bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of Excess Cement and Tissue Response to Fixed Implant‐Supported Dentures after Cementation
Authors: Korsch Michael , Robra Bernt‐Peter , Walther Winfried
Published: July 2013

Background

The cementation of fixed implant‐supported restorations involves the risk of excess cement remaining in the peri‐implant tissue that may cause a peri‐implant tissue response with attachment loss.

Purpose

The aim was to study the peri‐implant tissue response after cementation and to detect potential predictors of excess cement.

Material and Methods

Clinical complications after cementation in several index cases led to a recall of all patients treated with a special methacrylate cement (one hundred five patients with one hundred eighty‐eight implants) and systematic reevaluation of 71 patients (68%) with one hundred twenty‐six implants (67%). In all cases, suprastructures including abutments were removed, and findings were documented.

Results

Implant diameter was significantly associated with the frequency of excess cement. Implant location or system had no significant effect. Excess cement in turn was associated with bleeding on probing, suppuration, and peri‐implant attachment loss. In the absence of excess cement 58.8% of implants had no peri‐implant attachment loss versus 37.3% when excess cement was present. With increasing retention time of the methacrylate cement, more peri‐implant attachment loss was detected. However, the latter association was not significant.

Conclusion

Larger diameters are significantly associated with excess cement in peri‐implant tissue. Consequences of excess cement may be increased bleeding on probing, suppuration, and possibly peri‐implant attachment loss.
Accuracy of a Digital Impression System Based on Active Wavefront Sampling Technology for Implants Considering Operator Experience, Implant Angulation, and Depth
Authors: Giménez Beatriz , Özcan Mutlu , Martínez‐Rus Francisco , Pradíes Guillermo
Published: July 2013

Background

There is a scarce knowledge on the accuracy of intraoral digital impression systems for dental implants.

Purpose

The purpose of this study is to evaluate the accuracy of a digital impression system considering clinical parameters.

Materials and Methods

A master model with six implants (27, 25, 22, 12, 15, 17) was fitted with polyether ether ketone scan bodies. Implant no. 25 was placed with 30° mesial angulation in relation to the vertical plane (y axis), and implant no. 15 was positioned with 30° distal angulation. Implant no. 22 was placed 2 mm and no. 12, 4 mm below the gingiva. Experienced (n = 2) and inexperienced operators (n = 2) performed scanning (Lava Chairside Oral Scanner; 3 M ESPE, St Paul, MN, USA) at standard and high accuracy mode. Measurements involved five distances (27‐25, 27‐22, 27‐12, 27‐15, 27‐17). Measurements with high accuracy three‐dimensional coordinated measuring machine (CMM) of the master model acted as the true values. The data obtained were subtracted from those of the CMM values.

Results

Experience of the operator significantly influenced the results (p = .000). Angulation (p = .195) and depth of implant (p = .399) did not show significant deviation from the true values. The mean difference between standard and high accuracy mode was 90 μm.

Conclusions

With the active wavefront sampling, technology‐based digital impression system training seems to be compulsory. Impressions of angulated implants may diminish the accuracy of the impression, yet the results were not significant.
Idiopathic dilated cardiomyopathy and chronic atrial fibrillation
Authors: Tuomainen Petri O. , Magga Jarkko , Fedacko Jan , Kärkkäinen Satu , Miettinen Kati , Vanninen Esko , Kuusisto Johanna , Peuhkurinen Keijo J.
Published: July 2013

Background

Atrial fibrillation (AF) is common in idiopathic dilated cardiomyopathy (IDC). We explored the clinical characteristics of IDC patients with chronic AF compared with those with sinus rhythm (SR).

Methods

A group of patients with IDC underwent extensive non‐invasive and invasive evaluation during a hospitalization period. The patients were further divided into two groups with AF (n = 19) and SR (n = 68).

Results

Left atrial diameter was greater (P<0·001), left ventricular end‐diastolic diameter smaller (P<0·05), left ventricular end‐diastolic and end‐systolic volumes smaller (P<0·01 for all), mean pulmonary artery pressure and pulmonary capillary wedge pressure higher (P<0·05 for both), cardiac output and maximal oxygen consumption lower (P<0·01 and P<0·05, respectively), and the levels of N‐terminal pro‐brain natriuretic peptide and interleukin‐6 higher (P<0·05 for both) in AF group compared with SR group. Left ventricular ejection fraction and left ventricular end‐diastolic pressure were similar in both groups.

Conclusions

In spite of otherwise more unfavourable prognostic factor profile, left ventricular size was observed to be smaller in chronic AF compared with SR in well‐characterized patients with IDC. The confirmation and possible explainers of this paradoxical phenomenon need further studies in larger patient cohorts.
Compound clear cell sarcoma misdiagnosed as a Spitz nevus
Authors: Kiuru Maija , Hameed Meera , Busam Klaus J.
Published: July 2013

Clear cell sarcoma (CCS) typically presents as a tumor in the deep soft tissue of extremities, but when centered in the dermis it may be confused with a melanocytic nevus, primary nodular or metastatic melanoma. Compound variants of CCS, i.e. tumor cells present in both the epidermis and underlying soft tissue have not yet been described. Herein we report such a case, which initially presented as a nodule on the left wrist of a young woman at 19 years of age. The lesion was then interpreted as ‘Spitz nevus, compound type’. Twelve years later the patient noticed an enlarged lymph node in the right axilla. The excised lymph node was nearly completely replaced by malignant tumor cells, which were immunoreactive for S100 protein. They resembled the tumor cells of the wrist lesion. Cytogenetic analysis of the metastatic tumor revealed a t(12;22) translocation. Fluorescence in situ hybridization confirmed Ewing's sarcoma breakpoint region 1 (EWSR1) rearrangement in 70% of the tumor cells, thereby supporting the diagnosis of metastatic CCS. Our case is of interest because it documents that CCS can involve the epidermis. This observation expands the morphological spectrum associated with this tumor.
Potential impacts of climate change on growth and prey consumption of stream‐dwelling smallmouth bass in the central United States
Authors: Pease Allison A. , Paukert Craig P.
Published: July 2013

Smallmouth bass (Micropterus dolomieu, SMB) is a broadly distributed, economically important species in the USA and Canada. Although previous research has suggested that projected climate warming may allow SMB to thrive beyond their current northern distribution, little research has been devoted to the population‐level effects of climate change on warm‐water fishes, including SMB. We modelled the impacts of projected climate change on growth of stream‐dwelling SMB along a north–south gradient in the central USA. Using downscaled regional projections from three global climate models, we generated scenarios for thermal habitat change for four populations (in Oklahoma, Missouri, Iowa and Minnesota) and used bioenergetics simulations to estimate prey consumption and growth under future projections. Bioenergetics simulations showed that prey consumption is expected to increase in all populations with moderate stream warming (2–3 °C). Growth potential is predicted to increase by 3–17% if not limited by food availability with stream warming by 2060 and was most pronounced for southern populations. For each 1 °C increase in stream temperature, SMB consumption would be expected to increase by about 27% and growth would increase by about 6%. Due to implications for species interactions, population performance and regulation of local fisheries, a better understanding of how SMB populations will respond to climate change is recommended for effective management and conservation.
Predictors of substance use reduction in an epidemiological first‐episode psychosis cohort
Authors: Rebgetz Shane , Conus Philippe , Hides Leanne , Kavanagh David J. , Cotton Sue , Schimmelmann Benno G. , McGorry Patrick D. , Lambert Martin
Published: July 2013

Aim

To assess the predictors of a significant decrease or cessation of substance use (SU) in a treated epidemiological cohort of first‐episode psychosis (FEP) patients.

Method

Participants were FEP patients of the Early Psychosis Prevention and Intervention Centre in Australia. Patients' medical files were reviewed using a standardized file audit. Data on 432 patients with FEP and baseline co‐morbid substance use disorder (SUD) were available for analysis. Predictors of reduction/cessation of SU at follow up were examined using logistic regression analyses.

Results

In univariate analyses, a reduction/cessation of SU was predicted by baseline measures reflecting higher education, employment, accommodation with others, cannabis use disorder (CUD) only (rather than poly‐SUDs), better global functioning and better premorbid social and occupational functioning, later age at onset of psychosis, and a diagnosis of non‐affective psychosis. In multivariate analysis, CUD alone and better premorbid social and occupational functioning remained significant predictors.

Conclusions

Addressing SUDs and social and occupational goals in people with FEP may offer opportunities to prevent SUDs becoming more severe or entrenched. Further longitudinal research on recovery from SU and FEP is needed to disentangle directions of influence and identify key targets for intervention.
Serum brain‐derived neurotrophic factor levels in epilepsy
Authors: Hong Z. , Li W. , Qu B. , Zou X. , Chen J. , Sander J. W. , Zhou D.
Published: July 2013

Background and purpose

To clarify the utility of serum brain‐derived neurotrophic factor (BDNF) as a biomarker for epilepsy diagnosis and severity.

Methods

Serum BDNF levels in 135 consecutive people with epilepsy meeting our criteria were assessed. Controls were 34 healthy individuals who over 12 months or longer had no complaints or signs of a neurological disorder. Serum BDNF concentrations were measured using Luminex technology.

Results

Gender, but not age, was found to be a significant factor related to serum BDNF levels in controls and people with epilepsy. Serum BDNF levels in people with epilepsy (mean 8798.5, SE 321.5 pg/ml) were not different from those of controls (mean 8919.5, SE 709.0 pg/ml). A multiple linear regression analysis, however, suggests that seizure frequency (P < 0.001) and epilepsy duration (P = 0.025) negatively correlate with serum BDNF levels independently of other factors. When BDNF cut‐off values of 6260 pg/ml were used, the sensitivity for distinguishing people with daily or more frequent seizures from those with fewer seizures was 80% and specificity was 90%.

Conclusions

It seems that the concentration of BDNF in serum is associated with disease severity in people with epilepsy and may be a helpful marker for severity.
Quantitative FLAIR analysis indicates predominant affection of the amygdala in antibody‐associated limbic encephalitis
Authors: Wagner Jan , Schoene‐Bake Jan‐Christoph , Malter Michael P. , Urbach Horst , Huppertz Hans‐Jürgen , Elger Christian E. , Weber Bernd
Published: July 2013

Purpose

Limbic encephalitis is an autoimmune‐mediated disease leading to temporal lobe epilepsy, mnestic deficits, and affective disturbances. Magnetic resonance imaging (MRI) usually shows signal and volume changes of the temporomesial structures. However, these abnormalities may be subtle, thereby hampering the diagnosis by conventional visual assessment. In the present study we evaluated the diagnostic value of a fully automated MRI postprocessing technique in limbic encephalitis and hippocampal sclerosis.

Methods

The MRI postprocessing was based largely on a recently described method allowing for an observer‐independent quantification of the fluid‐attenuated inversion recovery (FLAIR) signal intensities of amygdala and hippocampus. A 95% confidence region was calculated from the FLAIR intensities of 100 healthy controls. We applied this analysis to the MRI data of 39 patients with antibody‐associated limbic encephalitis and 63 patients with hippocampal sclerosis. Moreover, the results were compared to those of visual assessment by an experienced neuroradiologist.

Key Findings

The method detected limbic encephalitis and hippocampal sclerosis with a high sensitivity of 85% and 95%, respectively. The detection rate of the automated approach in limbic encephalitis was significantly superior to visual analysis (85% vs. 51%; p = 0.001), whereas no statistically significant difference for the detection rate in hippocampal sclerosis was found. Patients with limbic encephalitis had significantly higher absolute intensity values of the amygdala and a significantly higher percentage fell outside of the amygdalar confidence region compared to those with hippocampal sclerosis (79% vs. 27%; p < 0.001), whereas we found opposite results in the hippocampal analysis (38% vs. 95%; p < 0.001).

Significance

The FLAIR analysis applied in this study is a powerful tool to quantify signal changes of the amygdala and hippocampus in limbic encephalitis and hippocampal sclerosis. It significantly increases the diagnostic sensitivity in limbic encephalitis in comparison to conventional visual analysis. Furthermore, the method provides an interesting insight into the distinct properties of these two disease entities on MRI, indicating a predominant affection of the amygdala in limbic encephalitis, whereas the affection of the hippocampus is far less pronounced when compared to hippocampal sclerosis.
Antagonistic relationships between intron content and codon usage bias of genes in three mosquito species: functional and evolutionary implications
Authors: Behura Susanta K. , Singh Brajendra K. , Severson David W.
Published: July 2013

Genome biology of mosquitoes holds potential in developing knowledge‐based control strategies against vectorborne diseases such as malaria, dengue, WestNile, and others. Although the genomes of three major vector mosquitoes have been sequenced, attempts to elucidate the relationship between intron and codon usage bias across species in phylogenetic contexts are limited. In this study, we investigated the relationship between intron content and codon bias of orthologous genes among three vector mosquito species. We found an antagonistic relationship between codon usage bias and the intron number of genes in each mosquito species. The pattern is further evident among the intronless and the intron‐containing orthologous genes associated with either low or high codon bias among the three species. Furthermore, the covariance between codon bias and intron number has a directional component associated with the species phylogeny when compared with other nonmosquito insects. By applying a maximum likelihood–based continuous regression method, we show that codon bias and intron content of genes vary among the insects in a phylogeny‐dependent manner, but with no evidence of adaptive radiation or species‐specific adaptation. We discuss the functional and evolutionary significance of antagonistic relationships between intron content and codon bias.
A questionnaire study of equine gastrointestinal parasite control in Scotland
Authors: Stratford C. H. , Lester H. E. , Morgan E. R. , Pickles K. J. , Relf V. , McGorum B. C. , Matthews J. B.
Published: July 2013

Reasons for performing study

Anthelmintic resistance in equine gastrointestinal nematodes is a threat to equine health and welfare. Detailed knowledge of anthelmintic use and parasite control methods is a prerequisite to identification of potential risk factors for resistance.

Objectives

To identify parasite control practices employed by equine owners in Scotland and investigate management factors associated with anthelmintic resistance.

Study design

Questionnaire study of equine parasite control in Scotland.

Methods

Questionnaires were available electronically, distributed at a conference and mailed to clients. Key areas explored included general background, grazing management, anthelmintic treatment practices and use of diagnostic tests.

Results

A total of 193 responses detailing information on parasite control programmes of 993 equids were analysed. Moxidectin (MOX) and ivermectin or related combination products were the most commonly administered anthelmintics in the preceding 12 months. Treatments licensed for use against cyathostomin encysted larvae and tapeworms were administered by 80% and 90% of respondents, respectively. This was often achieved through indiscriminate use of MOX and MOX‐praziquantel products. Faecal egg count (FEC) analysis had been performed on 62% of yards and regular use of FECs reduced annual anthelmintic treatment frequency. Veterinarians had the greatest influence on control practices. While 40% of respondents believed that they practised targeted dosing, this was not associated with delaying treatment beyond the egg reappearance period of the anthelmintic used.

Conclusions

Responses indicated increasing veterinary involvement and use of FECs. The majority of respondents administered anthelmintics licensed against cyathostomin encysted larvae and tapeworms. However, responses suggested that owners did not understand the definition of ‘targeted’ dosing regimens.

Potential relevance

The high frequency of MOX use represents a potential risk factor for macrocyclic lactone resistance. As veterinarians were the most influential factor in anthelmintic choice, awareness of macrocyclic lactone resistance and potential risk factors for its development and spread should be incorporated into client advice.
Factors associated with survival in 148 recumbent horses
Authors: Winfield L. S. , Kass P. H. , Magdesian K. G. , Madigan J. E. , Aleman M. , Pusterla N.
Published: July 2013

Reasons for performing study

There are currently few data available on the prognosis and outcome of recumbent horses.

Objectives

To investigate the outcome of hospitalised horses that had been recumbent in the field or hospital and factors affecting their survival within the first 3 days of hospitalisation and survival after 3 days to hospital discharge.

Study design

Retrospective analysis of clinical records.

Methods

Records of 148 horses admitted to the William R. Pritchard Veterinary Medical Teaching Hospital, University of California Davis from January 1995 to December 2010 with a history of recumbency or horses that became recumbent while hospitalised were evaluated. Exact logistic regression was used to assess the association between clinical parameters and survival within the first 3 days of hospitalisation and survival to hospital discharge after 3 days.

Results

There were 109 nonsurvivors and 39 survivors. Multivariate analysis showed variables associated with an increased odds of death within the first 3 days of hospitalisation included duration of clinical signs prior to presentation, with horses showing clinical signs for over 24 h having increased odds of death (P = 0.043, odds ratio [OR] 4.16, 95% confidence interval [95% CI] 1.04–16.59), the presence of band neutrophils (P = 0.02, OR 7.94, 95% CI 1.39–45.46), the horse not using the sling (P = 0.031, OR 4.22, 95% confidence interval 1.14–15.68) and horses that were unable to stand after treatment (P<0.0001, OR 231.15, 95% CI 22.82–2341.33). Increasing cost was associated with lower odds of death (P = 0.017, OR 0.96, for each additional $100 billed, 95% CI 0.93–0.99).

Conclusions

This study demonstrates that the duration of clinical signs, response to treatment and the ability of horses to use a sling are associated with survival to hospital discharge for recumbent horses.
Structure of NADP+‐dependent glutamate dehydrogenase from Escherichia coli – reflections on the basis of coenzyme specificity in the family of glutamate dehydrogenases
Authors: Sharkey Michael A. , Oliveira Tânia F. , Engel Paul C. , Khan Amir R.
Published: July 2013

Glutamate dehydrogenases (GDHs; EC 1.4.1.2–4) catalyse the oxidative deamination of l‐glutamate to α‐ketoglutarate, using NAD+ and/or NADP+ as a cofactor. Subunits of homo‐hexameric bacterial enzymes comprise a substrate‐binding domain I followed by a nucleotide‐binding domain II. The reaction occurs in a catalytic cleft between the two domains. Although conserved residues in the nucleotide‐binding domains of various dehydrogenases have been linked to cofactor preferences, the structural basis for specificity in the GDH family remains poorly understood. Here, the refined crystal structure of Escherichia coli GDH in the absence of reactants is described at 2.5‐Å resolution. Modelling of NADP+ in domain II reveals the potential contribution of positively charged residues from a neighbouring α‐helical hairpin to phosphate recognition. In addition, a serine that follows the P7 aspartate is presumed to form a hydrogen bond with the 2′‐phosphate. Mutagenesis and kinetic analysis confirms the importance of these residues in NADP+ recognition. Surprisingly, one of the positively charged residues is conserved in all sequences of NAD+‐dependent enzymes, but the conformations adopted by the corresponding regions in proteins whose structure has been solved preclude their contribution to the coordination of the 2′‐ribose phosphate of NADP+. These studies clarify the sequence–structure relationships in bacterial GDHs, revealing that identical residues may specify different coenzyme preferences, depending on the structural context. Primary sequence alone is therefore not a reliable guide for predicting coenzyme specificity. We also consider how it is possible for a single sequence to accommodate both coenzymes in the dual‐specificity GDHs of animals.
Functional differentiation of small heat shock proteins in diapause‐destined Artemia embryos
Authors: King Allison M. , Toxopeus Jantina , MacRae Thomas H.
Published: July 2013

Encysted embryos of Artemia franciscana cease development and enter diapause, a state of metabolic suppression and enhanced stress tolerance. The development of diapause‐destined Artemia embryos is characterized by the coordinated synthesis of the small heat shock proteins (sHsps) p26, ArHsp21 and ArHsp22, with the latter being stress inducible in adults. The amounts of sHsp mRNA and protein varied in Artemia cysts, suggesting transcriptional and translational regulation. By contrast to p26, knockdown of ArHsp21 by RNA interference had no effect on embryo development. ArHsp21 provided limited protection against stressors such as desiccation and freezing but not heat. ArHsp21 may have a non‐essential or unidentified role in cysts. Injection of Artemia adults with amounts of ArHsp22 double‐stranded RNA less than those used for other sHsps killed females and males, curtailing the analysis of ArHsp22 function in developing embryos and cysts. The results indicate that diapause‐destined Artemia embryos synthesize varying amounts of sHsps as a result of differential gene expression and mRNA translation and also suggest that these sHsps have distinctive functions.
The expanding roles of 1‐methyl‐tryptophan (1‐MT): in addition to inhibiting kynurenine production, 1‐MT activates the synthesis of melatonin in skin cells
Authors: Moreno Ana C. R. , Clara Renan O. , Coimbra Janine B. , Júlio Ariane R. , Albuquerque Renata C. , Oliveira Edson M. , Maria‐Engler Silvya S. , Campa Ana
Published: July 2013

Indoleamine 2,3‐dioxygenase 1 (IDO1), the rate‐limiting enzyme of tryptophan catabolism, has been strongly associated with the progression of malignancy and poor survival in melanoma patients. As a result, IDO1 is a leading target for interventions aimed at restoring melanoma immune surveillance. Here, in a scenario involving the tryptophan catabolism, we report that melatonin biosynthesis is driven by 1‐methyl‐tryptophan (1‐MT), a competitive inhibitor of IDO1, in human fibroblasts, melanocytes and melanoma cells. In addition to melatonin biosynthesis, 1‐MT induced the expression of tryptophan hydroxylase, arylalkylamine‐N‐acetyltransferase and hydroxyindole O‐methyltransferase mRNA in fibroblasts and melanocytes. We observed a great variability in the levels of IDO1 mRNA expression and kynurenine release between skin cells and melanoma cell lines in response to interferon‐γ, a classical IDO1 inducer. In this setting, melatonin was shown to downregulate kynurenine production. Furthermore, in a condition of low basal activity of IDO1, it was observed that 1‐MT, as well melatonin, inhibited the proliferation of human melanoma cells. Taken together, our results suggest that 1‐MT may serve as more than just a tool to disrupt tumor immune escape (via the inhibition of IDO1) because it was shown to act directly on the proliferation of human melanoma cells and induce melatonin biosynthesis in the tumor milieu. Moreover, 1‐MT‐mediated inhibition of IDO occurs in normal skin and melanoma cells, which addresses the possibility that all cells in the skin microenvironment can be targeted by 1‐MT. Our findings provide innovative approaches into understanding tumor therapy related to the control of tryptophan metabolism by 1‐MT.
Association of decreased sympathetic nervous activity with mortality of older adults in long‐term care
Authors: Shibasaki Koji , Ogawa Sumito , Yamada Shizuru , Iijima Katsuya , Eto Masato , Kozaki Koichi , Toba Kenji , Akishita Masahiro , Ouchi Yasuyoshi
Published: July 2013

Aim

To investigate the relationship between physical function, mortality and autonomic nervous activity measured by heart rate variability of elderly in long‐term care.

Methods

Cross‐sectional and longitudinal studies were carried out at hospitals and health service facilities for the elderly in Nagano prefecture, Japan, from July 2007 to March 2011. A total of 105 long‐term care older adults and 17 control older adults with independent physical function were included. The Functional Independence Measure (FIM) and Barthel Index were determined as indices of physical function. Twenty‐four‐hour Holter monitoring was carried out. From RR intervals in electrocardiograms, heart rate and standard deviations of all NN intervals in all 5‐min segments of the entire recording, power spectral density, low frequency, high frequency and low frequency/high frequency (LF/HF) were calculated.

Results

FIM score and Barthel Index were 46 ± 26 and 30 ± 31, respectively, in long‐term care elderly. FIM and Barthel index were significantly correlated with heart rate and the standard deviations of all NN intervals after adjustment for age, sex, cardiovascular risk factors and FIM. Furthermore, LF/HF was significantly decreased in long‐term care elderly compared with control elderly after adjustment for covariates. In addition, decrease in LF/HF was an independent risk factor for mortality.

Conclusion

Low LF/HF activity was observed in long‐term care elderly and was related to an increase of overall mortality. Geriatr Gerontol Int 2014; 14: 159–166.
Size variability of handwriting in healthy Korean older adults
Authors: Yoon Ji Hye , Kim HyangHee , Kim JungWan , Park Eunjeong , Kim Soo Ryon
Published: July 2013

Aim

The aim of the present study was to delineate how age‐related deterioration affects the handwriting of healthy elderly (HE) subjects.

Methods

A total of 235 HE (54 males, 181 females) aged 57–91 years participated as subjects in the study. In order to compare the area of handwriting, we divided the participants into two groups: (i) aged 57–74 years; and (ii) aged 75–91 years. The writing stimulus was a four‐syllabic word with one‐to‐one grapheme‐to‐phoneme correspondence. The size of each syllable in the target word was measured using a software program. Alignment of the word to baseline was assessed using a multiple‐choice checklist.

Results

As compared with handwriting by the younger group, the older group showed greater variability in the size of the written syllables within the word (P = 0.023).

Conclusion

The handwriting was characterized by unequal size among syllables and non‐perpendicular alignment, which could be explained by several factors. First, the variability might have resulted from irregular fine movement motor control in older adults. Second, the deterioration of visual feedback and visuomotor integration in normal aging might have affected handwriting performance. In conclusion, variability of handwriting can be sensitive in predicting the aging process. Geriatr Gerontol Int 2014; 14: 458–463.
Successful tunneled catheter placement in a hemodialysis patient with idiopathic multiple central venous stenoses
Authors: Zhao Yuliang , Cui Tianlei , Yu Yang , Liu Fang , Fu Ping , Zhou Li , Li Xiao
Published: July 2013

Central venous stenosis (CVS) in hemodialysis patients could be secondary to central venous catheterization, high flow arteriovenous fistula, as well as extrinsic compression. However, we report a senile hemodialysis patient of left internal jugular vein stenosis and right innominate vein occlusion unrelated to any known risk factors. Aided by computed tomography and digital subtraction angiography, we managed to dilate the stenosis by percutaneous balloon angioplasty, followed by successful tunneled catheter placement. Nephrologists should be aware of idiopathic CVS and its impact on the creation and preservation of vascular access. When confronted with difficulties in catheter placement, practitioners need to consider the possibilities of idiopathic CVS and refer to radiological tests.
Central Nervous System Venulitis Presenting as Migraine
Authors: Orr Serena L. , dos Santos Marlise P. , Jurencak Roman , Michaud Jean , Miller Elka , Doja Asif
Published: July 2013

Objective

To describe a case of pediatric central nervous system (CNS) venulitis.

Background

Primary angiitis of the CNS is a rare but increasingly well‐recognized cause of morbidity in children. It primarily involves the arteries and arterioles of the CNS, with only 1 published case of a pediatric patient found to have isolated CNS venulitis on brain biopsy.

Case Report

A 17‐year‐old female with a 4‐year history of migraines presented with increasingly frequent migraines and right‐sided hemiplegia. Infectious, hematologic, and rheumatologic work‐ups were negative. Brain magnetic resonance imaging showed multiple rim‐enhancing lesions consistent with calcifications affecting the deep left white matter. On brain biopsy, there was evidence of an inflammatory process involving small veins and venules. The patient displayed clinical improvement with a course of high‐dose steroids and 6 monthly cyclophosphamide infusions followed by maintenance therapy with mycophenolate mofetil.

Discussion

We describe a case of pediatric CNS venulitis presenting with migraine.
Preserving hepatic artery flow during portal triad blood inflow occlusion reduces the outgrowth of hepatocarcinoma in mice after ischemia–reperfusion
Authors: Shi Bin , Li Chong Hui , Chen Yong Wei , Yang Shi Zhong , Zhang Ai Qun , Dong Jia Hong
Published: July 2013

Aim

To investigate the effect of different hepatic vascular occlusion maneuvers on the growth of hepatocarcinoma after liver ischemia–reperfusion (I/R) injury.

Methods

A mice hepatocarcinoma model was established by portal vein injection of H22 hepatoma cells. After 3 days, the mice underwent sham operation, occlusion of portal triad (OPT), portal vein (OPV), or intermittent clamping (INT) operation. The hepatic I/R injury, pathological changes, hepatic replacement area, proliferative cell nuclear antigen expression, and extracellular signal‐regulated kinase (ERK) 1/2 activation were assessed 5 days after reperfusion.

Results

Alanine aminotransferase and aspartate aminotransferase levels in the OPV group were significantly lower than those in the OPT and INT groups at 24 h after reperfusion. The hepatic injury of clamped liver lobes in the OPV group, represented by histopathological alterations and myeloperoxidase activity, was much slighter than that in the OPT and INT groups. The values of hepatic replacement area in the sham operation, OPT, OPV, and INT groups were 7.661 2.55%, 35.61 1 4.23%, 9.02 1 3.01%, and 19.95 1 4.10%, respectively. Proliferative cell nuclear antigen expression and ERK1/2 activation of tumor cells were the highest in the OPT group, and the lowest in the OPV and INT groups.

Conclusion

Preserving hepatic artery flow during portal triad blood inflow occlusion substantially inhibits the outgrowth of hepatocarcinoma via attenuating hepatic I/R injury in a murine liver tumor model. These results suggest a better prevention of hepatic tumor outgrowth after hepatectomy by using the selective portal vein clamping method in liver cancer patients.
Information needs and information‐seeking behaviour analysis of primary care physicians and nurses: a literature review
Authors: Clarke Martina A. , Belden Jeffery L. , Koopman Richelle J. , Steege Linsey M. , Moore Joi L. , Canfield Shannon M. , Kim Min S.
Published: July 2013

Background

The increase in the adoption of electronic health records (EHR) has contributed to physicians and nurses experiencing information overload. To address the problem of information overload, an assessment of the information needs of physicians and nurses will assist in understanding what they view as useful information to make patient care more efficient.

Objective

To analyse studies that assessed the information needs and information‐seeking behaviour of physicians and nurses in a primary care setting to develop a better understanding of what information to present to physicians when they making clinical decisions.

Method

A literature review of studies was conducted with a comprehensive search in PubMed, cinahl, scopus, as well as examination of references from relevant papers and hand‐searched articles to identify articles applicable to this review.

Results

Of the papers reviewed the most common information needs found among physicians and nurses were related to diagnoses, drug(s) and treatment/therapy. Colleagues remain a preferred information source among physicians and nurses; however, a rise in Internet usage is apparent.

Conclusion

Physicians and nurses need access to the Internet and job‐specific resources to find practitioner‐oriented information. In addition, effective usage of resources is important for improving patient care.
Library services and user satisfaction in developing countries: a case study
Authors: Mairaj Muhammad Ijaz , Naseer Mirza Muhammad
Published: July 2013

Background

Punjab Institute of Cardiology (PIC) is a recognised teaching hospital for cardiac care in the Punjab province of Pakistan. PIC has established a library to fulfil the research and information needs of health care professionals. This study aims to evaluate the satisfaction of users with the services of PIC library.

Methodology

A purposive sample of 15 health care professionals was selected. A semistructured interview technique based on an interview guide was used for collection of data. The data were qualitatively analysed using a thematic approach.

Results

Users of PIC library were satisfied with the library collection, organisation, reference and circulation services, staff attitudes, cooling and heating. They were concerned about library space, hours, furniture and environment, and suggested more availability of electronic library services, newer collections, better Internet access and comfortable furniture.

Conclusion

The study proved useful to investigate users' satisfaction with the services of PIC library. It concludes that the PIC library should maintain and strengthen the services with which users are satisfied, and improve those about which they are concerned. The study will be useful to libraries in other developing countries for improvement in their services.
Pathological characteristics of the different stages of Acanthamoeba keratitis
Authors: Sun Yuzhao , Hong Jing , Zhang Pei , Peng Rongmei , Xiao Gege
Published: July 2013

Aims

To classify the clinical stages of Acanthamoeba keratitis (AK), and clarify the relationship between pathological changes and clinical features.

Methods and results

Between January 2007 and May 2012, AK was diagnosed in 11 eyes by pathological examination and confocal laser scanning microscopy. Pathological investigation of all cornea samples from keratoplasty was done with periodic acid‐Schiff and haematoxylin and eosin stains. AK clinical stage, pathological features and postoperative treatment were studied retrospectively. The 11 cases were classified into development stage, convalescence stage, or cicatricial stage. In the development stage, marked conjunctival hyperaemia, a corneal epithelial defect, obvious corneal infiltration and progressive inflammation were seen; pathological changes comprised abundant inflammatory cells and a rounded cyst in the oedematous stroma, as well as a very small amount of neovascularization. In the convalescence cases, moderate conjunctival hyperaemia, corneal disciform structures, repair of the corneal epithelial defect and abundant neovascularization were seen; pathological changes included significant tissue necrosis and a small, shrunken cyst in the stroma, as well as significant neovascularization. In the cicatricial stage, keratoleukoma was seen; pathological changes comprised a few inflammatory cells and shrunken cysts scattered in the stroma. There were no cases of recurrence.

Conclusions

The pathological features of different clinical stages confirmed the new clinical classification of AK.
Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) Trial: Rationale and design
Authors: Johnston S. Claiborne , Easton J. Donald , Farrant Mary , Barsan William , Battenhouse Holly , Conwit Robin , Dillon Catherine , Elm Jordan , Lindblad Anne , Morgenstern Lewis , Poisson Sharon N. , Palesch Yuko
Published: July 2013

Background

Ischemic stroke and other vascular outcomes occur in 10–20% of patients in the three-months following a transient ischemic attack or minor ischemic stroke, and many are disabling. The highest risk period for these outcomes is the early hours and days immediately following the ischemic event. Aspirin is the most common antithrombotic treatment used for these patients.

Aim

The aim of POINT is to determine whether clopidogrel plus aspirin taken <12 h after transient ischemic attack or minor ischemic stroke symptom onset is more effective in preventing major ischemic vascular events at 90 days in the high-risk, and acceptably safe, compared with aspirin alone.

Design

POINT is a prospective, randomized, double-blind, multicenter trial in patients with transient ischemic attack or minor ischemic stroke. Subjects are randomized to clopidogrel (600 mg loading dose followed by 75 mg/day) or matching placebo, and all will receive open-label aspirin 50–325 mg/day, with a dose of 162 mg daily for five-days followed by 81 mg daily strongly recommended.

Study Outcomes

The primary efficacy outcome is the composite of new ischemic vascular events — ischemic stroke, myocardial infarction, or ischemic vascular death — by 90 days. The primary safety outcome is major hemorrhage, which includes symptomatic intracranial hemorrhage.

Discussion

Aspirin is the most common antithrombotic given to patients with a stroke or transient ischemic attack, as it reduces the risk of subsequent stroke. This trial expects to determine whether more aggressive antithrombotic therapy with clopidogrel plus aspirin, initiated acutely, is more effective than aspirin alone.
A Systematic Review of the Benefits of Mindfulness-Based Interventions following Transient Ischemic Attack and Stroke
Authors: Lawrence Maggie , Booth Jo , Mercer Stewart , Crawford Elizabeth
Published: July 2013

Background

Recent epidemiological studies have demonstrated an association between perceived psychological stress and ischemic stroke. A feature of stroke is recurrence; 30–40% within five-years following first transient ischemic attack/stroke. Equipping patients with skills and coping strategies to help reduce or manage perceived psychological stress may represent an important secondary prevention intervention. Mindfulness-based interventions are structured, group-based self-management programmes with potential to help people with long-term conditions cope better with physical, psychological, or emotional distress. Review evidence suggests significant benefits across a range of physical and mental health problems. However, we could find no evidence synthesis relating specifically to the benefits of mindfulness-based interventions following transient ischemic attack/stroke.

Aim

The review aims to evaluate the benefits of mindfulness-based interventions following transient ischemic attack/stroke.

Methods

Six major databases were searched using subject headings and key words. Papers were screened using review-specific criteria. Critical appraisal and data extraction were conducted independently by two reviewers. Statistical meta-analysis was not possible; therefore findings are presented in narrative form.

Results

Four studies involving 160 participants were reviewed. Three papers reported mindfulness-based interventions delivered to groups; one paper reported a mindfulness-based intervention which was delivered one to one. The results demonstrate a positive trend in favor of the benefits of mindfulness-based interventions across a range of psychological, physiological, and psychosocial outcomes including anxiety, depression, mental fatigue, blood pressure, perceived health, and quality of life. No evidence of harm was found.

Conclusion

Following transient ischemic attack/stroke, people may derive a range of benefits from mindfulness-based interventions; however, further methodologically robust trials are required.
Setting Priorities for Stroke Care and Research
Authors: Morgenstern L. B. , Smith W. S.
Published: July 2013

Recent publications describing the sobering global increase in stroke mortality and global life years lost due to stroke despite improvements in developed countries have drawn focus on the severe impact of stroke in the developing world. At the same time, three recent interventional trials that failed to demonstrate an important role for catheter-based therapies in acute stroke have called into question this expensive use of technology. Coupling all of this new data leads to the natural conclusion that a focus on stroke prevention for the developing world, and for the poor in developed countries, should be where we set our priorities for the foreseeable future.
Towards a Gendered Evaluation of (Highly) Skilled Immigration Policies in Europe
Authors: Kofman Eleonore
Published: July 2013

Immigration policies reflect to varying degrees the calibration and stratification of desirable knowledge. The criteria adopted have varied across countries and immigration systems. However, despite the evidence that skilled women migrate more than men, little attention has been paid to the extent to which immigration policies impact differently on women and men and result in gender inequalities, and how the valuation of skills is gendered in its criteria and outcomes. Several European states have developed policies to attract the (highly) skilled in an attempt to make themselves as competitive as possible within a knowledge economy. The key criteria are salaries and educational qualifications which, together with the differential evaluation of skills, produce gender outcomes. This article explores how European policies for the (highly) skilled produce and reinforce inequalities in gendered circulations, not just between women and men, but also in terms of intersectional differences, such as race/nationality and age.

Policy Implications

Publish more disaggregated data by gender, race/nationality and age to support analysis of the implications of immigration policies.

Develop gender‐based and intersectional assessments of immigration policies.

Encourage states and international organizations to take into account the (in)equality aspects in the development of immigration policies.
Immigrant Entrepreneurs: The Identification of Foreign Market Opportunities
Authors: Smans Melanie , Freeman Susan , Thomas Jill
Published: July 2013

Building on the very few studies that examine how immigrant entrepreneurs identify opportunities to conduct business in foreign markets, this article explores how Italian immigrant entrepreneurs in Australia identify such opportunities. Relying on social network theory (Patel and Conklin, 2009), international business research indicates that social ties, including kinship and ethnic ties, facilitate the flow of information that enables entrepreneurs to identify opportunities (Ellis, 2011; Hayton, Chandler and DeTienne, 2011). This study finds that the Italian immigrant entrepreneurs prefer to receive information about business opportunities from trusting, social ties, particularly country of origin (Italy) regional based ethnic ties, rather kinship ties for fear of damaging the relationship. However both first and second generation immigrants do use kinship ties to gain knowledge about Italian market conditions. Implications for policy and practice, limitations of the study and ideas for future research are also presented.
The investigation of the possible relationship between Coxsackie viruses and pemphigus
Authors: Kaçar Nida , Cevahir Nural , Demirkan Neşe , Şanlı Berna
Published: July 2013

Background

Pemphigus is a group of autoimmune bullous diseases on which the etiopathogenesis of several viruses has been blamed. Coxsackie viruses (CVs) are the causative agents of hand, foot, and mouth disease, and herpangina, which have been strongly associated with several autoimmune diseases. The onset of pemphigus after CV infection and cephalosporin use has been reported.

Objective

To detect the presence of CV in patients with pemphigus.

Materials and methods

Reverse transcriptase‐polymerase chain reaction analysis for CV RNA sequences and immunohistochemical staining for the CV and adenovirus receptor expression were performed on patient skin samples. CV‐IgM and ‐IgG serum levels were analyzed.

Results

Thirty‐two patients and 40 controls were investigated. Neither the CV and adenovirus receptor expression nor CV RNA sequences was established in the skin samples of patients. The ratio of CV‐IgG positivity was higher in patients (12.5%) than in the controls (5%; P > 0.05).

Conclusion

Our preliminary results indicate that the viral genome of CV does not become persistent in the skin. Further studies with a larger number of cases are needed to clarify the place of CVs in the etiopathogenesis of pemphigus.