bluuebunny/crossref_metadata_2025 huggingface dataset:
Prostate Volume Index and Chronic Inflammation of the Prostate Type IV with Respect to the Risk of Prostate Cancer
Authors: Porcaro Antonio B. , Novella Giovanni , Molinari Alberto , Terrin Alessandro , Minja Anila , De Marco Vincenzo , Martignoni Guido , Brunelli Matteo , Cerruto Maria A. , Curti Pierpaolo , Cavalleri Stefano , Artibani Walter
Published: August 2014

Background: Benign prostatic hyperplasia and prostate cancer (PCA) alter the normal growth patterns of zonal anatomy with changes of prostate volume (PV). Chronic inflammatory infiltrates (CII) type IV are the most common non-cancer diagnosis of the prostate after biopsy. Objective: To evaluate associations of both PV index (PVI), i.e. the ratio of transitional zone volume (TZV) to peripheral zone volume (PZV), and CII with PCA in patients undergoing biopsy. Subjects and Methods: Between January 2007 and December 2008, 268 consecutive patients who underwent prostate biopsy were retrospectively evaluated. PV and TZV were measured by transrectal ultrasound. PZV was computed by subtracting the PV from the TZV. CII were evaluated according to standard criteria. Significant associations of PVI and the presence of CII (CII+) with PCA risk were assessed by statistical methods. Results and Limitations: We evaluated 251 patients after excluding cases with painful rectal examinations, prostate-specific antigen (PSA) >20 μg/ml and metastases. The PCA detection rate was 41.1%. PVI was a negative independent predictor of PCA. A PVI ≤1.0 was directly [odds ratio (OR) = 2.36] associated with PCA, which was detected more frequently in patients with a PVI ≤1.0 (29.1%) than in those with a PVI >1.0 (11.9%). CII+ was inversely (OR = 0.57) and independently associated with PCA, which was detected less frequently in cases with CII (9.9%) than in those without CII (21.1%). Potential study limitations might relate to the fact that PV was not measured by prostatectomy specimens and there was PSA confounding for CII and PCA. Conclusions: Low values of PVI are directly associated with risk of PCA, which was almost 2.5 times higher in patients with a PVI ≤1.0. The PVI might be an effective parameter for clustering patients at risk of PCA. CII+ was inversely associated with risk of PCA and decreased the probability of detecting PCA by 43%. The role of the PVI and CII in PCA carcinogenesis needs further research.
Activation of the Hypothalamic-Pituitary-Gonadal Axis in Infancy: Minipuberty
Authors: Kuiri-Hänninen Tanja , Sankilampi Ulla , Dunkel Leo
Published: August 2014

The hypothalamic-pituitary-gonadal (HPG) axis is active in the midgestational foetus but silenced towards term because of the negative feedback effects mediated by the placental hormones. This restraint is removed at birth, leading to reactivation of the axis and an increase in gonadotrophin levels. Gonadotrophin levels are high during the first 3 months of life but decrease towards the age of 6 months except for FSH levels in girls that remain elevated until 3-4 years of age. After this, the HPG axis remains quiescent until puberty. The postnatal gonadotrophin surge results in gonadal activation in both sexes. In boys, testosterone levels rise to a peak at 1-3 months of age and then decline following LH levels. Postnatal HPG axis activation is associated with penile and testicular growth and therefore considered important for the development of male genitalia. In girls, elevated gonadotrophin levels result in the maturation of ovarian follicles and in an increase in oestradiol levels. Biological significance and possible long-term consequences of this minipuberty remain elusive, as do the mechanisms that silence the HPG axis until puberty. However, the first months of life provide a ‘window of opportunity' for functional studies of the HPG axis prior to pubertal development.
Retrograde Intrarenal Surgery versus Percutaneous Nephrolithotomy for Treatment of Renal Stones >2 cm: A Meta-Analysis
Authors: Zheng Changjian , Xiong Bo , Wang Hongzhi , Luo Jun , Zhang Chenggou , Wei Wei , Wang Yarong
Published: August 2014

Objective: To systematically review the efficacy and safety of retrograde intrarenal surgery (RIRS) versus percutaneous nephrolithotomy (PCNL) for the treatment of renal calculi >2 cm. Methods: We searched PubMed, Cochrane Library, Embase and the Chinese Biomedical Literature Database about RIRS and PCNL for the treatment of renal stones. The retrieval time ended in December 2013. All clinical trials were retrieved and their included references investigated. Two reviewers independently assessed the quality of all included studies, and the eligible studies were included and analyzed using the RevMan 5.2 software. Results: Two randomized controlled trials and six clinical controlled trials were included, involving a total of 590 patients. Our meta-analysis showed that there were not significant differences in stone-free rate (relative risk [RR] = 0.95, 95% confidence interval (CI) 0.88-1.02, p = 0.11) and fever (RR = 0.95, 95% CI 0.54-1.67, p = 0.85) between RIRS and PCNL. We found that hospital stay (weighted mean difference [WMD] = -2.10, 95% CI -3.08 to -1.11, p < 0.10) and bleeding (RR = 0.20, 95% CI 0.06-0.68, p = 0.01) were lower and operation time was longer (WMD = 19.11, 95% CI 7.83-30.39, p < 0.10) for RIRS. Conclusion: RIRS is a safe and effective procedure. It can successfully treat patients with stones >2 cm with a high stone-free rate and significantly reduce hospital stay without increasing complications. RIRS can be used as an alternative treatment to PCNL in selected cases with larger renal stones. However, further randomized trials are needed to confirm these findings.
The Memory Alteration Test Discriminates between Cognitively Healthy Status, Mild Cognitive Impairment and Alzheimer's Disease
Authors: Custodio Nilton , Lira David , Herrera-Perez Eder , Nuñez del Prado Liza , Parodi José , Guevara-Silva Erik , Castro-Suarez Sheila , Montesinos Rosa , Cortijo Patricia
Published: August 2014

Background/Aims: Dementia is a worldwide public health problem and there are several diagnostic tools for its assessment. The aim of this study was to evaluate the performance of the Memory Alteration Test (M@T) to discriminate between patients with early Alzheimer's disease (AD), patients with amnestic mild cognitive impairment (a-MCI), and subjects with a cognitively healthy status (CHS). Methods: The discriminative validity was assessed in a sample of 90 patients with AD, 45 patients with a-MCI, and 180 subjects with CHS. Clinical, functional, and cognitive studies were independently performed in a blinded fashion and the gold standard diagnosis was established by consensus on the basis of these results. The test performance was assessed by means of a receiver operating characteristic curve analysis as area under the curve (AUC). Results: M@T mean scores were 17.7 (SD = 5.7) in AD, 30.8 (SD = 2.3) in a-MCI, and 44.5 (SD = 3.1) in CHS. A cutoff score of 37 points had a sensitivity of 98.3% and a specificity of 97.8% to differentiate a-MCI from CHS (AUC = 0.999). A cutoff score of 27 points had a sensitivity of 100% and a specificity of 98.9% to differentiate mild AD from a-MCI and from CHS (AUC = 1.000). Conclusions: The M@T had a high performance in the discrimination between early AD, a-MCI and CHS.
Ischaemic Cavities in the Cerebellum: An ex vivo 7-Tesla MRI Study with Pathological Correlation
Authors: De Cocker Laurens J.L. , van Veluw Susanne J. , Biessels Geert Jan , Spliet Wim G.M. , Thunnissen Isabel E. , Luijten Peter R. , Hendrikse Jeroen , Zwanenburg Jaco J.M.
Published: August 2014

Background: Small cerebellar cavities (≤15 mm) are often observed coincidentally in ageing subjects and have also been associated with migraine. Although generally assumed to be of ischaemic origin, descriptive imaging studies are sparse and imaging findings have not been correlated with histopathology. We aimed to investigate whether small ischaemic cavities in the cerebellum show characteristic infarct patterns that might be helpful for diagnostic imaging. Methods: We examined 40 whole postmortem cerebella with 7-tesla MRI ex vivo for the presence of small ischaemic cavities. The scan protocol included a T2-, T2*- and fluid-attenuated inversion recovery-weighted sequence for all specimens. We investigated to which degree small ischaemic cavities affect the cortical, juxtacortical and/or deep subcortical regions of the cerebellum. In a subset of the cavities identified, we correlated the imaging data with histopathological findings. This was performed by cutting the particular cerebellar specimen into 5-mm-thick slices. Serial sections were performed if cavities remained unidentified macroscopically. Results: Twenty-two cavities were seen on ex vivo MRI in 8 out of 40 examined cerebella. Twenty out of 22 cerebellar cavities were located in the cortex, and only 2 in the deep white matter, with no cavities located in the juxtacortical white matter. None of the 20 cerebellar cortical cavities showed extension into the juxtacortical white matter on MRI, although in 1 cortical cavity some surrounding gliosis was seen to extend into the juxtacortical white matter. Nine out of 22 cavities were sampled for pathological correlation, including 7 cerebellar cortical cavities and both cavities or lacunes in the deep white matter. Three out of 7 cortical and both the deep cavities were histopathologically verified as cavities of ischaemic origin, while the remaining cortical cavities could not be retrieved upon histopathologic examination. Some microscopic gliosis was seen to extend into the juxtacortical white matter of all confirmed cortical cavities. Conclusion: Knowledge of typical infarct patterns may facilitate the detection and characterisation of cerebellar ischaemic cavities in vivo. Cerebellar cortical cavities appeared to be much more common than deep cavities and presented on imaging as a full-thickness defect in the cerebellar cortex without extension in the adjacent white matter.
Application of Customized Birth Weight Curves in the Assessment of Perinatal Outcomes in Infants of Diabetic Mothers
Authors: González-González Nieves L. , González-Dávila Enrique , Cabrera Francisco , Vega Begoña , Padron Erika , Bartha José Luis , Armas-Gonzalez Marina , García-Hernández José A.
Published: August 2014

Objective: To determine whether the use of customized curves (CC) allows better detection of large- (LGA) or small-for-gestational age (SGA) infants at risk of adverse perinatal morbidity than non-CC in women with diabetes mellitus (DM). Material and Methods: A model of CC was applied to all infants of diabetic mothers (IDM) who attended the Hospital Universitario Materno Infantil de Canarias between 2008 and 2011. We compared perinatal outcomes of IDM classified as LGA or SGA by non-CC versus CC. Results: One of 4 LGA was appropriate for gestational age (AGA) by CC (false-positive rate: 25%) and 30% of SGA by CC were not identified by non-CC (false-negative rate). False-positive LGA and SGA showed similar perinatal outcomes to AGA infants. The rates of cesarean section, cephalopelvic disproportion, total fetal distress and shoulder dystocia were significantly higher in false-negative LGA than in AGA by CC (p < 0.004, p < 0.02, p < 0.04 and p < 0.04, respectively). Fetal distress was higher in false-negative SGA than in AGA by CC (p < 0.03). Discussion: In pregnancies complicated by DM, the use of CC allowed more accurate identification of LGA and SGA infants at high risk of perinatal morbidity than non-CC.
Sevelamer Is Cost-Saving vs. Calcium Carbonate in Non-Dialysis-Dependent CKD Patients in Italy: A Patient-Level Cost-Effectiveness Analysis of the INDEPENDENT Study
Authors: Ruggeri Matteo , Cipriani Filippo , Bellasi Antonio , Russo Domenico , Di Iorio Biagio , Springer Healthcare Italia s.r. S.
Published: August 2014

Objectives: To conduct a cost-effectiveness analysis of sevelamer versus calcium carbonate in patients with non-dialysis-dependent CKD (NDD-CKD) from the Italian NHS perspective using patient-level data from the INDEPENDENT-CKD study. Methods: Patient-level data on all-cause mortality, dialysis inception and phosphate binder dose were obtained for all 107 sevelamer and 105 calcium carbonate patients from the INDEPENDENT-CKD study. Hospitalization and frequency of dialysis data were collected post hoc for all patients via a retrospective chart review. Phosphate binder, hospitalization, and dialysis costs were expressed in 2012 euros using hospital pharmacy, Italian diagnosis-related group and ambulatory tariffs, respectively. Total life years (LYs) and costs per treatment group were calculated for the 3-year period of the study. Bootstrapping was used to estimate confidence intervals around outcomes, costs, and cost-effectiveness and to calculate the cost-effectiveness acceptability curve. A subgroup analysis of patients who did not initiate dialysis during the INDEPENDENT-CKD study was also conducted. Results: Sevelamer was associated with 0.06 additional LYs (95% CI -0.04 to 0.16) and cost savings of EUR -5,615 (95% CI -10,066 to -1,164) per patient compared with calcium carbonate. On the basis of the bootstrap analysis, sevelamer was dominant compared to calcium carbonate in 87.1% of 10,000 bootstrap replicates. Similar results were observed in the subgroup analysis. Results were driven by a significant reduction in all-cause mortality and significantly fewer hospitalizations in the sevelamer group, which offset the higher acquisition cost for sevelamer. Conclusions: Sevelamer provides more LYs and is less costly than calcium carbonate in patients with NDD-CKD in Italy.
Endoscopic Sphincterotomy Using the Rendezvous Technique for Choledocholithiasis during Laparoscopic Cholecystectomy: A Case Report
Authors: Tanaka Takayuki , Haraguchi Masashi , Tokai Hirotaka , Ito Shinichiro , Kitajima Masachika , Ohno Tsuyoshi , Onizuka Shinya , Inoue Keiji , Motoyoshi Yasuhide , Kuroki Tamotsu , Kanemastu Takashi , Eguchi Susumu
Published: August 2014

A 50-year-old male was examined at another hospital for fever, general fatigue and slight abdominal pain. He was treated with antibiotics and observed. However, his symptoms did not lessen, and laboratory tests revealed liver dysfunction, jaundice and an increased inflammatory response. He was then admitted to our hospital and underwent an abdominal computed tomography scan and magnetic resonance cholangiopancreatography (MRCP), which revealed common bile duct (CBD) stones. He was diagnosed with mild acute cholangitis. As the same time, he was admitted to our hospital and an emergency endoscopic retrograde cholangiopancreatography was performed. Vater papilla opening in the third portion of the duodenum and presence of a peripapillary duodenal diverticulum made it difficult to perform cannulation of the CBD. In addition, MRCP revealed that the CBD was extremely narrow (diameter 5 mm). We therefore performed laparoscopic cholecystectomy and endoscopic sphincterotomy using the rendezvous technique for choledocholithiasis simultaneously rather than laparoscopic CBD exploration. After the operation, the patient was discharged with no complications. Although the rendezvous technique has not been very commonly used because several experts in the technique and a large operating room are required, this technique is a very attractive and effective approach for treating choledocholithiasis, for which endoscopic treatment is difficult.
Lipid Screening in Children and Adolescents in Community Practice: 2007 to 2010
Authors: Margolis Karen L. , Greenspan Louise C. , Trower Nicole K. , Daley Matthew F. , Daniels Stephen R. , Lo Joan C. , Kharbanda Elyse O. , Sinaiko Alan R. , Magid David J. , Parker Emily D. , Chandra Malini , Tavel Heather M. , O’Connor Patrick J.
Published: August 2014

Background—

Integrated guidelines on cardiovascular health and risk reduction in children issued in 2011 newly recommended universal screening for dyslipidemia in children at 9 to 11 years and 17 to 21 years.

Methods and Results—

We determined the frequency and results of lipid testing in 301 080 children and adolescents aged 3 to 19 enrolled in 3 large US health systems in 2007 to 2010 before the 2011 guidelines were issued. Overall, 9.8% of the study population was tested for lipids. The proportion tested varied by body mass index percentile (5.9% of normal weight, 10.8% of overweight, and 26.9% of obese children) and age (8.9% of 9- to 11-year olds and 24.3% of 17- to 19-year olds). In normal weight individuals, 2.8% of 9- to 11-year olds and 22.0% of 17- to 19-year olds were tested. In multivariable models, age and body mass index category remained strongly associated with lipid testing. Sex, race, ethnicity, and blood pressure were weakly associated with testing. Abnormal lipid levels were found in 8.6% for total cholesterol, 22.5% for high-density lipoprotein-cholesterol, 12.0% for non–high-density lipoprotein-cholesterol, 8.0% for low-density lipoprotein-cholesterol, and 21% for triglycerides (age, 10–19 years). There was a strong and graded association of abnormal lipid levels with body mass index, particularly for high-density lipoprotein-cholesterol and triglycerides (2- to 6-fold higher odds ratio in obese when compared with that in normal weight children).

Conclusions—

Lipid screening was uncommon in 9- to 11-year olds and was performed in a minority of 17- to 19-year olds during 2007 to 2010. These data serve as a benchmark for assessing change in practice patterns after the new recommendations for pediatric lipid screening and management.
ST–Segment-Elevation Myocardial Infarction Patients Randomized to a Pharmaco-Invasive Strategy or Primary Percutaneous Coronary Intervention
Authors: Sinnaeve Peter R. , Armstrong Paul W. , Gershlick Anthony H. , Goldstein Patrick , Wilcox Robert , Lambert Yves , Danays Thierry , Soulat Louis , Halvorsen Sigrun , Ortiz Fernando Rosell , Vandenberghe Katleen , Regelin Anne , Bluhmki Erich , Bogaerts Kris , Van de Werf Frans
Published: August 2014

Background—

In the Strategic Reperfusion Early After Myocardial Infarction (STREAM) trial, a pharmaco-invasive (PI) strategy was compared with primary percutaneous coronary intervention (pPCI) in ST—segment-elevation myocardial infarction patients presenting within 3 hours after symptom onset but unable to undergo pPCI within 1 hour. At 30 days, the PI approach was associated with a nominally but nonstatistically significant lower incidence of the composite primary end point of death, shock, congestive heart failure, and reinfarction when compared with pPCI. The aim of the present study was to determine the effect of these strategies on 1-year mortality.

Methods and Results—

Vital status at 1 year was available in 936 of 944 (99.2%) and 941 of 948 (99.3%) patients in the PI and pPCI arm, respectively. At 1 year, all-cause mortality rates (6.7% versus 5.9%) were similar for PI and pPCI-treated patients (
P
=0.49; risk ratio, 1.13; 95% confidence interval, 0.79–1.62). Cardiac mortality rates were similar as well (4.0% versus 4.1%,
P
=0.93; risk ratio, 0.98; 95% confidence interval, 0.62–1.54). Overall, only 34 patients died between day 30 and 1 year, 20 in the PI arm and 14 in the pPCI arm, of whom 20 died of noncardiac reasons (13 in the PI and 7 in the pPCI arm). There was no significant difference in 1-year all-cause mortality between the 2 groups among the prespecified key subgroups.

Conclusions—

At 1 year, mortality rates in the PI and pPCI arms were similar in ST—segment-elevation myocardial infarction patients presenting within 3 hours after symptom onset and unable to undergo pPCI within 1 hour.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00623623.
Dietary Linoleic Acid and Risk of Coronary Heart Disease: A Systematic Review and Meta-Analysis of Prospective Cohort Studies
Authors: Farvid Maryam S. , Ding Ming , Pan An , Sun Qi , Chiuve Stephanie E. , Steffen Lyn M. , Willett Walter C. , Hu Frank B.
Published: August 2014

Background—

Previous studies on intake of linoleic acid (LA), the predominant n-6 fatty acid, and coronary heart disease (CHD) risk have generated inconsistent results. We performed a systematic review and meta-analysis of prospective cohort studies to summarize the evidence regarding the relation of dietary LA intake and CHD risk.

Methods and Results—

We searched MEDLINE and EMBASE databases through June 2013 for prospective cohort studies that reported the association between dietary LA and CHD events. In addition, we used unpublished data from cohort studies in a previous pooling project. We pooled the multivariate-adjusted relative risk (RR) to compare the highest with the lowest categories of LA intake using fixed-effect meta-analysis. We identified 13 published and unpublished cohort studies with a total of 310 602 individuals and 12 479 total CHD events, including 5882 CHD deaths. When the highest category was compared with the lowest category, dietary LA was associated with a 15% lower risk of CHD events (pooled RR, 0.85; 95% confidence intervals, 0.78–0.92;
I
2
=35.5%) and a 21% lower risk of CHD deaths (pooled RR, 0.79; 95% confidence intervals, 0.71–0.89;
I
2
=0.0%). A 5% of energy increment in LA intake replacing energy from saturated fat intake was associated with a 9% lower risk of CHD events (RR, 0.91; 95% confidence intervals, 0.87–0.96) and a 13% lower risk of CHD deaths (RR, 0.87; 95% confidence intervals, 0.82–0.94).

Conclusions—

In prospective observational studies, dietary LA intake is inversely associated with CHD risk in a dose–response manner. These data provide support for current recommendations to replace saturated fat with polyunsaturated fat for primary prevention of CHD.
Dipeptidyl‐Peptidase 4 Inhibition and the Vascular Effects of Glucagon‐like Peptide‐1 and Brain Natriuretic Peptide in the Human Forearm
Authors: Devin Jessica K. , Pretorius Mias , Nian Hui , Yu Chang , Billings Frederic T. , Brown Nancy J.
Published: August 2014

Background

Dipeptidyl‐peptidase 4 (
DPP
4) inhibitors improve glycemic control in patients with diabetes mellitus by preventing the degradation of glucagon‐like peptide‐1 (
GLP
‐1).
GLP
‐1 causes vasodilation in animal models but also increases sympathetic activity; the effect of
GLP
‐1 in the human vasculature and how it is altered by
DPP
4 inhibition is not known.
DPP
4 also degrades the vasodilator brain natriuretic peptide (
BNP
) to a less potent metabolite. This study tested the hypothesis that
DPP
4 inhibition potentiates the vasodilator responses to
GLP
‐1 and
BNP
in the human forearm.

Method and Results

Seventeen healthy subjects participated in this randomized, double‐blinded, placebo‐controlled crossover study. On each study day, subjects received
DPP
4 inhibitor (sitagliptin 200 mg by mouth) or placebo. Sitagliptin increased forearm blood flow and decreased forearm vascular resistance without affecting mean arterial pressure and pulse.
GLP
‐1 and
BNP
were infused in incremental doses via brachial artery. Venous
GLP
‐1 concentrations were significantly higher during sitagliptin use, yet there was no effect of
GLP
‐1 on forearm blood flow in the presence or absence of sitagliptin.
BNP
caused dose‐dependent vasodilation; however, sitagliptin did not affect this response.
GLP
‐1 and
BNP
had no effect on net norepinephrine release.

Conclusions

These data suggest that
GLP
‐1 does not act as a direct vasodilator in humans and does not contribute to sympathetic activation. Sitagliptin does not regulate vascular function in healthy humans by affecting the degradation of
GLP
‐1 and
BNP
.

Clinical Trial Registration

URL
:
www.clinicaltrials.gov/
Unique identifier:
NCT
01413542.
Population-Based Study of Blood Biomarkers in Prediction of Subacute Recurrent Stroke
Authors: Segal Helen C. , Burgess Annette I. , Poole Debbie L. , Mehta Ziyah , Silver Louise E. , Rothwell Peter M.
Published: August 2014

Background and Purpose—

Risk of recurrent stroke is high in the first few weeks after transient ischemic attack or stroke and clinical risk prediction tools have only limited accuracy, particularly after the hyperacute phase. Previous studies of the predictive value of biomarkers have been small, been done in selected populations, and have not concentrated on the acute phase or on intensively treated populations. We aimed to determine the predictive value of a panel of blood biomarkers in intensively treated patients early after transient ischemic attack and stroke.

Methods—

We studied 14 blood biomarkers related to inflammation, thrombosis, atherogenesis, and cardiac or neuronal cell damage in early transient ischemic attack or ischemic stroke in a population-based study (Oxford Vascular Study). Biomarker levels were related to 90-day risk of recurrent stroke as hazard ratio (95% confidence interval) per decile increase, adjusted for age and sex.

Results—

Among 1292 eligible patients, there were 53 recurrent ischemic strokes within 90 days. There were moderate correlations (
r
=0.40–0.61;
P
<0.0001) between the inflammatory biomarkers and between the cell damage and thrombotic subsets. Associations with risk of early recurrent stroke were weak, with significant associations limited to interleukin-6 (adjusted hazard ratio, 1.12; 1.01–1.24;
P
=0.033) and C-reactive protein (adjusted hazard ratio, 1.15; 1.02–1.30;
P
=0.022) after adjusting for age, sex, hypertension, smoking, and diabetes mellitus although P-selectin seemed to predict stroke after transient ischemic attack (adjusted hazard ratio, 1.28; 1.00–1.63;
P
=0.046).

Conclusions—

In the largest study to date, we found limited predictive use for early recurrent stroke for a panel of inflammatory, thrombotic, and cell damage biomarkers.
Predictors of Mortality in Patients With Lacunar Stroke in the Secondary Prevention of Small Subcortical Strokes Trial
Authors: Sharma Mukul , Pearce Lesly A. , Benavente Oscar R. , Anderson David C. , Connolly Stuart J. , Palacio Santiago , Coffey Christopher S. , Hart Robert G.
Published: August 2014

Background and Purpose—

The Secondary Prevention of Small Subcortical Stroke trial (SPS3) recruited participants meeting clinical and radiological criteria for symptomatic lacunes. Individuals randomized to dual antiplatelet therapy with clopidogrel and aspirin had an unanticipated increase in all-cause mortality compared with those assigned to aspirin. We investigated the factors associated with mortality in this well-characterized population.

Methods—

We identified independent predictors of mortality among baseline demographic and clinical factors by Cox regression analysis in participants of the SPS3 trial. Separately, we examined the effect on mortality of nonfatal bleeding during the trial.

Results—

During a mean follow-up of 3.6 years, the mortality rate was 1.78% per year for the 3020 participants (mean age, 63 years). Significant independent predictors of mortality at study entry were age, diabetes mellitus, history of hypertension, systolic blood pressure (hazard ratio [HR], 1.3 per 20 mm Hg increase), serum hemoglobin <13 g/dL (HR, 1.6), renal function (HR, 1.3 per estimated glomerular filtration rate decrease of 20 mL/min), and body mass index (HR, 1.8 per 10 kg/m
2
decrease). Participants with ischemic heart disease (
P
=0.01 for interaction) and normotensive/prehypertensive participants (
P
=0.03 for interaction) were at increased risk if assigned to dual antiplatelet therapy. Nonfatal major hemorrhage increased mortality in both treatment arms (HR, 4.5; 95% confidence interval, 3.1–6.6;
P
<0.001).

Conclusions—

Unexpected interactions between assigned antiplatelet therapy and each of ischemic heart disease and normal/prehypertensive status accounted for increased mortality among patients with recent lacunar stroke given dual antiplatelet therapy. Despite extensive exploratory analyses, the mechanisms underlying these interactions are uncertain.

Clinical Trial Registration—

URL:
http://www.SPS3ClinicalTrials.gov
. Unique identifier: NCT00059306.
Nematodes from galls on Myrtaceae. VIII. Fergusobia from small galls on shoot buds, with descriptions of four new species
Authors: Davies KERRIE A. , BARTHOLOMAEUS FAERLIE , Giblin-Davis ROBIN M. , YE WEIMIN , TAYLOR GARY S. , THOMAS W. KELLEY
Published: August 2014

Small shoot bud galls induced by the Fergusobia (Nematoda: Neotylenchidae)/Fergusonina (Diptera: Fergusoninidae) mutualism occur on various Eucalyptus spp. Four new species of Fergusobia, collected from small shoot bud galls on Eucalyptus camaldulensis, E. gomphocephala and E. leucoxylon, are described. Fergusobia gomphocephalae Davies n. sp. is morphologically characterized by a combination of a small C-shaped parthenogenetic female with a variable, conoid tail, a small C-shaped infective female with a hemispherical tail tip, and an arcuate or J-shaped male with a broad tail, angular spicule and short peloderan bursa. Fergusobia leucoxylonae Davies n. sp. has a C-shaped parthenogenetic female with a conoid tail with a narrowly rounded tip, an arcuate infective female with a broadly rounded tail tip, and an almost straight to barely J-shaped male with angular (not heavily sclerotised) spicule and short bursa. Fergusobia schmidti Davies & Bartholomaeus n. sp. has an arcuate to open C-shaped parthenogenetic female with a relatively large body diameter, relatively long stylet and small tail with a broadly rounded tail tip, an open C-shaped infective female with a broadly rounded to hemispherical tail tip, and an arcuate to barely J-shaped male with spicules angular at about 33% of their length and peloderan bursa arising at about half body length. Fergusobia sporangae Davies n. sp. has an arcuate to open C-shaped parthenogenetic female with a relatively long stylet and a broadly rounded tail tip, an arcuate infective female with a short tail with a broadly rounded to hemispherical tip, and an arcuate to barely J-shaped male with angular (not heavily sclerotised) spicule and short peloderan bursa. Various forms of small shoot bud galls are described. From phylogenetic analyses based on sequences of the D2/D3 expansion segment of the large subunit rRNA gene, the four new species belong to two sister clades of Fergusobia. The larval shield morphology of their associated fly species and possible genetic relationships are discussed.
Description of the males of Euprosthenops australis Simon, 1898 and Euprosthenopsis pulchella (Pocock, 1902) (Araneae: Pisauridae)
Authors: SILVA ESTEVAM L. CRUZ DA , SIERWALD PETRA
Published: August 2014

The spider family Pisauridae, with 333 described species (Platnick 2014), can be considered as a moderately diverse spider family. Together with the worldwide distribution, its members exhibit an exceptionally wide range of foraging and prey capture behavior, from web-based hunters, water surface hunters to ambush hunters in the vegetation (Silva & Sierwald 2013).
A New SATIRE-S Spectral Solar Irradiance Reconstruction for Solar Cycles 21–23 and Its Implications for Stratospheric Ozone*
Authors: Ball William T. , Krivova Natalie A. , Unruh Yvonne C. , Haigh Joanna D. , Solanki Sami K.
Published: August 2014

The authors present a revised and extended total and spectral solar irradiance (SSI) reconstruction, which includes a wavelength-dependent uncertainty estimate, spanning the last three solar cycles using the Spectral and Total Irradiance Reconstruction—Satellite era (SATIRE-S) model. The SSI reconstruction covers wavelengths between 115 and 160 000 nm and all dates between August 1974 and October 2009. This represents the first full-wavelength SATIRE-S reconstruction to cover the last three solar cycles without data gaps and with an uncertainty estimate. SATIRE-S is compared with the Naval Research Laboratory Spectral Solar Irradiance (NRLSSI) model and ultraviolet (UV) observations from the Solar Radiation and Climate Experiment (SORCE) Solar Stellar Irradiance Comparison Experiment (SOLSTICE). SATIRE-S displays similar cycle behavior to NRLSSI for wavelengths below 242 nm and almost twice the variability between 242 and 310 nm. During the decline of the last solar cycle, between 2003 and 2008, the SSI from SORCE SOLSTICE versions 12 and 10 typically displays more than 3 times the variability of SATIRE-S between 200 and 300 nm. All three datasets are used to model changes in stratospheric ozone within a 2D atmospheric model for a decline from high solar activity to solar minimum. The different flux changes result in different modeled ozone trends. Using NRLSSI leads to a decline in mesospheric ozone, while SATIRE-S and SORCE SOLSTICE result in an increase. Recent publications have highlighted increases in mesospheric ozone when considering version 10 SORCE SOLSTICE irradiances. The recalibrated SORCE SOLSTICE version 12 irradiances result in a much smaller mesospheric ozone response than that of version 10, and this smaller mesospheric ozone response is similar in magnitude to that of SATIRE-S. This shows that current knowledge of variations in spectral irradiance is not sufficient to warrant robust conclusions concerning the impact of solar variability on the atmosphere and climate.
On the Link between Arctic Sea Ice Decline and the Freshwater Content of the Beaufort Gyre: Insights from a Simple Process Model
Authors: Davis Peter E. D. , Lique Camille , Johnson Helen L.
Published: August 2014

Recent satellite and hydrographic observations have shown that the rate of freshwater accumulation in the Beaufort Gyre of the Arctic Ocean has accelerated over the past decade. This acceleration has coincided with the dramatic decline observed in Arctic sea ice cover, which is expected to modify the efficiency of momentum transfer into the upper ocean. Here, a simple process model is used to investigate the dynamical response of the Beaufort Gyre to the changing efficiency of momentum transfer, and its link with the enhanced accumulation of freshwater. A linear relationship is found between the annual mean momentum flux and the amount of freshwater accumulated in the Beaufort Gyre. In the model, both the response time scale and the total quantity of freshwater accumulated are determined by a balance between Ekman pumping and an eddy-induced volume flux toward the boundary, highlighting the importance of eddies in the adjustment of the Arctic Ocean to a change in forcing. When the seasonal cycle in the efficiency of momentum transfer is modified (but the annual mean momentum flux is held constant), it has no effect on the accumulation of freshwater, although it does impact the timing and amplitude of the annual cycle in Beaufort Gyre freshwater content. This suggests that the decline in Arctic sea ice cover may have an impact on the magnitude and seasonality of the freshwater export into the North Atlantic.
Regional Characteristics of Extreme Rainfall Extracted from TRMM PR Measurements
Authors: Hamada Atsushi , Murayama Yuki , Takayabu Yukari N.
Published: August 2014

Characteristics and global distribution of regional extreme rainfall are presented using 12 yr of the Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar (PR) measurements. By considering each rainfall event as a set of contiguous PR rainy pixels, characteristic values for each event are obtained. Regional extreme rainfall events are defined as those in which maximum near-surface rainfall rates are higher than the corresponding 99.9th percentile on a 2.5° × 2.5° horizontal-resolution grid.

The geographical distribution of extreme rainfall rates shows clear regional differences. The size and volumetric rainfall of extreme events also show clear regional differences. Extreme rainfall rates show good correlations with the corresponding rain-top heights and event sizes over oceans but marginal or no correlation over land. The time of maximum occurrence of extreme rainfall events tends to be during 0000–1200 LT over oceans, whereas it has a distinct afternoon peak over land. There are also clear seasonal differences in which the occurrence over land is largely coincident with insolation.

Regional extreme rainfall is classified by extreme rainfall rate (intensity) and the corresponding event size (extensity). Regions of “intense and extensive” extreme rainfall are found mainly over oceans near coastal areas and are likely associated with tropical cyclones and convective systems associated with the establishment of monsoons. Regions of “intense but less extensive” extreme rainfall are distributed widely over land and maritime continents, probably related to afternoon showers and mesoscale convective systems. Regions of “extensive but less intense” extreme rainfall are found almost exclusively over oceans, likely associated with well-organized mesoscale convective systems and extratropical cyclones.
Responses of Tropical and Subtropical High-Cloud Statistics to Global Warming
Authors: Noda A. T. , Satoh M. , Yamada Y. , Kodama C. , Seiki T.
Published: August 2014

Data from global high-resolution, nonhydrostatic simulations, covering a 1-yr period and with horizontal grid sizes of 7 and 14 km, were analyzed to evaluate the response of high cloud to global warming. The results indicate that, in a warmer atmosphere, high-cloud cover increases robustly and associated longwave (LW) cloud radiative forcing (CRF) increases on average. To develop a better understanding of high-cloud responses to climate change, the geographical distribution of high-cloud size obtained from the model was analyzed and compared with observations. In warmer atmospheres, the contribution per cloud to CRF decreases for both the LW and shortwave (SW) components. However, because of significant increases in the numbers of high clouds in almost all cloud size categories, the magnitude of both LW and SW CRF increases in the simulations. In particular, the contribution from an increase in the number of smaller clouds has more effect on the CRF change. It was also found that the ice and liquid water paths decrease in smaller clouds and that particularly the former contributes to reduced LW CRF per high cloud.
Synoptic-Scale Atmospheric Motions Modulated by Spring Phytoplankton Bloom in the Sea of Japan
Authors: Isobe Atsuhiko , Kako Shin’ichiro , Iwasaki Shinsuke
Published: August 2014

Atmospheric responses to biological heating caused by the spring phytoplankton bloom in the Sea of Japan are investigated. Sea surface temperature (SST) is first computed using a mixed-layer model with an ocean reanalysis product. Satellite-derived surface chlorophyll concentrations representing phytoplankton population are input to an equation for attenuation coefficients of solar radiation penetrating the mixed layer. Two sets of SST are obtained by this model, using the attenuation coefficients with and without phytoplankton. It is found that the phytoplankton bloom increases SST by up to 0.8°C by mid-May, especially in the northern Sea of Japan. Thereafter, two experiments using a regional atmospheric numerical model are conducted for April and May. One imposes SST synthesized by multiple satellite observations on the lower boundary of the model (the green case). The satellite-derived SST includes influences of biological heating by phytoplankton in the actual ocean. The other uses SST reduced by differences between SSTs computed by the mixed-layer model with and without phytoplankton (the blue case). Under modest wind conditions, extratropical cyclones east and south of the Japan Islands in the blue case develop more rapidly than in the green case. Cyclones are likely initiated by the cool and dry air mass that enhances lower-level baroclinicity above oceanic fronts. This cool and dry air mass is transported from the Sea of Japan, where SST decreases in the absence of phytoplankton. Therefore, incorporating ocean biology is potentially capable of improving regional atmospheric and ocean general circulation models.
Removing Solar Radiative Effect from the VIIRS M12 Band at 3.7 μm for Daytime Sea Surface Temperature Retrievals
Authors: Liu Quanhua , Ignatov Alexander , Weng Fuzhong , Liang XingMing
Published: August 2014

Operational sea surface temperature (SST) retrieval algorithms are stratified into nighttime and daytime. The nighttime algorithm uses two split-window Visible Infrared Imaging Radiometer Suite (VIIRS) bands—M15 and M16, centered at ~11 and ~12 m, respectively—and a shortwave infrared band—M12, centered at ~3.7 m. The M12 is most transparent and critical for accurate SST retrievals. However, it is not used during the daytime because of contamination by solar radiation, which is reflected by the ocean surface and scattered by atmospheric aerosols. As a result, daytime VIIRS SST and cloud mask products and applications are degraded and inconsistent with their nighttime counterparts. This study proposes a method to remove the solar contamination from the VIIRS M12 based on theoretical radiative transfer model analyses. The method uses either of the two VIIRS shortwave bands, centered at 1.6 m (M10) or 2.25 m (M11), to correct for the effect of solar reflectance in M12. Subsequently, the corrected daytime brightness temperature in M12 can be used as input into nighttime cloud mask and SST algorithms. Preliminary comparisons with the European Centre for Medium-Range Weather Forecasts (ECMWF) SST analysis suggest that the daytime SST products can be improved and potentially reconciled with the nighttime SST product. However, more substantial case studies and assessments using different SST products are required before the transition of this research work into operational products.
Relationships between Tropical Cyclone Intensity and Eyewall Structure as Determined by Radial Profiles of Inner-Core Infrared Brightness Temperature
Authors: Sanabia Elizabeth R. , Barrett Bradford S. , Fine Caitlin M.
Published: August 2014

Radial profiles of infrared brightness temperature for 2405 different satellite observations from 14 western North Pacific tropical cyclones (TCs) from the 2012 season were analyzed and compared to intensity and changes in intensity. Four critical points along the inner core of each infrared (IR) brightness temperature (BT) profile were identified: coldest cloud top (CCT), first overshooting top (FOT), and lower (L45) and upper (U45) extent of the inner eyewall. Radial movement of the mean CCT point outward with increasing TC intensity, combined with subsequent warming of the mean L45 point with intensity, highlighted structure changes that are consistent with eye and eyewall development. When stratified by latitude and vertical wind shear, the CCT point moved radially outward for all cases, notably at higher intensities for lower-latitude TCs and at lower intensities for higher-latitude TCs. The majority of the warming of the L45 point with increasing intensity occurred for low-latitude and low-shear cases. Slopes of IR BT between the four critical points were statistically significantly negatively correlated with intensity, indicating that stronger (weaker) TCs had more (less) negative slopes of IR BT and more (less) vertical eyewall profiles. Furthermore, except in high-shear cases, the most negative correlations were found in the inner eyewall, consistent with results from recent studies based on radar reconnaissance data. Finally, 12-h changes in slope were found to lead 12-h changes in intensity most often at higher latitudes, providing evidence that changes in the secondary TC circulation may lead changes in the primary TC circulation for both strengthening and weakening TCs.
Brokerage Professions and Implementing Reform in an Age of Experts
Authors: Kellogg Katherine C.
Published: August 2014

In this comparative ethnographic case study of the implementation of a reform related to the Affordable Care Act in two community health centers, I find that professionals may not compete to claim new tasks (and thereby not implement reform) if these tasks require them to acquire information unrelated to their professional expertise, use work practices that conflict with their professional identity, or do impure or low-value tasks that threaten their professional interests. In such cases, reform may be implemented if lower-status workers fill in the gaps in the division of labor between the professions targeted by the reform, playing a brokerage role by protecting each profession’s information, meanings, and tasks in everyday work. When the new tasks represent professionally ill-defined problems, brokers can be more effective if they use buffering practices rather than connecting practices—managing information rather than transferring it, matching meanings rather than translating them, and maintaining interests rather than transforming them—to accomplish reform. By playing a buffering role in the interstices between existing professional jurisdictions, lower-status workers can carve out their own jurisdiction, becoming a brokerage profession between existing professions that need to collaborate with one another for reform to occur.
Economies of Dying
Authors: Livne Roi
Published: August 2014

As efforts are made to contain health care spending, the decision to stop trying to cure severely ill patients and focus on comfort care has become an economic as well as a moral issue. This article examines the intricate intersection of economics and morality in U.S. hospice care. Using historical, interview, and ethnographic methods, I explain the resonance between hospice practitioners’ moral motivations and policymakers’, insurers’, and providers’ efforts to economize near the end of life. Drawing on theoretical literature on morality in markets, I analyze the moralization of economic scarcity. I argue that rather than posing an external financial constraint on the achievement of moral goals, scarcity itself can bear moral meanings. In the case of hospice care, the view that “less is better” and the wish to save patients from over-treatment converge with financial interests to limit spending on end-of-life care and imbue financial constraints with positive moral meanings.
No place to run, no place to hide: Socio-organizational processes and patterns of inmate victimization
Authors: de Almeida Odilza Lines , Paes-Machado Eduardo
Published: August 2014

This paper discusses the victimization patterns of inmates of the largest prison unit of Bahia. It uses data from a screening survey with 591 participants, which culminated in 107 semistructured interviews and direct observation. The study demonstrates that 54.3% of inmates report some type of material, physical, and psychological victimization. It asserts that those patterns are structured by institutional violence, jail arrangements, and criminal gangs in the prison. It also demonstrates the influence of the availability of economic, cultural, and social capital in the levels of vulnerability. It concludes that the drama of inmate victimization is a key to understand the dynamics of a prison system that is more dystopian than we can imagine.
Lionardo Salviati and the collection of Proverbi toscani: Philological issues with Codex Cl. I 394
Authors: D’Eugenio Daniela
Published: August 2014

This article offers an overview of my research conducted on Proverbi toscani, a collection of proverbs kept at the Biblioteca Ariostea in Ferrara and generally attributed to Lionardo Salviati. I attribute and date the five unidentified writers who transcribe proverbs in the codex, focusing on the question of authorship, and I aim to elucidate the different phases in which additions were made from the late 16th century to the second decade of the 17th century. First, by way of analyzing the different handwritings in the document and their characteristics, I demonstrate how the codex cannot be considered solely Lionardo Salviati’s manuscript, but rather the product of an entourage of copyists. Next, I resolve the still unclear issue of Salviati’s own handwriting, which, starting from Peter Brown’s study (1962), I intend to identify with strong evidence. As a result, I attribute only a small section of the collection to Lionardo Salviati himself. Finally, I argue against the attribution of a group of proverbs to Gianfilippo Magnanini, identifying them instead as the work of his son Ottavio Magnanini. I also compare Codex Cl. I 394 with Codex Cl. II 25, which I identify for the first time as a copy of the collection of Proverbi toscani.