bluuebunny/crossref_metadata_2025 huggingface dataset:
Decreased Plasma Nesfatin-1 Level Is Related to the Thyroid Dysfunction in Patients with Type 2 Diabetes Mellitus
Authors: Liu Fupeng , Yang Qing , Gao Ning , Liu Fangfang , Chen Shaohua
Published: June 2014

Aims. Thyroid dysfunction is frequently observed in patients with type 2 diabetes mellitus (T2DM), but the underlying mechanism is still poorly understood. The present study aimed to investigate whether nesfatin-1 played a role in the thyroid dysfunction in patients with T2DM.Methods. 55 euthyroid patients were enrolled in this study including 30 patients with T2DM and 25 patients with impaired glucose regulation (IGR). 30 age-matched healthy people were also included as the control. The plasma levels of nesfatin-1, thyrotropin (TSH), and glycosylated hemoglobin (HbA1c) as well as the body mass index (BMI) were comparatively analyzed among the three groups.Results. The nesfatin-1 was significantly lower in patients with T2DM than in patients with IGR and in the control. On the contrary, the TSH level was significantly higher in patients with T2DM than in patients with IGR and in the control. Simple regression analysis showed that the plasma nesfatin-1 was negatively correlated with the TSH and HbA1c levels and positively correlated with the BMI. With multiple stepwise regression analysis, the nesfatin-1 remained to be independently correlated with the TSH, BMI, and HbA1c.Conclusions. The study was suggesting a role of nesfatin-1 in thyroid dysfunction in patients with T2DM.
Clinical, Laboratory, and Management Profile in Patients of Liver Abscess from Northern India
Authors: Ghosh Soumik , Sharma Sourabh , Gadpayle A. K. , Gupta H. K. , Mahajan R. K. , Sahoo R. , Kumar Naveen
Published: June 2014

Objective. To describe the clinical profile, microbiological aetiologies, and management outcomes in patients with liver abscess.Methods. A cross-sectional study was conducted from May, 2011, to April, 2013, on 200 consecutive liver abscess patients at PGIMER and Dr. RML Hospital, New Delhi. History, examination, and laboratory investigations were recorded. Ultrasound guided aspiration was done and samples were investigated. Chi-square test and multivariate regression analysis were performed to test association.Results. The mean age of patients was 41.13 years. Majority of them were from lower socioeconomic class (67.5%) and alcoholic (72%). The abscesses were predominantly in right lobe (71%) and solitary (65%). Etiology of abscess was 69% amoebic, 18% pyogenic, 7.5% tubercular, 4% mixed, and 1.5% fungal. Percutaneous needle aspiration was done in 79%, pigtail drainage in 17%, and surgical intervention for rupture in 4% patients. Mortality was 2.5%, all reported in surgical group. Solitary abscesses were amoebic and tubercular whereas multiple abscesses were pyogenic (P=0.001). Right lobe was predominantly involved in amoebic and pyogenic abscesses while in tubercular abscesses left lobe involvement was predominant (P=0.001).Conclusions. The commonest presentation was young male, alcoholic of low socioeconomic class having right lobe solitary amoebic liver abscess. Appropriate use of minimally invasive drainage techniques reduces mortality.
Time-Varying Risk Attitude and Conditional Skewness
Authors: Liu Zhifeng , Zhang Tingting , Wen Fenghua
Published: June 2014

Much literature finds that the skewness in the return distribution is negatively correlated with the risk premium coefficient, and speculation is the reason for the skewness in the return distribution. As further research, this paper, first taking up the time-varying property of the risk premium coefficient, proposes a GARCH-M model with a time-varying coefficient of the risk premium for an empirical study of the correlation between the conditional skewness in the return distribution and the time-varying risk attitude. The empirical study indicates that the coefficient of the risk premium varies with the time, and even in a mature market the conditional skewness in the return distribution is negatively correlated with the time-varying coefficient of the risk premium.
HIV/AIDS Awareness among VCT Clients: A Cross-Sectional Study from Delhi, India
Authors: Mehra Bhanu , Bhattar Sonali , Bhalla Preena , Rawat Deepti
Published: June 2014

The contribution of India to the global burden of HIV/AIDS is significant. A major barrier that the country has faced in its battle against this disease is the inadequate and inaccurate information about it among the population. The present analysis explores the knowledge about HIV/AIDS among clients attending a voluntary counselling and testing (VCT) facility in India. Two hundred clients attending the VCT facility were assessed in this regard using a structured predesigned questionnaire. Sixty-three (31.5%) of the respondents had never heard of HIV/AIDS. In comparison to males, a significantly higher number of females had not heard about the disease (P<0.01). Lower levels of education of participants were found to be significantly associated with the response of not having heard of HIV/AIDS (P<0.01) as was an occupation status of being an unemployed man/housewife (P=0.002). For the 137 (68.5%) respondents who had heard about HIV/AIDS, television was the source of information in 130 (94.9%) followed by posters in 93 (67.9%) and newspapers in 88 (64.2%). While the knowledge about HIV transmission and prevention was good, the extent of misconceptions was high (61.8%). Our study highlights the strong need to raise the levels of HIV awareness among Indian population.
Nutrient and Phytoplankton Dynamics along the Ocean Road Sewage Discharge Channel, Dar es Salaam, Tanzania
Authors: Hamisi Mariam I. , Mamboya Florence A.
Published: June 2014

Ocean Road shoreline is situated close to Dar es Salaam largest fish market and is subjected to sewage discharge. In this study, temporal and spatial variations of physicochemical parameters and phytoplankton were studied in five stations along the Ocean Road Coast. Phytoplankton composition, temperature, dissolved oxygen (DO), salinity, water clarity, pH, and dissolved inorganic nutrients (DIN) including nitrite, nitrate, and phosphate were measured. Results revealed that DIN were significantly higher in the station close to the discharge point than other stations (P<0.0001). There were no significant temporal variations in DIN except nitrate that was significantly higher during Northeast Monsoon than Southeast Monsoon (P<0.001). Other environmental parameters showed no significant differences except clarity, conductivity, and DO. Occurrence of potential harmful species such asTrichodesmium, Microcystis,andPseudo-nitzschiawas observed. The phytoplankton biomass (chlorophylla) ranged from 3.2 to 56.5 mg m−3and 18 to 113 mg m−3for Mjimwema (MJ) and Ocean Road (OR) stations, respectively. There was significant difference (P=0.0033) in chlorophyllaamong the stations being higher in OR II. The phytoplankton biomass was positively correlated with nutrient concentration in all stations except OR I. This study suggests an alarming level of DIN at OR that may alter phytoplankton biomass, abundance, and composition.
Pharmacology of Hallucinations: Several Mechanisms for One Single Symptom?
Authors: Rolland Benjamin , Jardri Renaud , Amad Ali , Thomas Pierre , Cottencin Olivier , Bordet Régis
Published: June 2014

Hallucinations are complex misperceptions, that principally occur in schizophrenia or after intoxication induced by three main classes of drugs: psychostimulants, psychedelics, and dissociative anesthetics. There are at least three different pharmacological ways to induce hallucinations: (1) activation of dopamine D2 receptors (D2Rs) with psychostimulants, (2) activation of serotonin 5HT2A receptors (HT2ARs) with psychedelics, and (3) blockage of glutamate NMDA receptors (NMDARs) with dissociative anesthetics. In schizophrenia, the relative importance of NMDAR and D2R in the occurrence of hallucinations is still debated. Slight clinical differences are observed for each etiology. Thus, we investigated whether the concept of hallucination is homogenous, both clinically and neurobiologically. A narrative review of the literature is proposed to synthesize how the main contributors in the field have approached and tried to solve these outstanding questions. While some authors prefer one explanatory mechanism, others have proposed more integrated theories based on the different pharmacological psychosis models. In this review, such theories are discussed and faced with the clinical data. In addition, the nosological aspects of hallucinations and psychosis are addressed. We suggest that if there may be common neurobiological pathways between the different pharmacological systems that are responsible for the hallucinations, there may also be unique properties of each system, which explains the clinical differences observed.
Adiponectin and Atherosclerosis in Rheumatoid Arthritis
Authors: Dessein Patrick H. , Tsang Linda , Solomon Ahmed , Woodiwiss Angela J. , Millen Aletta M. E. , Norton Gavin R.
Published: June 2014

In the present study, we examined the potential impact of adiponectin on carotid ultrasound determined atherosclerosis in 210 (119 black and 91 white) RA patients in mixed regression models. Total adiponectin concentrations were smaller in patients with compared to those without the metabolic syndrome (MetS) defined waist criterion (median (range) = 6.47 (1.23–34.54) versus 8.38 (0.82–85.30) ng/mL,P=0.02, resp.); both total and high molecular weight (HMW) adiponectin concentrations were larger in patients with compared to those without joint deformities (7.97 (0.82–85.30) and 3.51 (0.01–35.40) versus 5.36 (1.29–19.49) and 2.34 (0.01–19.49) ng/mL,P=0.003and 0.02, resp.). Total and HMW adiponectin concentrations were associated with carotid artery plaque in patients with MetS waist (odds ratio (95% CI) = 0.87 (0.76–0.99) and 0.92 (0.85–0.99) per 1-standard deviation increment,P=0.02for both) and those without joint deformities (odds ratio (95% CI) = 0.94 (0.88–0.99) and 0.94 (0.89–0.99),P=0.03for both). Plaque prevalence was lower in patients without compared to those with joint deformities (23.4% versus 42.6,P=0.004in multivariable analysis). In RA patients with abdominal obesity or no clinically evident joint damage, adiponectin concentrations are reduced but nevertheless associated with decreased carotid atherosclerosis.
Rare Manifestation of a Rare Disease, Acute Liver Failure in Adult Onset Still’s Disease: Dramatic Response to Methylprednisolone Pulse Therapy—A Case Report and Review
Authors: Valluru Nalini , Tammana Venkata S. , Windham Michael , Mekonen Eyasu , Begum Rehana , Sanderson Andrew
Published: June 2014

Adult onset Still’s disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. It is characterized by daily fevers, arthralgias or arthritis, typical skin rash, and leukocytosis. Hepatic involvement is frequently observed in the course of AOSD with mildly elevated transaminases and/or hepatomegaly. Fulminant hepatic failure, occasionally requiring urgent liver transplantation, is a rare manifestation of AOSD. Here, we present a case of 22-year-old woman with no significant medical history who initially came with fever, arthralgias, myalgias, generalized weakness, and sore throat. Laboratory data showed mildly elevated transaminases and markedly elevated ferritin levels. She was diagnosed with AOSD based on Yamaguchi diagnostic criteria and was started on prednisone. Three months later, while she was on tapering dose of steroid, she presented with fever, abdominal pain, jaundice, and markedly elevated transaminases. Extensive workup excluded all potential causes of liver failure. She was diagnosed with AOSD associated acute liver failure (ALF). Intravenous (IV) methylprednisolone pulse therapy was started, with dramatic improvement in liver function. Our case demonstrated that ALF can present as a complication of AOSD and IV mega dose pulse methylprednisolone therapy can be employed as a first-line treatment in AOSD associated ALF with favorable outcome.
Cryoablation of Early-Stage Primary Lung Cancer
Authors: Inoue Masanori , Nakatsuka Seishi , Jinzaki Masahiro
Published: June 2014

Worldwide, lung cancer is the most commonly diagnosed cancer, and lobectomy is the gold-standard treatment for early-stage non-small cell lung cancer (NSCLC). However, many patients are poor surgical candidates for various reasons. Recently, image-guided ablation is being used for lung tumors. Cryoablation has been applied for the treatment of cancer in various nonaerated organs; recently it has been adapted to the treatment of lung tumors. Since an ice ball can be detected by computed tomography (CT), cryoablation of lung tumors is performed under CT guidance. Its first clinical application was reported in 2005, and it has been reported to be feasible in a few studies. Minor complications occurred at a high frequency (up to 70.5%), but major complications were rare (up to 1%). The most common complication is pneumothorax, and most cases need no further intervention. Local efficacy depends on tumor size and presence of a thick vessel close to the tumor. Midterm survival after cryoablation is 77%–88% at 3 years in patients with early-stage NSCLC. Although surgery is the gold-standard treatment for such patients, the initial results of cryoablation are promising. In this paper, the current status of cryoablation for primary lung tumors is reviewed.
Treatment of Rheumatoid Arthritis with Traditional Chinese Medicine
Authors: Lee Wen-Yuan , Chen Hsin-Yi , Chen Kuan-Chung , Chen Calvin Yu-Chian
Published: June 2014

Rheumatoid arthritis (RA) is a chronic inflammatory disease that will affect quality of life and, working efficiency, and produce negative thoughts for patients. Current therapy of RA is treated with disease-modifying antirheumatic drugs (DMARDs). Although most of these treatment methods are effective, most patients still have a pleasant experience either due to poor efficacy or side effects or both. Interleukin-6 receptor (IL6R) is important in the pathogenesis of RA. In this study, we would like to detect the potential candidates which inhibit IL6R against RA from traditional Chinese medicine (TCM). We use TCM compounds from the TCM Database@Taiwan for virtually screening the potential IL6R inhibitors. The TCM candidate compound, calycosin, has potent binding affinity with IL6R protein. The molecular dynamics simulation was employed to validate the stability of interaction in the protein complex with calycosin. The analysis indicates that protein complex with calycosin is more stable. In addition, calycosin is known to be one of the components ofAngelica sinensis, which has been indicated to have an important role in the treatment of rheumatoid arthritis. Therefore, calycosin is a potential candidate as lead compounds for further study in drug development process with IL6R protein against rheumatoid arthritis.
Breastfeeding Duration: A Survival Analysis—Data from a Regional Immunization Survey
Authors: Robert E. , Coppieters Y. , Swennen B. , Dramaix M.
Published: June 2014

Objective. To report the duration of and factors associated with exclusive and any breastfeeding among the French-speaking community of Belgium (Wallonia).Material and Methods. A two-stage cluster sample was drawn from the population of children aged 18–24 months living in the area in 2012. Anamnestic data on breastfeeding and sociodemographic information were collected from 525 mothers. Cox’s proportional hazards model was used to identify factors associated with discontinuing breastfeeding.Results and Discussion. Only 35.1% of the women were satisfied with their duration of any breastfeeding. At 3 months, 54.1% of the infants were breastfed, of which 40.6% exclusively, with these percentages falling to 29.1% and 12.6% at 6 months. Exclusive and any breastfeeding durations were independently positively associated (P<0.05) with foreign-born mothers, awareness of WHO recommendations, and maternity leave >3 months. Exclusive BF duration was associated with higher parental income and the prenatal decision to breastfeed. The duration of any breastfeeding was associated with the mothers’ age of ≥30 years and whether they were exclusively breastfeeding at discharge from the maternity unit.Conclusions. Programs promoting and supporting BF should concentrate on training prenatal health-care professionals. Prenatal professional advice may promote adherence to WHO BF guidelines. The benefits of exclusive BF should be emphasized. Pregnant women should be discouraged from introducing supplementary feeding in the maternity ward.
A Memetic Differential Evolution Algorithm Based on Dynamic Preference for Constrained Optimization Problems
Authors: Dong Ning , Wang Yuping
Published: June 2014

The constrained optimization problem (COP) is converted into a biobjective optimization problem first, and then a new memetic differential evolution algorithm with dynamic preference is proposed for solving the converted problem. In the memetic algorithm, the global search, which uses differential evolution (DE) as the search scheme, is guided by a novel fitness function based on achievement scalarizing function (ASF). The novel fitness function constructed by a reference point and a weighting vector adjusts preference dynamically towards different objectives during evolution, in which the reference point and weighting vector are determined adapting to the current population. In the local search procedure, simplex crossover (SPX) is used as the search engine, which concentrates on the neighborhood embraced by both the best feasible and infeasible individuals and guides the search approaching the optimal solution from both sides of the boundary of the feasible region. As a result, the search can efficiently explore and exploit the search space. Numerical experiments on 22 well-known benchmark functions are executed, and comparisons with five state-of-the-art algorithms are made. The results illustrate that the proposed algorithm is competitive with and in some cases superior to the compared ones in terms of the quality, efficiency, and the robustness of the obtained results.
Antioxidant and Antimicrobial Activity of Ophiurasaponin Extracted fromOphiopholis mirabilis
Authors: Wang Rongzhen , Xue Xiaoyu , Zhen Jingrong , Guo Chenghua
Published: June 2014

The aim of this study was to analyze antioxidant and antimicrobial activity of ophiurasaponin extracted fromOphiopholis mirabilis(overall). Ophiurasaponin was extracted with solvent extraction and purified through AB-8 macroporous resin, silica gel column chromatography, Sephadex LH-20 gel column chromatography, and C18 ODS column chromatography. The antioxidant activity of ophiurasaponin was detected by the chemiluminescence assay. The paper filtering method and the modified agar dilution method were used to determine antimicrobial activity. The results showed that the content of crude ophiurasaponin and the refined ophiurasaponin was 46.75% and 96.72%, respectively. The values of the IC50of hydroxyl-radicals, superoxide anions, and peroxide were 25.54 mg/mL, 9.98 mg/mL, and 1.37 mg/mL, respectively. The refined ophiurasaponin had a good inhibitory effect onEscherichia coli,Bacillus subtilis,Staphylococcus aureus,Aerobacter aerogenes,andProteusbacillus vulgaris, and the minimum inhibitory concentration (MIC) was 0.0443 mg/mL. In conclusion, ophiurasaponin fromOphiopholis mirabilishad obvious antioxidant activities and antimicrobial activities which could provide the theoretical basis for further research and development of antioxidant and antimicrobial marine drugs.
Decreasing the Dose to the Rectal Wall by Using a Rectal Retractor during Radiotherapy of Prostate Cancer: A Comparative Treatment Planning Study
Authors: Nilsson Kristina , Johansson Andreas K. , Montelius Anders , Turesson Ingela , Heikkinen Risto O. , Ljung Gunilla , Isacsson Ulf
Published: June 2014

Aim. The aim of the study was to examine the dosimetric effect of rectal retraction, using a rectal retractor, by performing a comparative treatment planning study. Material and Methods. Treatment plans using volumetric arc therapy (VMAT) were produced for ten patients both with and without rectal retraction. A hypofractionation scheme of 42.7 Gy in seven fractions was used. The dose to the rectal wall was evaluated for both methods (with and without retraction) using four dose-volume criteria: V40.1 Gy, V38.3 Gy, V36.5 Gy, and V32.6 Gy. Results. The retraction of the rectal wall increased the distance between the rectal wall and the prostate. The rectal wall volume was reduced to zero for all dose-volume values except for V32.6 Gy, which was 0.2 cm3 in average when the rectal retractor was used. Conclusion. There was a significant decrease of V40.1 Gy, V38.3 Gy, V36.5 Gy, and V32.6 Gy when the rectal retractor was used without compromising the dose coverage of planning target volume (PTV).
Serum IL-17, IL-23, and TGF-βLevels in Type 1 and Type 2 Diabetic Patients and Age-Matched Healthy Controls
Authors: Roohi Azam , Tabrizi Mina , Abbasi Farzaneh , Ataie-Jafari Asal , Nikbin Behrouz , Larijani Bagher , Qorbani Mostafa , Meysamie Alipasha , Asgarian-Omran Hossein , Nikmanesh Bahram , Bajouri Arezou , Shafiey Novin , Maleki Akram
Published: June 2014

Type 1 diabetes is recognized as an autoimmune inflammatory disease and low grade inflammation is also observed in type 2 diabetic patients. Interleukin 17 (IL-17) is a new player in inflammation. Th17 cells, as the main source of IL-17, require transforming growth factorβ(TGF-β) and interleukin 23 (IL-23). The aim of this study was to investigate serum IL-17, IL-23 and TGF-βlevels in diabetic patients and controls. In this case-control study, serum levels of IL-17, IL-23, and TGF-βwere measured in 24 type 1 diabetic patients and 30 healthy controls using the ELISA method. Simultaneously, the same methodology was used to compare serum concentration of these three cytokines in 38 type 2 diabetic patients and 40 healthy controls. There was no significant difference between serum levels of IL-17 and IL-23 cytokines between cases and controls. However, TGF-βwas significantly lower in type 1 diabetic patients (P<0.001). Serum IL-17 and IL-23 levels demonstrate no association with type 1 and type 2 diabetes, but, in line with previous studies, TGF-βlevels were lower in type 1 diabetic patients.
Leaf Litter Decomposition and Nutrient Dynamics Associated with Common Horticultural Cropland Agroforest Tree Species of Bangladesh
Authors: Hasanuzzaman Md. , Hossain Mahmood
Published: June 2014

Mangifera indica,Zizyphus jujuba,Litchi chinensis, andArtocarpus heterophyllusare the most common cropland agroforest horticultural tree species of Bangladesh. This study focused on leaf litter decomposition and nutrient (N, P, and K) dynamics during the decomposition process. This experiment was conducted for 180 days by using litter bag technique during dry and wet seasons. Mass loss was the highest (49% and 57%) forA. heterophyllusand the lowest (25%) was found forL. chinensis. The highest initial rates (0.75% and 2.35%/day) of decomposition were observed forZ. jujubaand the lowest (0.50% and 0.79%/day) forL. chinensis. The highest decay constant was observed forA. heterophyllus(2.14 and 2.34) and the lowest (0.88 and 0.94) forL. chinensis. Leaf litter of all the studied species showed a similar pattern (K > N > P) of nutrient release during the decomposition process.Zizyphus jujubashowed comparatively higher return of N, P, and K than others. However, a significant (P<0.05) higher amount of mass loss, rate of decomposition, decay constant, and amount of nutrient return from leaf litter were observed during the wet season.
Mast Cells Density Positive to Tryptase Correlates with Angiogenesis in Pancreatic Ductal Adenocarcinoma Patients Having Undergone Surgery
Authors: Ammendola Michele , Sacco Rosario , Sammarco Giuseppe , Donato Giuseppe , Zuccalà Valeria , Luposella Maria , Patruno Rosa , Marech Ilaria , Montemurro Severino , Zizzo Nicola , Gadaleta Cosmo Damiano , Ranieri Girolamo
Published: June 2014

Background. Literature data suggest that cells such as mast cells (MCs), are involved in angiogenesis. MCs can stimulate angiogenesis by releasing of several proangiogenic cytokines stored in their cytoplasm. In particular MCs can release tryptase, a potentin vivoandin vitroproangiogenic factor. Nevertheless few data are available concerning the role of MCs positive to tryptase in primary pancreatic cancer angiogenesis. This study analyzed MCs and angiogenesis in primary tumour tissue from patients affected by pancreatic ductal adenocarcinoma (PDAC).Method. A series of 31 PDAC patients with stageT2-3N0-1M0(by AJCC for Pancreas Cancer Staging 7th Edition) was selected and then underwent surgery. Tumour tissue samples were evaluated by means of immunohistochemistry and image analysis methods in terms of number of MCs positive to tryptase (MCDPT), area occupied by MCs positive to tryptase (MCAPT), microvascular density (MVD), and endothelial area (EA). The above parameters were related to each other and to the main clinicopathological features.Results. A significant correlation between MCDPT, MCAPT, MVD, and EA group was found by Pearson’st-test analysis (rranged from 0.69 to 0.81;Pvalue ranged from 0.001 to 0.003). No other significant correlation was found.Conclusion. Our pilot data suggest that MCs positive to tryptase may play a role in PDAC angiogenesis and they could be further evaluated as a novel tumour biomarker and as a target of antiangiogenic therapy.
Is Dopamine an Iatrogenic Disruptor of Thyroid and Cortisol Function in the Extremely Premature Infant?
Authors: Ng Sze M. , Watson Gabriella , Turner Mark A. , Newland Paul , Weindling A. Michael
Published: June 2014

Background. Dopamine is frequently used as an inotropic and vasoactive agent in neonatal intensive care units. Recent studies have reported that treatment with dopamine is associated with hypothyroxinaemia of prematurity. Objectives. The aim of this study was to determine if dopamine treatment in extremely premature infants altered thyroid and cortisol function. Methods. We prospectively measured plasma cortisol, TSH, free T4, total T4, and free triiodothyronine concentrations in babies born below 28 weeks’ gestation within 5 days of birth, who were either treated with dopamine (D+) or who did not receive any dopamine (D−) within 12 hours of birth. Clinical Risk Index for Babies scores, lowest mean arterial pressure and highest plasma lactate concentrations in the first 12 hours, were recorded. Results. There were 78 babies included in the study (43 males). Mean gestational age was 25 weeks and 3 days (SD 1.3 weeks). Univariate analyses showed significant differences in cortisol and thyroid function between D+ and D−. Multivariable analyses showed that dopamine, gestation, and CRIB were independent factors affecting FT4 concentrations. No independent factors were shown to affect cortisol or TSH concentrations. Conclusion. Dopamine administration appeared to affect FT4 concentrations but not cortisol concentrations. The mechanisms are unclear but the effect does not appear to be related to hypotension or tissue underperfusion.
Risk Prediction Models for Melanoma: A Systematic Review
Authors: Usher-Smith Juliet A. , Emery Jon , Kassianos Angelos P. , Walter Fiona M.
Published: June 2014

Melanoma incidence is increasing rapidly worldwide among white-skinned populations. Earlier diagnosis is the principal factor that can improve prognosis. Defining high-risk populations using risk prediction models may help targeted screening and early detection approaches. In this systematic review, we searched Medline, EMBASE, and the Cochrane Library for primary research studies reporting or validating models to predict risk of developing cutaneous melanoma. A total of 4,141 articles were identified from the literature search and six through citation searching. Twenty-five risk models were included. Between them, the models considered 144 possible risk factors, including 18 measures of number of nevi and 26 of sun/UV exposure. Those most frequently included in final risk models were number of nevi, presence of freckles, history of sunburn, hair color, and skin color. Despite the different factors included and different cutoff values for sensitivity and specificity, almost all models yielded sensitivities and specificities that fit along a summary ROC with area under the ROC (AUROC) of 0.755, suggesting that most models had similar discrimination. Only two models have been validated in separate populations and both also showed good discrimination with AUROC values of 0.79 (0.70–0.86) and 0.70 (0.64–0.77). Further research should focus on validating existing models rather than developing new ones. Cancer Epidemiol Biomarkers Prev; 23(8); 1450–63. ©2014 AACR.
Influence of Biospecimen Variables on Proteomic Biomarkers in Breast Cancer
Authors: Meric-Bernstam Funda , Akcakanat Argun , Chen Huiqin , Sahin Aysegul , Tarco Emily , Carkaci Selin , Adrada Beatriz E. , Singh Gopal , Do Kim-Anh , Garces Zerzhinski M. , Mittendorf Elizabeth , Babiera Gildy , Bedrosian Isabelle , Hwang Rosa , Krishnamurthy Savitri , Symmans William F. , Gonzalez-Angulo Ana Maria , Mills Gordon B.
Published: June 2014

Background: PI3K/Akt/mTOR signaling is being actively pursued as a therapeutic target for breast cancer. We sought to determine if tumor heterogeneity and biospecimen variables affect the evaluation of PI3K/Akt/mTOR pathway markers.

Methods: Intraoperative image-guided core-needle biopsies (CNB), and central and peripheral surgical tumor specimens were prospectively collected in 53 patients with invasive breast cancer. Specimens were assessed with reverse-phase protein arrays (RPPA) and immunohistochemistry (IHC).

Results: There was a moderate or strong correlation between the expression of 149 (97%) of the 154 different RPPA markers in the center and periphery. Correlation was higher for smaller tumors, in patients who did not undergo neoadjuvant therapy, and with shorter cold ischemia time. Of 154 markers, 132 (86%) were not statistically different between the center and periphery, and 97 (63%) were not different between the CNB and the surgical specimen (average of the central and peripheral specimen). pAkt S473 and PTEN had a significant correlation between central and peripheral specimens, and between CNB and surgical specimen. However, pAkt S473, pS6 S235/236, and pS6 240/244 levels were significantly higher in CNB than the central specimens both by RPPA and by IHC.

Conclusions: Most individual proteomic biomarkers studied do not have significant intratumoral heterogeneity. However, protein and phosphoprotein levels are affected by biospecimen type and other preanalytic variables. PI3K pathway activation is greater in CNB compared with postexcision surgical samples suggesting a potential loss of phosphorylation during surgical manipulation, or with cold ischemia of surgical specimens. Clin Cancer Res; 20(14); 3870–83. ©2014 AACR.
Blocking Immunosuppressive Checkpoints for Glioma Therapy: The More the Merrier!
Authors: Castro Maria G. , Baker Gregory J. , Lowenstein Pedro R.
Published: May 2014

Immunosuppressive checkpoints mediated by IDO, CTLA4, and PD1/PDL1 play a critical role in glioma progression and the efficacy of immunotherapies. Combined blockade of these immunosuppressive checkpoints in a glioma model elicited long-term survival. This combined blockade adds to the armamentarium of anti-glioma therapies, which could be implemented in clinical trials. Clin Cancer Res; 20(20); 5147–9. ©2014 AACR.
Breast Cancer Cell Apoptosis with Phytoestrogens Is Dependent on an Estrogen-Deprived State
Authors: Obiorah Ifeyinwa E. , Fan Ping , Jordan V. Craig
Published: June 2014

Phytoestrogens have been investigated as natural alternatives to hormone replacement therapy and their potential as chemopreventive agents. We investigated the effects of equol, genistein, and coumestrol on cell growth in fully estrogenized MCF7 cells, simulating the perimenopausal state, and long-term estrogen-deprived MCF7:5C cells, which simulate the postmenopausal state of a woman after years of estrogen deprivation, and compared the effects with that of steroidal estrogens: 17β estradiol (E2) and equilin present in conjugated equine estrogen. Steroidal and phytoestrogens induce proliferation of MCF7 cells at physiologic concentrations but inhibit the growth and induce apoptosis of MCF7:5C cells. Although steroidal and phytoestrogens induce estrogen-responsive genes, their antiproliferative and apoptotic effects are mediated through the estrogen receptor. Knockdown of ERα using siRNA blocks all estrogen-induced apoptosis and growth inhibition. Phytoestrogens induce endoplasmic reticulum stress and inflammatory response stress–related genes in a comparable manner as the steroidal estrogens. Inhibition of inflammation using dexamethasone blocked both steroidal- and phytoestrogen-induced apoptosis and growth inhibition as well as their ability to induce apoptotic genes. Together, this suggests that phytoestrogens can potentially be used as chemopreventive agents in older postmenopausal women but caution should be exercised when used in conjunction with steroidal anti-inflammatory agents due to their antiapoptotic effects. Cancer Prev Res; 7(9); 939–49. ©2014 AACR.
Perceptual Assimilation and Discrimination of Non-Native Vowel Contrasts
Authors: Tyler Michael D. , Best Catherine T. , Faber Alice , Levitt Andrea G.
Published: June 2014

Research on language-specific tuning in speech perception has focused mainly on consonants, while that on non-native vowel perception has failed to address whether the same principles apply. Therefore, non-native vowel perception was investigated here in light of relevant theoretical models: the Perceptual Assimilation Model (PAM) and the Natural Referent Vowel (NRV) framework. American-English speakers completed discrimination and native language assimilation (categorization and goodness rating) tests on six nonnative vowel contrasts. Discrimination was consistent with PAM assimilation types, but asymmetries predicted by NRV were only observed for single-category assimilations, suggesting that perceptual assimilation might modulate the effects of vowel peripherality on non-native vowel perception. © 2014 S. Karger AG, Basel
Bicuspid Aortic Valve Morphology and Associated Cardiovascular Abnormalities in Fetal Turner Syndrome: A Pathomorphological Study
Authors: van Engelen Klaartje , Bartelings Margot M. , Gittenberger-de Groot Adriana C. , Baars Marieke J.H. , Postma Alex V. , Bijlsma Emilia K. , Mulder Barbara J.M. , Jongbloed Monique R.M.
Published: June 2014

Introduction: Bicuspid aortic valve (BAV) is common in Turner syndrome (TS). In adult TS, 82-95% of BAVs have fusion of the right and left coronary leaflets. Data in fetal stages are scarce. The purpose of this study was to gain insight into aortic valve morphology and associated cardiovascular abnormalities in a fetal TS cohort with adverse outcome early in development. Material and Methods: We studied post-mortem heart specimens of 36 TS fetuses and 1 TS newborn. Results: BAV was present in 28 (76%) hearts. BAVs showed fusion of the right and left coronary leaflet (type 1 BAV) in 61%, and fusion of the right coronary and non-coronary leaflet (type 2 BAV) in 39%. There were no significant differences in occurrence of additional cardiovascular abnormalities between type 1 and type 2 BAV. However, all type 2 BAV hearts showed ascending aorta hypoplasia and tubular hypoplasia of the B segment, as opposed to only 55 and 64% of type 1 BAV hearts, respectively. Discussion: The proportion of type 2 BAV seems higher in TS fetuses than in adults. Fetal type 2 BAV hearts all had severe aortic pathology, possibly contributing to a worse prognosis of type 2 than type 1 BAV in TS.
Wireless Accelerometry is Feasible in Acute Monitoring of Upper Limb Motor Recovery after Ischemic Stroke
Authors: Le Heron Campbell , Fang Kun , Gubbi Jayavardhana , Churilov Leonid , Palaniswami Marimuthu , Davis Stephen , Yan Bernard
Published: June 2014

Background: Clinical deterioration in the acute stage of ischemic stroke powerfully predicts outcome and may serve as a marker for urgent intervention. However, accurate monitoring of acute stroke patients is hampered by the lack of validated continuous monitoring devices. We sought to assess the use of wireless accelerometry in this setting, hypothesizing that stroke patients would have a greater difference in movement between upper limbs than controls and that the magnitude of correlation between upper limb movements would be negatively associated with the National Institutes of Health Stroke Scale (NIHSS) score. Methods: In this pilot study, 20 patients with acute ischemic stroke and unilateral upper limb weakness and 10 controls were recruited from a comprehensive stroke centre. All subjects were fitted with two 3-axis accelerometers and underwent 24 h of continuous accelerometry recording of upper limb movements and repeat NIHSS assessments. The intra-class correlation coefficient (ICC), assessing the similarity (or otherwise) of spontaneous movements in each arm was calculated. The association between NIHSS (total and motor subset scores) and the magnitude of ICC was estimated by Spearman's rank correlation, receiver-operating characteristic curve analysis was performed and the optimal diagnostic threshold value of ICC was calculated. Results: The magnitude of the ICC was significantly associated with the baseline NIHSS score (p = 0.02) and non-significantly associated with the baseline NIHSS motor score (p = 0.08). At the optimal diagnostic threshold of ICC magnitude = 0.7, wireless accelerometry distinguished patients from controls with a sensitivity of 0.95, a specificity of 0.6 and a diagnostic odds ratio of 28.5. Conclusions: The wireless accelerometry system successfully detects a motor deficit in the setting of acute ischemic stroke, accurately differentiating patients from controls, and correlates well with the baseline NIHSS score. Its use is feasible in the acute stroke setting. Overall, it shows promise as a diagnostic tool to continuously monitor acute stroke patients but requires validation in a larger trial.
The Effect of Physical Effort on Voice Characteristics
Authors: Primov-Fever Adi , Lidor Ronnie , Meckel Yoav , Amir Ofer
Published: June 2014

Background: Individuals using their voice intensively during physical effort are at risk for developing voice problems. This study was aimed at examining the influence of physical activity on voice characteristics. Methods: Fourteen physical education students (age: 27 ± 4.23 years) were recorded in a resting position, and during mild, moderate, and high exercise intensities (active conditions). Participants were also recorded immediately after each activity, while standing (recovery condition). All recordings were analyzed acoustically. Results: A significant elevation in the fundamental frequency (F0) was observed with the increase in activity level (p < 0.05). For all other acoustic measures, a gradual increase was observed as the activity level was raised. This increase was statistically significant for a specific set of measures (jitter, PPQ5, and shimmer) during the active conditions. In most cases, significant contrasts were found only between the high activity level and the other levels. During the recovery conditions, a similar increase in values was observed. However, these findings failed to reach statistical significance. Conclusion: Findings imply that high levels of physical effort lead to a significant reduction in vocal stability and to an elevation in F0. These changes result from vocal effort and could therefore lead to voice disorders and pathology.
Anti-Carbonic Anhydrase II Antibodies in End-Stage Renal Disease Patients
Authors: Alver Ahmet , Menteşe Ahmet , Menteşe Ümit , Sümer Ayşegül , Uçar Fahri , Us Altay Diler
Published: June 2014

Objective: The aim of this study was to investigate the presence of anti-carbonic anhydrase (CA II) autoantibodies in patients with end-stage renal disease (ESRD) and relationships between the autoantibody titers and ghrelin, glucose, blood urea nitrogen (BUN) and creatinine. Subjects and Methods: Serum CA II autoantibody titers, malondialdehyde (MDA), BUN, creatinine and ghrelin levels were measured in 45 ESRD patients and 45 healthy subjects. Results: The CA II autoantibody titers in the ESRD group (0.170 ± 0.237) were significantly higher than those in the control group (0.079 ± 0.032; p = 0.035). MDA and ghrelin levels were also significantly higher in the ESRD group (p < 0.001). A weak positive correlation was determined between anti-CA II antibody titers and MDA, and a negative correlation was observed between ghrelin levels and anti-CA II antibody titers (r = 0.287, p = 0.028 and r = -0.278, p = 0.032, respectively). Conclusions: In ESRD patients, the results showed the development of an autoimmune response against CA II. This suggests that anti-CA II antibodies could be involved in the pathogenesis of ESRD.
Perforation and Bacterial Contamination of Microscope Covers in Lumbar Spinal Decompressive Surgery
Authors: Osterhoff Georg , Spirig José , Klasen Jürgen , Kuster Stefan P. , Zinkernagel Annelies S. , Sax Hugo , Min Kan
Published: June 2014

Objective: To determine the integrity of microscope covers and bacterial contamination at the end of lumbar spinal decompressive surgery. Materials and Methods: A prospective study of 25 consecutive lumbar spinal decompressions with the use of a surgical microscope was performed. For detection of perforations, the microscope covers were filled with water at the end of surgery and the presence of water leakage in 3 zones (objective, ocular and control panel) was examined. For detection of bacterial contamination, swabs were taken from the covers at the same locations before and after surgery. Results: Among the 25 covers, 1 (4%) perforation was observed and no association between perforation and bacterial contamination was seen; 3 (4%) of 75 smears from the 25 covers showed post-operative bacterial contamination, i.e. 2 in the ocular zone and 1 in the optical zone, without a cover perforation. Conclusions: The incidence of microscope cover perforation was very low and was not shown to be associated with bacterial contamination. External sources of bacterial contamination seem to outweigh the problem of contamination due to failure of cover integrity.
Shifts in Hormonal Stress Reactivity during Adolescence Are Not Associated with Changes in Glucocorticoid Receptor Levels in the Brain and Pituitary of Male Rats
Authors: Dziedzic Noelle , Ho Amy , Adabi Bita , Foilb Allison R. , Romeo Russell D.
Published: June 2014

Preadolescent animals display protracted hormonal stress responses mediated by the hypothalamic-pituitary-adrenal (HPA) axis compared to adults. Though the mechanisms that underlie this shift in stress reactivity are unknown, reduced glucocorticoid-dependent negative feedback on the HPA axis has been posited to contribute to this differential responsiveness. As the glucocorticoid receptors (GRs) are integral to this feedback response, we hypothesize that prior to puberty there will be fewer GRs in the neural-pituitary network that mediate negative feedback. To test this hypothesis we measured GR protein levels in the brains of preadolescent (28 days old), midadolescent (40 days old) and adult (77 days old) male rats via immunohistochemistry. Additionally, we assessed stress-induced plasma adrenocorticotropic hormone and corticosterone in prepubertal (30 days old) and adult (70 days old) male rats and examined GR protein levels via Western blot in the brain and pituitary. We found that despite substantial adolescent-related changes in hormonal responsiveness, no significant differences were found between these ages in GR protein levels in regions that are important in negative feedback, including the medial prefrontal cortex, paraventricular nucleus of the hypothalamus, hippocampal formation, and pituitary. These data indicate that the extended hormonal stress response exhibited by preadolescent animals is independent of significant pubertal changes in GR protein levels.
Cushing's Syndrome in a Morbidly Obese Patient Undergoing Evaluation before Bariatric Surgery
Authors: Borsoi Livia , Ludvik Bernhard , Prager Gerhard , Luger Anton , Riedl Michaela
Published: June 2014

Objective: Cushing's syndrome (CS) is extremely rare in morbidly obese patients. To date, no occurrences in obese patients with BMI above 60 kg/m2 have been reported in the literature. Case Report: This case report describes a patient who was admitted to the ward of the Clinical Division of Endocrinology and Metabolism of the Medical University of Vienna in preparation for bariatric surgery. The patient was a 49-year-old female who showed morbid obesity (BMI 61.6 kg/m2), hypertension, and substituted hypothyroidism. Preoperative work-up revealed CS due to an adrenal adenoma. Therefore, the patient underwent unilateral adrenalectomy followed by bariatric surgery 6 months later. Conclusion: Since undiagnosed CS might result in severe perioperative complications in a population already at increased risk, this case report underlines the importance of careful endocrine evaluation of morbidly obese patients. After all, even rare endocrine causes should be excluded.
Nephrectomy in Autosomal Dominant Polycystic Kidney Disease: A Patient with Exceptionally Large, Still Functioning Kidneys
Authors: Spithoven Edwin M. , Casteleijn Niek F. , Berger Paul , Goldschmeding Roel
Published: June 2014

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. It is characterized by progressive cyst formation in both kidneys, often leading to end-stage kidney disease. Indications for surgical removal of an ADPKD kidney include intractable pain, hematuria, infection, or exceptional enlargement and small abdominal cavity hampering implantation of a donor kidney. We report the case of an extraordinarily large ADPKD kidney weighing 8.7 kg (19.3 lb) with a maximal length of 48 cm (19 inch), and with cysts filled with both clear and bloody fluid.
Noninducibility in Postinfarction Ventricular Tachycardia as an End Point for Ventricular Tachycardia Ablation and Its Effects on Outcomes
Authors: Ghanbari Hamid , Baser Kazim , Yokokawa Miki , Stevenson William , Della Bella Paolo , Vergara Pasquale , Deneke Thomas , Kuck Karl-Heinz , Kottkamp Hans , Fei She , Morady Fred , Bogun Frank
Published: May 2014

Background—

Although ventricular tachycardia (VT) ablation is a widely used therapy for patients with VT, the ideal end points for this procedure are not well defined. We performed a meta-analysis of the published literature to assess the predictive value of noninducibility of postinfarction VT for long-term outcomes after VT ablation.

Methods and Results—

We performed a systematic review of MEDLINE (1950–2013), EMBASE (1988–2013), the Cochrane Controlled Trials Register (Fourth Quarter, 2012), and reports presented at scientific meetings (1994–2013). Randomized controlled trials, case–control, and cohort studies of VT ablation were included. Outcomes reported in eligible studies were freedom from VT/ventricular fibrillation and all-cause mortality. Of the 3895 studies evaluated, we identified 8 cohort studies enrolling 928 patients for the meta-analysis. Noninducibility after VT ablation was associated with a significant increase in arrhythmia-free survival compared with partial success (odds ratio, 0.49; 95% confidence interval, 0.29–0.84;
P
=0.009) or failed ablation procedure (odds ratio, 0.10; 95% confidence interval, 0.06–0.18;
P
<0.001). There was also a significant reduction in all-cause mortality if patients were noninducible after VT ablation compared with patients with partial success (odds ratio, 0.59; 95% confidence interval, 0.36–0.98;
P
=0.04) or failed ablation (odds ratio, 0.32; 95% confidence interval, 0.10–0.99;
P
=0.049).

Conclusions—

Noninducibility of VT after VT ablation is associated with improved arrhythmia-free survival and all-cause mortality.