bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunological Modes of Pregnancy Loss: Inflammation, Immune Effectors, and Stress
Authors: Kwak‐Kim Joanne , Bao Shihua , Lee Sung Ki , Kim Joon Woo , Gilman‐Sachs Alice
Published: March 2014

Inflammatory immune response plays a key role in reproductive failures such as multiple implantation failures (MIF), early pregnancy loss, and recurrent pregnancy losses (RPL). Cellular immune responses particularly mediated by natural killer (NK), and T cells are often dysregulated in these conditions. Excessive or inappropriate recruitment of peripheral blood NK cells to the uterus may lead to cytotoxic environment in utero, in which proliferation and differentiation of trophoblast is hampered. In addition, inadequate angiogenesis by uterine NK cells often leads to abnormal vascular development and blood flow patterns, which, in turn, leads to increased oxidative stress or ischemic changes in the invading trophoblast. T‐cell abnormalities with increased Th1 and Th17 immunity, and decreased Th2 and T regulatory immune responses may play important roles in RPL and MIF. A possible role of stress in inflammatory immune response is also reviewed.
The Visionary Psyche: Jung's Analytical Psychology and Its Impact on Theories of Shamanic Imagery
Authors: Scott Emma
Published: March 2014

This article considers the shaman's visionary encounters with spirit beings from the critical viewpoint of several innovative theories of shamanism: Richard Noll's cognitive approach and Michael Winkelman's neurophenomenological perspective. These distinct approaches are analyzed in light of Jung's central concepts of the archetypes, the collective unconscious, and the individuation process, which have had a huge formative influence upon the academic investigation of visions and spiritual experiences. The centrality of Jung's theoretical reasoning within these recent studies of shamanism strongly demonstrates the continued importance of his analytical psychology and provides valuable insight into the historical and conceptual development of this expanding field of interest.
Differential clinical characteristics, treatment response and prognosis of locally advanced adenocarcinoma/adenosquamous carcinoma and squamous cell carcinoma of cervix treated with definitive radiotherapy
Authors: Chen Jenny Ling‐Yu , Huang Chao‐Yuan , Huang Yu‐Sen , Chen Ruey‐Jien , Wang Chun‐Wei , Chen Yu‐Hsuan , Cheng Jason Chia‐Hsien , Cheng Ann‐Lii , Kuo Sung‐Hsin
Published: March 2014

Objective

To compare tumor characteristics and clinical outcome of patients with cervical locally advanced adenocarcinoma (AC)/adenosquamous carcinoma (ASC) and squamous cell carcinoma (SCC).

Design

Retrospective study.

Setting

National Taiwan University Hospital, Taipei, Taiwan.

Population

All patients with cervical SCC (n = 35), AC or ASC (n = 194) with FIGO stage ≥IIB who received definitive radiotherapy or concurrent chemoradiotherapy (CCRT) from January 1995 to December 2009.

Method

Medical and histopathological record review.

Main outcome measures

Progression‐free survival (PFS), local recurrence‐free survival, distant metastasis‐free survival, and overall survival (OS).

Results

Compared with the SCC subgroup, patients with AC/ASC were significantly younger (p = 0.007), more of them without clinical symptoms were diagnosed by abnormal Pap smear findings (p = 0.043), and less responded to treatment (p = 0.018). After a median follow‐up of 59.3 months, patients with AC/ASC had worse 5‐year PFS (30.0% vs. 47.6%, p = 0.044), worse 5‐year distant metastasis‐free survival (41.5% vs. 69.9%, p = 0.005), and trends toward worse 5‐year local recurrence‐free survival (64.4% vs. 76.2%, p = 0.165) and worse 5‐year OS (41.3% vs. 58.1%, p = 0.090) than patients with SCC. In univariate analysis, early FIGO stage and complete treatment response were significantly associated with PFS and OS. Histology of non‐AC/ASC and Point A biologically equivalent doses in 2‐Gy fractions >85 Gy were significantly associated with better PFS, and CCRT was significantly associated with better OS. In multivariate analysis, complete treatment response and early FIGO stage remained significant factors for predicting better PFS and OS.

Conclusions

Cervical AC/ASC may be more aggressive than is SCC. For cervical AC/ASC, more comprehensively effective treatments are warranted.
The validity of the variable “NICU admission” as an outcome measure for neonatal morbidity: a retrospective study
Authors: Wiegerinck Melanie M.J. , Danhof Nora A. , Van Kaam Anton H. , Tamminga Pieter , Mol Ben Willem J.
Published: March 2014

Objective

To determine whether “neonatal intensive care unit (NICU) admission” is a valid surrogate outcome measure to assess neonatal condition in clinical studies.

Design

Retrospective study.

Setting

Tertiary hospital in the Netherlands.

Population

Neonates admitted to NICU during a 10‐year period. Inclusion was restricted to singletons born beyond 37 weeks of gestation, and admitted to NICU in the first 24 h for delivery‐related morbidity.

Methods

Patient characteristics and admission data were compared for four groups based on the line of care during delivery, i.e. home birth (Ia), midwife‐led hospital delivery (Ib), secondary care (II), tertiary care (III).

Main outcome measures

Percentage of neonates/infants that died during NICU admission, diagnosis on admission, treatment received and a Neonatal Therapeutic Intervention Score System (NTISS).

Results

We studied 776 newborns (Ia 52, Ib 25, II 160, III 512, 27 unknown). The mortality rate differed significantly (Ia 15%, Ib 12%, II 22%, III 1%, p < 0.01), as did the NTISS morbidity scores at admission [Ia 12.0 (6.0–23.0), Ib 8.5 (6.3–10.0), II 21.0 (15.0–30.0), III 6.0 (4.0–9.0); p < 0.01], diagnosis at admission, received treatment and the duration of admission.

Conclusions

The severity of neonatal illness after 37 weeks of gestation differed depending on the line of care in which they were born, with neonates born in secondary care consistently having the highest morbidity, and those born in tertiary care having the lowest. NICU admission should not be used as an outcome measure for neonatal morbidity, specifically not when comparing different birth settings.
In Vitro and In Vivo Characterization of Three Different Modes of Pump Operation When Using a Left Ventricular Assist Device as a Right Ventricular Assist Device
Authors: Stevens Michael C. , Gregory Shaun D. , Nestler Frank , Thomson Bruce , Choudhary Jivesh , Garlick Bruce , Pauls Jo P. , Fraser John F. , Timms Daniel
Published: March 2014

Dual rotary left ventricular assist devices (LVADs) have been used clinically to support patients with biventricular failure. However, due to the lower vascular resistance in the pulmonary circulation compared with its systemic counterpart, excessively high pulmonary flow rates are expected if the right ventricular assist device (RVAD) is operated at its design LVAD speed. Three possible approaches are available to match the LVAD to the pulmonary circulation: operating the RVAD at a lower speed than the LVAD (mode 1), operating both pumps at their design speeds (mode 2) while relying on the cardiovascular system to adapt, and operating both pumps at their design speeds while restricting the diameter of the RVAD outflow graft (mode 3). In this study, each mode was characterized using in vitro and in vivo models of biventricular heart failure supported with two VentrAssist LVADs. The effect of each mode on arterial and atrial pressures and flow rates for low, medium, and high vascular resistances and three different contractility levels were evaluated. The amount of speed/diameter adjustment required to accommodate elevated pulmonary vascular resistance (PVR) during support with mode 3 was then investigated. Mode 1 required relatively low systemic vascular resistance to achieve arterial pressures less than 100 mm Hg in vitro, resulting in flow rates greater than 6 L/min. Mode 2 resulted in left atrial pressures above 25 mm Hg, unless left heart contractility was near‐normal. In vitro, mode 3 resulted in expected arterial pressures and flow rates with an RVAD outflow diameter of 6.5 mm. In contrast, all modes were achievable in vivo, primarily due to higher RVAD outflow graft resistance (more than 500 dyn·s/cm5), caused by longer cannula. Flow rates could be maintained during instances of elevated PVR by increasing the RVAD speed or expanding the outflow graft diameter using an externally applied variable graft occlusion device. In conclusion, suitable hemodynamics could be produced by either restricting or not restricting the right outflow graft diameter; however, the latter required an operation of the RVAD at lower than design speed. Adjustments in outflow restriction and/or RVAD speed are recommended to accommodate varying PVR.
Evaluation of Conventional Nonpulsatile and Novel Pulsatile Extracorporeal Life Support Systems in a Simulated Pediatric Extracorporeal Life Support Model
Authors: Wang Shigang , Evenson Alissa , Chin Brian J. , Kunselman Allen R. , Ündar Akif
Published: March 2014

The objective of this study is to evaluate two extracorporeal life support (ECLS) circuits and determine the effect of pulsatile flow on pressure drop, flow/pressure waveforms, and hemodynamic energy levels in a pediatric pseudopatient. One ECLS circuit consisted of a Medos Deltastream DP3 diagonal pump and Hilite 2400 LT oxygenator with arterial/venous tubing. The second circuit consisted of a Maquet RotaFlow centrifugal pump and Quadrox‐iD Pediatric oxygenator with arterial/venous tubing. A 14Fr Medtronic Bio‐Medicus one‐piece pediatric arterial cannula was used for both circuits. All trials were conducted at flow rates ranging from 500 to 2800 mL/min using pulsatile or nonpulsatile flow. The post‐cannula pressure was maintained at 50 mm Hg. Blood temperature was maintained at 36°C. Real‐time pressure and flow data were recorded using a custom‐based data acquisition system. The results showed that the Deltastream DP3 circuit produced surplus hemodynamic energy (SHE) in pulsatile mode at all flow rates, with greater SHE delivery at lower flow rates. Neither circuit produced SHE in nonpulsatile mode. The Deltastream DP3 pump also demonstrated consistently higher total hemodynamic energy at the pre‐oxygenator site in pulsatile mode and a lesser pressure drop across the oxygenator. The Deltastream DP3 pump generated physiological pulsatility without backflow and provided increased hemodynamic energy. This novel ECLS circuit demonstrates suitable in vitro performance and adaptability to a wide range of pediatric patients.
Which measures of adiposity are related to Australian adolescent's perception of their weight?
Authors: Fredrickson Julia , Kremer Peter , Swinburn Boyd , de Silva Andrea , McCabe Marita
Published: March 2014

Aim

To determine which measurement of adiposity – standardised body mass index (BMI‐z), waist circumference or body fat percentage – is most closely correlated with adolescents' weight perception and whether this differs by gender.

Methods

Weight and height (used to calculate BMI‐z), waist circumference and body fat percentage were measured in 2278 adolescents aged between 12 and 16 and compared with self‐reported weight status.

Results

The distribution of subjects across the three weight categories (underweight, healthy weight and overweight) differed significantly between BMI‐z, waist circumference and body fat percentage (p < 0.001). BMI‐z was most closely aligned with perceived weight status in boys and girls, and waist circumference was also a good correlate of weight perception in boys. Boys were more likely than girls to underestimate their weight when it was defined by BMI‐z; however, girls were equally likely to underestimate their weight when it was defined by waist circumference. The majority of adolescents underestimated their weight status when it was defined by BF%.

Conclusion

BMI‐z is the closest correlate of self‐perceived weight status. In the absence of internationally accepted reference values for waist circumference, BMI‐z is the most appropriate measure to verify weight perception.
Exploring five common assumptions on Attention Deficit Hyperactivity Disorder
Authors: Batstra Laura , Nieweg Edo H. , Hadders‐Algra Mijna
Published: March 2014

The number of children diagnosed with attention deficit hyperactivity disorder (ADHD) and treated with medication is steadily increasing. The aim of this paper was to critically discuss five debatable assumptions on ADHD that may explain these trends to some extent. These are that ADHD (i) causes deviant behaviour, (ii) is a disease, (iii) is chronic and (iv) is best treated by medication and (v) that classification should precede treatment.

Conclusion

We argue that ADHD is not a disease, not the cause of deviant behaviour and in most cases not chronic. Treatment for attention and hyperactivity problems could start with psychosocial interventions and without a diagnostic label. A stepped diagnosis approach may reduce overdiagnosis without risking undertreatment.
Congestive heart failure risk in cancer patients treated with vascular endothelial growth factor tyrosine kinase inhibitors: a systematic review and meta‐analysis of 36 clinical trials
Authors: Qi Wei‐Xiang , Shen Zan , Tang Li‐Na , Yao Yang
Published: March 2014

Aims

Congestive heart failure (CHF) associated with vascular endothelial growth factor tyrosine‐kinase inhibitors (VEGFR‐TKIs) has emerged as a relevant problem in clinical and scientific communities. We performed an up‐to‐date, comprehensive meta‐analysis to determine the overall incidence and risk of CHF in cancer patients receiving VEGFR‐TKIs.

Methods

The databases of PubMed, Web of Science and abstracts presented at the American Society of Clinical Oncology up to August 31 2013 were searched for relevant articles. Statistical analyses were conducted to calculate the summary incidence, odds ratio (OR) and 95% confidence intervals (CIs) by using either random effects or fixed effect models according to the heterogeneity of included studies.

Results

A total of 10 553 patients from 36 clinical trials were included. The overall incidence of all grade and high grade CHF associated with VEGFR‐TKIs was 3.2% (95% CI 1.8%, 5.8%) and 1.4% (95% CI 0.9%, 2.3%), respectively. The use of VEGFR‐TKIs significantly increased the risk of developing all grade (OR 2.37, 95% CI 1.76, 3.20, P < 0.001) and high grade (OR 3.51, 95% CI 1.74, 7.05, P < 0.001) CHF. In subgroup analyses, the risk of CHF did not significantly vary with tumour types (P = 0.071 for all grade; P = 0.72 for high grade) and VEGFR‐TKIs (P = 0.55 for all grade; P = 0.99 for high grade). Meta‐regression indicated that CHF might possibly occur early in the treatment of VEGFR‐TKIs. No evidence of publication bias was observed.

Conclusion

The use of VEGFR‐TKIs is associated with a significantly increased risk of developing congestive heart failure in cancer patients. Clinicians should be aware of this risk and provide close monitoring in patients receiving these therapies.
Donor‐derived myelodysplastic syndrome and acute leukaemia after allogeneic haematopoietic stem cell transplantation: incidence, natural history and treatment response
Authors: Dietz Andrew C. , DeFor Todd E. , Brunstein Claudio G. , Wagner John E.
Published: March 2014

Donor‐derived myelodysplastic syndrome/acute leukaemia (DD‐MDS/AL) is a rare life‐threatening complication of allogeneic haematopoietic stem cell (HSC) transplantation. However, it is unknown whether the risk differs by HSC source. Therefore, we evaluated the incidence of DD‐MDS/AL in 2390 engrafted patients. With a median follow‐up of 7·1 years (1–20·8), the incidence of DD‐MDS/AL was 0·53% (95% confidence interval (CI), 0·01–1·41%], 0·56% (95%CI, 0·01–1·36%) and 0·56% (95%CI, 0·01–1·10%) in recipients of bone marrow (n = 1117), peripheral blood (n = 489) and umbilical cord blood (UCB, n = 784), respectively. While follow‐up is shorter in recipients of UCB and peripheral blood, incidence of DD‐MDS/AL is, thus far, similar between HSC sources.
Impaired ICOSL in human myeloid dendritic cells promotes Th2 responses in patients with allergic rhinitis and asthma
Authors: Shen C. , Hupin C. , Froidure A. , Detry B. , Pilette C.
Published: March 2014

Background

Myeloid dendritic cells (mDCs) and costimulatory molecules such as ICOSL/B7H2 play a pivotal role in murine experimental asthma, while little is known in human allergic disease.

The aim of this study was to characterize the phenotype and ICOSL expression of mDCs from allergic rhinitis patients (AR) and their functional correlates on mDC regulation of T cell responses.

Methods

Human blood myeloid, CD1c+ DCs were isolated from AR or healthy controls. Expression of costimulatory molecules inducible costimulatory ligand (ICOSL) and programmed death ligand 1 (PD‐L1) was analysed in blood mDCs by flow cytometry and in nasal tissue biopsies by dual immunostaining. Blood mDCs were cocultured with (allogeneic) CD4+ T cells before immunoassays for cytokine responses.

Results

mDCs from AR patients expressed a lower level of ICOSL, in both blood and nasal tissue. mDCs from AR were constitutively primed to induce Th2 cytokines and TNF in allogeneic CD4+ T cells, while no difference was observed for IFN‐γ or IL‐10. Production of IL‐10 and IL‐12 did not differ between AR and control mDCs. Blockade of ICOSL in control DCs up‐regulated IL‐13 but not IFN‐γ in cocultures with T cells, while PD‐L1 blockade up‐regulated both IL‐13 and IFN‐γ.

Conclusions

Our data show that mDCs from patients with AR display impaired expression of ICOSL, and this defect licenses mDCs to promote aberrant IL‐13‐ and IL‐5‐producing Th2 cell responses.
Epithelial function and dysfunction in asthma
Authors: Loxham M. , Davies D. E. , Blume C.
Published: March 2014

Asthma was previously defined as an allergic Th2‐mediated inflammatory immune disorder. Recently, this paradigm has been challenged because not all pathological changes observed in the asthmatic airways are adequately explained simply as a result of Th2‐mediated processes. Contemporary thought holds that asthma is a complex immune disorder involving innate as well as adaptive immune responses, with the clinical heterogeneity of asthma perhaps a result of the different relative contribution of these two systems to the disease. Epidemiological studies show that exposure to certain environmental substances is strongly associated with the risk of developing asthma. The airway epithelium is first barrier to interact with, and respond to, environmental agents (pollution, viral infection, allergens), suggesting that it is a key player in the pathology of asthma. Epithelial cells play a key role in the regulation of tissue homeostasis by the modulation of numerous molecules, from antioxidants and lipid mediators to growth factors, cytokines, and chemokines. Additionally, the epithelium is also able to suppress mechanisms involved in, for example, inflammation in order to maintain homeostasis. An intrinsic alteration or defect in these regulation mechanisms compromises the epithelial barrier, and therefore, the barrier may be more prone to environmental substances and thus more likely to exhibit an asthmatic phenotype. In support of this, polymorphisms in a number of genes that are expressed in the bronchial epithelium have been linked to asthma susceptibility, while environmental factors may affect epigenetic mechanisms that can alter epithelial function and response to environmental insults. A detailed understanding of the regulatory role of the airway epithelium is required to develop new therapeutic strategies for asthma that not only address the symptoms but also the underlining pathogenic mechanism(s) and prevent airway remodelling.
Exercise‐induced bronchospasm related to different phenotypes of rhinitis without asthma in primary schoolchildren: the French Six Cities Study
Authors: Caillaud D. , Horo K. , Baiz N. , Banerjee S. , Charpin D. , Lavaud F. , de Blay F. , Raherison C. , Annesi‐Maesano I.
Published: March 2014

Background

Exercise‐induced bronchospasm (EIB) is frequent among asthmatic children. However, opinions differ on the relation between EIB and rhinitis in the absence of asthma.

Objectives

We assessed the relationship between EIB and various phenotypes of rhinitis according to asthmatic status at the general population level in the Six Cities Study.

Methods

Of 7781 schoolchildren with a mean age of 10 years underwent an EIB test and skin prick test to assess allergic sensitization. Their parents completed a standardized questionnaire recording asthma‐like symptoms and past‐year rhinoconjunctivitis, ever hay fever (EHF), and a score for allergic rhinitis (SFAR) ≥7 as a marker of ‘past‐year allergic rhinitis’. Exercise‐induced bronchospasm was defined as a fall in peak expiratory flow rate ≥15% after exercise.

Results

Of the 6813 schoolchildren retained for analysis, 227 (3.33%) experienced EIB after exercise. Odds ratios [95% confidence intervals] between EIB and allergic rhinitis phenotypes in the absence of asthma were 1.56 [0.92–2.63] for EHF, 1.97 [1.16–3.35] for past‐year rhinoconjunctivitis, and 1.84 [1.16–2.91] for a SFAR ≥7. Results were unchanged after adjustment for confounders. Multiple correspondence analysis showed that EIB, although related to asthma, constitutes a separate entity. Exercise‐induced bronchospasm was not significantly related to familial history of asthma.

Conclusion

In our large population‐based sample of children, different phenotypes of atopic rhinitis were associated with EIB, independently of asthma. Exercise‐induced bronchospasm, although related to asthma, seems to constitute a separate entity.

Clinical relevance

In this large (6813) sample of 10‐year children drawn from the general population, EIB is associated with rhinitis phenotypes in the absence of asthma. Furthermore, it constitutes an entity independent from asthma and is not related to a familial history of asthma. Thus, investigating these symptoms could be important in this disease, as a specific nasal treatment might improve EIB in these children.
The beneficial effect of acromegaly control on blood pressure values in normotensive patients
Authors: Sardella Chiara , Urbani Claudio , Lombardi Martina , Nuzzo Alessandro , Manetti Luca , Lupi Isabella , Rossi Giuseppe , Del Sarto Simone , Scattina Ilaria , Di Bello Vitantonio , Martino Enio , Bogazzi Fausto
Published: March 2014

Objective

Control of acromegaly may ameliorate blood pressure (BP) in hypertensive (HT) patients. We evaluated the impact of acromegaly control on BP values of normotensive (NT) acromegalics.

Design

Retrospective cohort study.

Patients

Fifty‐eight naïve patients with acromegaly (39 F; age range, 30–69 years), including 28 NT and 30 HT subjects, participated in the study.

Measurements

Blood pressure was measured by clinical measurement and 24‐h ambulatory monitoring at diagnosis and after 24 months of medical therapy for acromegaly.

Results

Acromegaly was controlled by medical therapy in 15 NT and 17 HT patients at 24 months. In the NT group, systolic (SBP) or diastolic (DBP) BP significantly increased (all P < 0·005) when acromegaly was uncontrolled, but did not change when the disease was controlled. Changes in SBP and DBP were also significantly different between uncontrolled and controlled NT patients. At 24 months, clinical hypertension was detected only in uncontrolled NT patients (46% vs 0%, P < 0·001), whereas ambulatory hypertension was found in 38% of uncontrolled and in 7% of controlled NT subjects (P = 0·035). In the HT group, ambulatory SBP increased in patients with uncontrolled acromegaly (24‐h SBP P = 0·046, day SBP P = 0·005, night SBP P = 0·005), whereas ambulatory DBP decreased in subjects with controlled disease (24‐h DBP P = 0·008, day DBP P = 0·026).

Conclusions

Control of acromegaly has a beneficial effect on BP regulation either in HT or NT subjects; in the latter, it may prevent progression towards hypertension.
Global Trade in Exotic Pets 2006–2012
Authors: BUSH EMMA R. , BAKER SANDRA E. , MACDONALD DAVID W.
Published: March 2014

International trade in exotic pets is an important and increasing driver of biodiversity loss and often compromises the standards required for good animal welfare. We systematically reviewed the scientific and gray literature and used the United Nations Environment Programme ‐ World Conservation Monitoring Centre (UNEP‐WCMC) Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) trade database to establish temporal and geographical trade patterns of live exotic birds, mammals, and reptiles and to describe trends in research, taxonomic representation, and level of threat and legal protection of species traded. Birds were the most species‐rich and abundant class reported in trade; reptiles were second most abundant but unusually the most studied in this context; and mammals were least abundant in trade. Mammalian and reptilian species traded as pets were more likely to be threatened than expected by random. There have been a substantial number of Appendix I listed captive‐bred mammals and birds and wild‐caught birds and reptiles reported in trade to CITES. We identified the Middle East's emerging role as a driver of demand for exotic pets of all taxa alongside the well‐established and increasing role of South America and Southeast Asia in the market. Europe, North America, and the Middle East featured most heavily in trade reports to CITES, whereas trade involving South America and Southeast Asia were given most emphasis in the literature. For effective monitoring of and appropriate response to the international exotic pet trade, it is imperative that the reliability and detail of CITES trade reports improve and that scientific research be directed toward those taxa and locations that are most vulnerable.

El Mercado Global de Mascotas Exóticas 2006‐2012
The Biogeography of Globally Threatened Seabirds and Island Conservation Opportunities
Authors: SPATZ DENA R. , NEWTON KELLY M. , HEINZ REINA , TERSHY BERNIE , HOLMES NICK D. , BUTCHART STUART H. M. , CROLL DONALD A.
Published: March 2014

Seabirds are the most threatened group of marine animals; 29% of species are at some risk of extinction. Significant threats to seabirds occur on islands where they breed, but in many cases, effective island conservation can mitigate these threats. To guide island‐based seabird conservation actions, we identified all islands with extant or extirpated populations of the 98 globally threatened seabird species, as recognized on the International Union for Conservation of Nature Red List, and quantified the presence of threatening invasive species, protected areas, and human populations. We matched these results with island attributes to highlight feasible island conservation opportunities. We identified 1362 threatened breeding seabird populations on 968 islands. On 803 (83%) of these islands, we identified threatening invasive species (20%), incomplete protected area coverage (23%), or both (40%). Most islands with threatened seabirds are amenable to island‐wide conservation action because they are small (57% were <1 km2), uninhabited (74%), and occur in high‐ or middle‐income countries (96%). Collectively these attributes make islands with threatened seabirds a rare opportunity for effective conservation at scale.

La Biogeografía de Aves Marinas Amenazadas Globalmente y las Oportunidades de Conservación en Islas
Archaeological Evidence of Validity of Fish Populations on Unexploited Reefs as Proxy Targets for Modern Populations
Authors: LONGENECKER KEN , CHAN YVONNE L. , TOONEN ROBERT J. , CARLON DAVID B. , HUNT TERRY L. , FRIEDLANDER ALAN M. , DEMARTINI EDWARD E.
Published: March 2014

Reef‐fish management and conservation is hindered by a lack of information on fish populations prior to large‐scale contemporary human impacts. As a result, relatively pristine sites are often used as conservation baselines for populations near sites affected by humans. This space‐for‐time approach can only be validated by sampling assemblages through time. We used archaeological remains to evaluate whether the remote, uninhabited Northwestern Hawaiian Islands (NWHI) might provide a reasonable proxy for a lightly exploited baseline in the Main Hawaiian Islands (MHI). We used molecular and morphological techniques to describe the taxonomic and size composition of the scarine parrotfish catches present in 2 archaeological assemblages from the MHI, compared metrics of these catches with modern estimates of reproductive parameters to evaluate whether catches represented by the archaeological material were consistent with sustainable fishing, and evaluated overlap between size structures represented by the archaeological material and modern survey data from the MHI and the NWHI to assess whether a space‐for‐time substitution is reasonable. The parrotfish catches represented by archaeological remains were consistent with sustainable fishing because they were dominated by large, mature individuals whose average size remained stable from prehistoric (AD approximately 1400–1700) through historic (AD 1700–1960) periods. The ancient catches were unlike populations in the MHI today. Overlap between the size structure of ancient MHI catches and modern survey data from the NWHI or the MHI was an order of magnitude greater for the NWHI comparison, a result that supports the validity of using the NWHI parrotfish data as a proxy for the MHI before accelerated, heavy human impacts in modern times.

Evidencia Arqueológica de la Validez de Poblaciones de Peces en Arrecifes Sin Explotar como Objetivos de Apoderamiento para Poblaciones Actuales
EXPANSIONARY VERSUS CONTRACTIONARY GOVERNMENT SPENDING
Authors: Makin Anthony J.
Published: March 2014

This article theoretically examines the impact of different forms of government spending on national income in a financially open economy with a significant net international investment position the central bank of which sets domestic interest rates to target inflation. It shows that whether government spending is expansionary or contractionary ultimately depends on the productivity of that expenditure, a result that has major implications for the efficacy of fiscal policy deployed for either stimulus or austerity reasons. The key prediction of the model is that public consumption and unproductive public investment are procyclical, whereas only productive public investment is countercyclical. (JEL F41)
Quercetin ameliorates tunicamycin‐induced endoplasmic reticulum stress in endothelial cells
Authors: Suganya N. , Bhakkiyalakshmi E. , Suriyanarayanan S. , Paulmurugan R. , Ramkumar K. M.
Published: March 2014

Objective

Endothelial dysfunction highlights that it is a potential contributor in the pathogenesis of vascular complications arising from endoplasmic reticulum stress (ER stress) and has been emerging as a main causative factor in vascular failure. Here, we hypothesize that the natural flavonoid, quercetin plays an effective role in reducing ER stress in human umbilical vein endothelial cells.

Materials and methods

Human umbilical vein endothelial cells were pre‐treated with different concentrations of quercetin (0–100 μm) before inducing ER stress using tunicamycin (TUN) (0.75 μg/ml); cytotoxicity was assessed by MTT assay. Expression levels of ER stress responsive genes, antioxidant enzymes and apoptotic markers were assessed by qRT‐PCR, while roles of caspase‐3 and PARP cleavage were measured by western blot analysis.

Results

Quercetin pre‐treatment at 25 and 50 μm had a cytoprotective effect on cells against TUN‐induced toxicity. Quercetin administration modulated expression level of ER stress genes coding for glucose‐regulated protein 78 (GRP78) and C/EBP‐homologous protein (CHOP), and antioxidant enzymes such as superoxide dismutase and catalase, along with free radical generation assessed by malondialdehyde assay. Induction of apoptosis was prevented with reduction in expression level of Bax, and concomitant increase in Bcl‐2 levels, thus proving its potential against ER stress.

Conclusion

The current study indicates that quercetin modulated stress responsive genes GRP78 and CHOP, helping endothelial cells prevent TUN‐induced ER stress.
Double‐Outlet Right Atrium Associated with Hypoplastic Right Heart Structures and Aortic Stenosis: Echocardiographic Features
Authors: Thankavel Poonam Punjwani , Gabbert Barry , Ramaciotti Claudio
Published: March 2014

Mini‐Abstract

Double‐outlet right atrium, also known as straddling tricuspid valve without a ventricular septal defect, is an extremely rare congenital cardiac anomaly, in which the tricuspid valve has 2 ostia. We describe an infant with this finding in association with hypoplastic right heart structures and a dysplastic aortic valve.
Right Ventricular Isovolumic Acceleration in Acute Pulmonary Embolism
Authors: Cetiner Mehmet Ali , Sayin Muhammet Rasit , Yildirim Nesligul , Karabag Turgut , Dogan Sait Mesut , Kucuk Emrah , Aydin Mustafa
Published: March 2014

Objective

In this study, we examined the role of isovolumic acceleration (IVA) measured with right ventricle (RV) tissue Doppler imaging (TDI) to predict the presence of acute pulmonary embolism (APE) in hemodynamically stable patients with clinical suspicion of APE.

Materials and Method

This study included 25 hemodynamically stable (systolic blood pressure >90 mmHg) patients diagnosed with APE for the first time. Twenty‐five subjects with similar demographic characteristics in whom APE was excluded due to preexisting clinical suspicion were also enrolled as the control group. All control group subjects were enrolled after proved to have no evidence of APE on imaging. Both groups were compared with respect to RV‐IVA measured with TDI in addition to conventional echocardiographic parameters.

Results

Among the echocardiography parameters, only RV‐IVA was impaired in patients with hemodynamically stable APE compared to controls (2.85 [1.37–6.42] m/sec2 vs. 3.32 [2.24–6.52] m/sec2, respectively; P = 0.02). A receiver operating characteristic (ROC) analysis was performed to determine the RV‐IVA value to predict clinically suspected APE. A cutoff level of 3.22 m/sec2 had a sensitivity of 64% and a specificity of 60%; a cutoff level of 3.17 m/sec2 had a sensitivity of 64% and a specificity of 64%; and a cutoff level of 3.10 m/sec2 had a sensitivity of 60% and specificity of 64% (ROC area under curve: 0.691, 95% CI: 0.543–0.839, P = 0.02).

Conclusion

Results of our study suggest that RV‐IVA may be a useful parameter to detect subtle alterations in RV and may predict the presence of APE in hemodynamically stable patients.
Left Ventricular Restrictive Filling Pattern and the Presence of Contractile Reserve in Patients with Low‐Flow/Low‐Gradient Severe Aortic Stenosis
Authors: Mahfouz Ragab A. , El Zayat Ahmed , Yousry Ahmed
Published: March 2014

Objective

We sought to study diastolic function in patients with low‐flow/low‐gradient aortic stenosis (LF/LGAS) and to clarify the relationship between contractile reserve on dobutamine stress echocardiography (DSE) and the restrictive filling pattern on echocardiography in patients with LF/LGAS.

Patients and Methods

Thirty patients with LF/LG severe AS were divided into 2 groups. Group I included 14 patients with contractile reserve on DSE. Group II included 16 patients with no contractile reserve on DSE. Diastolic function was studied in all patients using baseline echo Doppler study.

Results

No significant difference was found between both groups regarding baseline left ventriculae end‐diastolic dimension (LVEDD), ejection fraction (EF), stroke volume, aortic valve area (AVA), mean transaortic pressure gradient, septal thickness or posterior wall thickness, P > 0.05. Transmitral E/A ratio was 1.3 ± 0.5 compared to 2.6 ± 0.7, respectively, deceleration time (DT) was 160 ± 31 compared to 120 ± 15 ms, isovolumic relaxation time (IVRT) was 81 ± 22 compared to 53 ± 18 ms, S/D ratio was 1.2 ± 0.3 compared to 0.8 ± 0.2, respectively, (P < 0.001 for all).Three patients in group I had restrictive pattern of diastolic dysfunction compared to 12 in group II (P < 0.003). DSE data in both groups showed a peak SV of 64 ± 11 mL compared to 50 ± 7 mL (P < 0.005), peak EF was 42 ± 9 compared to 34 ± 11% (P < 0.03). Peak stress mean transaortic pressure gradient was 39 ± 9 compared to 22 ± 10 mmHg, respectively, P < 001.

Conclusion

Restrictive filling pattern of diastolic dysfunction on baseline echo Doppler study may predict lack of contractile reserve in patients with LF/LG severe AS.
Unroofed Coronary Sinus Atrial Septal Defect: Diagnosis by Multimodality Cardiac Imaging
Authors: Aljizeeri Ahmed , Dennie Carole J. , Chan Kwan‐Leung , Beauchesne Luc M.
Published: March 2014

Mini‐Abstract

Unroofed coronary sinus is a rare congenital cardiac anomaly. It is a communication between the coronary sinus and the left atrium. The associated interatrial shunt can cause right atrial volume overload and possible paradoxical embolization. It is classified into four subtypes on the basis of the extent of the roof absence and the presence of persistent left superior vena cava. Although the diagnosis can be suspected by two‐dimensional echocardiography, three‐dimensional echocardiography and computerized cardiac tomography provide incremental value in delineating the precise anatomy of this condition.
Bone marrow examination in patients with immune thrombocytopenia: is there anything different in older patients?
Authors: Gunduz Eren , Kivanc Banu Kara , Arik Deniz , İsiksoy Serap , Bal Cengiz , Akay Olga Meltem
Published: March 2014

Immune thrombocytopenia (ITP) is a disorder characterised by immune‐mediated accelerated platelet destruction and suppressed platelet production. In the bone marrow examinations of patients with ITP, some investigators found megakaryocyte numbers to be increased while others have found them to be normal. Although recent guidelines recommend against bone marrow examinations in typical ITP patients, the recent introduction of thrombopoietin receptor agonists as an effective treatment for ITP has refocused attention on abnormalities of bone marrow megakaryocytes. In this study, we retrospectively analysed the bone marrow aspiration, flow cytometry‐CD45 side scatter (SSC) and biopsy results of our patients with ITP by dividing them into two groups according to age (<60 yr and ≥60 yr). Ninety eight newly diagnosed ITP patients were included in the study. CD45 SSC results were recorded as percentages of normoblasts, granulocytes, lymphocytes, monocytes and myeloid/erythroid ratio. Length of the biopsy specimen, cellularity, presence of dysplasia or fibrosis with number, morphology and distribution of megakaryocytes were recorded. In group 1, there were 49 patients. Mean age was 41.31 ± 12.77 yr. In group 2, there were 49 patients. Mean age was 70.78 ± 7.88 yr. Megakaryocyte numbers on bone marrow aspirates were not recorded in most patients, so we could not comment on this point. Flow cytometry results and bone marrow findings were similar between two groups. In conclusion, there is no difference between bone marrow examinations of young and older patients with ITP, and biopsy should not be recommended in typical ITP patients as already mentioned in guidelines.
The use of erythropoietin‐stimulating agents versus supportive care in newborns with hereditary spherocytosis: a single centre's experience
Authors: Morrison Jacqueline F. , Neufeld Ellis J. , Grace Rachael F.
Published: March 2014

Hereditary Spherocytosis (HS) is a common haemolytic anaemia in which 75% of cases are autosomal dominant. As most newborns with HS have a family history of disease, haematologists often see these infants before their physiologic haemoglobin nadir, which is exaggerated in comparison with healthy infants. The objective of this study was to evaluate the frequency of implementation and cost of erythropoietin‐stimulating agents (EPO) versus transfusion in infants with HS at a single paediatric programme. In the last decade, only 15% of infants with HS at our centre have been treated with EPO, which costs twice that of a single transfusion and EPO treated infants did not always avoid transfusion. Infrequent prescription of EPO therapy to infants with HS at our centre may be related to the incomplete data supporting its use.
Experts’ considerations on HLA‐haploidentical stem cell transplantation
Authors: Patriarca Francesca , Luznik Leo , Medeot Marta , Zecca Marco , Bacigalupo Andrea , Di Bartolomeo Paolo , Arcese William , Corradini Paolo , Ciceri Fabio , Vago Luca , Kanakry Christopher G. , Fleischhauer Katharina , Martelli Massimo F. , Bosi Alberto , Rambaldi Alessandro , Cesaro Simone , Russo Domenico , Fanin Renato
Published: March 2014

Recently, novel strategies to control graft‐versus‐host disease and facilitate engraftment have allowed an increasing number of human leukocyte antigen (HLA)‐haploidentical hematopoietic stem cell transplantation (haploHSCT) to be performed. A meeting was convened to review the biological rationale and the clinical results of various T‐cell‐depleted (TCD) and T‐cell‐replete (TCR) HLA‐haploidentical ‘transplant platforms’. The objective of the meeting was to promote discussion and consent among leading researchers in the field on three main crucial issues for haploHSCT: (i) eligibility criteria, (ii) choice of the most suitable donor, and (iii) choice of the most appropriate transplant platform. The experts in attendance agreed that a patient who is eligible for an allogeneic transplant and lacks an HLA‐identical sibling or an HLA‐matched unrelated donor should be considered for an alternative donor transplant. Together with the experience of the individual center, the most important decision criteria in choosing an alternative donor source should be the rapidity of transplantation so as to avoid disease relapse/progression. The choice of the mismatched donor should be driven by younger age, ABO blood group compatibility, and Cytomegalovirus status. If a TCD transplant is planned, NK‐alloreactive donors and/or the mother should be preferred. Prospective comparative studies are needed to establish the relative efficacy of different transplant platforms. However, expertise in stem cell manipulation and in adoptive immunotherapy is essential if a TCD transplant platform is chosen.
Control of postharvest green mould of citrus by haliscosamine isolated from Haliclona viscosa sponge
Authors: Amraoui Belkassem El , wahidi Majida El , Fassouane Aziz
Published: March 2014

The aim of this study was to evaluate the antifungal activity of haliscosamine isolated from Haliclona viscosa sea sponge from the Moroccan Atlantic coast against Penicillium digitatum, the causal agent of citrus green mould. The in vitro antifungal activity of haliscosamine, determined using the agar disc‐diffusion method, showed that haliscosamine and DESOGERME SP VEGETAUX® (reference product) have fungicidal activity with inhibition diameters of 19 and 18 mm, respectively. Haliscosamine and a positive control (DESOGERME SP VEGETAUX®) were tested in vivo in comparison with a negative control on orange fruits in normal storage conditions. This test showed that after four weeks of storage, the rate of decay of citrus fruits treated with haliscosamine or DESOGERME does not exceed 14%, whereas in the negative control the decay rate is 77%. The results of in vitro and in vivo tests indicate that haliscosamine and DESOGERME SP VEGETAUX® have an important antifungal potential against P. digitatum and that haliscosamine (a natural product) may represent an alternative to the use of chemical fungicides.
Comparison of three conventional PCR test (Bulman & Marshall, ) versions for the molecular identification of Globodera pallida and G. rostochiensis cysts and juveniles
Authors: van de Vossenberg B. T. L. H. , Voogd J. G. B. , Westenberg M. , Karssen G.
Published: March 2014

Three different versions of the conventional PCR described by Bulman & Marshall () for the identification of cysts and juveniles of Globodera pallida and G. rostochiensis were compared: the original Bulman & Marshall, Bulman & Marshall as described in EPPO PM 7/40 (2) and an in‐house modified version of the Dutch National Plant Protection Organization (NPPO‐NL). The versions differ from each other in thermocycler conditions and primer sequences. Two different polymerases (Invitrogen and Roche) were assessed using the different test versions, and performance criteria analytical sensitivity and analytical specificity were determined. Roche‐based reaction mixes had the highest amplicon yield and were used for further comparison of the different test versions. The different test versions performed equally well in terms of analytical specificity. No false positive or false negative results were observed. The test version NPPO‐NL proved to be the most sensitive test version with a limit of detection of 1 juvenile for both G. pallida and G. rostochiensis.
The invasive Impatiens glandulifera Royle (Himalayan balsam) in the Republic of Macedonia: first record and forecast
Authors: Pacanoski Z. , Saliji A.
Published: March 2014

A population of Impatiens glandulifera Royle, an invasive plant species native to the Western Himalayas, was recorded in 2013 near the village Gorno Sedlarce in the north‐western mountainous region of the Republic of Macedonia. I. glandulifera is a new alien species to the Macedonian flora. The surveys revealed an intensive growth and a low to medium density population of I. glandulifera. The population's density was not quantified, but several stands of different sizes were found. A rapid ecological risk assessment, mainly based on knowledge about invasion histories in North–Western and Central European countries, showed that this species, which is on the EPPO List of Invasive Alien Plants, is a serious threat to Macedonian biodiversity. Biological invasions of I. glandulifera affect biodiversity worldwide, and, consequently, the invaded ecosystems may experience significant losses in economic and cultural values. There is a clear need to develop a strategy for control of I. glandulifera to protect biodiversity, as a whole.
Shedding new light on the role of the sunshine vitamin D for skin health: the lncRNA‐skin cancer connection
Authors: Holick Michael F.
Published: March 2014

Throughout evolution, vertebrates including humans have depended on the sunshine vitamin D for their calcified skeletons. As our hunter gatherer forefathers ventured from the equator, their skin tone became much lighter in order to permit an adequate amount of ultraviolet B radiation to enter the skin to produce the vitally important vitamin D. Although sensible sun exposure does not significantly increase risk of skin cancer, it has remained a mystery as to why. Jiang and Bikle in their viewpoint provide a novel insight as to how Mother Nature was able to balance the need for receiving adequate sun exposure to produce vitamin D while limiting damage caused by the DNA absorbing the ultraviolet B radiation. Long non‐coding RNAs which are plentiful in cells have a dual personality. Some enhance malignancy, while others act as tumor suppressors. Jiang and Bikle provide compelling evidence that these long non‐coding RNAs in skin cells are responsive to 1,25‐dihydroxyvitamin D3 by decreasing their carcinogenic activity while enhancing their tumor suppression function presumably as a strategy for reducing ultraviolet‐induced non‐melanoma skin cancer. Mother Nature got it right. Sensible sun exposure is important for maintaining an adequate vitamin D status. Once formed in the skin, vitamin D can exit into the circulation to carry out its physiologic functions on calcium and bone metabolism. Some vitamin D however remains in the skin and is activated to interact with its vitamin D receptor to control cell proliferation using a variety of strategies including interacting with long non‐coding RNAs to reduce risk of photocarcinogenesis.