis. It appears to be some evidence for a role for rifaximin and mesalazine in treating symptomatic uncomplicated diverticular disease. Finally, there is not currently adequate evidence to recommend any medical treatment for the prevention of diverticulitis recurrence.
A dataset of factors that influence preservice teachers' intentions to use Web 2.0 technologies in future teaching practices
Authors: Yusop Farrah Dina
Published: July 2015

In recent years, researchers have focused on investigating factors that influence preservice teachers' utilization of Web 2.0 technologies in their classrooms. Findings indicate that preservice teachers' intentions, beliefs and attitudes toward technology are important determinants of the success of future technology integration. However, studies tracking the impact of Web 2.0 training on preservice teachers' intentions are still lacking. Moreover, publicly available datasets on the topic are still very limited. This paper presents a dataset of various independent and dependent variables that may influence preservice teachers' intentions to use Web 2.0 technologies in their future teaching practices. A questionnaire modified to conform to the theory of planned behavior (TPB) was distributed to 100 preservice teachers at a public university in Malaysia. The resulting dataset should be beneficial to preservice teacher educators in designing effective training that best nurtures future preservice teachers' familiarity and intentions to utilize Web 2.0 technologies. Interested researchers sharing similar sample characteristics may also utilize this dataset to conduct more rigorous statistical analyses.
A dataset of three educational technology experiments on differentiation, formative testing and feedback
Authors: Haelermans Carla , Ghysels Joris , Prince Fernao
Published: July 2015

This paper describes a dataset with data from three individually randomized educational technology experiments on differentiation, formative testing and feedback during one school year for a group of 8th grade students in the Netherlands, using administrative data and the online motivation questionnaire of Boekaerts. The dataset consists of pre‐ and posttest scores for each experiment, as well as background information on the students, such as gender, age, ability, grade repetition and neighborhood characteristics. It also includes motivation of students. The dataset, or parts of it, could be interesting to use in future studies, focusing on effects of the use of educational technology, for comparison with similar and/or slightly different experiments, and for studies such as meta‐analyses or replication studies, especially given the individual experimental setup.
Peroxisomal Disorders: A Review on Cerebellar Pathologies
Authors: De Munter Stephanie , Verheijden Simon , Régal Luc , Baes Myriam
Published: July 2015

Peroxisomes are organelles with diverse metabolic tasks including essential roles in lipid metabolism. They are of utmost importance for the normal functioning of the nervous system as most peroxisomal disorders are accompanied with neurological symptoms. Remarkably, the cerebellum exquisitely depends on intact peroxisomal function both during development and adulthood. In this review, we cover all aspects of cerebellar pathology that were reported in peroxisome biogenesis disorders and in diseases caused by dysfunction of the peroxisomal α‐oxidation, β‐oxidation or ether lipid synthesis pathways. We also discuss the phenotypes of mouse models in which cerebellar pathologies were recapitulated and search for connections with the metabolic abnormalities. It becomes increasingly clear that besides the most severe forms of peroxisome dysfunction that are associated with developmental cerebellar defects, milder impairments can give rise to ataxia later in life.
Bird and bat predation services in tropical forests and agroforestry landscapes
Authors: Maas Bea , Karp Daniel S. , Bumrungsri Sara , Darras Kevin , Gonthier David , Huang Joe C.‐C. , Lindell Catherine A. , Maine Josiah J. , Mestre Laia , Michel Nicole L. , Morrison Emily B. , Perfecto Ivette , Philpott Stacy M. , Şekercioğlu Çagan H. , Silva Roberta M. , Taylor Peter J. , Tscharntke Teja , Van Bael Sunshine A. , Whelan Christopher J. , Williams‐Guillén Kimberly
Published: July 2015

Understanding distribution patterns and multitrophic interactions is critical for managing bat‐ and bird‐mediated ecosystem services such as the suppression of pest and non‐pest arthropods. Despite the ecological and economic importance of bats and birds in tropical forests, agroforestry systems, and agricultural systems mixed with natural forest, a systematic review of their impact is still missing. A growing number of bird and bat exclosure experiments has improved our knowledge allowing new conclusions regarding their roles in food webs and associated ecosystem services. Here, we review the distribution patterns of insectivorous birds and bats, their local and landscape drivers, and their effects on trophic cascades in tropical ecosystems. We report that for birds but not bats community composition and relative importance of functional groups changes conspicuously from forests to habitats including both agricultural areas and forests, here termed ‘forest‐agri’ habitats, with reduced representation of insectivores in the latter. In contrast to previous theory regarding trophic cascade strength, we find that birds and bats reduce the density and biomass of arthropods in the tropics with effect sizes similar to those in temperate and boreal communities. The relative importance of birds versus bats in regulating pest abundances varies with season, geography and management. Birds and bats may even suppress tropical arthropod outbreaks, although positive effects on plant growth are not always reported. As both bats and birds are major agents of pest suppression, a better understanding of the local and landscape factors driving the variability of their impact is needed.
Long‐term hormonal follow‐up after human Puumala hantavirus infection
Authors: Partanen Terhi , Koivikko Minna , Leisti Päivi , Salmela Pasi , Pääkkö Eija , Karttunen Ari , Sintonen Harri , Risteli Leila , Hautala Nina , Vapalahti Olli , Vaheri Antti , Kauma Heikki , Hautala Timo
Published: July 2015

Objective

Nephropathia epidemica (NE) is a haemorrhagic fever with renal syndrome (HFRS) caused by Puumala hantavirus (PUUV). Pituitary haemorrhage and hypopituitarism may complicate recovery from acute NE.

Design

Forty‐seven of our recent cohort of 58 NE patients volunteered to be re‐examined in order to estimate the burden of hormonal deficiency 4 to 8 years after the acute illness. Two patients had suffered from pituitary haemorrhage, but many others exhibited pituitary oedema during their acute infection. In this study, we searched for symptoms of hormonal deficiency, performed hormonal laboratory screening, and most patients underwent pituitary MRI examination.

Results

The pituitary size had diminished in all patients in whom MRI was performed (P < 0·001). One patient with acute phase haemorrhage had made a complete recovery while the other continued to require hormonal substitution. In addition, hormonal laboratory abnormalities were observed in nine other patients; these being attributable to several reasons, for example independent peripheral hormonal diseases, side effects of medication or other secondary causes such as obesity. None of them had signs of late‐onset pituitary insufficiency caused by their previous NE. Health‐related quality of life (mean and median 15D score) of patients was comparable to that of age‐standardized general population.

Conclusions

None of our patients had developed obvious late‐onset hypopituitarism despite of the fact that pituitary gland can be affected during acute NE. We recommend requesting a history of hantavirus infection whenever the possibility of pituitary dysfunction is suspected at least in patients originating from regions with high NE infection rate.
REVISITING GLADWELL'S HOCKEY PLAYERS: INFLUENCE OF RELATIVE AGE EFFECTS UPON EARNING THE PHD
Authors: Kniffin Kevin M. , Hanks Andrew S.
Published: July 2015

We examine the influence of relative age effects (RAE) upon specific factors related to earning a Doctor of Philosophy (PhD): age at degree, time to degree, and salary upon completion. Drawing on the 2010 Survey of Earned Doctorates, we find no significant influence of RAE. Specifically, when controlling for discipline‐specific variation, we find no influence of RAE on the age of people earning the PhD and no influence on post‐graduate salary. However, we estimate a relative salary loss due to redshirting of over $138,000 in lifetime earnings for individuals who earn the PhD. To the extent that earning the PhD is considered an outstanding achievement, our findings support the view that redshirting is unnecessary and costly. (JEL D01, D12, I20, I28, J24, J44)
HCV infection is associated with lower survival in simultaneous liver kidney transplant recipients in the United States
Authors: Perumpail Ryan B. , Wong Robert J. , Scandling John D. , Ha Le Dung , Todo Tsuyoshi , Bonham Clark A. , Saab Sammy , Younossi Zobair M. , Ahmed Aijaz
Published: July 2015

Background

The frequency of simultaneous liver kidney transplantation (SLKT) has been increasing over the past decade. Hepatitis C virus (HCV) infection is the most common indication for liver transplantation in the United States. Given the rising prevalence of HCV‐related SLKT, it is important to understand the impact of HCV in this patient population.

Methods

We conducted a retrospective cohort study using data from the United Network for Organ Sharing registry to assess adult patients undergoing SLKT in the United States from 2003 to 2012. Patient survival following SLKT was assessed using Kaplan–Meier methods and multivariate Cox proportional hazards models.

Results

Patients infected with non‐HCV have significantly lower survival following SLKT compared to non‐HCV patients at three (three‐yr survival: 71.0% vs. 78.9%, p < 0.01) and five yr (five‐yr survival: 61.4% vs. 72.5%, p < 0.01). The results of multivariate regression analyses demonstrated that patients infected with HCV had significantly lower survival following SLKT than patients with non‐HCV disease (HR 1.41, 95% CI, 1.19–1.67, p < 0.001). In addition, lower post‐SLKT survival was noted among patients with diabetes (HR 1.34, 95% CI, 1.13–1.58, p < 0.001) and hepatocellular carcinoma (HR 1.60, 95% CI, 1.17–2.18, p < 0.01).

Conclusions

Hepatitis C infection is associated with lower patient survival following SLKT.
Is China Relinquishing Manufacturing Competitiveness to Mexico in US Markets?
Authors: Lin Yue
Published: July 2015

The present paper expands on the understanding of the competition between China and Mexico in US markets. Using the OECD International Trade by Commodity Statistics covering the period 2002–2012, we undertake both relative‐market‐share analysis and constant‐market‐share analysis. Through comparison of market share changes at both macro and micro levels, we find that on the one hand China's total negative impact on Mexican manufactured exports has been greatly reduced since 2007; on the other hand, China is increasingly aligned with Mexico in terms of its competitive position over the US market, consolidating its competitiveness in high and medium‐to‐high technology products and gaining market share in the US market, mainly at the expense of the most advanced economies. This changing pattern suggests the intensification of competition between Mexico and China, but also a potential for cooperation, with the enhancement of bilateral intra‐industry trade as a result of different technology choices and specialization paths.
Endoscopic resection of colorectal lesions: The narrowing divide between East and West
Authors: Burgess Nicholas G. , Bourke Michael J.
Published: July 2015

Colonic polypectomy is an effective way of reducing colon cancer mortality. Multiple techniques now exist for the resection of polyps, and the endoscopist must decide on the appropriate resection approach for individual patients and lesions. This decision should maximize efficacy, safety and cost‐effectiveness and provide optimal oncological outcomes while minimizing unnecessary surgical treatment. Advances in endoscopic imaging technology are improving the accuracy of endoscopic diagnosis and allowing more precise risk assessment of colonic lesions. Resection technique can be tailored to the endoscopic findings. Diminutive (≤5 mm) and small polyps (≤9 mm) are best resected primarily by snare techniques. Cold snare polypectomy has proven safety, but efficacy and technique require further study. There is variation in techniques used for polyps 6–20 mm in size and incomplete resection rates for conventional polypectomy may be considerable. Endoscopic mucosal resection (EMR) is well established, safe and effective for lesions without submucosal invasion (SMI); however, recurrence is a key limitation. Endoscopic submucosal dissection (ESD) is well established in the East; however, it is resource intensive and its role in lesions with a low risk of SMI is questionable. ESD in the West remains incompletely defined and is associated with high adverse event rates, but it is becoming increasingly available and successful as experience grows. Emerging full‐thickness resection technologies are still in their infancy and remain experimental as a result of the absence of reliable closure devices and techniques. Patient‐focused outcomes should guide technique selection.
Measuring gross motor activities in Rett syndrome
Authors: Humphreys Peter
Published: July 2015

This commentary is on the original article by Lor et al. on pages 1137–1142 of this issue.
Lipoprotein(a) predicts a new onset of chronic kidney disease in people with Type 2 diabetes mellitus
Authors: Yun J.‐S. , Ahn Y.‐B. , Song K.‐H. , Yoo K.‐D. , Park Y.‐M. , Kim H.‐W. , Ko S.‐H.
Published: July 2015

Aims

We investigated the association between lipoprotein(a) [Lp(a)] level and new‐onset chronic kidney disease (CKD) in patients with Type 2 diabetes.

Methods

We conducted a prospective cohort study from March 2003 to December 2004 with a median follow‐up time of 10.1 years. Patients aged 25–75 years with Type 2 diabetes and without CKD [estimated glomerular filtration rate (eGFR) ≥ 90 ml/min/1.73 m2) were consecutively enrolled. The eGFR was measured at least twice every year , and new‐onset CKD was defined as a decreased eGFR status of < 60 ml/min/1.73 m2 using a Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) equation.

Results

Of the 862 patients who were enrolled, 560 (65.0%) completed the follow‐up and 125 (22.3%) progressed to CKD. The mean age and duration of diabetes were 53.3 ± 9.6 and 7.5 ± 6.0 years, respectively. The baseline eGFR was 101.8 ± 11.3 ml/min/1.73 m2. After adjusting for multiple confounding factors, a Cox hazard regression analysis revealed that the third tertile of Lp(a) was significantly associated with the development of CKD during the observation period when compared with the first tertile [hazard ratio 2.12 (95% confidence interval 1.33–3.36); P = 0.001).

Conclusions

In this prospective, longitudinal, observational cohort study, we demonstrated that the Lp(a) level was an independent prognostic factor for the future development of CKD in patients with Type 2 diabetes.
Culturally appropriate health education for Type 2 diabetes in ethnic minority groups: an updated Cochrane Review of randomized controlled trials
Authors: Creamer J. , Attridge M. , Ramsden M. , Cannings‐John R. , Hawthorne K.
Published: July 2015

Aims

To give an updated perspective of interventions from additional data collected since our first review, conducted in 2008.

Background

This updated Cochrane Review incorporates new information from recent randomized controlled trials on culturally appropriate diabetes health education interventions.

Methods

An electronic literature search of six databases was repeated, with databases of ongoing trials checked and three journals hand‐searched. Meta‐analysis was carried out for sufficiently homogeneous outcomes, and common themes among trials were highlighted.

Results

A total of 22 new trials were added to the original 11. Meta‐analysis of 28 trials containing suitable data showed significant improvements in glycaemic control (HbA1c) and diabetes knowledge over a period of 24 months, after the delivery of culturally appropriate education to participants, compared with those receiving ‘conventional’ care. There were no consistent benefits over the control group in other selected outcome measures, and lack of data continued to make analysis of several outcome measures difficult.

Conclusions

Research activity in this field has increased considerably over the past 6 years, with culturally appropriate diabetes education showing consistent benefits over conventional care in terms of glycaemic control and diabetes knowledge, sustained in the short‐ to mid‐term. Further research is needed to determine the clinical significance of these improvements and their cost‐effectiveness.
Risk of Recurrent Neurologic Stroke or Transient Ischemic Attack in Patients with Cryptogenic Stroke and Intrapulmonary Shunt
Authors: Sinha Rahul S. , Hussain Zeeshan , Bhatia Nirmanmoh , Stoddard Marcus F.
Published: July 2015

Background and Purpose

Cardio‐embolic phenomenon is believed to underlie a significant proportion of cryptogenic strokes. We recently showed that intrapulmonary shunt (IPS) was associated with cryptogenic stroke and transient ischemic attack (TIA). We hypothesized that patients with prior cryptogenic stroke or TIA that had an IPS were at a higher risk for recurrent ischemic events.

Methods

The population included subjects with cryptogenic cerebrovascular accident (CVA) or TIA. Inclusion criteria were age ≥18 years, sinus rhythm, and clinically indicated transesophageal echocardiography (TEE). Exclusion criteria were hemorrhagic CVA, septal defect, and patent foramen. Patients were followed from index TEE.

Results

Of 71 patients, 8 were lost to follow‐up. A total of 23 patients had and 40 were without IPS. Average follow‐up duration was 38.3 ± 19.2 months. Groups were similar at baseline. There was no significant difference in the recurrence of ischemic CVA or TIA in the IPS versus non‐IPS groups (0% vs. 7.5%; P = NS). There was no difference between the incidence of hemorrhagic CVA in the IPS and non‐IPS groups (4.3% vs. 5.0%; P = NS). The proportion of patients on warfarin in the IPS group was significantly higher compared to the non‐IPS group (17.4% vs. 0%; P < 0.05).

Conclusions

Patients with IPS and cryptogenic stroke or TIA did not have a higher recurrence of ischemic cerebral events. Warfarin was significantly higher at follow‐up in the IPS compared to the non‐IPS group, which may explain these findings. A study randomizing patients with IPS and cryptogenic stroke or TIA to warfarin or no warfarin would be of great interest.
Dietary therapy is not the best option for refractory nonsurgical epilepsy
Authors: Vaccarezza María Magdalena , Silva Walter Horacio
Published: July 2015

The ketogenic diet (KD) is currently a well‐established treatment for patients with medically refractory, nonsurgical epilepsy. However, despite its efficacy, the KD is highly restrictive and constitutes a treatment with serious potential adverse effects, and often with difficulties in its implementation and compliance. Patients on the KD require strict follow‐up and constant supervision by a medical team highly experienced in its management in order to prevent complications. Other alternative treatments for patients with refractory epilepsy include vagus nerve stimulation (VNS), new‐generation antiepileptic drugs (AEDs), corpus callosotomy (CC), and responsive focal cortical stimulation (RNS). In this review, we explain not only the difficulties of the KD as a therapeutic option for refractory epilepsy but also the benefits of other therapeutic strategies, which, in many cases, have proven to have better efficacy than the KD itself.
Heterogeneous flows foster heterogeneous assemblages: relationships between functional diversity and hydrological heterogeneity in riparian plant communities
Authors: Lawson James R. , Fryirs Kirstie A. , Lenz Tanja , Leishman Michelle R.
Published: July 2015

Riparian ecosystems are biophysically complex and highly diverse taxonomically, structurally and functionally. While many environmental factors determine the structure and function of riparian vegetation communities, hydrology is thought to be the ‘master variable’. Flooding and variability in water availability are known to be key drivers of taxonomic diversity, but their influence on the functional trait diversity of riparian vegetation communities remains largely unexplored.

We collected data on species abundance, quantitative plant functional traits and hydrology from 15 sites distributed across south‐eastern Australia to address the following questions: (a) Is functional trait diversity related to the frequency and magnitude of flooding disturbance? (b) Is functional trait diversity related to variability in seasonal water availability within the riparian zone?

We confirm that metrics describing both flooding disturbance and patterns of water availability exhibit strong relationships with functional trait diversity in riparian vegetation communities of south‐eastern Australia. Our key finding is that functional trait diversity in these systems tends to be positively associated with variability in hydrological conditions and the intensity of rare, high‐magnitude flooding events, rather than average patterns of flow.

Our study highlights the importance of extreme flooding events and temporal patterns of water availability as determinants of diversity in riparian vegetation communities. These relationships may have significant consequences for plant communities experiencing alterations to hydrology caused by anthropogenic flow modification and the changing climate.
The Spillover Effect of Urban Village Removal on Nearby Home Values in Beijing
Authors: Zhang Yingjie , Zheng Siqi , Song Yan , Zhong Yongguang
Published: July 2015

An urban village is a typical type of informal housing settlement in which rural migrants stay in Chinese cities. As urban villages are being woven into modern urban landscapes, we estimate the size of their negative externality and also the positive spillover effect of their removal on nearby formal housing communities. We employ two micro data sets: one includes all the existing urban villages in 2006 and a unique micro survey of 50 villages conducted in 2008, and the other contains 24,000 micro resale records in the formal housing sector from 2006 to 2011. Our findings show that an average urban village causes a 2.5 percent housing price discount in nearby communities, and the removal of this urban village triggers a 3.3–4.3 percent housing price appreciation. However, more careful consideration is needed for the other side of the coin—the welfare change of those rural migrants who are displaced during this process.
First prospective report on immune tolerance in poor risk haemophilia A inhibitor patients with a single factor VIII/von Willebrand factor concentrate in an observational immune tolerance induction study
Authors: Kreuz W. , Escuriola Ettingshausen C. , Vdovin V. , Zozulya N. , Plyushch O. , Svirin P. , Andreeva T. , Bubanská E. , Campos M. , Benedik‐Dolničar M. , Jiménez‐Yuste V. , Kitanovski L. , Klukowska A. , Momot A. , Osmulskaya N. , Prieto M. , Šalek S. Z. , Velasco F. , Pavlova A. , Oldenburg J. , Knaub S. , Jansen M. , Belyanskaya L. , Walter O. ,   the ObsITI study group and the ObsITI committee
Published: July 2015

Introduction/background

Development of neutralizing inhibitors against factor VIII (FVIII) is a major complication of haemophilia A treatment.

Aim

The ongoing, international, open‐label, uncontrolled, observational immune tolerance induction (ObsITI) study evaluates ITI, the standard of care in patients with inhibitors.

Patients/methods

Forty‐eight prospective patients in this interim analysis received a single plasma‐derived, von Willebrand factor‐stabilized, FVIII concentrate (pdFVIII/VWF) for ITI. According to recommended Bonn protocol, ‘low responders’ at ITI start (<5 BU) received 50–100 IU FVIII kg−1 daily, or every other day; ‘high responders’ (≥5 BU) received 100 IU FVIII kg−1 every 12 h.

Results

Forty of 48 patients (83.3%), had at least one risk factor for poor ITI‐prognosis at ITI start (i.e. age ≥7 years, >2 years since inhibitor diagnosis, inhibitor titre ≥10 BU at the start of ITI, or prior ITI failure). Nonetheless, 34 patients (70.8%) achieved complete success, 3 (6.3%) partial success, 1 (2.1%) partial response; ITI failed in 10 patients (20.8%), all with poor prognosis factors. All six low responders achieved complete success. ITI outcome was significantly associated with inhibitor titre level at ITI start (P = 0.0068), number of poor prognosis factors for ITI success (P = 0.0187), monthly bleeding rate during ITI (P = 0.0005) and peak inhibitor titre during ITI (P = 0.0007). Twenty‐two of 35 high responder patients (62.9%) with ≥1 poor prognosis factor achieved complete success.

Conclusion

Treatment with a single pdFVIII/VWF concentrate, mainly according to the Bonn protocol, resulted in a high ITI success rate in haemophilia A patients with inhibitors and poor prognosis for ITI success.
Fibromyalgia syndrome in Turkish hemodialysis patients
Authors: Leblebici Berrin , Özelsancak Rüya , Yılmaz Emine Ece , Doruk Pınar
Published: July 2015

The aim of our study was to evaluate the frequency of fibromyalgia syndrome (FMS) in hemodialysis (HD) patients and to assess whether this syndrome is associated with gender, age, duration of HD, or various laboratory parameters. This study was composed of 221 chronic HD patients (99 females and 122 males), and we recorded each participant's age, gender, causes of kidney failure, HD duration, education level, and symptoms related to FMS, which was diagnosed according to the 2010 American College of Rheumatology criteria. We documented the laboratory parameters for all patients. In addition, patients with FMS filled out the Fibromyalgia Impact Questionnaire. Twenty‐two patients met the diagnostic criteria for FMS (9%), and there were no statistically significant differences related to age, gender, or HD duration between FMS and non‐FMS groups (P > 0.05). In addition, the education levels were lower in patients diagnosed with FMS (P < 0.05), and there were statistically significant differences related to sleep disturbance, fatigue, and cognitive symptoms between the two groups (P < 0.05) as well. However, their laboratory parameters were similar (P > 0.05). There was a higher prevalence of FMS in HD patients than in the general population. Sleep disturbances, fatigue, education level, and cognitive symptoms were associated with FMS, but there was no correlation between the laboratory parameters and this condition.
Awareness of cervical cancer risk factors and symptoms: cross‐sectional community survey in post‐conflict northern Uganda
Authors: Mwaka Amos D. , Orach Christopher G. , Were Edward M. , Lyratzopoulos Georgios , Wabinga Henry , Roland Martin
Published: July 2015

Background

Lack of awareness of risk factors and symptoms for cancer may lead to late diagnosis and poor prognosis.

Objective

We assessed community awareness about cervical cancer risk factors and symptoms and perceptions about prevention and cure of cervical cancer in order to contribute data to inform interventions to improve cervical cancer survival.

Design

Cross‐sectional population‐based survey.

Setting and participants

We conducted this study in Gulu, a post‐conflict district in Uganda in 2012. The sample included 448 persons aged 18 years and above, selected through a multi‐stage stratified cluster sampling process.

Data collection methods and analysis

We collected data using a pretested structured questionnaire. Logistic regressions were used to determine magnitudes of associations between socio‐demographic and outcome variables.

Results

Most participants (444/448) had heard about cervical cancer. Known risk factors including multiple sexual partners, human papillomavirus infection, and early onset of sexual activity, were recognized by 88%, 82%, and 78% of respondents respectively. 63% of participants believed that prolonged use of family planning pills and injections caused cervical cancer. The majority of participants recognized symptoms of cervical cancer including inter‐menstrual bleeding (85%), post‐menopausal bleeding (84%), and offensive vaginal discharge (83%). 70% of participants believed that cervical cancer is preventable and 92% believed that it could be cured if diagnosed at an early stage.

Discussion and conclusions

Recognition of cervical cancer risk factors and symptoms was high among study participants. Targeted interventions including increasing availability of HPV vaccination, population‐based cervical screening and diagnostic services can translate high awareness into actual benefits.
Getting it right! Enhancing youth involvement in mental health research
Authors: Mawn Lauren , Welsh Patrick , Kirkpatrick Lauren , Webster Lisa A.D. , Stain Helen J.
Published: July 2015

Background

Few studies relating to youth mental health have actively involved young people in the design and conduct of research.

Aims

This qualitative study explores the perceptions of young people about involving them in mental health research.

Method

An opportunistic sample of eight young people (aged 14–24 years) from non‐statutory mental health organizations was interviewed. Interviews were transcribed verbatim, and inductive thematic analysis was conducted.

Results

Six key themes emerged reflecting a desire for young people to have the opportunity to actively contribute to every stage of the research process. Meaningful research involvement was perceived as offering opportunities to develop personal skills, contribute to making a difference and ensuring research projects were more relevant.

Conclusions

Young people with an active interest in mental health promotion demonstrate a desire to be involved in research with training in research methods likely to facilitate this process. Researchers need training on how best to actively and meaningfully involve young people in mental health research.
HIV and new onset seizures: slipping through the cracks in HIV care and treatment
Authors: Sikazwe I , Elafros MA , Bositis CM , Siddiqi OK , Koralnik IJ , Kalungwana L , Theodore WH , Okulicz JF , Potchen MJ , Birbeck GL
Published: July 2015

Objectives

The aim of the study was to describe patient characteristics and outcomes among HIV‐positive adults presenting to a Zambian tertiary care hospital with new‐onset seizures.

Methods

From July 2011 to June 2013, adults with seizures and a known or probable diagnosis of HIV infection were screened for a cohort study. Demographic and clinical data were obtained, including information on engagement in HIV services and in‐patient mortality. Analyses were conducted to identify characteristics associated with poor engagement in care and death.

Results

A total of 320 of 351 screened adults were HIV‐positive, with 268 of 320 experiencing new‐onset seizures. Of these, 114 of 268 (42.5%) were female, and their mean age was 36.8 years. Seventy‐nine of the 268 patients (29.5%) were diagnosed with HIV infection during the index illness. Among those who were aware of their HIV‐positive status, 59 of 156 (37.8%) had disengaged from care. Significant functional impairment (Karnofsky score < 50) was evident in 44.0% of patients. Cerebrospinal fluid was not obtained in 108 of 268 (40.3%). In‐patient mortality outcomes were available for 214 patients, and 47 of these 214 (22.0%) died during hospitalization. Patients with significant functional impairment were more likely to undergo lumbar puncture (P = 0.046). Women and the functionally impaired were more likely to die (P = 0.04 and < 0.001, respectively).

Conclusions

Despite the availability of care, less than half of HIV‐infected people with new‐onset seizures were actively engaged in care and in‐patient mortality rates were high. In the absence of clinical contraindication, lumbar puncture should be performed to diagnose treatable conditions and reduce morbidity and mortality. Continued efforts are needed to expand community‐based testing and improve HIV care retention rates. Qualitative studies are needed to elucidate factors contributing to lumbar puncture usage in this population.
Biodiversity dynamics of chironomid midges in high‐altitude lakes of the Alps over the past two millennia
Authors: Ilyashuk Elena A. , Ilyashuk Boris P. , Tylmann Wojciech , Koinig Karin A. , Psenner Roland
Published: July 2015

Climate change is one of the key drivers of changes in the biodiversity of the planet. There is, however, a general lack of long‐term data sets showing trends in taxonomic diversity of aquatic insects in high mountain environments particularly vulnerable to climate change. Using palaeolimnological techniques, we explored the changes in subfossil chironomid assemblages from three remote water bodies in the Eastern Alps, with the main focus on taxonomic turnover over different intervals of the late Holocene.

Major changes in the assemblages coincided with shifts between different climate regimes and were mainly associated with the taxonomic shifts indicating the crossing ecological thresholds related to the ice‐cover duration in alpine lakes.

Patterns of assemblage turnover through the past 2000 years differ between the study sites. Nevertheless, despite site‐specific differences in the physical setting and taxonomic composition, the study sites reveal substantial chironomid assemblage turnover (>1.0 SD) since AD 1850. The highest chironomid turnover (0.87 SD) over the last 30 years (AD 1980–2010), more than three times greater (0.26 SD) than in the previous 30 years, is observed in the lake situated at the highest elevation among the study lakes.

Applying non‐linear structural equation modelling, we found that cold‐season (October–May) temperatures and therefore lake ice phenology are among the most important environment variables affecting the chironomid assemblages.

The results of this study suggest that further climate warming will increase the risk of ecological alterations in remote Alpine freshwaters, including major shifts in chironomid fauna.
Intracanal molar barometric pressure differentials at simulated altitude conditions – proof of concept study
Authors: Roberts H. W. , Kirkpatrick T. C.
Published: July 2015

Aim

To evaluate whether objective data could be obtained regarding internal pressure conditions of a molar tooth with canals prepared but not filled exposed to reduced barometric pressures that could be experienced by aircrew.

Methodology

The root canals of five mandibular molars were prepared but not filled. Root apices were sealed with a resin‐modified glass–ionomer liner and root surfaces sealed with a dental adhesive. The sealed root surfaces were then coated with a polyvinylsiloxane (PVS) adhesive and the teeth inserted into cylinders of PVS impression material to the level of the cervical enamel junction. Barometric pressure transducers were placed in the pulp chambers with the endodontic access sealed with cotton and a provisional restoration. The specimens were then subjected to a manually controlled, atmospheric altitude challenge consisting of a slow ascent and descent to a simulated 25 000 feet above sea level followed by a rapid altitude climb and descent. The real‐time difference between intracanal and simulated atmospheric pressures were recorded and correlated (Pearson's, P = 0.05).

Results

No tooth material fractured, and there was no failure of the provisional restorations. Barometric pressures inside the closed prepared molar canals and the ambient atmospheric pressure were found to correlate (r2 = 0.97–0.99; P < 0.0001), but pressure equalization lags were observed. However, no differences greater than six pounds per square inch (310 torr) were noted.

Conclusion

This pilot study established a protocol that demonstrated that objective data regarding barometric pressures within the prepared canals of molars can be obtained at simulated altitude conditions.
Heart Rate Variability and Baroreceptor Sensitivity in Acute Stroke: A Systematic Review
Authors: Yperzeele Laetitia , van Hooff Robbert-Jan , Nagels Guy , De Smedt Ann , De Keyser Jacques , Brouns Raf
Published: July 2015

Background

Autonomic nervous system dysfunction is common after acute stroke and is associated with elevated risk of cardiac arrhythmia and mortality. Heart rate variability and baroreceptor sensitivity have been investigated as parameters of autonomic nervous system dysfunction for the prediction of stroke outcome.

We performed a systematic literature review on heart rate variability and baroreceptor sensitivity as parameters for autonomic nervous function in acute stroke. Twenty-two studies were included. Associations between heart rate variability or baroreceptor sensitivity and stroke severity, early and late complications, dependency and mortality were reported. However, interpretability of most studies and extrapolation to general stroke population are limited due to many confounding factors such as varying methodology, small sample sizes, survival selection, and exclusion of patients with frequently occurring comorbidities in stroke. Key issues, such as the effect of thrombolytic therapy on autonomic function, autonomic nervous system dysfunction in the hyperacute phase of stroke, and correlation with the risk of recurrent stroke have not been investigated. Also, nonlinear techniques have remained largely unexplored in this domain, in spite of their advantage to provide more solid evaluation in the occurrence of arrhythmia.

Key messages

Cardiac autonomic dysfunction, represented by reduced heart rate variability or impaired baroreceptor sensitivity, is associated with stroke severity, early and late complications, dependency, and mortality. Large-scale prospective studies applying internationally accepted standards of measures for analysis of heart rate variability and baroreceptor sensitivity are needed in patients with acute stroke.
Close Encounters: Minority and Majority Perceptions of Discrimination and Intergroup Relations in Antwerp, Belgium
Authors: Alanya Ahu , Swyngedouw Marc , Vandezande Veronique , Phalet Karen
Published: July 2015

Increasing numbers of second-generation Muslims are highly qualified and locally embedded in today's European cities. This does not protect them, however, from experiencing discrimination in intergroup encounters in school, at work, or in the street. Taking an approach from local intergroup relations between ethnic minorities and the majority society, we draw on the TIES (The Integration of the European Second Generation) surveys to compare Turkish and Moroccan minorities and majority Belgians in Antwerp, Belgium. Our research aims (1) to establish minority and majority perspectives on (reverse) personal discrimination (2) in different life domains, and (3) to differentiate internally between gender, socioeconomic attainments, and local climates. Structural equation models show minority and majority group perspectives on discrimination as gendered and situated inter-group encounters in socioeconomic and civic domains of life.
Economic growth, labour flexibilization and employment quality in Colombia, 2002–11
Authors: FARNÉ Stefano , VERGARA Carlos Andrés
Published: July 2015

Over the period 2002–11, the Colombian labour market saw a marked improvement in employment opportunities, accompanied by an increase in nonstandard forms of employment. The authors look at how this affected employment quality, using a composite index based on Categorical Principal Components Analysis (CATPCA). They observe a small but widespread improvement in employment quality – mainly for self‐employed women – brought about by higher earnings, increased social protection and less time‐related underemployment. However, a considerable “quality deficit” remains, which calls for policies to strengthen labour market institutions and stimulate productivity and investment.
Impact of Electrode Type on Mapping of Scar‐Related VT
Authors: BERTE BENJAMIN , RELAN JATIN , SACHER FREDERIC , PILLOIS XAVIER , APPETITI ANTHONY , YAMASHITA SEIGO , MAHIDA SAAGAR , CASASSUS FREDERIC , HOOKS DARREN , SELLAL JEAN‐MARC , AMRAOUI SANA , DENIS ARNAUD , DERVAL NICOLAS , COCHET HUBERT , HOCINI MÉLÈZE , HAÏSSAGUERRE MICHEL , WEERASOORIYA RUKSHEN , JAÏS PIERRE
Published: July 2015

Mapping of Scar‐Related VT

Background

Substrate‐based VT ablation is mostly based on maps acquired with ablation catheters. We hypothesized that multipolar mapping catheters are more effective for identification of scar and local abnormal ventricular activity (LAVA).

Methods and results

Phase1: In a sheep infarction model (2 months postinfarction), substrate mapping and LAVA tagging (CARTO®3) was performed, using a Navistar (NAV) versus a PentaRay (PR) catheter (Biosense Webster). Phase2: Consecutive VT ablation patients from a single center underwent NAV versus PR mapping. Point pairs were defined as a PR and a NAV point located within a 3D‐distance of ≤3 mm. Agreement was defined as both points in a pair being manually tagged as normal or LAVA.

Four sheep (4 years, 50 ± 4.8 kg) and 9 patients were included (53 ± 14 years, 8 male, 6 ischemic cardiomyopathy). Mapping density was higher within the scar with PR versus NAV (3.2 vs. 0.7 points/cm2, P = 0.001) with larger bipolar scar area (68 ± 55 cm2 vs. 58 ± 48 cm2, P = 0.001). In total, 818 point pairs were analyzed. Using PR, far‐field voltages were smaller (PR vs. NAV; bipolar: 1.43 ± 1.84 mV vs. 1.64 ± 2.04 mV, P = 0.001; unipolar; 4.28 ± 3.02 mV vs. 4.59 ± 3.67 mV, P < 0.001). More LAVA were also detected with PR (PR vs. NAV; 126 ± 113 vs. 36 ± 29, P = 0.001). When agreement on LAVA was reached (overall: 72%; both LAVA, 40%; both normal, 82%) higher LAVA voltages were recorded on PR (0.48 ± 0.33 mV vs. 0.31 ± 0.21 mV, P = 0.0001).

Conclusion

Multipolar mapping catheters with small electrodes provide more accurate and higher density maps, with a higher sensitivity to near‐field signals. Agreement between PR and NAV is low.
Upper thermal tolerance of wild‐type, domesticated and growth hormone‐transgenic coho salmon Oncorhynchus kisutch
Authors: Chen Z. , Devlin R. H. , Farrell A. P.
Published: July 2015

In coho salmon Oncorhynchus kisutch, no significant differences in critical thermal maximum (c. 26·9° C, CTmax) were observed among size‐matched wild‐type, domesticated, growth hormone (GH)‐transgenic fish fed to satiation, and GH‐transgenic fish on a ration‐restricted diet. Instead, GH‐transgenic fish fed to satiation had significantly higher maximum heart rate and Arrhenius breakpoint temperature (mean ± s.e. = 17·3 ± 0·1° C, TAB). These results provide insight into effects of modified growth rate on temperature tolerance in salmonids, and can be used to assess the potential ecological consequences of GH‐transgenic fishes should they enter natural environments with temperatures near their thermal tolerance limits.
Overexpression of CD55 from Barrett's esophagus is associated with esophageal adenocarcinoma risk
Authors: Murao Takahisa , Shiotani Akiko , Fujita Yoshihiko , Yamanaka Yoshiyuki , Kamada Tomoari , Manabe Noriaki , Hata Jiro , Nishio Kazuto , Haruma Ken
Published: July 2015

Background and Aim:

Although several molecular biomarkers for esophageal adenocarcinoma (EAC) have been shown to be useful disease indicators, none has been established as a reliable indicator for risk of EAC or have progressed to routine use. The aim was to identify biomarkers of high risk for EAC in patients with Barrett's esophagus (BE).

Methods:

Following endoscopic observation by magnified endoscopy with narrow band imaging (ME‐NBI), brushing was followed by obtaining biopsy samples from columnar‐lined esophagus (CLE) and from EAC lesions of EAC patients, and from age‐ and sex‐matched non‐EAC controls with BE. Total RNA was extracted for microarray analysis using Affymetrix GeneChip Human Genome U133 plus 2.0 Array. Real‐time‐PCR analysis of identified candidate genes was used to confirm the results.

Results:

Overall, 9 EAC patients and 50 patients with BE were studied. Seventy‐nine candidate genes were identified by microarray analysis based on a proportional hazards model (P < 0.005). Six genes exhibited significantly differential expressions in both BE and cancer lesions of the EAC group compared to BE of the controls. In the brushing samples, median CD55 relative expression levels in cancer lesions were highest and decreased in BE of EAC group and BE of the controls, in that order (P < 0.001).

Conclusion:

Over expression of CD55 in brushing samples taken from BE may be associated with the risk of EAC.