bluuebunny/crossref_metadata_2025 huggingface dataset:
Adolescents' views and experiences of treatments for Type 2 diabetes: a qualitative study
Authors: Turner K. M. , Percival J. , Dunger D. B. , Olbers T. , Barrett T. , Shield J. P. H.
Published: September 2014

Aim

To explore adolescents' views and experiences of different treatments for Type 2 diabetes, in order to improve treatment concordance and consider how the current treatment pathway for adolescent Type 2 diabetes could be improved.

Methods

In‐depth interviews were held with 12 adolescents who had been diagnosed with Type 2 diabetes. Adolescents were sampled from a UK cohort study. Data were analysed thematically.

Results

Interviewees struggled to maintain lifestyle changes. Insulin, metformin and liraglutide were described as effective but, in some cases, as resulting in side effects. Injected treatments were viewed less favourably than oral medications. Weight loss surgery was considered an acceptable treatment for obese adolescents who had tried other treatments for their diabetes. It was apparent that some adolescents had not been surprised by their diagnosis and did not fully appreciate the implications of having diabetes. It was also evident that some individuals had not told peers about their diagnosis due to fearing how they would react. Factors identified as improving treatment concordance included reminders and viewing treatment as effective and easy to take.

Conclusions

Adolescents want treatments that are effective, discrete, easy to take and do not make them different from their peers. As liraglutide was described as effective, and surgery viewed as acceptable in certain circumstances, greater consideration should be given to their potential role in treating adolescent Type 2 diabetes. Practitioners need to ensure that adolescents appreciate the implications of having diabetes and may want to address adolescents' concerns regarding how others view this condition.
Dorothy Hodgkin Lecture 2014 Understanding genes identified by genome‐wide association studies for Type 2 diabetes
Authors: Rutter G. A.
Published: September 2014

Whilst the heritable nature of Type 2 diabetes has been recognized for many years, only in the past two decades have linkage analyses in families and genome‐wide association studies in large populations begun to reveal the genetic landscape of the disease in detail. Whilst the former have provided a powerful means of identifying the genes responsible for monogenic forms of the disease, the latter highlight relatively large genomic regions. These often harbour multiple genes, whose relative contribution to exaggerated disease risk is uncertain. In the present study, the approaches that have been used to dissect the role of just a few (TCF7L2, SLC30A8, ADCY5, MTNR1B and CDKAL1) of the ~ 500 genes identified at dozens of implicated loci are described. These are usually selected based on the strength of their effect on disease risk, and predictions as to their likely biological role. Direct determination of the effects of identified polymorphisms on gene expression in disease‐relevant tissues, notably the pancreatic islet, are then performed to identify genes whose expression is affected by a particular polymorphism. Subsequent functional analyses then involve perturbing gene expression in vitro in β‐cell lines or isolated islets and in vivo in animal models. Although the majority of polymorphisms affect insulin production rather than action, and mainly affect the β cell, effects via other tissues may also contribute, requiring careful consideration in the design and interpretation of experiments in model systems. These considerations illustrate the scale of the task needed to exploit genome‐wide association study data for the development of new therapeutic strategies.
Obstructive sleep apnoea in people with Type 1 diabetes: prevalence and association with micro‐ and macrovascular complications
Authors: Manin G. , Pons A. , Baltzinger P. , Moreau F. , Iamandi C. , Wilhelm J. M. , Lenoble P. , Kessler L. , Kessler R.
Published: September 2014

Aims

Few reports have assessed the relationship between Type 1 diabetes and sleep disorders. The purposes of our study were to determine the prevalence of obstructive sleep apnoea in Type 1 diabetes and to compare the clinical profile of people with Type 1 diabetes with or without obstructive sleep apnoea.

Methods

In this cross sectional study of 67 consecutive people with Type 1 diabetes, we performed polysomnography as part of their yearly check‐ups.

Results

In our cohort, with a mean BMI of 25.8 ± 4.7 kg/m2, the prevalence of obstructive sleep apnoea [apnoea–hypopnoea index (AHI) > 10/h] was 46%. Severe obstructive sleep apnoea (AHI ≥ 30/h) was present in 19% of the patients. We found no significant differences in age, sex, body mass index, HbA1c or Epworth sleepiness scale score between people with or without obstructive sleep apnoea. People with obstructive sleep apnoea had a longer course of diabetes mellitus (P < 0.01) and a higher prevalence of retinopathy (P < 0.01), neuropathy (P = 0.05), cardiovascular disease (P < 0.01) and hypertension (P < 0.01). The occurrence of macrovascular complications was independently associated with the presence of OSA [odds ratio (OR) 8.28; 95% confidence interval (CI), 1.56–43.97; P = 0.013] and the duration of diabetes (OR 1.08; 95% CI, 1.02–1.15; P = 0.01). Moreover, retinopathy was independently associated with OSA (OR 4.54; 95% CI, 1.09–18.82; P = 0.04) and the duration of diabetes (OR 1.09; 95% CI, 1.04–1.15; P = 0.001).

Conclusions

The prevalence of obstructive sleep apnoea was high in people with Type 1 diabetes. Obstructive sleep apnoea was independently associated with macrovascular complications and retinopathy. Obesity and excessive daytime sleepiness were uncommon in this population.
Inhibition of the amygdala central nucleus by stimulation of cerebellar output in rats: a putative mechanism for extinction of the conditioned fear response
Authors: Magal Ari , Mintz Matti
Published: September 2014

The amygdala and the cerebellum serve two distinctively different functions. The amygdala plays a role in the expression of emotional information, whereas the cerebellum is involved in the timing of discrete motor responses. Interaction between these two systems is the basis of the two‐stage theory of learning, according to which an encounter with a challenging event triggers fast classical conditioning of fear‐conditioned responses in the amygdala and slow conditioning of motor‐conditioned responses in the cerebellum. A third stage was hypothesised when an apparent interaction between amygdala and cerebellar associative plasticity was observed: an adaptive rate of cerebellum‐dependent motor‐conditioned responses was associated with a decrease in amygdala‐dependent fear‐conditioned responses, and was interpreted as extinction of amygdala‐related fear‐conditioned responses by the cerebellar output. To explore this hypothesis, we mimicked some components of classical eyeblink conditioning in anesthetised rats by applying an aversive periorbital pulse as an unconditioned stimulus and a train of pulses to the cerebellar output nuclei as a cerebellar neuronal‐conditioned response. The central amygdala multiple unit response to the periorbital pulse was measured with or without a preceding train to the cerebellar output nuclei. The results showed that activation of the cerebellar output nuclei prior to periorbital stimulation produced diverse patterns of inhibition of the amygdala response to the periorbital aversive stimulus, depending upon the nucleus stimulated, the laterality of the nucleus stimulated, and the stimulus interval used. These results provide a putative extinction mechanism of learned fear behavior, and could have implications for the treatment of pathologies involving abnormal fear responses by using motor training as therapy.
Increased number of teeth predict acquisition of mutans streptococci in infants
Authors: Nelson Suchitra , Albert Jeffery M. , Soderling Eva , Malik Anchal , Curtan Shelley , Geng Cuiyu , Milgrom Peter
Published: September 2014

This longitudinal study of 194 very‐low birthweight (VLBW) and 184 normal birthweight (NBW) infants hypothesized that the causal pathway between birth group (VLBW or NBW) and mutans streptococci (MS) acquisition (presence) at 18–20 months is mediated by biological, behavioral, and caregiver MS levels. Biological (number of teeth at 8 and 18–20 months and enamel hypoplasia) and behavioral (brushing/cleaning, sweet snacks, breastfeeding, and dental access) factors were assessed using dental examinations and caregiver questionnaire responses at 8 and 18–20 months. Infant MS acquisition and caregiver MS levels were assessed from saliva and plaque samples collected at 8 and 18–20 months. Structural equation modeling evaluated the causal pathway with latent variables for biology and behavior. Mutans streptococci presence was similar between birth groups at 18–20 months (40% in VLBW infants and 49% in NBW infants), but was significantly higher for NBW infants at 8 months. Increased number of teeth at 8 and 18–20 months was associated with biological risk. Infants whose caregivers had a 1‐point higher score on MS had a significantly (1.5) higher odds of MS presence. Caregiver behavior was not associated with MS presence. Early‐intervention efforts should focus on delaying initial acquisition and improving caregiver awareness of taking care of erupting primary teeth.
Financial Clarity: Education, Literacy, Capability, Counseling, Planning, and Coaching
Authors: Delgadillo Lucy M.
Published: September 2014

This conceptual paper discusses the definitions of financial education, financial literacy, financial capability, financial counseling, financial planning, and financial coaching. Financial therapy is mentioned briefly but it will be addressed in a subsequent paper. Because the definitions of these concepts are not universally accepted, the terms are often used interchangeably. Therefore, the goal of the paper is to initiate dialogue about the meaning of the terms and their usage among educators, practitioners, and researchers. To relieve the lack of clarity, implications are presented for research, training, and intervention programs.
Preparing a Manuscript for Publication
Authors: Adams Rebecca A.
Published: September 2014

The phrase “publish or perish” might not be spoken among faculty colleagues, but it reverberates in the minds of young untenured professionals (Sadler, ). The need to publish in a professional journal also exists for other faculty members seeking to share their research. The purpose of this essay is to provide assistance in getting manuscripts accepted for publication in peer‐reviewed journals.
Cryptic diversity within the rotifer Polyarthra dolichoptera along an altitudinal gradient
Authors: Obertegger Ulrike , Flaim Giovanna , Fontaneto Diego
Published: September 2014

Cryptic species (species that are difficult or impossible to distinguish morphologically) are found worldwide and neglecting them may hamper our understanding of species‐environment relationships. The rotifer Polyarthra dolichoptera occurs across wide environmental gradients, indicating the potential for a cryptic species complex. We used P. dolichoptera as a model to investigate spatial patterns and relationships of cryptic species with environmental variables along a broad altitudinal gradient.

We sequenced 575 specimens of Polyarthra from 42 waterbodies from Germany, Hungary and Italy sampled in summer. Thirty‐five lakes were distributed along an altitudinal gradient (250–2564 m a.s.l.) in a geographically restricted area, the Trentino–South Tyrol region, Italy, and one lake (Lake Tovel) was sampled in two basins and at different depths year‐round to investigate temporal and spatial patterns of cryptic species. We used the Generalised Mixed Yule Coalescent model to delimit cryptic species (GMYC entities) based on a phylogenetic tree and related their presence/absence to space and the environment by applying Mantel tests and variance partitioning.

We found twelve GMYC entities of P. dolichoptera. In variance partitioning, most explained variability was attributed to the interaction between space and altitude and by environmental variables and geographical space alone. However, by splitting the data into sets of low‐ and high‐altitude lakes, the strong effect of altitude was removed; conductivity and silica played a major role in high‐altitude lakes, whereas neither environment nor space were related to entity occurrence in low‐altitude lakes. In Lake Tovel, three cryptic entities were found that did not show spatial segregation; however, two entities showed temporal segregation while the third one occurred throughout the year.

Our study showed that P. dolichoptera is a complex of species which distribution is driven by geography and environmental parameters whose importance is different in low‐ and high‐altitude lakes. Considerable unexplained variability points to a major contribution of other variables, potentially in‐lake properties such as competition, predation and species behaviour.
Are Homes Near Water Bodies and Wetlands Worth More or Less? An Analysis of Housing Prices in One Connecticut Town
Authors: Cohen Jeffrey P. , Cromley Robert G. , Banach Kevin T.
Published: September 2014

Proximity to wetlands and water bodies can be considered an amenity (for open space and recreation value), as well as a possible nuisance (with the potential for flooding or development restrictions), although the overall effect may be different depending on location. Studies of the impacts of wetlands and water on housing prices can also be prone to spatial autocorrelation problems arising from omitted unobservables. McMillen and Redfearn explain that locally weighted regressions (LWRs) can address spatial autocorrelation. In addition to ordinary least squares (OLS), we use LWR to control for spatial effects and analyze how proximity to water bodies and wetland areas impact real sales prices of homes in one Connecticut town in 2000–2009. With OLS regressions, proximity to wetland areas and water bodies are insignificant determinants of the real sale price of homes. When we control for spatial effects with a nonparametric (i.e., LWR) approach, the significance of the water variable is different than from OLS—while greater distance from wetlands leads to an insignificant relationship with housing price, the water distance effect becomes negative and significant. These results imply that incorporating potential spatial heterogeneity in the data is crucial for accurately estimating the direction, magnitudes, and statistical significance of the relationships between environmental variables and housing prices.
Deletion of the α2A/α2C‐adrenoceptors accelerates cutaneous wound healing in mice
Authors: Romana‐Souza Bruna , Nascimento Adriana P. , Brum Patricia C. , Monte‐Alto‐Costa Andréa
Published: September 2014

The α2‐adrenoceptors regulate the sympathetic nervous system, controlling presynaptic catecholamine release. However, the role of the α2‐adrenoceptors in cutaneous wound healing is poorly understood. Mice lacking both the α2A/α2C‐adrenoceptors were used to evaluate the participation of the α2‐adrenoceptor during cutaneous wound healing. A full‐thickness excisional lesion was performed on the dorsal skin of the α2A/α2C‐adrenoceptor knockout and wild‐type mice. Seven or fourteen days later, the animals were euthanized and the lesions were formalin‐fixed and paraffin‐embedded or frozen. Murine skin fibroblasts were also isolated from α2A/α2C‐adrenoceptor knockout and wild‐type mice, and fibroblast activity was evaluated. The in vivo study demonstrated that α2A/α2C‐adrenoceptor depletion accelerated wound contraction and re‐epithelialization. A reduction in the number of neutrophils and macrophages was observed in the α2A/α2C‐adrenoceptor knockout mice compared with wild‐type mice. In addition, α2A/α2C‐adrenoceptor depletion enhanced the levels of nitrite and hydroxyproline, and the protein expression of transforming growth factor‐β and vascular endothelial growth factor. Furthermore, α2A/α2C‐adrenoceptor depletion accelerated blood vessel formation and myofibroblast differentiation. The in vitro study demonstrated that skin fibroblasts isolated from α2A/α2C‐adrenoceptor knockout mice exhibited enhanced cell migration, α‐smooth muscle actin _protein expression and collagen deposition compared with wild‐type skin fibroblasts. In conclusion, α2A/α2C‐adrenoceptor deletion accelerates cutaneous wound healing in mice.
Consumer understanding, perceptions and behaviours with regard to environmentally friendly packaging in a developing nation
Authors: Scott Lyndsey , Vigar‐Ellis Debbie
Published: September 2014

There has been very little research conducted into sustainable consumption patterns, knowledge and attitudes in relation to environmentally friendly packaging in South Africa. Market research that has been conducted in relation to sustainable consumption has largely been based on overseas studies and is therefore limited in that its reflection of information is from a first world country perspective. Environmental knowledge has been found to impact environmentally friendly behaviour both directly and indirectly. Both quantitative and qualitative data were collected to investigate South African respondents' understanding (knowledge) and perceptions of environmentally friendly packaging as well as the extent to which they exhibited green behaviour with regard to environmentally friendly packaging activities such as reusing and recycling.

The data gathered for this study were collected by means of a questionnaire distributed to respondents using snowball sampling through Facebook networks. The snowball sample required respondents to answer the questionnaire and pass it on to other Facebook users. The unique benefit of this study is that it is conducted in a developing nation where issues such as sustainable consumption are new and evolving. There is limited promotion or implementation of environmentally responsible practices by authorities or industry. South African consumers in this study were found to exhibit limited knowledge of what environmentally friendly packaging is, how to differentiate it from normal packaging, as well as its benefits. However, actions are even less evident with regard to environmentally friendly packaging. Recommendations of how to improve knowledge as well as facilitate purchase of environmentally friendly packaging are provided.
Non‐Participation: How Age Influences Inactive Women's Views of Exercise
Authors: Milne Marcia , Divine Alison , Hall Craig , Gregg Melanie , Hardy James
Published: September 2014

Physical activity studies have often excluded women, resulting in limited information regarding the influences on women's non‐participation. The present study aimed to explore the exercise views and cognitions of inactive adult women. Forty women aged 25–75 took part in the focus groups. Themes that emerged from the interviews included merits of exercise, thoughts and feelings, knowledge, barriers, and strategies. Results indicated that inactivity is due to a variety of culminating factors; health‐promotion strategies need to specifically target different age groups. These strategies include increasing awareness of the social and psychological benefits of exercise, exercise as a supplement to activities of daily living, changing the perception of what constitutes exercise, and representing exercisers as a variety of ages and body shapes.
Assessing and Monitoring Post‐Traumatic Stress Disorder Through Natural Interaction With an Adaptive Dialogue System
Authors: Papangelis Alexandros , Makedon Fillia , Gatchel Robert
Published: September 2014

We present an Adaptive Dialogue System, able to make conversation in natural language with post‐traumatic stress disorder (PTSD)‐suffering users, and guide the way that allows eliciting information about their disorder and progress of their treatment. As the conversation unfolds, the system gathers information enabling us to calculate a PTSD score and perform an initial screening of the users. We generate the system's response in real time and continuously monitor an estimate of the user's emotional state. If a user becomes frustrated, angry, sad, etc., we provide encouragement and observe any changes in the dialogue. The system will be trained with data from real and simulated interactions, using automatic virtual agents. Last, we present our plans for evaluation with PTSD‐suffering and non‐PTSD‐suffering users.
Effect of Nutrient Application on Growth, Metabolic and Enzymatic Activities of Rice Seedlings During Flooding Stress and Subsequent Re‐Aeration
Authors: Lal B. , Gautam P. , Rath L. , Haldar D. , Panda B. B. , Raja R. , Shahid M. , Tripathi R. , Bhattacharyya P. , Mohanty S. , Nayak A. K.
Published: September 2014

The impact of submergence on the allometry, changes in metabolic activities and antioxidant enzymes during oxidative stress in four Indica rice varieties namely IR‐20, IR‐64 Sub1, Swarna Sub1 and Savitri Sub1 was studied. The differential response of flooding under clear and turbid water with different nutrient application schedules was also examined during and after 12 days of complete submergence. Submergence substantially reduced allometric parameters and the activities of antioxidant enzymes but increased the % change in chlorophyll, soluble sugars and malondialdehyde (MDA) across cultivars with drastic effects on IR‐20. Turbid water resulted in higher leaf senescence, lodging, higher depletion of chlorophyll and soluble sugars because of poor light transmission. Pre‐submergence N application resulted in higher lodging, leaf senescence and higher MDA level but depletion of chlorophyll and NSC leading to higher % change over prior to submergence. Basal P application reduced the senescence and lodging, whereas increased the antioxidant enzyme activities. Foliar spray of post‐submergence N with basal P improved the retention and regain of chlorophyll, soluble sugar and increased the dry matter, leaf area and root shoot ratio. Crop establishment could therefore be enhanced in areas where untimely flooding is anticipated by applying basal P and foliar spray of urea after desubmergence.
Nitrogen Removal by Stormwater Management Structures: A Data Synthesis
Authors: Koch Benjamin J. , Febria Catherine M. , Gevrey Muriel , Wainger Lisa A. , Palmer Margaret A.
Published: September 2014

A comprehensive synthesis of data from empirically based published studies and a widely used stormwater best management practice (BMP) database were used to assess the variability in nitrogen (N) removal performance of urban stormwater ponds, wetlands, and swales and to identify factors that may explain this variability. While the data suggest that BMPs were generally effective on average, removal efficiencies of ammonium (NH4), nitrate (NO3), and total nitrogen (TN) were highly variable ranging from negative (i.e., BMPs acting as sources of N) to 100%. For example, removal of NO3 varied from (median ±1 SD) −15 ± 49% for dry ponds, 32 ± 120% for wet ponds, 58 ± 210% for wetlands, and 37 ± 29% for swales. Across the same BMP types, TN removal was 27 ± 24%, 40 ± 31%, 61 ± 30%, and 50 ± 29%. NH4 removal was 9 ± 36%, 29 ± 72%, 31 ± 24%, and 45 ± 34%. BMP size, age, and location explained some of the variability. For example, small and shallow ponds and wetlands were more effective than larger, deeper ones in removing N. Despite well‐known intra‐annual variation in N fluxes, most measurements have been made over short time periods using concentrations, not flow‐weighted N fluxes. Urban N export is increasing in some areas as large storms become more frequent. Thus, accounting for the full range of BMP performance under such conditions is crucial. A select number of long‐term flux‐based BMP studies that rigorously measure rainfall, hydrology, and site conditions could improve BMP implementation.
Safety of classic and biologic systemic therapies for the treatment of psoriasis in elderly: an observational study from national BIOBADADERM registry
Authors: Medina C. , Carretero G. , Ferrandiz C. , Dauden E. , Vanaclocha F. , Gómez‐García F.J. , Herrera‐Ceballos E. , De la Cueva‐Dobao P. , Belinchón I. , Sánchez‐Carazo J.L. , Alsina M. , López‐Estebaranz J.L. , Ferrán M. , Carrascosa J.M. , Torrado R. , Argila D. , Rivera R. , Jiménez‐Puya R. , García‐Doval I. ,   the BIOBADADERM Study Group
Published: September 2014

Background

Psoriasis patients over 65 years‐old (elderly) constitute a growing group, underrepresented in clinical trials, and likely to be more prone to adverse events.

Objective

To describe safety of systemic psoriasis therapy in patients over 65 years‐old compared to younger patients.

Methods

Patients registered in Biobadaderm, a Spanish national registry of psoriasis patients treated with systemic therapy, were grouped in elderly (≥ 65 years old) and younger patients. Rates of adverse events were described by severity and type, and the risks compared in both groups, taking into account exposure to classic or biologic drugs, using Cox regression.

Results

175 (9.8%) of 1793 patients were elderly. Overall risk of adverse events was not higher in elderly (drug group adjusted HR 1.09 (95%CI: 0.93‐1.3)). Serious adverse events were more common in elderly (drug group adjusted HR 3.2 (95%CI: 2.0‐5.1)). Age adjusted HR of all adverse events was lower for patients exposed to biologics compared to classic drugs in the whole sample (HR 0.7 (95%CI: 0.6‐0.7)). Age did not seem to modify the effect of therapy (biologic vs. classic) in the risk of adverse events (likelihood ratio test for interaction, p = 0.12 for all adverse events, p = 0‐09 for serious adverse events).

Conclusions

Serious adverse events are more common in elderly patients, although they may be related to other variants that are associated with this age group and not due to the treatment itself. Use of biologics was associated with lower risk of adverse events in the whole group. We found no differences in this association between young and elderly. These results are reassuring, although uncontrolled confounding could not be excluded as an explanation for these findings, and the power of the study to detect differences was low.
Molluscum contagiosum surrounded by a white halo and Sezary syndrome
Authors: Le Treut C. , Granel‐Brocard F. , Bursztejn A.‐C. , Barbaud A. , Plénat F. , Schmutz J.‐L.
Published: September 2014

Background

Molluscum contagiosum (MC) is caused by a DNA virus of the poxvirus group. It is common in children, and is also found in sexually active adults and HIV‐seropositive patients. Cellular immunity is essential to controlling MC virus infection. We report the first observation of a patient with stage IV Sezary syndrome, who presented multiple molluscum contagiosum, spread and surrounded by a pale halo.

Case report

A woman aged 70 presented with aggravation of Sezary syndrome diagnosed in 2009 and treated with topical corticosteroids. The examination showed a generalized pruritic exanthem and multiple flesh‐coloured papules from 1 to 3 mm, spread over the entire skin surface and surrounded by a white halo. Histological examination of a lesion showed the presence of infected cells with intracytoplasmic inclusions infected in an acanthotic epidermis, surrounded by a melaninopenic hypomelanosis with a normal melanocyte density. There was no inflammatory character. The diagnosis of multiple molluscum contagiosum was given, the application of clobetasol propionate was suspended and treatment with chlorambucil 4 mg/day and prednisone 0.5 mg/kg/day was started. The evolution of the rash and pruritus was rapidly favourable. After 3 months, the rash and pruritus had regressed. There was no molluscum contagiosum or clear halo.

Conclusion

We report the original observation of a patient with stage IV Sezary syndrome, who presented multiple molluscum contagiosum, spread and surrounded by a pale halo, without inflammation, eczema or disappearance of melanocytes. This halo could be due to the secretion of a protein by molluscum contagiosum inhibiting inflammation around this MC. To our knowledge, this phenomenon reported in a patient with severe atopic dermatitis associated with Sezary syndrome has not previously been described.
Parenting and Naturally Occurring Declines in the Antisocial Behavior of Children and Adolescents: A Process Model
Authors: Buck Katharine Ann , Dix Theodore
Published: September 2014

This review examines why, without clinical intervention, antisocial behavior tends to decline naturally as everyday family processes unfold over time. Despite considerable research on why antisocial behavior develops and interventions that reduce it, aspects of everyday parenting that lead antisocial behavior to decline in most children without intervention are poorly understood. We examined the positive parenting and child processes that may be the basis for these declines. From research on antisocial behavior, we isolated longitudinal studies in which naturally occurring declines occurred, reviewed what is known about parenting that promotes these declines, evaluated methods needed to understand them, and have proposed a process model that details relevant parenting and child processes.
Tracking protein dynamics with photoconvertible Dendra2 on spinning disk confocal systems
Authors: WOODS ELENA , COURTNEY JANE , SCHOLZ DIMITRI , HALL WILLIAM W. , GAUTIER VIRGINIE W.
Published: September 2014

Understanding the dynamic properties of cellular proteins in live cells and in real time is essential to delineate their function. In this context, we introduce the Fluorescence Recovery After Photobleaching‐Photoactivation unit (Andor) combined with the Nikon Eclipse Ti E Spinning Disk (Andor) confocal microscope as an advantageous and robust platform to exploit the properties of the Dendra2 photoconvertible fluorescent protein (Evrogen) and analyse protein subcellular trafficking in living cells. A major advantage of the spinning disk confocal is the rapid acquisition speed, enabling high temporal resolution of cellular processes. Furthermore, photoconversion and imaging are less invasive on the spinning disk confocal as the cell exposition to illumination power is reduced, thereby minimizing photobleaching and increasing cell viability. We have tested this commercially available platform using experimental settings adapted to track the migration of fast trafficking proteins such as UBC9, Fibrillarin and have successfully characterized their differential motion between subnuclear structures. We describe here step‐by‐step procedures, with emphasis on cellular imaging parameters, to successfully perform the dynamic imaging and photoconversion of Dendra2‐fused proteins at high spatial and temporal resolutions necessary to characterize the trafficking pathways of proteins.
SUPPORTIVE CARE IN ADVANCED KIDNEY DISEASE: PATIENT ATTITUDES AND EXPECTATIONS
Authors: Da Silva‐Gane Maria , Farrington Ken
Published: September 2014

Treatment with dialysis has benefitted large numbers of patients with advanced kidney disease. It is though highly intrusive and demanding and some elderly, frail patients may tolerate it poorly. Some of these patients who are either approaching ‘end‐stage’ kidney disease or ‘failing’ despite being on dialysis may choose to pursue supportive or palliative approaches, partially or fully replacing the dialysis option. Here, we describe some of the challenges confronting these patients and present data on the attitudes and perceptions to supportive care and end‐of‐life care planning of patients on haemodialysis including some whose prognosis was poor. The main focus for these patients appeared to be on holding on to what they had, adapting by living ‘from day to day’ in the present, and continuing to hope for the best. Advance care planning was seen as potentially useful by patients, once clarity surrounding its purpose had been established.
Low‐dose propranolol regimen for infantile haemangioma
Authors: Tan Cherise ES , Itinteang Tinte , Leadbitter Philip , Marsh Reginald , Tan Swee T
Published: September 2014

Aims

Propranolol, now the preferred treatment for problematic proliferating infantile haemangioma (IH), at an empirical cardiovascular dosage of 2–3 mg/kg/day is associated with variable complication rates. A meta‐analysis shows complications in 31% of patients at a mean dosage of 2.12 mg/kg/day. This study reports on the minimal dosage and duration of treatment to achieve accelerated involution and side effects using a stepwise escalation regimen.

Methods

Consecutive patients with problematic proliferating IH treated with propranolol were identified from our vascular anomalies database. Propranolol was commenced at 0.5 mg/kg/day in two divided doses and increased to 1 mg/kg/day after 24 h. The patients were reviewed after 1 week, and the dosage was increased to 1.5 mg/kg/day. The dosage was further increased by 0.5 mg/kg/day, if necessary, to achieve accelerated involution.

Results

Forty‐four patients, aged 3 weeks to 11 months (mean, 3.8 months), received propranolol therapy for problematic proliferating IH. The minimal dosage required to achieve accelerated involution was 1.5–2 mg/kg/day. Treatment was maintained for an average of 9.3 months and discontinued at an average age of 14.2 months. Rebound growth occurred in the first patient of this series when propranolol was withdrawn at 7.5 months of age, requiring reinstitution of treatment. Slight rebound growth following cessation of treatment was observed in four other patients, but reinstitution of propranolol was not required. Minor complications were observed in three (6.8%) patients.

Conclusions

Propranolol at 1.5–2 mg/kg/day, administered in divided doses with stepwise escalation, is safe and effective for treating problematic proliferating IH. Treatment is continued to an average age of 14.2 months.
Hyperspectral imaging techniques for the characterization of Haematococcus pluvialis (Chlorophyceae)
Authors: Nogami Satoru , Ohnuki Shinsuke , Ohya Yoshikazu
Published: September 2014

A hyperspectral imaging camera was combined with a bright‐field microscope to investigate the intracellular distribution of pigments in cells of the green microalga Haematococcus pluvialis, a synonym for H. lacustris (Chlorophyceae). We applied multivariate curve resolution to the hyperspectral image data to estimate the pigment contents in culture and revealed that the predicted values were consistent with actual measurements obtained from extracted pigments. Because it was possible to estimate pigment contents in every pixel, the intracellular distribution of the pigments was investigated during various life‐cycle stages. Astaxanthin was localized specifically at the eyespot of zoospores in early culture stages. Then, it became widely distributed in cells, but subsequently localized differently than the chl. Integrated with our recently developed image‐processing program “HaematoCalMorph,” the hyperspectral imaging system was useful for monitoring intracellular distributions of pigments during culture as well as for studying cellular responses under various conditions.
Circulating CD56dim natural killer cells and CD56+ T cells that produce interferon‐γ or interleukin‐10 are expanded in asymptomatic, E antigen‐negative patients with persistent hepatitis B virus infection
Authors: Conroy M. J. , Mac Nicholas R. , Grealy R. , Taylor M. , Otegbayo J. A. , O'Dea S. , Mulcahy F. , Ryan T. , Norris S. , Doherty D. G.
Published: September 2014

Infection with hepatitis B virus (HBV) can result in spontaneous resolution or chronic infection, which can remain asymptomatic or can progress to cirrhosis and/or hepatocellular carcinoma. The host immune response is thought to be a major determinant of the outcome of HBV infection and virus‐specific cytotoxic T lymphocytes (CTL) can mediate immunity against the virus and cause liver pathology. Antigen‐nonspecific innate lymphocytes may also contribute to HBV infection and liver disease, therefore, we examined the frequencies, phenotypes, cytolytic activities and cytokine profiles of circulating natural killer (NK) cells, CD1d‐restricted invariant natural killer T (iNKT) cells and CD56+ T cells in 102 asymptomatic HBV‐infected patients and compared them with those in 66 uninfected control subjects. NK cells expressing low levels of CD56 (CD56dim) and CD56+ T cells were significantly expanded in the circulation of HBV‐infected patients compared with control subjects. CD1d expression and iNKT cell frequencies were similar in both groups. Despite these expansions, we did not detect augmented natural or cytokine‐induced cytotoxicity in the HBV‐infected subjects. All lymphocyte populations studied produced interferon‐γ (IFN‐γ) significantly more frequently when taken from HBV‐infected patients compared with when taken from healthy controls. Additionally, NK cells from the patients more frequently produced interleukin‐10. As our HBV‐infected cohort consisted of asymptomatic patients with low viral loads, we propose that CD56dim NK cells and CD56+ T cells control HBV infection by noncytolytic mechanisms.
Mucormycoses caused byLichtheimiaspecies
Authors: Schwartze Volker U. , Jacobsen Ilse D.
Published: September 2014

Mucormycoses are life‐threatening infections with fungi from the order Mucorales (Mucoromycotina). Although mucormycoses are uncommon compared to other fungal infections, e.g. aspergillosis and candidiasis, the number of cases is increasing especially in immunocompromised patients.Lichtheimia(formerlyAbsidia) species represent the second to third most common cause of mucormycoses in Europe. This mini review presents current knowledge about taxonomy and clinical relevance ofLichtheimiaspecies. In addition, clinical presentation and risk factors will be discussed. Proper animal infection models are essential for the understanding of the pathogenesis and the identification of virulence factors of fungal pathogens. To date, several animal models have been used to studyLichtheimiainfection. A brief overview of the different models and the main conclusions from the infection experiments is summarised in this review.
Rapid screening for human‐pathogenic Mucorales using rolling circle amplification
Authors: Dolatabadi S. , Najafzadeh M. J. , de Hoog G. S.
Published: September 2014

Mucormycosis has emerged as a relatively common severe mycosis in patients with haematological and allogeneic stem cell transplantation. Source of transmission is from unidentified sources in the environment. Early diagnosis of infection and its source of contamination are paramount for rapid and appropriate therapy. In this study, rolling circle amplification (RCA) is introduced as a sensitive, specific and reproducible isothermal DNA amplification technique for rapid molecular identification of six of the most virulent species (Rhizopus microsporus, R. arrhizus var. arrhizus, R. arrhizus var. delemar, Mucor irregularis, Mucor circinelloides, Lichtheimia ramosa, Lichtheimia corymbifera). DNAs of target species were successfully amplified, with no cross reactivity between species. RCA can be considered as a rapid detection method with high specificity and sensitivity, suitable for large screening.
Toll‐like receptor‐4‐mediated autophagy contributes to microglial activation and inflammatory injury in mouse models of intracerebral haemorrhage
Authors: Yang Zhao , Liu B. , Zhong L. , Shen Hanchao , Lin Chuangan , Lin Li , Zhang Nan , Yuan Bangqing
Published: September 2014

Aims

Much evidence demonstrates that Toll‐like receptor‐4 (TLR4)‐mediated microglial activation is an important contributor to the inflammatory injury in intracerebral haemorrhage (ICH). However, the exact mechanism of TLR4‐mediated microglial activation induced by ICH is not clear. In addition, microglial autophagy is involved other forms of nervous system injury. To explore the relationship between TLR4 and autophagy, we investigated the role of TLR4‐mediated microglial autophagy and inflammation in ICH.

Methods

We detected TLR4 expression, autophagy and inflammation of microglia treated with lysed erythrocytes in vitro, and observed the cerebral water content and neurological deficit of ICH mice [TLR4−/− and wild type (WT)] in vivo.

Results

We found that lysed erythrocyte treated microglia (TLR4−/−) had reduced autophagy and inflammation compared with microglia (WT) in vitro. ICH mice (TLR4−/−) had reduced water content and neurological injury compared with ICH mice (WT). The autophagy inhibitor (3‐methyladenine) decreased microglial activation and inflammatory injury due to lysed erythrocyte treatment, and improved the neurological function of ICH mice.

Conclusions

Taken together, these data suggested that TLR4 induced autophagy contributed to the microglial activation and inflammatory injury and might provide novel therapeutic interventions for ICH.
NEGOTIATING DOMAINS OF PATIENT DIGNITY IN VA SPINAL CORD INJURY UNITS: PERSPECTIVES FROM INTERDISCIPLINARY CARE TEAMS AND VETERANS
Authors: Lind Jason D. , Powell‐Cope Gail , Chavez Margeaux A. , Fraser Marsha , Harrow Jeffrey
Published: September 2014

Patient dignity is a significant concern among inpatient Veterans with spinal cord injuries (SCIs) because they may lack physical control over their bodies and thus rely on others for a variety of specialized needs, including mobility, personal care, wound care, bowel and bladder care, and rehabilitation, among others. This study examines the complexities of providing and negotiating dignified care in the context of interdisciplinary care teams in SCI, and the challenges Veterans with SCI face maintaining dignity in the context of limited independence. Based on a mixed methods approach that included in‐depth interviews, observations, and pile sorting at six Veterans Health Administration (VA) SCI units, the goal of this study was to explore ways in which dignity was defined, negotiated, and conferred during patient and provider interactions. Study results have immediate value to VA leadership, VA providers, and Veterans by calling attention to the ways in which the concept of patient dignity can be integrated into clinical practice on SCI units. This study provides a methodological framework to capture complex interactions among interdisciplinary care teams and patients, and offers a significant contribution to our understanding of how patient and provider interactions are conferred and negotiated.
ANTHROPOLOGIST AND GOVERNMENT EMPLOYEE: A DESCRIPTION OF CAREER PATHS TO BECOMING AN APPLIED ANTHROPOLOGIST WITH THE U.S. DEPARTMENT OF VETERAN AFFAIRS
Authors: Fix Gemmae M.
Published: September 2014

The U.S. government is the largest employer of anthropologists, with an increasing presence in the Department of Veteran Affairs (VA). However, there has been limited discussion of the path from graduate school to an applied career. This article describes the motivations and trajectories of anthropologists employed by VA. Interviewees described their VA work as embodying the principles of anthropology and the ability to see the results of their work as deeply gratifying.
Coexistence of mixed phenotype Creutzfeldt‐Jakob disease, Lewy body disease and argyrophilic grain disease plus histological features of possible Alzheimer's disease: A multi‐protein disorder in an autopsy case
Authors: Fernández‐Vega Iván , Ruiz‐Ojeda Javier , Juste Ramon A. , Geijo Maria , Zarranz Juan Jose , Sánchez Menoyo Jose Luis , Vicente‐Etxenausia Ikerne , Mediavilla‐García Jennifer , Guerra‐Merino Isabel
Published: September 2014

We report hereby an autopsy case of sporadic mixed phenotype CJD without hereditary burden and a long‐term clinical course. An 80‐year old man was diagnosed with mild cognitive impairment 27 months before death, caused by bronchopneumonia and severe respiratory impairment. During this time, the patient developed gradual mental deterioration, some sleeping problems and myoclonus. Other clinical manifestations were progressive gait problems, language deterioration, presence of primitive reflexes and irritability. In keeping with those symptoms, a rapidly evolving dementia was clinically suspected. Cerebrospinal fluid test for 14‐3‐3 protein was negative. However, an abnormal EEG and MRI at end‐stage of disease were finally consistent with CJD. Post‐mortem examination revealed a massive cortical neuronal loss with associated reactive astrocytosis, also evident in the white matter. Diffuse spongiform changes involving some basal ganglia, especially medial thalamus, some troncoencephalic nuclei, mainly inferior olivary nucleus and the molecular layer of the cerebellum were seen. Immunorreactive deposits for anti‐prion protein antibody were present at different areas of the CNS. Additionally, Lewy bodies were observed at the brainstem and amygdala. Furthermore, argirophilic grains together with oligodendroglial coiled bodies and pre‐tangle inclusions in the neurons from the limbic system containing hyperphosphorylated 4R tau were noted. To the best of our knowledge, this is the first case of CJD combined with Lewy body disease and argirophilic grain disease. Furthermore, we believe this case is an extremely rare combination of MM2‐cortical‐type and MM2‐thalamic‐type sporadic CJD (sCJD), which explains the broad spectrum of MM2‐type sCJD findings and symptoms. Moreover, histological features of possible Alzheimer's disease were also reported.
An autopsy case of Balamuthia mandrillaris amoebic encephalitis, a rare emerging infectious disease, with a brief review of the cases reported in Japan
Authors: Itoh Kyoko , Yagita Kenji , Nozaki Tomoyoshi , Katano Harutaka , Hasegawa Hideki , Matsuo Koushun , Hosokawa Youhei , Tando So , Fushiki Shinji
Published: September 2014

Balamuthia mandrillaris is an amoeba found in fresh water and soil that causes granulomatous amoebic encephalitis. We report herein an autopsy case of B. mandrillaris amoebic encephalitis, which was definitely diagnosed by PCR. An 81‐year‐old man, who had Sjögren's syndrome, manifested drowsiness 2 months before his death with progressive deterioration. Neuroimaging demonstrated foci of T2‐ and fluid‐attenuated inversion recovery high and T1 low‐intensity with irregular post‐contrast ring enhancement in the cerebral hemisphere, thalamus and midbrain. Pathologically, multiple hemorrhagic and necrotic lesions were found in the cerebrum, thalamus, midbrain, pons, medulla and cerebellum, which were characterized by liquefactive necrosis, marked edema, hemorrhage and necrotizing vasculitis associated with the perivascular accumulation of amoebic trophozoites, a few cysts, and the infiltration of numerous neutrophils and microglia/macrophages. The trophozoites were ovoid or round, 10–60 μm in diameter, and they showed foamy cytoplasm and a round nucleus with small karyosome in the center. The PCR and immunohistochemistry from paraffin‐embedded brain specimens revealed angioinvasive encephalitis due to B. mandrillaris. Human cases of B. mandrillaris brain infection are rare in Japan, with only a few brief reports in the literature.